I vividly remember the shame I felt lying in the examination room with a hospital gown that barely covered half my body. I was 19 years old. I had been excited for the appointment, my first with a gynecologist. In my mind, going to the gynecologist meant I was that much closer to true adulthood, which felt exhilarating. But this would be the most embarrassing medical appointment of my life.
I’d known instantly that the gown wouldn’t fit even after the nurse told me she grabbed the largest adult size they had. That size happened to be for someone much smaller than me. “Why couldn’t they have just given me a sheet that would cover me?” I thought to myself. That’s what other doctors had done. Yet, the embarrassment of the gown was only heightened after the doctor, my mother’s longtime OB-GYN, ended the appointment with words that would weigh on my heart for months to come. “We’ll have to work on you losing some weight,” he said. “I can’t let you remain this size.”
Stunned and embarrassed, I laughed and agreed. Of course, I would lose weight, doc—don’t worry. Never mind that my weight had nothing to do with the appointment, which revealed I was in perfect health. Despite this fact, it didn’t surprise me that the doctor felt compelled to make the appointment about my weight even though I didn’t bring my weight up.
Sex. Abortion. Parenthood. Power.
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As a fat Black woman, my relationship with my body and the relationship others think I should have with my body are at odds. While my self-esteem isn’t and has never been perfect, I reject the idea that I should hate myself because my existence bothers others. Even as a teenager, I understood that my mother’s doctor’s words were not an evaluation of my worth. I stood, even in that moment, in pride: I was a healthy young woman taking charge of her reproductive health; that was the most important part of that experience.
But that wasn’t the first nor the last time a health-care professional would invalidate me. Later that same year my primary care physician suggested I lose weight to stop the insomnia I’ve faced for much of my life. The same doctor would also hint that my anxiety and depression linked to my weight. She would then go on to suggest weight loss surgery while handing me a prescription of Zoloft to shut me up.
As a fat Black woman, seeking health care can be both traumatic and difficult. As Black women, we experience heightened discrimination from doctors, a fact that came to the national stage after tennis star Serena Williams talked about nearly dying following childbirth earlier this year. As fat women, we experience more mistreatment than thin patients.
Discrimination against fat patients has been well documented. In a recent Huffington Post article, Michael Hobbes spoke with multiple plus size women who detailed horrific encounters with physicians, reporting how “[d]octors have shorter appointments with fat patients and show less emotional rapport in the minutes they do have. Negative words—’noncompliant,’ ‘overindulgent,’ ‘weak willed’—pop up in their medical histories with higher frequency.”
What’s disheartening about this information is that it isn’t new. At all. Fat women have been complaining to their doctors and loved ones about mistreatment by health-care professionals for years. So, why did it take someone like Hobbes, a thin white man, to get our cries heard? It’s yet another instance of the unearned authority our society has given white men over health care. The lived experiences of fat people and Black people—specifically Black women—should be enough.
The blatant attack on fat bodies within health care will continue to not only alienate fat patients, it could kill them. A study by the American Psychological Association found that doctors prescribe different treatment to fat patients than to those who are thin, and that the treatment for fat patients often ignores the root of the problem at hand. According to the study, “[r]esearch has shown that doctors repeatedly advise weight loss for fat patients while recommending CAT scans, blood work, or physical therapy for other, average weight patients.”
Information like that takes me back to my experience in the gynecologist’s office, and to offices of doctors throughout my entire life. Time after time I was told that weight loss was a catchall cure for my aliments, whether they be chronic migraines, insomnia, or even just a common cold.
However, my experiences have been coded by my Blackness as well.
Black women continue to face unfair and even violent treatment by health-care professionals, especially with regards to their reproductive health. Black women are three to four times more likely than white women to die from pregnancy-related complications according to the Centers for Disease Control and Prevention. That is effectively a Black maternal mortality crisis. And yet, the health-care system fails to rectify this epidemic.
When you consider the instances of discrimination in health care that have been noted by both plus size and Black women, the intersection between sizeism and racism is obvious. How are fat Black women expected to trust health-care professionals when doctors have demonstrated an inability to listen to our needs—the needs that will ultimately help keep us alive?
The answer is: we don’t. Instead, we continue to fear health-care professionals and seek out medical advice through other avenues, or we suffer in silence. But we don’t have to live in a world where medicine and medical care remain inaccessible to us. It is the job of health-care providers to acknowledge and serve the needs of everyone.
Knowing medicine’s history of discrimination, health-care professionals need to take time to make sure patients like myself feel comfortable in their hands. Doctors must come to terms with and acknowledge the part their institution has played in furthering racism and fatphobia. This starts with realizing that fat people are still people. Our concerns should be taken seriously, not brushed off.
Weight is not a determinate of health, and weight loss is not a universal cure.