How to deal with a contested term such as ‘blackness’ in the field of health and medicine? How to attend to ethnic diversity without reproducing negative stereotypes about ethnic groups? How do concepts of sexuality and ethnicity gain meaning in relation to each other?
On Friday November 17th, Professor Laura Serrant (Professor of Nursing in the Faculty of Health and Wellbeing at Sheffield Hallam University) addressed these questions at the Amsterdam Research Center for Gender and Sexuality. In the lecture 'Blackness', Sexuality and Sexual health: More than a sum of our parts, she explored how research into sexual health has developed a particular genre in which black research subjects have been biologized, reduced to physicality and phenotype. This, she argues, erases the political and social context of their health situation, and results in health interventions that are too simplistic.
Serrant argues for an understanding of identities as socially scripted. Through three important cases in the history of the representation of Black people in science she discusses how this social scripting related to sexuality. First is the case of Saartje Baartman, a woman from South-Africa who was part of freak-shows in London and Paris in the early 19th century. Especially her large buttocks got the attention of the audience. To the audience, they signified her ‘sexual primitivism’. After her death in 1815, Baartmans body was dissected by French naturalist and zoologist George Cuvier, as part of his study into racial evolution. Again, Baartman was put on display. This time it was a different sexualized part of her body that got attention: the so-called ‘hottentot apron’ was what Cuvier considered the most interesting part of her body for his fellow scientists. Serrant explains that even though this might seem like a distant case it took until 2002 before France agreed to repatriate her remains to South Africa, upon the request of Nelson Mandela. The story continues to be important for understanding how black sexuality has been depicted as primitive 1. The second case that Serrant introduces, is that of the notorious Tuskegee Study of Untreated Syphilis in the Negro Male. This was a clinical study into the natural progression of syphilis that was started in 1932 in Alabama by the US Public Health Service. The four hundred African American participants of the experimental group of the study were not informed about, nor treated for, the sexually transmitted disease, not even when penicillin was found to cure it. Though many students of health and medicine have learned about this experiment and it spurred the development of standards of ethics, Serrant points out that it tends to be forgotten that the experiment ran until 1972. Again, the role that racism played in the development of science on sexuality and sexual health comes to the fore.
The third and most recent case is that of the extraction and use of Henrietta Lacks’ cells in medical research. The cells of Henrietta Lacks were the first one from which full human cell line could be detracted – the HeLa cell line. Lacks, who suffered from cervical cancer, did not know her cells were used for this. Long after Lacks died in 1951, her children learnt about the importance of their mothers’ cells in medical research, for example in the development of the polio vaccine. Next to this being a lesson on informed consent, the story holds a second message. Because the HeLa cells multiplied so fast, it started to contaminate different laboratories that used the cells for research. Because of this, the researchers became more interested in the background of the person whom they were detracted from. Because Henrietta was an African-American woman, the high rate of reproductivity of the cells in the laboratories became linked to a more general discourse on sexual promiscuity and blackness 2,3
These examples show how black bodies have been represented as hypersexual and hyper procreative. They are, Serrant argues, historically scripted as ‘risky bodies’: risky not only to themselves but also to the wider society. Though the explicit focus on the physical and on physical difference now seems to have withered, Serrant reminds us that their traces are still noticeable. Images of black bodies as hypersexual are still present today, albeit in a softened way. In her work on sexual decision-making among Caribbean Black men, Serrant found how such representations interfere with sexual behaviour. The men in Serrants study expected to be confronted with racial stereotypes in the process of STD-testing. Therefore, they often opted not to get tested at all. Serrant calls this ‘screaming silences’: “viewpoints and information that are not openly said, heard or evidenced in the available (mainstream or easily accessible) bodies of literature related to a specific subject” (Serrant-Green, 2010: 348).
Though the research of Serrant focuses on the UK, her arguments have wider resonance. In the Netherlands, the racializing of sexuality has been observed in research into sexual health and hiv-prevention. This body of research shows that some sexually transmitted diseases and sexual behaviours are exclusively associated with ethnic minority groups. Their sexual behaviour and the risks that are linked to ethnic minority groups, in turn, are considered to be threatening to the general population, such as in the case of hiv 5.
Serrant shows that such sexual stereotypes of ethnic groups do not only refer to hypersexuality. On the contrary, for example in the case of Asian men, who are often depicted as asexual, this results in a lack of attention to possible health problems. A similar case also appeared in Dutch research into sexual health of youth, in which youth with a Chinese background are rarely studied or are rendered an unimportant group when it comes to sexual health 6.
In the last part of her lecture, Serrant invites the audience to develop methods to start hearing these silences. This would prevent researchers from reducing differences in health outcomes to differences in bodies and forces us to look at the processes creating these differences. Ultimately, Serrant challenges the audience to not shy away from questions that are seemingly about biology and health. These issues require attention from the social sciences to interrogate and understand the interlocking and inseparability of the biological and the social.
1. Scully, P. & Crais, C. Race and Erasure: Sara Baartman and Hendrik Cesars in Cape Town and London. J. Br. Stud. 47, 301–323 (2008).
2. Landecker, H. in Biotechnology and Culture: Bodies, Anxieties, Ethics. (ed. Brodwin, P.) 53–72 (Indiana University Press, 2000).
3. M’charek, A. Race, Time and Folded Objects: The HeLa Error. Theory, Cult. Soc. 31, 29–56 (2014).
4. Serrant-Green, L. The sound of ‘silence’: a framework for researching sensitive issues or marginalised perspectives in health. J. Res. Nurs. 16, 347–360 (2010).
5. Proctor, A., Krumeich, A. & Meershoek, A. Making a difference: The construction of ethnicity in HIV and STI epidemiological research by the Dutch National Institute for Public Health and the Environment (RIVM). Soc. Sci. Med. 72, 1838–1845 (2011).
6. Krebbekx, W., Spronk, R. & M’charek, A. Ethnicizing Sexuality: An analysis of research practices in the Netherlands. Ethn. Racial Stud. 40, 636–655 (2017).