- J. Marion Sims has gone down in history as the "Father of Modern Gynecology."
- Many of his medical achievements came at the cost of the health and well-being of enslaved Black women.
- He performed surgical experiments on enslaved Black women, often without the use of anesthesia.
In 2018, after a series of protests, New York City's Public Design Commission voted unanimously to remove a statue of J. Marion Sims from Central Park.
Sims has gone down in history as the "Father of Modern Gynecology." He developed a surgical technique for the repair of vesicovaginal fistula, a severe complication of obstructed childbirth. He also invented the Sims speculum, a surgical instrument used for examining the vagina and cervix, the Sims sigmoid catheter, a thin tube used to aid the removal of uterine tissue among other functions, and the Sims position, a posture used for rectal examination, treatments, enemas, and examining women for vaginal wall prolapse.
But many of his achievements came at the cost of the health and well-being of Black women. In recent years, his troubling history of medical experimentation on enslaved Black women has come into question.
Procedures performed without anesthesia
While Sims occasionally conducted experimental surgery on white women, his main subjects were a group of enslaved Black women with fistulas (an opening between the vagina and the bladder or rectum) who were offered by their slave owners under intentionally loose contracts in the 1840s.
These procedures were performed without anesthesia, often repeated several times, and never involved consent from the patients — stripping these women of any freedom to govern their own bodies. One subject, a woman by the name of Anarcha, was operated on 30 times before the repair of her fistulas was declared a success.
During some occasions, Sims would administer opium to his enslaved subjects after their surgical procedures to immobilize them and keep them from resisting, which may have been seen as an acceptable therapeutic practice at the time.
In the 19th century, many men of medicine held the racist belief that Black people held a higher pain threshold than white people. Some believe that may have been the basis for Sims' experimentation on enslaved Black women, however others point out that Sims was aware that his patients were in pain. When recounting one of his procedures on Lucy, an enslaved Black woman who was operated on without anesthesia, Sims wrote in his autobiography, "I thought she was going to die … it took Lucy two or three months to recover entirely." Historian Julia Axelrod wrote, "'Sims failed utterly to recognise his patients as autonomous persons."
A history of unequal reproductive medical care
Race-based physiological myths have long influenced medical practice. In fact, a 2016 study involving 222 white medical students and residents found that half held false physiological beliefs about African American patients. Nearly 60% thought their skin was thicker, and 12% thought their nerve endings were less sensitive than those of white people. Another 2007 study found that relative to other racial groups, physicians are twice as likely to underestimate Black patients' pain. Perhaps as a consequence, Black patients receive less pain treatment than their white counterparts.
Sims' influence on modern gynecology has contributed to a history of unequal reproductive medical care for Black women. After his death, researchers used the cervical cancer cells of Henrietta Lacks without permission or compensation. In 1961, a doctor performed a hysterectomy, known then as a "Mississippi appendectomy," on Fannie Lou Hamer, sterilizing her without her knowledge or consent.
A 2021 Health Equity study found that Black women in the US are more than three times more likely to experience a pregnancy-related death than white women, even when controlling for education and income – a stat that has remained consistent since national tracking for maternal mortality began.
Black women also have higher rates of preterm birth, Black infants have a mortality rate two times that of white infants, and Black women suffer disproportionately more morbidity and mortality rates from cervical, endometrial, and ovarian cancers with worse overall survival in all major gynecological malignancies compared with their white counterparts.
Black women were experimented on to improve health care for white women
Societal, institutional, and systemic racism has endangered the lives of Black women for centuries. The implications of racist experimentations, like those conducted by Sims, continue to be felt by victims of medical racism today. In a 2023 CDC study, Black women reported experiences of mistreatment during maternity care at the highest rate of women surveyed. Another study found that three out of four Black participants believe there is bias in how their pain is diagnosed.
Prior to Sims' exploration, the study of gynecology did not exist. Medical students were not instructed on pregnancy, childbirth, or gynecological diseases, and resident doctors were often trained to deliver babies using dummies. Sims recognized an untapped area in treating vesicovaginal fistulas, a condition that had been attempted by several previous generations of surgeons without significant success.
As enslaved Black women were considered to be the property pf their owners, and therefore did not have their own rights of refusal, Sims' experimented on Black women in order to improve gynecological outcomes for white women.
In his personal memoir, "The Story of My Life," Sims wrote that without the ability to perfect his techniques on Black women, whom he describes as being "the very bottom," he could not have later ascended his practice to the aristocratic families, "the upper crust," of Montgomery.
Black women created opportunities for Sims, granting him access to a higher class of clientele, solidifying his medical reputation, and opening the door to career opportunities in the field of medicine. Yet the health and well-being of Black women continues to be systematically neglected, today just as it was then.