From Henrietta to HeLa: A History of Racism and a Reality of Distrust in the American Medical System, Meg Summerside
Modern Racism in Suffragette, Yvonne Krumrey
Having It All: Discrimination in the Reproductive Care of Trans-Men, Ellery Cohn
The Representation of Culture, Place, and Subjectivity in Training Day, Mason Eastwood
From Henrietta to HeLa: A History of Racism and a Reality of Distrust in the American Medical System, Meg Summerside
Those who subscribe to Western medicine probably have not been diagnosed with Polio. They have probably heard of vaccines and chemotherapy and of individuals living past the age of 80, but who has heard of Henrietta Lacks? Rapid scientific advancement in the 20th century has completely altered medicine from any form seen prior. Thanks to antibiotics, chemotherapy, immunizations, and the eradication of some infectious diseases, life spans have increased by nearly 15 years over the course of the 20th century (Encyclopedia Britannica). Today, we are saving more lives with modern medicine than ever before; but these advancements did not come without costs or sacrifices. The incredible progress and success of western medicine in the 20th century has depended greatly on the marginalization of minority groups for the purpose of using them as human subjects for a variety of experiments. Many marginalized men and women have sacrificed their lives and well being for medical advancements, most without their knowledge or consent. Henrietta lacks is the face of this reality. Henrietta and other silent victims were African Americans who were mislead, misinformed, used and abused by the American medical system under the pretense of medical progress. The story of Henrietta Lacks along with several other case studies represent the horrific treatment and exploitation of minority groups that stains the history of medical research in the United States and has influenced the way African Americans view and rely on our medical systems today.
Henrietta’sremarkable story represents the unfortunately common struggle experienced by African Americans throughout US history. Beyond Henrietta, there are more ways in which this history of the African American population has shaped the face of modern medicine. Through the examination of Henrietta’s history as well as the histories of other case studies utilizing African Americans as human subjects, I will unveil the reality of race relations in our medical systems and explore the current culture regarding African Americans relationship with medicine and medical history in the United States. I will also address the historic and current systems of institutionalized racism in our medical system that has dictated this culture. In order to understand the history of medicine in the Unite States, we must address the way in which race intertwines with this history – starting with the immortal life of Henrietta Lacks (Skloot, 2010). She never wore a white lab coat or graduated from high school; yet she would go on to change the face of medicine forever.
Henrietta Lacks was a poor African American woman from rural Virginia who lived her life as a tobacco farmer. She had a husband, 5 children, a modest hand built home, and many, many tumors. On January 29th, 1951 Henrietta made the 20-mile journey to Johns Hopkins Hospital in Baltimore, one of the best “colored” hospitals in the country, to see a doctor regarding a concern she had about a “knot” she palpated in her womb. This lump developed into a severe case of cervical carcinoma, and on October 4th, 1951, Henrietta was dead. Before she died, there were more than just oncologists interested in her tumors. A medical researcher named Dr. George Gey took a sample of her tumor during Henrietta’s cancer treatment, as he did with any patient who “consented”, and cultured her cells in his lab (Skloot, 2010, p. 31). This culture became the first immortal cell line ever produced and was eventually mass produced and employed for medical research around the world; and so begins the immortal life of Henrietta Lacks.
In the mid 20th century, using patients for research and experimentation without explicit consent was a common practice. Neither Henrietta nor her family had any idea that doctors would be harvesting her cells during her treatment. Hopkins hospital required patients to sign a form prior to being seen by a doctor stating that the patient consented to any procedure a doctor deemed necessary (Skloot, 2010, p. 31). On the surface, it may appear that Hopkins was progressive in implementing this policy of written consent, though with deeper investigation this is an example of an inherently racist policy. Such policies can often be veiled with a façade of equality, as demonstrated throughout our history by policies such as Social Security which excluded many minority populations unemployment plans and social insurance, New Deal policies that administered highly unequal aid to minorities, and more (Roediger, 2010). Following this same historical theme, the Hopkins consent forms were of no use to a patient who could not read them, which was the situation of many poor African Americans living in urban industrial or rural farm communities. Even in situations where the patient had the ability to read, the complicated medical jargon was often incomprehensible, the case for Henrietta whose knowledge of a cell was limited to the place where prisoners are held. Another issue with this form is evident – it essentially gives the doctors power to do whatever they please to a patient without having to solicit further consent. This includes experimenting with untested treatments, limiting pain medications, and taking cell or body samples without requiring further conversation with the patient.
Her tumors cultured, Henrietta died unrecognized and was buried in an unmarked grave. The cells Dr. Gey cultured went on to facilitate groundbreaking research with cancer, AIDS, Parkinson’s, effects of radiation and toxins on humans, gene mapping, salmonella, tuberculosis, hereditary genetic disorders, and countless other medical pursuits. Her cells changed the norms of lab procedures and introduced the importance of sterility, refrigeration, and proper specimen storage and aided in the development of the first Polio vaccine, saving countless lives and changing the course of human history (Grady, 2010; Skloot 2010; del Carpio 2013).
Henrietta’s cells, over 20 tons of them produced (Skloot 2010), were essential to the advancements of modern medicine, yet she remained largely anonymous for the past 60 years. The cells were known only as “HeLa” cells (named by Gey) and were declared by many the “Mother of Modern Medicine” (del Carpio, 2013). Science textbooks often misidentified the woman behind HeLa as Helen Lane or Helen Larson and it was not until 2010, with the publication of Rebecca Skloot’s meticulously researched book The Imortal Life of Henrietta Lacks, that Henrietta’s life and the ethical dilemmas in our nation’s medical research history were brought to light. By focusing on the story of Henrietta Lacks, the book raises questions regarding race in medicine and roots of our nation’s medical advancements. The book became a New York Times bestseller and drew attention to Henrietta and her legacy and paid the long overdue respect and recognition she deserved. Since the release of the book Henrietta has received several posthumous honorary degrees, has been inducted into the Maryland Woman’s Hall of Fame, and has even had a high school endowed with her name. Though justifiably recognized and honored, Henrietta is not the only individual who sacrificed for the sake of advances in modern medicine.
Henrietta’s name may now be known, but many stories of injustices in our medical system remain unnoticed. Various studies, both documented and undocumented have thrived off of the exploitation of African Americans. As Clyde Woods expresses in his chapter “Sittin’ On Top of the World” (2007), progress in our society is based on, and made impossible without, the marginalization and suffering of certain racial groups. Woods is specifically referring to progress in capitalism, but medical progress subscribes to the same norm (and exists within the capitalist system). Woods asserts, “The sweat of its (slaves) adherents greased the wheels of world commerce. Their backs were the foundation of industrial capitalism and their hands were its fuel” (Wood, 2007, p. 58). The exploitation of Henrietta supports this assertion; especially since healthcare and medicine is a $110 billion and growing industry (Select USA). Within this gigantic medical industry thrives the HeLa cell culture industry, generating an incalculable amount of both monetary and intellectual gain. A vile of HeLa cells, as of 2010, was sold for an average of $256 each (Skloot, 2010, p. 198); yet, the surviving family of Henrietta Lacks cannot afford health insurance (del Carpio, 2013). Black suffering indeed fueled all of this medical progress and profit, without just compensation or recognition, just as Woods asserts.
There have been many studies that have exploited unknowing African American subjects for medical progress. Two other examples are the Mississippi Appendectomies and the Tuskegee syphilis studies. The Mississippi Appendectomies was the systematic forced sterilization of poor black women without the women’s knowledge or consent. Doctors performed the hysterectomies under the pretense of appendectomies in order to prevent poor black women from reproducing and to give young, inexperienced doctors the opportunity to practice the hysterectomy procedure (Skloot, 2010, p. 51). These sterilizations are a blatant disregard for the basic human rights our nation claims to provide. “Not only do these sterilization abuses represent a direct assault on women of color's ‘needs, wishes, hopes’ and bodies, but also signify a wholesale disregard for the racial and ethnic existential claims of the communities in which these women are embedded” (Suite et al., 2007, p. 880)2. Here, Suite is expressing how these women were not only grossly abused, but also they way in that this abuse has larger implications in the overall worlds in which these women live. Beyond respecting individuals’ bodies in medicine, we must also consider culture and experiences, which may affect an individual’s experience in a medical setting.
The Tuskegee syphilis studies began in the 1930s in Macon County, Alabama, included over 600 African American men, and continued for over 40 years (Brandt, 1978). The studies aimed to investigate the effects of syphilis on humans, from infection to death. In the 1940s penicillin was discovered as an effective cure for syphilis, yet researchers refused to treat the ailing men, and the syphilis study continued for another 30 years. Rather than treating them, the health professionals watched as these African Americans suffered and died from an excruciating, curable disease.
In both the Mississippi Appendectomies and the Tuskegee syphilis studies, researchers chose black men and women not only because they were inherently marginalized, but also because they were deemed “particularly prone to disease, vice, and crime” (Brandt, 1978, p. 21). These are not the only two examples of horribly cruel and immoral treatment of African Americans in the medical realm. It we live in a country with a history of an accepted practice to test drugs or new surgical techniques on slaves, often without anesthesia, and it was not long ago that medical schools across the country were offering a money reward for black bodies (Skloot, 2010, p. 166). Recognition of this history is essential to understanding present day relations in the medical field. Dr. James Small, instructor at City College of New York, proclaimed, “Our whole relationship to Whites has been that of their practicing genocidal conspiratorial behavior on us from the whole slave encounter up to the Tuskegee Study. People make it sound nice by saying the Tuskegee "Study." But do you know how many thousands and thousands of our people died of syphilis because of that?” (Thomas & Quinn, 1991, p. 1499). Those who are proponents of this “genocidal” behavior for the improvement of the white race are known as eugenicists.
Eugenics is defined as “an effort to cleanse the human species of genetic defects and other ‘undesirable’ traits” (Finney, 2014, p. 17). In the early 20th century, the eugenics movement gained traction in the United States due to concerns regarding reproducing African Americans. Eugenics was seen by many to “present solutions to social problems across Europe and North America” (Gerodetti, 2006, p. 217). Eugenics was the driving force behind the Tuskegee syphilis studies, Mississippi Appendectomies, and more. A renowned genetic researcher named Alexis Carrel made his success through the use of HeLa cells and used them to study the growth of immortal organs in the lab and eventually the evolution of an immortal human. He was also a proud eugenicist. This position is ironic as his research depended on the “undesirable” genes of Henrietta Lacks. In her book, Skloot states, “Carrel wasn’t interested in immortality of the masses. He was a eugenicist: organ transplantation and life extension were ways to preserve what he saw as the superior white race, which he believed was being polluted by less intelligent and inferior stock, namely the poor, uneducated, and nonwhite” (Skloot, 2010, p. 59). Eugenics correlates the observable physical appearance of an individual or group of individuals with the moral and psychological traits in order to establish worth, or in this case right to live or reproduce. It is a practice that relies on the “interpretation of the relationship between the seen and the unseen, constructed historically in many different ways” (Stoler 2000, p. 371). Eugenics demonstrates how certain individuals identify “undesirable” groups by physical traits and use those traits to draw conclusions on traits that make up the personality and morals of individuals in that group. In her chapter “Racial Histories and Their Regimes of Truth”, Ann Stoler discusses this idea and the way in which the discourse surrounding racist thinking has many different facets, including both “old” and “new” racism (Stoler 2000). Eugenics throughout our history and persisting today supports Stoler’s argument that we as a society are not as incredibly evolved from our racist histories as we may think, and this too runs true in the sector of racism in medicine.
Though we would like to think that cases such as those that occurred in Baltimore, Alabama, Mississippi and countless other places are restricted to our sad, racist, history as a nation, this is not necessarily the case. Recent studies conducted by Georgetown University and Johns Hopkins University School of Public Health and Hygiene suggest that today “many physicians practicing today still hold prejudices which might prevent them from adequately treating their patients of color” (Schulman et al., 1999; Suite et al. 2007, p. 881). In ֱ’s Office of Health Equity (OHE) 2013 report on health disparities in the state, huge discrepancies were found between white and non-white residents in ֱ. Coloradans of color were found to be consistently at higher risk for living without clean air or water and are at higher risk of obesity, poor oral health, underage pregnancy, and infectious disease (OHE Health Disparities, 2013). These disturbing realities of the state of out current medical system bring us to the conclusion that we are still living in a country with a health regime ridden with institutionalized racism.
This reality of inequality is not lost on the marginalized populations in our nation and has caused a culture of distrust in the medical system throughout many African American communities. In 1989, a series of stories was published by the largest black newspaper on the West Coast, The Los Angeles Sentinel, which suggested that African Americans were being intentionally infected with HIV and Essence, a popular black magazine, published and article entitled "AIDS: Is It Genocide?" (Thomas & Quinn, 1991). Unfortunately, these theories regarding HIV have empirical support in these communities, as is seen in ֱ where an African American woman is sixteen times more likely to contract AIDS than one of her white peers (OHE Health Disparities, 2013). Furthermore, It was a commonly held belief among black communities in Baltimore that Johns Hopkins was built in a poor, predominantly African American neighborhood in order to benefit the scientists who would have easy access to subjects (Skloot, 2010, p. 166). Henrietta’s daughter in law, Bobbette, explained, “You’d be surprised how many people disappeared in East Baltimore when I was a girl…I lived there in the fifties when they got Henrietta, and we weren’t allowed to go anywhere near Hopkins. When it got dark and we were young, we had to be on the steps, or Hopkins might get us” (Skloot, 2010, p. 165). These fears also do not arise unjustified, as Harris et al. (1996, p. 631) confirmed: “Southern blacks became a prime source for medical school dissection experiments and autopsy specimens. This practice continued in the post bellum South in the form of 'night-doctors' who stole and dissected the bodies of blacks.” The fears and mistrust that many African Americans have in the medical system is repeatedly reinforced by both history and current statistics.
Henrietta’s family is a prime example of how our medical system’s tattered history regarding race relations has negatively affected the way in which African Americans view, trust, and rely on our nation’s medical system. With good reason, Henrietta’s surviving family was angry and distrustful towards Johns Hopkins and the doctors in general after Henrietta’s death. Their wife and mother was taken away from them; years later they were told their mother is still alive, a concept they cannot comprehend. They are poked and prodded for further testing and badgered by researchers and doctors – all without any explanation. “Hopkins killed my mother and them white doctors experimented on her cause she was black” proclaimed Henrietta’s daughter Deborah. She also feared that the doctors who were claiming to be using her own blood for further medical testing were actually injecting her with the same “bad blood” that had killed her mother – reminiscent of the Tuskegee syphilis studies (Skloot, 2010, p. 53, 186). Deborah is not the only member of Henrietta’s family who is weary of the US medical system; Henrietta’s late husband refused medical treatment for severe gangrene in his feet, and her son is in need of angioplasty and swore to never do it – he doesn’t want to be experimented on and exploited like his mother (Skloot, 2010, p. 163). The Lacks’s not only have a right to compensation for their mother’s contribution to science, but they also have a right to a legacy of pride in what their mother helped the medical field accomplish. Instead, the Lacks’s are left with a legacy of fear and distrust in the medical system.
It is reasonable to assert that this distrust in doctors and unwillingness of some individuals to seek medical care has contributed to the discrepancies in health between races, but more importantly, it is essential to recognize the way in which the failures of our medical system have contributed to these discrepancies. “Public health professionals must recognize that the history of slavery and racism in the United States has contributed to the present social environment, in which those blacks, whose behavior places them at greater risk, are also among the most disadvantaged members of our society” (Thomas & Quinn, 1991, 1498). It cannot be ignored that a preposterous and egregious past of exploitation and abuse has produced communities with adverse to hospitals and medical professionals. .Henrietta, Mississippi, Tuskegee – they have all played a rightful role in creating a culture of distrust in the American medical system.
The story of Henrietta Lacks allows for a personal and detailed account of one woman wronged by the United States medical system. She was deceived and exploited and long after her death. Her family still feels this pain. Countless other names and faces remain unknown, and our health system remains as broken as ever: “The promises of opportunity and equality envisioned by the civil rights movement have failed to be realized for the vast majority of American Blacks” (Thomas & Quinn 1991, p. 1498). Such inequalities paired with repeated and brutal instances of exploitation and abuse in the African American community for the sake of medicine has formed a culture of distrust of doctors and health professionals. There is no way of knowing where we would be in the medical world without many of the horrendous experiments and treatments of marginalized groups, but maybe we could still be exactly where we are today. Maybe we would be even more progressive. Is the exploitation of minorities really essential to progress? Or is that just how we’ve been trained to see the world? A serious paradigm shift is essential in both the medical communities and African American communities in order to change the path of modern medicine. Who knows how the Lacks’s story would have been different if just one of the hundreds of medical professionals hounding the Lacks family had taken one moment to say, “Let me tell you how your mother changed the world.”
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Modern Racism in Suffragette, Yvonne Krumrey
In the wake of Saudi Arabia granting women the right to vote in October 2015, a film about the women’s suffrage movement comes out in theaters. Presenting feminism with a film set in a prominently racist era of history with an all-white cast, which was marketed with insensitive language, is all too reminiscent of an era of exclusion we thought was long over. Despite critics congratulating its progressiveness, the film Suffragette actually ignores the racist nature of the movement of the first wave feminists and justifies the film’s whitewashing of history through its white feminist ideology. Setting the film in the UK, overlooking the historical women of color involved in the movement, and feeding into the white feminist hypocrisy of present day, the film fulfills a niche that allows it to still be considered “progressive.” Whitewashing a progressive era allows the film to be celebrated by its millennial target audience yet still accepted by the more conservative older generation. To critically examine this historical film, we must be aware of the history it is attempting to portray and start with the discourse surrounding the suffragette movement of the 1920s. Second, we must look at the film itself and analyze the choices and statements it makes regarding race. Finally, questions and theories of racism analyzing the film and the decisions it made in celebrating women’s suffrage will shed light on the film’s modern implications and its historical inaccuracies.
The film revolves around a fictional textile factory worker, Maud Watts, who acts, firstly, as a witness to the suffragette movement, secondly, as a hesitant activist, and finally, as a suffragette with nothing to lose and a willingness to take radical measures to advance the women’s vote. Watts becomes involved with the movement after witnessing a coworker, Violet Miller, participate in a violent demonstration. Another suffragette, Alice Haughton, encourages the women of the factory to join the movement by demonstrating in the street. When Miller cannot testify to government officials at a hearing for suffrage due to injuries caused by her abusive husband, Watts takes her place. This solidifies a personal stake in the movement for Watts, so she attends the government announcement on the decision to grant women’s suffrage. After the suffragettes learn that they’re not granted the right to vote, riots break out. Watts is jailed for a week. During her incarceration, she meets Emily Davidson, who is connected to the suffragette leader Emmeline Pankhurst. Pankhurst was a middle-class career activist who advocated for socioeconomic rights as well as women’s suffrage. After being released from prison, Watts attends an underground rally led by Pankhurst. She is arrested again. After the police drop her off at her home, her husband throws her out. Later, the public discovers she’s a suffragette. Her boss fires her and her husband forbids her from visiting their son based on legal, and sexist grounds. He then gives her son up for adoption as he cannot take care of the child himself and he has the legal right to forbid Maud from taking him. With nothing left to lose, Watts gets more and more involved in the movement and more and more violent as well. She’s imprisoned again and force-fed during her hunger strike. After her release, she and Davidson attempt to gain national attention at the Epsom Derby, and while their original plan is disrupted, Davidson becomes a martyr by stepping into the race and getting trampled. The film concludes with Watts attending Davidson’s funeral followed by real footage of the funeral in 1913. Before the credits roll, the screen displays the year British women achieved suffrage: 1928, and follows with each nation up until “Saudi Arabia 2015” (Owen & Gavron, 2015). The film made twenty-nine million dollars at the box office, it cost fifteen million to produce, and it had an all-white cast. The film was received well overall, with a 73% rating on Rotten Tomatoes (Suffragette, 2016).
The history of women’s suffrage movements clue us into how Suffragette chose to portray history and why its portrayal is not only exclusionary, but inaccurate. While the early 1900s suffrage movement in the UK was less racially controversial than the movement in the US, it still reflected similar white supremacist attitudes. Suffragettes of this era from the US, like Susan B. Anthony, Anna Howard Shaw, and Rebecca Ann Latimer Felton, would often compare women’s suffrage to black suffrage, but not in a positive way. They argued that white women were more entitled to the vote than racial minorities (Ortberg, 2014). Many were openly racist, often proclaiming that women’s suffrage would strengthen white exceptionalism. For example, Elizabeth Cady Stanton was a suffragette who also protested slavery, and yet, when discussing women’s suffrage and the black vote, she said, “What will we and our daughters suffer if these degraded black men are allowed to have the rights that would make them even worse than our Saxon fathers?” (Ortberg, 2014, n.p.). Susan B. Anthony once claimed that the middle-class white woman’s struggle was more desperate than the black American man’s struggle: “Mr. [Frederick] Douglass talks about the wrongs of the Negro; but with all the outrages that he to-day suffers, he would not exchange his sex and take the place of Elizabeth Cady Stanton” (Ortberg, 2014, n.p.). Not only is this sentiment ironic, considering the disparity between the civil rights of Stanton and Douglass, but alarmingly, the rights of black women or Native American women did not come up, revealing how big name suffragettes had extremely limited intersectionality. According to sociologist A. Javier Trevino (2015), intersectionality is “the ways in which several demographic factors—especially social class, race, ethnicity, and gender—combine to affect people’s experiences” (p. 5). This means that people who are in multiple minority groups have different struggles than the groups they fit into do. Therefore, when Anthony and Stanton compared the black man’s struggle to the white woman’s struggle, they ignored the intersectionality black women in America face. The film touches on intersectionality by framing the issue from the perspective of working class women, but other representation stops there. This exclusion and lack of consideration was common across the Global North, but in the UK, the Caucasian population allowed for the issue of race to be swept under the rug. According to Anita Anand, author of Sophia: Princess, Suffragette, Revolutionary, “There were some [British suffragettes] who were outright fascists: Norah Elam, who earlier in her life happily worked alongside” women of color in the movement and then “turned into a Blackshirt later,” Blackshirts being members of the Italian fascist party (Flint, 2015, n.p.). Women of the early suffragette movement worked with women of color in the movement when convenient, but true feelings about race emerged later when the same women of color fought battles revolving around racial discrimination and the white suffragettes were not on their side. This is a reality the film’s writers and directors chose to ignore.
Using the social situation in the US as context for the entire western world at the time, we can see the inaccuracy between the film’s representation of the movement and the reality of the movement itself. Despite what the end of the film states and what is often celebrated as the year women achieved the vote in the US, 1920 was the year white women could partake in civil liberty. Minority women, due to property laws, the grandfather clause, and other unfair and racist voting limitations, could not vote. All women were able to legally vote in 1965 when the Voting Rights Act began removing barriers that prevented people of color from participating in the elections. There is a 45-year gap between the 19th Amendment and the VRA. This distinction is not a matter of semantics but an illustration of the exclusionary nature of the white women’s suffrage movement.
In the US, women of color played a large role in women’s suffrage despite the active exclusion they faced from the white supremacists within the movement. These women were not made into historical figures and are often forgotten, especially in whitewashed historical reflections, such as this film. In the UK, Indian women had a part in women’s suffrage, led by the princess Sophia Duleep Singh, an anti-imperialist feminist advocate (Leszkiewicz, 2013). Mrs. Pankhurst, who we see as the film’s powerful suffragette leader, and Duleep Singh led a riot on November 18, 1910, which was violently intercepted by the police. However, “Sophia was not the only Indian suffragette. An Indian women’s group took part in the 1911 coronation procession of 60,000 suffragettes” (Suffragette, 2016, n.p.). These women were a real part of the movement and represented a significant group of women in the UK.
The 1920s women’s rights movement featured in the film paints a very different picture of feminism than the modern movement of today. Now the third wave focuses on securing rights for LGBT women and men, getting rid of gender roles and rape culture, and closing the gender wage gap. Many in the third wave also focus on issues specific to women of color, like the Black Lives Matter movement, and supporting women who wear hijabs who are often victims of Islamophobia. The second wave, which occurred from 1960-1990, is still dominant in the mainstream circles of feminist discourse and representation. Much in the same way, in the context of modern race discourse, the current mainstream form of racism is colorblindness. Colorblindness is the belief that we are in a post-racial society of equality. Ignoring the reality of racism as a present condition and claiming equality allows us to blame inequalities that still remain on their victims (Smith, 2013). Modern mainstream society is still catching up to the third wave feminism and its inclusion and often uses colorblindness to disregard race. It appears that popular media representations of feminism, like Suffragette, are behind the progressive times. This is disappointing for a film that celebrates the progressive and ever-changing movement of feminism, especially when focusing on a time of great social change. In fact, the film takes the role of historical correctionist or revisionist, as it whitewashes history to fit the colorblindness that is plaguing the current movements.
The casting choice lends insight into how the writers chose to ignore, misrepresent, or even completely erase the racism in the women’s suffrage movement in the 1910s. Many supporters argue that since the film’s director is from the UK, she simply wanted to reflect her own nation’s history. However, the setting hides this problematic era of history, as the UK had seemingly less racial tension and oppression inside its borders. This choice would justify an all-white cast and the ignorance of the controversies of the US. Despite the very white population of the UK at the time, the film erases the contributions women of color made. Duleep Singh and the Indian suffragettes were recognized by and worked alongside Pankhurst (Suffragette, 2016). There was no space for Duleep Singh even though Ms. Pankhurst was featured heavily in the film (Suffragette, 2016). The director, Sarah Gavron, gave her reason for whitewashing the historic movement:
We interrogated the writ and photographic evidence, and the truth is, it’s a very, very different picture from the U.S. The U.S. had a lot of women of color involved in the movement, some who were excluded, some who weren’t excluded. But in the UK, it wasn’t like that, because we had pockets of immigration...it was later, around the war, around the fifties, that really the UK shifted and changed in a really wonderful way to produce what we have today. (Erbland, 2015, n.p.)
Despite being set in a predominantly white nation, the film still whitewashes the events. In response to a casting director refusing him for a film set in 1800s UK, Gus, a character in the detective sitcom Psych, said, “So what are you saying? Black people hadn’t been invented yet?” Gavron's excuse has been addressed and questioned many times. Suffragette isn’t the first film to whitewash history. Hannah Flint (2015), writer for Metro.co.uk noticed the imbalanced representation of the film, saying, “If I’m to go by the historical accuracy of the film, then we’re meant to believe that there were no women, nay people of colour, living in Britain during the early 20th century” (n.p.). This isn’t true. There were many Indian and black people in the UK at the time as a result of Britain’s colonial history. In fact, “one-hundred years earlier the British slave trade had been abolished, with slavery following suit in 1833, and though the black immigrant population had declined due to continued scientific racism and discrimination from white society towards the end of the 19th century, there was still between 20,000 and 25,000 [black individuals] living in the capital in the early 1900s” (Flint, 2015, n.p.). This number only represents the people of African descent, not other minorities that lived in the UK, yet there isn’t a single person of color in the film.
Gavron claims she and her team chose the time frame of the movement when women of color were less involved because she wanted to show “the period of these sixteen months where militancy was at its height and the state was more brutal to these women… [she] hoped to remind people of the battle that paved the way for the world that we live in now and how hard fought for it was” (Tangcay, 2015, n.p.). Sensationalizing an important movement and its violence instead of representing its diversity is not only harmful but disrespectful to the women who faced the brutality, especially to the women not represented in the film who, historically, were active members. Gavron claims that her team “went through [written] and photographic evidence” in order to decide who to represent in the film. However, it’s important to question why the photographs and papers were mainly white, and if they truly represented the movement (Tangcay, 2015, n.p.). The early suffragettes wanted media attention to promote their cause. The white suffragette agenda probably had a say in the framing of the camera to align more favorably with common white supremacist mainstream society. Gavron also admits Duleep Singh’s role in the movement but seems to have written her off in the film because she was an aristocrat. She must have forgotten that being an aristocrat was one of the only ways women of color had influence at this time. It’s also important to note that Pankhurst herself was much better off socioeconomically than the women Gavron wanted in the spotlight, undermining her excuse to exclude Duleep Singh. To many modern feminists, choosing to focus on working-class women with upper-class Pankhurst as a leader justifies the film’s pale demographic. The spotlight is essential and powerful, representing a group of suffragettes that have been previously excluded, but it’s a pretty thin substitution for the representation the film truly needs. Suffragette only excludes another group of women who have yet to be accurately represented in the mainstream media.
The “historical” film also overlooks the UK’s intense colonial involvement. The setting is in a British bubble, ignoring international movements and politics that extended beyond London. The women in the film are outraged, and rightfully so, about the treatment they receive in the workplace, in government, and in their homes. However, they never comment on the similar disrespect and dehumanization the British imperialists enacted on the people, especially women, of the nations they colonized. The characters in the film also fail to acknowledge that these suffragettes more than likely would have had imperialistic and supremacist attitudes. Instead the director’s modern day colorblindness swept these issues under the rug.
Suffragette created further controversy in its promotion, as the actresses Meryl Streep, Carey Mulligan, Anne-Marie Duff, and Romola Garai donned t-shirts that read “I’d rather be a rebel than a slave.” In doing so, the actresses solidified the exclusion and insensitivity of the film, as well as bringing back the attitude the original movement had towards people of color (Abad-Santos, 2015). Pankhurst herself said this in a speech, which is also featured in the film, comparing white women’s situation and actual slavery (, 2015). As we noted with Susan B. Anthony and Elizabeth Cady Stanton, this was a common pattern in the early suffragette movements. While many women did and do struggle to assert their personhood, it is not the same as slavery. Legally enforced slavery was not the women’s situation in the most powerful nation in the world at the time, and comparing the two was another way white suffragettes erased the struggles of women of color. Many black women in the US and the UK had ties to slavery, whether their parents and grandparents were subjected to it or they were themselves. As it had only been 30 years since slavery was abolished, these black women were (and are) still living in the shadow of slavery. Pankhurst reduced their experience in order to compare it to the situation of white women at the time: “I’d rather be a rebel than a slave.” She also implied that slavery was a choice. This ignores the intersectional experience of women of color by claiming that all women are “enslaved” by patriarchy, and racial oppression is erased. “I’d rather be a rebel than a slave” was used to promote a film with the purpose of representing feminine inclusion. Meryl Streep and many others that approved of the film are indicative of the limited perspective, white privilege, and insensitivity second wave white feminists often retain from the 1960s movements.
Every historical film tries to represent a specific time period, but it’s impossible to not be influenced by the current setting. As many human rights movements suffer a “lag” in their transition into recognition and acceptance in mainstream culture, it appears as though second wave feminism, the movement of the 1960-1990s, is finally emerging in the mainstream. The focuses of the second wave are family dynamics, sexual freedom, reproductive rights, and equal treatment in the workplace. These issues were most pertinent to upper middle-class white women. The problem is that the second wave’s exclusionary nature, which earned the nickname “white feminism,” focuses only on white, middle- to upper-class, straight, cisgender, non-sex worker women. This movie, released in 2015, reflects the movement as it was in 1925. The film’s timing and reception are also indicative of the current mindset of the mainstream feminist movement. The film avoids the problem of racism by plainly ignoring the role of women of color and eliminating their presence in feminist history. The film takes a colorblind stance by leaving out the presence of women of color so it doesn’t have to address the racism of the early suffragettes. The director's whitewashing of the cast is a literal representation of eliminating the historical women of color. This glorifies the imperialistic, racist women of the early 1900s suffragette movement. White women claim all ownership of the suffrage movement, ignoring the fight and struggles women of color suffered when walking alongside them. The film’s setting, 1900s Britain, was not a time of colorblindness but was still infected with imperialistic racism. Colorblindness is an updated kind of racism. The colorblindness the film describes is indicative of our time, not the past. As colorblindness is widespread now, the film’s colorblindness is accepted and celebrated, despite its damage.
With all films that take a political or philosophical stance, we must ask, “What message is being sent?” With historical films, we also can ask “How is glamorization keeping old ideas alive?” Second wave feminism has been “out” of progressive feminist discourse since the 1990s and was replaced by the third wave, but in the mainstream it is being kept alive. In the film, Gavron shows us the first wave movement through a second wave perspective. As the second wave is exclusive, this perspective suggests who deserved progress in the 1900s and who deserves it now. White women are shown having fought the hard fight for women everywhere, and therefore are deserving of the vote earlier than women of color as well as credit for liberation. This illusion is only encouraged by the colorblind stance of the film, censoring the racism of the movement. As Stuart Hall (1997) claims in his chapter “The Spectacle of the Other,” “naturalizations” are formed through representation in media (p. 245). Naturalization is the idea that differences of the “other” are made naturally, as opposed to situational or cultural (Hall, 1997, p. 245). In Suffragette, we see the naturalized idea that white women were the women strong enough to fight for suffrage, while absent women of color are naturalized as if they did not have a part in the movement. The film chose to highlight a part of history that was very hostile towards non-whites, and in a new era of racial tension and awareness, its colorblindness takes the side of exclusive white exceptionalism. This representation allows women of color to be simplified as helpless victims of the patriarchy, freed by the progressive white women. This is a primary concept of the second wave.
The film’s efforts to keep white feminism alive and whitewashing history is also very indicative of the white privilege of white women then and today. In a time when the UK was colonizing and exploiting thousands of people of color, though still at risk, white women were able to vocalize the inequalities they faced. Also, the fact that white women are the women represented and not women of color is a huge indicator of their current privilege. However, it could be hard to watch the violence and inequality affecting the women in the film and cry “Privilege!” especially in the face of the poverty of some of the women featured. The question of poverty and discrimination on one hand and privilege on the other is an important part of the discourse of intersectionality (Crosley-Corcoran, 2014). While being poor and working-class made the suffragettes secondary citizens, being white probably kept them from being killed in custody or deported. While the struggles of the women in the film were real and the movement important, the directors chose to take the path of simplification and ignore the reality that for suffragettes of color, the violence would have been more and the reward less.
The film uses white privilege as a means to ignore the racial situation of the setting. This is reminiscent of one of the points of Peggy McIntosh’s (1990) essay “White privilege: Unpacking the invisible knapsack,” “I do not have to educate my children to be aware of systemic racism for their own daily physical protection” (p. 1). The film, choosing a predominantly white group of women to focus on, does not have to contextualize its setting in the racist and imperialist society of the time. Being able to choose colorblindness is a white privilege that also perpetuates racism, as ignoring systematic racism is a first step of naturalizing racist ideas. At the conclusion of the film, there is a list of different countries and the year women in those countries earned suffrage. For the US, it says 1920 is the year women earned suffrage, which is only true for white women. Many American and British women of color cannot say that the white suffragettes of the early 1900s gave them the right to vote. The film’s intended audiences are white women, who will be able to celebrate a century of voting rights in 2020. The intended audience of the film was never meant to include women of color or queer women. This film reverts back to the age when white cis-gender women were the only women mainstream feminism represented, leaving no room for women of color and trans* women today in its feminist celebration. This exclusion continues the whitewashed representation of the women’s history movement and reflects the old ideology of white people being the heroes of women’s liberation history.
The film Suffragette and its director, Sarah Gavron, choose to represent a narrow aspect of the women’s suffrage movement that whitewashes the history of women’s rights and excludes women of color. Not only is the film historically inaccurate but it takes a backward stance on issues relevant to women today. The film uses colorblindness, white privilege, and naturalization of white people as the saviors of the movement to present a subplot of white exceptionalism in a film that is supposed to fall under the genre of civil rights historical fiction. Could Gavron have portrayed a more inclusive era of feminism and still made a statement? It would have been historically accurate to do so. In light of the progressive and inclusive feminist movement of today and the historical inaccuracies of the film, the film attempts to present a different reality than our reality and the reality of the early 1900s. The implications of this disconnect are exclusive to women of color and self-congratulatory for white women.
References
Abad-Santos, A. (2015, October 12). The week the internet turned on Meryl Streep. Retrieved December 13, 2015, from
Crosley-Corcoran, Gina. (2015). “Explaining white privilege to a broke white person” Huffington Post. May 8. Retrieved from
Erbland, K. (2015, October 13). 'Suffragette' Director Sarah Gavron Explains Why She Didn't Cast Women of Color. Retrieved December 13, 2015, from
Flint, H. (2015, October 12). Suffragette is good for white feminism, bad for intersectionality. Retrieved December 13, 2015, from
Hall, Stuart. (1997). The Spectacle of the ‘Other’. In Stuart Hall (Ed.), Representation: Cultural representation and signifying practices (pp. 223-290). London: Sage Publications.
Leszkiewicz, A. (2015, October 7). What did the suffragette movement in Britain really look like? Retrieved December 13, 2015, from
McIntosh, Peggy. (1990). “White privilege: Unpacking the invisible knapsack” Independent School Winter. Retrieved from
Ortberg, M. (2014, April 21). Suffragettes Who Mixed White Exceptionalism With Women's Rights. Retrieved December 13, 2015, from
Owen, Alison (Producer) & Gavron, Sarah (Director). (2015). Suffragette [Motion Picture]. United Kingdom: Film4.
Sanghani, R. (2015, October 6). The uncomfortable truth about racism and the suffragettes. Retrieved December 13, 2015, from
Smith, Jason. (2013). Between colorblind and colorconscious: Contemporary Hollywood films and struggles over racial representation. Journal of Black Studies, 44(8), 779-797. doi:10.1177/0021934713516860
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Suffragette Sophia Duleep Singh. (n.d.). Retrieved December 13, 2015, from
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Trevino, A. Javier. (2015). Investigating Social Problems. Los Angeles: Sage Publications.
Having It All: Discrimination in the Reproductive Care of Trans-Men, Ellery Cohn
A variety of media outlets,includingTime Magazine,The Wall Street Journal, andVogue,havediscussedreproductive options for modern, working cis-women, specifically citingegg freezingas the solution for the“having it all”dilemma. This dilemma is one that is often sensationalized as the struggle that these womenface to pursue a careerandhavea family.Elective egg freezing,in which the procedure is donein preparation for infertility due to age, isnotavailableformostwomen. Egg freezing is, however, available and covered for alargerportion of women who are facing imminent infertility due to an illness orassociatedtreatment(“Infertility”). Despite this coverage and the relative visibility of fertility preservation as a“women’s health”issue, a subset of those with female reproductive organs are being left out of the conversation and excluded from treatment options—pre-surgical trans-men.
Reproductive services, like egg freezing, are an area of healthcare in which bias and discrimination of trans people is evident.The exclusionary nature of insurance coverage and healthcare services regarding trans patients’ access to and experiences with reproductive services reflectsand perpetuatestransphobia in the United States healthcare system.This exclusion has given rise to a“having it all”dilemma that is different from the one cis-gendered, career-focused women face—that is, trans-men face the struggle to both have a body that matches their gender identity and have children.This essay will analyze the policies of Aetna, a Fortune 100 company,as a case study whose policies are representativeof most Americaninsurance providers (Lorenzetti).
Explicit insurance policiesthat prohibitthe coverage of egg freezing for trans-men due to“elective sterilization”in the form of sex reassignment surgeryarea form of gender discrimination(“Infertility”).In order to understand the discriminatory element of such insurancecoverage, it is first important to understand that sexreassignment surgeryis considered a medically necessary form of treatment for Gender Dysphoria. The American Medical Association has evaluated trans-health research and concluded that there is sufficient evidence to“[demonstrate] the effectiveness and medical necessity of mental health care, hormone therapy, and sex reassignment surgery as formsof therapeutic treatment for many patients diagnosed with [Gender Dysphoria]”(“Access”). Aetna considerssex reassignment surgeryto be medically necessaryas well, defining medical necessity to be“health services and supplies that under the applicable standard of care are appropriate: to improve or preserve health, life, or function; or to slow the deterioration of health, life, or function; or for the early screening, prevention, evaluation, diagnosis or treatment of a disease, condition, illness or injury”(Landau).Under this definition, sexreassignment surgery qualifies as medically necessary as a treatment for the condition of Gender Dysphoriaper the American Medical Association’s statement. Moreover, it improves the health and life of trans individuals becausestudies have found itto reduce rates of depression, HIV/AIDS, and substance abuse in trans patients (Padula394).Aetna covers the surgeryunder a number ofconditions,which includea referral letter confirming a history of Gender Dysphoria and the capacity to give informed consent (“GenderReassignment”).These conditionspresent a more mild barrierbarrierfor trans individuals to overcomethan that of paying for an uncovered surgery out of pocket.
Sex reassignment surgery for those transitioning from female to maleusually includes a hysterectomy and an oophorectomy,meaning the removal of the uterus and ovaries, in addition to genital reconstruction. The hysterectomy and oophorectomy are specificallyconsidered medically necessaryfor trans-menbecause these proceduresreduce the stresstheyexperience in association with theirfemalesex organs and menstruation,reduce the discomfort and expense associated with continued gynecological care,reduce the risk of cancer of the uterus, ovaries, or cervixafter the start of testosterone therapy,andreduce the doses of testosteronenecessary to beadministered and associated risks(“Transgender, Transsexual”).These reasons likely contributed to Aetna’s conclusion thatthe surgeryisa medical necessity forpeople with female sex organssuffering from GenderDyspohoria.
Female to male reassignment surgery, as stated above, involves removal of the uterus and ovaries and thus rendersapatient infertile.However, a trans-man’s ability to have biological children does not need to be impaired by the surgery; his eggs may be harvested prior to the surgery for future implantation in a surrogate or female partner.However,Aetna considerssex reassignment surgeryto be“elective sterilization,”despite designating is medically necessary as a treatment for Gender Dysphoria(“Infertility”).Aetna defines elective services to be all those that it does notspecificallycharacterize as medically necessary(“Cosmetic Surgery”). The dual characterization of the surgeryrepresents acontradiction in Aetna’s policy—a procedurecannotbe both medically necessary and elective. Consider the case of a woman who undergoes chemotherapy as a treatment for cancer, which will likely cause premature ovarian failure (Welt). Her treatment is necessaryfor her continued health and survival, and her resulting infertilityisan unfavorable, unavoidable outcome. It would be unreasonable for anyone to conclude that her sterilization was elective. This, in fact, seems to be Aetna’s logic. The insurance provider’s website states,“cryopreservation of mature oocytes or embryos is considered medically necessary for use in women facing infertility due to chemotherapy, pelvic radiotherapy, or other gonadotoxic therapies”(“Infertility”). Chemotherapy and the other therapies named in the policy are necessary treatments that confer similar medical necessityon other treatments, namely egg freezing, intended to mediate their detrimental effects on fertility. Sex reassignment surgery carries the same designation of necessity, and yet its unavoidable sterilizing effects are considered elective. As a result, egg freezing in pre-surgical trans-men is considered elective as well, despite the potential for the procedure to allow these patients to retain the ability to produce genetically related children.With egg freezing considered an elective procedure, trans patientswho choose to undergo it aresubject to the burden of paying for the expensive procedure out of pocket.The contradiction in Aetna’s policies denies opportunities to trans-men that are offered to cis-women, a discrepancy that indicatesdiscriminationbased on gender identity.
Aetna does facilitate its trans patients’ access to any reproductive services, essentially barring trans-men from undergoing egg freezing due to the prohibitively high cost. Egg freezing carries a significant financial burden for those who cannot access insurance coverage of it, namely trans-men. The process of retrieving and freezing eggs generally costs around $10,000, and egg thaw, fertilization, and transfer costs another $5,000 (“Cost”). With the cost of the procedures being this high, it is unlikely that trans-men, who suffer disproportionately from higher unemployment rates, will be able to pay for it out of pocket, meaning they willbe unableto have biological childrenafter sex reassignment surgery(Guequierre).Consider this financial burden in comparison with sperm freezing, which could be done by trans-women to preserve their ability to fertilize an egg and is not covered by Aetna either. The company claims that, like egg freezing, sperm freezing“is not considered treatment of disease”(“Infertility”). However, sperm freezing is significantly less expensive than egg freezing and does not pose an insurmountable financial barrier to those seeking to access it—the procedure costs between $300 and $500 dollars (“Sperm Storage”). Aetna’s exclusionary policies reveal a bias against trans-women in addition to trans-men, but the issue is less visible and less critical because sperm freezing services are easier to fund personally.
Insurance coverage would make egg freezing accessible to more trans-men, and this access would likely increase their mental wellbeing. A study done by researchers at theMax Planck Institute for Demographic Researchfound that“having up totwochildren increases happiness”(Myrskyla). Thisfinding suggests that trans-men who seek to have childrenwill have a greater level of cognitive wellbeingas well asa reduced risk of depression associated with the effects of their transgender status if they are able to reproduce. However, all trans-men cannot be expected to have children before their sex reassignment surgeries; they cannot be expected to have children if they believe themselves to beprohibitivelyyoung, partner-less,financially unstable,or focused on their careers, and they cannot be expected to postpone treating their Gender Dysphoria. Egg freezing gives them the freedom generally held by straight, cis-gendered people to choose to reproduce at another time. Therefore, denial of egg freezing coverage further denies trans-men the opportunities for wellbeing that are available to their cis-gendered counterparts.
Aetna’s logicfor coveringfertility procedures for cis-women with illnesses does not extend to that of trans-men,suggesting notan oversightbutrathera bias against trans-men.Evidence exists to suggest that coverage of“medically necessary and preventative services”for transgender people would be affordable and efficient within the population of the United States (Padula394). An analysis done by the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health even states that such coverage would be“economically attractive”to insurance providers, indicating that it would be cost-effective over 5 and 10-year scenarios (399).Coverage of the services is cost-effective in comparison to the cost of treatment for depression, substance abuse, and HIV/AIDS in transgender populations excluded fromthesenecessary and preventative services (394). The study does not explicitly nameegg freezing as one ofthe servicesaccounted for in the cost analysis, but it can be extrapolated that trans-men who cannot receive the procedure and are denied the chance to have children would experience anxiety and/ordepressionsimilar to those denied access tohormonal and surgical therapy and have similar detrimental health effects. In fact, a study done by the Institute for the Equality of Women and Men in Brussels found that an average of 42.4% of transgender respondents wanted to have children (Motmans92).Another study done on trans-men in Belgium found that54% of participants desired to have children, and 37.5% of the participants reported considering freezing eggs (Wierckx483).Theseresultscan be read to suggestthat other Western populations of transgender individuals would have similar ratesof a desire to have children, including those in the United States.Moreover,these resultsconfirm that asignificant portion oftrans-mendesire to have children, supporting the idea that some trans-men would react negatively to being denied the chance and possibly become depressed, engage in risky sex and contract HIV, and abuse substances,which would resultin higher costs from covered treatments for these afflictions.Based on the available data,it seems that Aetna’s exclusion of egg freezing coverage for trans-men is not a financial consideration.The fact that the companies do not provide coverage does not indicate a financially responsible or frugal policy decision butrather transphobia and favoring ofthe cis-gendered community.
The lack of coverage of egg freezing for trans-men in favor of cis-women facing similarly imminent sterilization points to the institutional minimization of the importanceofthe health and quality of life for trans people. Aetna’s policies are discriminatory, and yet they remain in effect because of the marginalization of the trans community and the malleable, cis-focused definition of“medically necessary.”The state of ֱ prohibits insurance providers from discriminating against transgender clients, specifically prohibiting the providers from“deny[ing], exclude[ing], or otherwise limit[ing] coverage for medically necessary services, as determined by an individual’s medical provider, if the item or service would be provided based on current standards of care to another individual without regard to their sexual orientation”(ֱ). ֱ’s definition of“sexual orientation”includes a person’s transgender status, meaning that companies like Aetna, which operates in ֱ, should not be able to legally provide“medically necessary”fertility preservation services to cis-women facing infertility without also providing them to trans-men(ֱ). Their exclusion of oocyte cryopreservation coverage for trans-men only narrowly avoids illegality with their technical, self-determination of the sterilizing effects of sex reassignment surgery as somehow separate from the surgery itself. Aetna’s consideration of trans-men’s sterilization as elective suggests that the company maintains a lesser value on trans individuals’ abilityto have children.
Itis clear that Aetnaisn’t relying on an economicor legalrationale to exclude coverage of egg freezing for trans-men, and it is probable thatthis exclusionis due to latent institutional transphobia at the provider level.Despite a recent movement to include trans health in medical education, such education has traditionally excluded trans health issues and continues to perpetuate cis-normativity. Trans health is subordinated or excluded in a number ofmedical curricula and texts,“contribut[ing] to the impression of research scarcity and, by extension,minimiz[ing] the importance of trans-related research”(Bauer 356). Moreover, the lesser visibility of the trans community in the medical education system contributes to the establishing and upholding of protocols and policies that focus on and favor cis-gendered patients(356). Trans erasure specifically impacts trans-men’s access to fertility preservation techniques because many providers believe they are ill prepared to treat trans patients and therefore do not present reproductive options prior to sex reassignment surgery or referral.In evidence of this, 50% of transgender respondents to a nationwide survey reported needing to educate their healthcare providers about appropriate transgender care(Grant).This statistic further suggests that medical education does not effectively educate professionals on trans health issues.Theinstitutional undervaluing of trans healthin educationreflected herefurtherlimits trans patients’ abilitiesto access reproductive services like egg freezing by diminishing providers’impressions of the importance of trans patients.Consider a case reported in a recent study on trans people’s experience with reproductive services: a trans-man was repeatedly denied information and services concerning egg freezing(James-Abra1367). Hewas dismissed by clinic staff until he decided to forgo disclosure of his transgender status, and clinic staff members were more receptive when they perceived him to be a cis-women (1367). This case suggeststhat“some [assisted reproduction] clinics provide differential access to services on the basis of gender identity”(1367).Researchfindings havesupportedthis deduction:19% of the same sample of transgender peoplepreviously mentionedreported being refused care due totheirgender identity(Grant).Available evidence points to a persistent disregard for trans health,specifically trans reproductive health, that makes it more difficult for trans-men to retain their preferred gender identity and receive care to facilitate their reproduction.
Institutional transphobia perpetuates the dilemma trans-men face between reaching their gender goals and reaching their reproductive goals, and personal transphobia on the part of providers further intensifies the problem. There is evidence tosuggest that trans patients have negative experiences when seeking reproductive serviceslike egg freezing. Astudy published in the journalHuman Reproductionindicates that trans patients experience difficulty receiving assisted reproductive services as a result of“problems with clinical documentation,”“impact of providers’ cis-normative and heteronormative assumptions,”and“refusal of services for prospective trans clients”(James-Abra1365). Each of these difficulties seems preventable with education and effort on the part of the healthcare providers.Anexample noted in the study further illustrates the role of preventable micro-aggressions: participants notedconsistent“unwillingness or lack of understanding on the part of some providers about how to acknowledge trans identities by using correct pronouns”(1367). It seems reasonable to conclude that providers would make notable attempts to use correct pronouns in reference to their patients in order to make them more comfortable and establish a stronger physician-patient relationship. The absence of such attempts suggests a bias on the part of the practitioners—a hint of transphobia in their lack of simple accommodations.This transphobia makes it morechallengingfor trans-men to disclose their transgender status to their providers and also receive care to facilitatetheir reproduction.
Trans individuals areroutinelyexcluded from resources and opportunities favorably allocated to cis-gendered individuals.Insurance providers could combat gender identity discrimination by covering the same procedures for cis-gendered and transgendered patients. Equal coverage, without the loopholes provided by self-determined designations of elective or medically necessary, wouldsimply and genuinely be in line with anti-discrimination laws. Moreover, equal coverage would oppose transphobia and the minimization of the importance of trans health, perhaps paving the way for equal and respectful treatment in all healthcare settings.Non-discriminatory coverage and treatment could dramatically increase trans people’s access to reproductive care,making it possiblefor those who want to “have it all”to do so.That is, they would no longer have to choose between being retaining the ability to have children and being comfortable with their anatomy and gender presentation.
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The Representation of Culture, Place, and Subjectivity in Training Day, Mason Eastwood
The film Training Day, directed by Antoine Fuqua, starring Denzel Washington and Ethan Hawke, is widely popular, and has appeared on television consistently since its debut in 2001 (Newmyer, Silver, & Fuqua, 2001). Washington’s performance in the film as a corrupt narcotics agent for LAPD earned him an Oscar for best actor, an accomplishment especially noteworthy for a black man considering recent controversy over the historic, dominant whiteness of the Oscars. Race plays a large role in Training Day given that much of the film is set in low income, predominantly black neighborhoods and housing projects. Without a thorough analysis of the film’s representation of the people in these places, their culture, and the forces that operate on them, Training Day, with all of its success, could be powerfully misleading. I will critically examine a specific representation of culture and place in the film and discuss the role of subjectivities that lie beneath these geographical aspects, bringing to light some of the realities the average viewer of Training Day might not pick up on.
First, I will define representation and emphasize why its manifestation as an entertaining film is an important thing to examine. Next, I will establish the relationship between culture, place, and subjectivity that is evident in the film, acknowledging systemic forces that have historically oppressed people of color in the United States. Finally, I will determine whether or not Training Day represents the aforementioned relationship well or if it poses a problem to society.
Representation is simply the way that some aspect of the world is portrayed, whether it be through art or through scholarly analysis. The purpose of representation can vary widely. For example, an anthropological ethnography might intend to inform an academic audience about the practices of people from a lesser-known part of the world. Alternatively, a film might intend to entertain a wider audience by representing some fictional group of people in a manner that drives a compelling storyline. Regardless of the purpose and intentions of any given pursuit, there are things one must acknowledge in order to absorb representation responsibly, and these notions certainly apply to the representation of impoverished communities of color in Training Day. There is some aspect of truth to every representation, but it may not be about the subjects being represented. Instead, the truth could reflect something about the person, or collective entity, doing the representing. Abu-Lughod (2008) states that “representations are…positioned truths” (p. 53). The gang members, drug dealers, families, and neighborhoods depicted in Training Day probably reflect some truth about the real lives of people resembling those characters, and about the reality of actual places resembling those neighborhoods, but they also hold truth about the perceptions and motives of the people responsible for the creation of the film. The different positionalities — experiences, lack of experiences, opinions, desires, and influences—of the filmmakers converge to create the representation that the audience takes in.
Similarly, it is important to recognize that “every view is a view from somewhere and every act of speaking a speaking from somewhere” (Abu-Lughod, 2008, p. 53). Training Day can be understood as both a view and an act of speaking. It reflects the views of the people who made it and “speaks” these views by playing on countless screens to countless audiences over time. The views, the voices, and the truths of Training Day come from many sources including the writer, the director, the actors, and the individuals or corporations that provided funds for the film. Since this paper is most concerned with the representation of racial truths, it is noteworthy that the writer, David Ayer, is a white man, and the director, Antoine Fuqua, is a black man. The race of these two men is certainly not a primary indication of the accuracy of the racial aspects of the film, but it can provide insight into the “somewhere” that the representation in Training Day comes from.
If these factors go unrecognized, it is easier to accept Training Day as presenting reality, rather than representing it. A great fictional film has the ability to lead the audience into believing it is real—a trick that can be particularly powerful if the film is about events that could occur in real life. Training Day is no exception. The story of two undercover policemen, one corrupt and the other forced to choose between two morally opposite paths, is not an entirely fictional concept. Considering the recent public awareness of racially motivated police misconduct, the premise of Training Day is especially salient even fifteen years after the film was released.
Relevant to this paper are the parts of the film in which Denzel Washington’s character Alonzo, along with Ethan Hawke’s character Jake, interacts with members of black communities in Los Angeles. In order to effectively examine the film’s representation of the relationship between culture, place, and subjectivity, I will refer in detail to one scene that occurs in a neighborhood characterized by crime and violence.
After using questionable tactics to force information out of a low-level crack dealer (played by Snoop Dogg), Jake and Alonzo drive to the house of the “Sandman,” an alleged high rolling drug kingpin. As the two officers enter the neighborhood, there is a close-up shot of several black men, some shirtless, some with chains on their necks and tattoos on their bodies, listening to rap music, smoking, leaning on the hoods of old cars, and talking with each other.
Without this quick shot, the audience would not know how to feel about the events that follow. The shot provides a sense of place and a sense of culture, both of which are represented as tightly bound. Culture is notoriously hard to define. It has been called “one of the most difficult concepts to interpret in all of the social sciences” (Norton & Walton-Roberts, 2014, p. 12). For this reason, I will begin with a simple definition of place that will aid in defining culture.
Place can be conceived as “space infused with meaning” (Oakes and Price, 2008, p. 254). Part of the anxiety the viewer of Training Day feels as Jake and Alonzo approach the house of the “Sandman” comes from the imagery described above, which is a large part of what makes the house, parking lot, and apartment building visible in the shot a distinct place. Imagining the same neighborhood inhabited by a different group of people, listening to a different type of music, being visited by people other than law officers elicits a different response. All of the aspects of that initial camera shot convey meaning about the unique environment Jake and Alonzo are entering and about the type of place it is.
The meaning conveyed about the “Sandman’s” neighborhood can be called culture. Oakes and Price (2008) write that the cultural geographer “raises questions about how we live in, experience, and shape a particular environment, about what living in and reshaping that environment means to us” (p. 1). It follows that the shirtless, necklaced, hip hop listening men are enacting culture by shaping the parking lot they inhabit, giving it meaning, and simultaneously making it a place among infinite spaces. Perhaps an appropriate definition of place is space infused with culture.
Another exercise helpful in highlighting the relationship between place and culture is to think of culture as “what makes one group different from another” (Norton & Walton-Roberts, 2014, p. 17). Had Jake and Alonzo crept up on a different neighborhood occupied by middle-class white men in golf shirts, sitting in lawn chairs, listening to country music, the scene would not mean the same thing. The two officers would be in a different place confronting a staggeringly different set of issues.
Establishing the relationship between culture and place and the film’s representation of it in this instance is not enough to determine whether or not Training Day poses a problem. Crang (2005), in his discussion of the interplay between material objects (such as the chain around the shirtless man’s neck) and culture, writes that “there is a danger of assuming ‘cultures’ as entities that act in and on the world, and paying too little attention to just how these ‘cultures’ come to be” (p. 171). The danger that Crang (2005) points to is the same danger the viewers of Training Day face, especially those who are not familiar with the intricacies of race relations in the United States. Consuming the images and scenes of mostly black, gang-ridden places without any historical context could lead to perpetuation of harmful race-based stereotypes that remove themselves from any of their sobering origins. To avoid this danger, I will bring the concept of subjectivity to the forefront while working through the scene in Training Day that immediately follows the place-establishing camera shot described above.
With a fake search warrant in hand, Jake (the only white person in the scene) and Alonzo prepare to enter the house of the “Sandman,” who the viewer quickly realizes does not actually reside there. At the front door, which is covered not by a screen, but by a grated metal second door, a woman with a cigarette hanging from her mouth (played by Macy Gray) reluctantly lets the two men in. After forcing the woman to the ground with his gun drawn, Alonzo demands to know if anyone else is in the house, only to learn that the woman’s nephew is playing in his room. When he finds the young boy, Alonzo, gun pointing directly at the child’s face, tells him to put his hands up. After patting the boy down, Alonzo seats him on the couch in the living room by his aunt, and proceeds to search the house, not for drugs, but for money he plans to steal.
While Alonzo searches the house and Jake attempts to keep the woman calm, it becomes apparent that the woman has dealt with the police before. She quickly grows suspicious that the search warrant is fake (it turns out to be a menu from a Chinese restaurant), and she also deduces that Jake is a rookie (the film is called Training Day because it is Jake’s first day on the job). When the woman realizes that Alonzo is stealing from her, she stands up and dares Jake to shoot her in front of the child. Jake, a young white man torn between getting the job he wants and doing the right thing, is clearly not prepared for that reaction.
Before Jake has to make the decision to assert force, Alonzo guiltily says that there was nothing found in the search, and that they are leaving. The woman, who at this point knows that Alonzo stole from her, follows the officers out of the house and calls on the hardened-looking, armed, shirtless men shown in the opening part of the scene to “blast” the officers. A full-blown shootout between Alonzo and the gang occurs but the two officers escape with only a couple of bullet holes in their car.
The viewer of this scene sympathizes with the woman who was robbed by Alonzo, as well as with the young child caught up in the literal and metaphorical crossfire between the community he is growing up in and the police. Some viewers might recognize that the scene depicts a place in which the people inhabiting it must protect themselves from the corrupt legal system as much as they must protect themselves from rival gangs. Other viewers might pick up on the fact that the young boy does not live with his parents, who could be dead, in jail, or simply absent. The feeling of conflict associated with viewing the potentially stereotypical gang shootout, and the relatively underrepresented act of police misconduct is all that the film directly evokes. However, as Crang (2005) suggests, a deeper look needs to be taken at what makes a scene like that an accurate, or inaccurate, representation of culture and place.
Rather than accepting the relationship between culture and place represented in the above scene from Training Day at face value, recognition of the role of subjectivity here is imperative. Nealon and Giroux (2012) write that “the ‘subject,’ unlike the self, is always understood in reference to preexisting social conditions and categories” (p. 37). Seeing the gang members, the aunt, and the child as subjected to certain forces, namely racial inequality and the complex set of circumstances that follows it, is important if the viewer of Training Day is to grasp the full gravity of what is being represented. Examining the things people are subjected to helps avoid dangerous viewpoint predicated solely upon the logically invalid conception of the “self.” Nealon and Giroux (2012) explain that “the self…is and always will be a subject” (p. 39). Any aspect of a person, a place, or a culture can be shown to have arisen from some combination of forces not explicitly controlled by that person, place, or culture, so the concept of the “self” is inherently flawed.
In the context of the scene being examined from Training Day, this entails viewing the low-income, gang-associated, violent neighborhood visited by Jake and Alonzo as having arisen due to forces beyond the control of the individuals residing in it. This method of consuming the representation is the only responsible one, although it is an endeavor that requires much more effort than simply, but erroneously, conceding the predicament of poverty, crime, and undue police presence to inherent cultural values borne out of the desires of a multitude of black “selves.”
A full-fledged undertaking of the past and current state of race relations in the United States is not the primary purpose of this paper, but some basic facts and ideas will help to illuminate some of the forces at play in neighborhoods like the one represented in Training Day. According to historian Howard Zinn (2012), the existence of such places began with slavery, which established “the inferior position of blacks in America for the next 350 years—that combination of inferior status and derogatory thought we call racism” (p. 9). This might seem an extreme explanation, but “the point is that the elements of this web are historical, not ‘natural’” (Zinn, 2012, p. 17). Zinn’s (2012) use of the word “natural” evokes a similar and equally problematic meaning as Nealon and Giroux’s (2012) use of the word “self.” Slavery, and its ensuing, ever-present consequences is but one of many forces that have historically contributed to the oppression of black lives in the United States. Discussing its role, however, points the viewer of representations of the oppressed black community towards an understanding of how culture and place are not spontaneously erected, as the terms “self” and “natural” imply. Poverty is not the “natural” status of black people in the United States. Neither is criminality, violence, nor familiarity with questionable police tactics. Anyone mildly intelligent could deduce that given some knowledge of history and biology (skin color is the only biological difference between members of different “races”), but it seems that many people do not.
As Alexander (2012) cynically puts it, placing the blame of crime, gang activity, and poverty on “natural” black culture, or black “selves,” “has tremendous appeal—before you know the facts—for it is consistent with, and reinforces, dominant racial narratives about crime and criminality dating back to slavery” (p. 219). By showing that the black neighborhood is actually victimized by law enforcement, Training Day gives its viewers the opportunity to acknowledge some of the facts that Alexander refers to and to reflect on the role of subjectivity in shaping culture and place. The problem is that the viewer may not be aware of the facts, so the positionality, the “somewhere”, the motives, of the creators of the representation could be lost on the audience. Instead of recognizing that culture and place exist as a result of a complicated combination of social and historic forces, which in this case have effectively narrowed the scope of freedom and choice for black subjects, viewers might choose to view the scene in Training Day as representing black people in their “natural” state. For example, viewers might not know that even though blacks and whites use and sell drugs at similar rates, “in at least fifteen states, blacks are admitted to prison on drug charges at a rate from twenty to fifty-seven times greater than that of white men” (Alexander, 2012, p. 218). The deeply troubling structural inequality lying beneath Jake and Alonzo’s visit to the house of the drug-dealing, black, gang-associated “Sandman” could fly above viewers’ heads, which could ultimately worsen the problem. However, because acts of racially motivated police brutality remain at the forefront of the social consciousness in this current era, it may be that facts like that are not as hidden from public view anymore.
As a final exercise in applying subjectivity to and denouncing the concepts of “self” and “natural” as they relate to the relationship between culture and place in the scene from Training Day, I will employ Nealon and Giroux’s (2012) argument that “the things that make us who we are are found in the context of where we live, where we’ve come from, and where we’re headed” (p. 40). Imagining the young boy from the scene as a real life character will be most useful. Children are a clear example of how subjectivity works because they are not yet fully autonomous beings in this world; they do not choose where they live, what school they go to, who their parents are, how much money they have, and many other things people might otherwise attribute to choices of the “self” instead of forces one is subjected to. The young boy lives with his aunt in a seemingly low -ncome neighborhood controlled by gang activity. At a young age, he had a gun pointed at him by a police officer. If that does not shape how he views law enforcement going forward, nothing will. He did not choose this place, or this culture that he lives within, but it will certainly affect him in some way. The poverty that the boy faces is not something that can be easily overcome in this country. Like his parents before him, he might not escape the place he currently resides. The boy came from a lineage of people who have been oppressed in this country for hundreds of years. He did not choose that, for “we don’t get to choose social attributes like our gender, race, class, and ethnicity, nor do we get to vote on what those attributes mean in a given social situation” (Nealon & Giroux, pp. 37-38). With these things in mind, it is not easy to say that the boy is headed in a great direction. If he lives to see adulthood, there is a good chance he will be the next to engage in a shootout with the police in his own front yard.
The boy is not to blame for his fate. The gang members are not entirely at fault for shooting at the police officers. The community as a whole cannot be solely charged with the creation of a culture and a place that in part exudes danger, violence, and conflict with law enforcement. It is likely that a scene resembling the one described above could occur in the real world. It is certain that places and cultures, albeit with more complexity and nuance, resembling the one represented in Training Day exist in the United States; one prerequisite for representation is that there be something to represent, and with the exception of some theatrics, the film appears to reflect a real part of society. However, there is no pause in Training Day filled with a historical bibliography about racial prejudice, oppression, slavery, and police misconduct to educate the viewer about the role subjectivity plays in creating the culture and place represented in the film.
I will not condemn Training Day because I believe it “speaks” from a position of knowledge and understanding about the forces operating on impoverished communities of color rather than from a stereotype-perpetuating view situated in a privileged, condescending realm far away from the reality of what is being represented. However, I will also not overtly praise the film for educating people about the relationship between culture, place, and subjectivity because it leaves a lot of responsibility with the audience to educate themselves prior to sitting in front of the screen. Instead, I point to a larger issue.
The fact that systemic racism, though often insidiously subtle and hidden behind false claims of equality, still exists, on scales ranging from the individual, to the neighborhood, to the nation, is appalling. Even more appalling is the fact that many Americans who consider themselves non-racists obliviously consume representations such as that of Training Day and blindly accept that racially segregated, low income, gang-driven neighborhoods filled exclusively with black people are normal, “natural” things. Despite the hints given in Training Day—the black communities are victimized by the police, and end up being protagonists in the story, the little boy is a symbol for subjectivity, the members of these communities are humans with depth of character instead of animated stereotypes—some viewers remain unaware of the tragedy that continues to unfold amidst the maintenance of cultures and places subjected to the very real oppression that exists at the heart of constructed racial differences in this country.
The act of watching Training Day without acknowledgement of structural inequality and racism is synonymous with the act of altogether ignoring those pervasive societal problems. To brush off the scene analyzed in this paper as representing a “natural” occurrence is to perpetuate dangerous myths of the black “self” that effectively allow racial stereotypes to continue to harm countless citizens of this imperfect nation. Training Day provides a much needed entry point into a larger discussion of the forces operating on communities of color in the United States, but the discussion is not an easy one to have. However, one cannot enter the movie theater with the sole intention of being entertained if any progress is to be made.
References
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Alexander, M. (2012). The new Jim Crow. In Charles A. Gallagher (Ed.), Rethinking the color line: readings in race and ethnicity (pp. 217-225). New York: McGraw Hill.
Crang, P. (2005). The geographies of material culture. In P. Cloke, P. Crang, & M. Goodwin (Eds.),Introducing Human Geographies(2 edition, pp. 168–180). London: Routledge.
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Zinn, H. (2012). Drawing the color line. In Charles A. Gallagher (Ed.), Rethinking the color line: Readings in race and ethnicity (pp. 9-17). New York: McGraw Hill.