Throughout this series, we have examined genetics stories that sit just beneath the surface of what we teach in high school biology. Stories about who gets credited, who gets exploited, and how scientific knowledge is shaped by the social world around it. Today’s story is one of the most important and least told in all of medicine. It begins in a genetics classroom, with a special focus on social justice.
We teach students in social studies classes that race is a social construct. However, we usually avoid this topic in the biology classroom. Nevertheless, it is imperative to establish a connection to the science classroom as well. This builds on my previous writings on genetic essentialism in curriculum (here) and racial disparities in science and medicine (here). Today, we delve into the socioscientific issue of eugenics, and where/how it still impacts society.
We know from population genetics that there is more genetic variation within racial groups than between them. We know that the traits we associate with race are superficial, shaped by environment and history, not by any meaningful biological boundary. This is settled science. And yet, for much of Western medical history, physicians operated on quite a contrary assumption: that racial differences were biological, fixed, and hierarchical. Such an alarming notion was not only written in the textbooks. It also got written onto the bodies of Black women.
The Story: A Science Built on Exploitation
Let me tell you a story.
James Marion Sims is widely known as the “Father of Modern Gynecology.” His development of the speculum and his surgical technique for repairing childbirth injuries, are considered landmark contributions to medicine. What is less often told in classrooms is how he developed those techniques. In the 1840s, Sims performed repeated experimental surgeries on enslaved Black women in Alabama, without anesthesia, and without their consent. He operated on some of these women dozens of times. He justified this by invoking a belief, common in 19th century medicine, that Black people had a fundamentally different physiology and genetics than white people, including a higher tolerance for pain.
This was not a fringe view. It was a medically endorsed, pseudoscientifically supported claim embedded in the very foundation of American medicine. A 2025 paper the Journal of Racial and Ethnic Health Disparities traces exactly how these dehumanizing narratives about Black bodies, constructed during the 19th century consolidation of medicine and gynecology, created some of the health disparities that researchers are still measuring today. The findings are unambiguous: the fabricated stories about Black bodies made up in the past, directly influenced the quality of care which Black patients are receiving in the present, including inadequate pain management and higher mortality rates. Ingrid Marra, the paper’s author, indicated that 84.6 % of the documents she analyzed showed differences in clinical practice between white and black patients and knowledge produced based on false biological differences appeared in 69.2% of documents analyzed.
The Genetics Connection: Essentialism as a Weapon
Here is where the genetics curriculum becomes essential. Students learning about Mendelian inheritance, genetic variation, and the biology of human populations need to understand that this knowledge comes with a history, and that history contains deliberate malpractice and injustice.
The eugenics movement, which gained significant institutional power in the late 19th and early 20th centuries, claimed to apply the principles of heredity to human populations. If traits were heritable, eugenicists argued, then society could be improved by controlling who reproduced. In practice, this meant deciding that Black, Indigenous, and other marginalized people carried “defective” genes and should be prevented from passing them on. This was genetic essentialism at its most dangerous: the flawed idea that complex human traits, including intelligence, morality, and worth, were fixed in the genome and distributed unequally across racial groups.
We have discussed genetic essentialism in this series before, in the context of humane genomics education and why updating our curriculum matters. The eugenics movement is the starkest illustration of where essentialism leads. It provided the delusional scientific-sounding justification for forced sterilization programs that targeted Black women, Indigenous women, women with disabilities, and anyone else deemed genetically undesirable. By the mid-20th century, tens of thousands of people in the United States had been sterilized under state eugenics laws. Black women were disproportionately targeted, sometimes sterilized during other procedures even without their knowledge. The practice was so common in the American South where it was called a “Mississippi appendectomy.”
This was not sound science. It was undeniably the misappropriation of genetic language to enforce a racial hierarchy. And it worked due to racist beliefs held by the scientific community and a lack of scientific literacy in the public sphere to challenge it.
The Echo Forward: This Is Not Just History
A 2023 review published in Obstetrics and Gynecology traced four historical pillars of current racial health inequity: the invention of race as a social construct, enslavement, the legal doctrine of Partus sequitur ventrem (which held that a child born to an enslaved mother was also enslaved), and the American eugenics movement. The authors present the case clearly: the stereotypes and myths generated by these systems did not disappear. They were absorbed into medical training, clinical assumptions, and institutional practice.
Marra indicates that Black women in the United States today are three to four times more likely to die from pregnancy-related complications than white women. Studies continue to document that Black patients are systematically undertreated for pain compared to white patients with identical conditions. When we ask why, existing research points us directly back to specific narratives constructed in the 19th century and carried forward into medical training for generations. These include the false belief that Black people have thicker skin than white people and therefore feel less pain. The false belief that Black people have a higher pain tolerance and require less anesthesia. The false belief that Black women are biologically stronger, more physically capable of enduring suffering, and less emotionally sensitive to it. The false belief that Black women are hypersexual and reproductively irresponsible. All of these fallacies were the premises on which both scientific experimentation and forced sterilization were carried out. Importantly, however, none of these have any basis in genetics or biology. They are instead rooted in the same essentialist logic that propped up slavery and the eugenics movement.
Despite these facts, a 2016 study published in PNAS found that a significant proportion of medical students and residents still endorsed at least some of these false biological presumptions about Black patients. These are not ancient myths that medicine has cleanly left behind. They are misleading facts that our genetics curriculum has long since disproven, but that medical culture has been far slower to unlearn.
The Point: Teaching the Whole Story
When I teach genetic variation and the social construction of race, I want students to understand not just the science, but the consequences of getting that science wrong, and of getting it wrong deliberately, in service of power. The story of gynecology is about what happens when pseudoscience masquerades as biology, when genetic essentialism is used to defend exploitation, and when the human bodies that made scientific progress possible are written out of the plot entirely.
Scientific literacy is not limited to knowing that race is a social construct. It is understanding why that truth was suppressed, who benefited from suppressing it, and who in turn paid the price. The genetics concepts we teach to help students understand human diversity are the very same concepts that, when distorted, built a medical system on the pain of Black women without their consent.
Shouldn’t we teach that part of the story too?
Class dismissed.
Edited by Sandhyaa Venkatachalam and Jayati Sharma
Cover photo (courtesy of Pexels):
https://www.pexels.com/photo/a-beige-gynecological-chair-7108391
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