(Anger) The Cycle of Pain: Endometriosis, Medical Racism, and the Violence of Gynecological Knowledge

This chapter examines how environmental racism, medical misogyny, and racialized scientific discourse shaped the diagnosis and treatment of endometriosis in the latter half of the twentieth century. Building on the eugenic frameworks established by Joe Vincent Meigs, who pathologized endometriosis as a “career-woman’s disease” afflicting only white, upper-class women, this chapter interrogates the systemic exclusion of Black women from diagnosis and care. Through archival analysis of mid-century gynecology research, the pioneering work of Black gynecologist Donald Chatman, and the development of environmental justice movements, this chapter reveals how medical racism and environmental toxicity became intertwined in the narrative of gynecological pain. Drawing from feminist disability studies and Black disability politics, it explores how toxins like dioxin and PCBs, disproportionately present in communities of color, have been linked to endometriosis, yet research and advocacy efforts have centered white women’s experiences. The chapter critiques the Endometriosis Association’s racial blind spots while calling for an anti-racist, intersectional approach to endometriosis research and care. By reframing endometriosis as both a site of environmental injury and diagnostic neglect, this chapter situates the disease within broader structures of racial capitalism, reproductive control, and ecological harm. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others Notes - 1. - 2. “Private class patient” refers to individuals who are able to pay for specialty care at full price without insurance. The physicians accepting these patients often did not accept insurance and expected their patients to pay upfront for treatments, meaning that the private-class patient was typically white and wealthy. - 3. Menorrhagia is excessive menstrual bleeding, typically identified as over 80 mL in one menstrual cycle. - 4. It is important to note that environmental pollution is not the only factor in developing endometriosis. It is a multifactorial disorder, but it can certainly be a contributing one and add to the disparities in healthcare access, which can make managing the disease and receiving adequate treatment more difficult for women of color.

Adamson, Joni, Mei Mei Evans, and Rachel Stein. 2002. Introduction: Environmental justice politics, poetics, and pedagogy. In The environmental justice reader: Politics, poetics, and pedagogy, ed. Joni Adamson, Mei Mei Evans, and Rachel Stein, 3–14. Tucson: University of Arizona Press. American College of Obstetrics and Gynecology. 1978. Important facts about endometriosis. Boston, MA: Center for the History of Medicine, Boston Women’s Health Collective, box 39, identifier H, Harvard Medical School. Angelon-Gaetz, Kim A., et al. 2010. Inequalities in the nuclear age: Impact of race and gender on radiation exposure at the Savannah River Site (1951–1999). New Solutions: A Journal of Environmental and Occupational Health Policy 20 (2): 195–210. https://doi.org/10.2190/NS.20.2.e. Assaf, B. T., and A. D. Miller. 2012. Pleural endometriosis in an aged rhesus macaque: A histopathological and immunohistochemical study. Veterinary Pathology 49 (4): 636–641. Ballweg, Mary Lou. 1995. Endometriosis and environmental toxins. In The endometriosis sourcebook, ed. Mary Lou Ballweg, 377–382. Chicago: Contemporary Books. Ballweg, Mary Lou, and Karen Gould. 1995. Dioxin danger in tampons—How to obtain safe sanitary supplies. In The endometriosis sourcebook, ed. Mary Lou Ballweg, 395–398. Chicago: Contemporary Books. Berger, J. A., S. B. Ganz, R. L. Marik, and T. G. Schneider. 1978. Endometriosis: New views, new therapies. Patient care, 24–96. Boston, MA: Center for the History of Medicine, Boston Women’s Health Collective. Blinick, G., and V. J. Merendino. 1951. The infrequency of pelvic endometriosis in Negro women. American Journal of Surgery 81 (6): 635–636. https://doi.org/10.1016/0002-9610(51)90153-5. Bonnar, J. 1983. Clinical manifestations and diagnosis of endometriosis. Irish Journal of Medical Science 152 (Suppl. 2): 5–8. https://doi.org/10.1007/BF02945273. Bougie, Olga, J. Healey, and S. S. Singh. 2019a. Behind the times: Revisiting endometriosis and race. American Journal of Obstetrics and Gynecology 221 (1): 35.e1–35.e5. Bougie, O., Ma I. Yap, L. Sikora, T. Flaxman, and S. Singh. 2019b. Influence of race/ethnicity on prevalence and presentation of endometriosis: A systematic review and meta-analysis. BJOG 126:1104–1115. Campbell, J. S., J. Wong, L. Tryphonas, D. L. Arnold, E. Nera, B. Cross, and E. LaBossiere. 1985. Is simian endometriosis an effect of immunotoxicity? Presented at the Ontario Association of Pathologists forty-eighth annual meeting, London, Ontario, October. Carpan, Carolyn. 2003. Representations of endometriosis in the popular press: “The career woman’s disease”. Atlantis 27 (2): 32–40. Chatman, Donald L. 1976. Endometriosis in the Black woman. American Journal of Obstetrics and Gynecology 125 (7): 987–989. Chen, Mel Y. 2011. Toxic animacies, inanimate affections. GLQ: A Journal of Lesbian and Gay Studies 17 (2–3): 265–286. Clare, Eli. 2017. Brilliant imperfection: Grappling with cure. Durham, NC: Duke University Press. Davis-Faulkner, Sheri. 2017. These days I hate going to the gynecologist. In The crunk feminist collection, ed. Brittney C. Cooper, Susana M. Morris, and Robin M. Boylorn, 559–566. New York: First Feminist Press. Fanton, J. W., and J. G. Golden. 1991. Radiation-induced endometriosis in Macaca mulatta. Radiation Research 126:141–146. Frazier, Chelsea M. 2016. Troubling ecology: Wangechi Mutu, Octavia Butler, and Black feminist interventions in environmentalism. Critical Ethnic Studies 2 (1): 40–72. Friedan, Betty. 2013. The feminine mystique. New York: Norton. Originally published 1963. Fritz, Mark A., and Leon Speroff. 2020. Clinical gynecologic endocrinology and infertility. 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins. Originally published 1973. Gerhard, I., and B. Runnebaum. 1992. Grenzen der hormonsubstitution bei schadstoffbelastung. Zentralblatt für Gynäkologie 114:593–602. Gray, Pamela Jane. 1981. Endometriosis—The “career woman’s disease”? Ms 9:1–9. Sophia Smith Collection, box 143, series 4, Smith College, Northampton, MA. Greenblatt, Robert B., and Ismet B. Sipahioglu. 1976. Endometriosis: The nature of the problem and approaches, old and new, to solving it. In Recent advances in endometriosis, ed. Robert Greenblatt, 1–11. Amsterdam/Philadelphia, PA: Excerpta Medica/The College of Physicians of Philadelphia, Mütter Museum. Hallman, J. C. 2023. Say Anarcha. New York: Macmillan. Hayden, C. T. 1956. Endometriosis; a review. California Medicine 85 (3): 157–162. Hill, Gladwin. 1948. Social ill is laid to endometriosis: women’s ailment restricting the propagation of intelligent class, says Dr. J.V. Meigs. New York Times, October 21, 30. Hobbs, John E., and A. R. Bortnick. 1940. Endometriosis of the lungs: An experimental and clinical study. American Journal of Obstetrics and Gynecology 40 (5): 832–843. https://doi.org/10.1016/S0002-9378(15)30807-3. Hoffman, Kelly M., et al. 2016. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between Blacks and Whites. Proceedings of the National Academy of Sciences of the United States of America 113 (16): 4296–4301. https://doi.org/10.1073/pnas.1516047113. Iengo, Ilenia. 2022. Endometriosis and environmental violence: An embodied, situated ecopolitics from the Land of Fires in Campania, Italy. Environmental Humanities 14 (2): 341–360. Jacoby, Vanessa L., et al. 2010. Racial and ethnic disparities in benign gynecologic conditions and associated surgeries. American Journal of Obstetrics and Gynecology 202 (6): 514–521. https://doi.org/10.1016/j.ajog.2010.02.039. Jagirdar, J., et al. 2013. Pleuro-pulmonary endometriosis in baboons (Papio spp.): Insights into pathogenesis. Journal of Medical Primatology 42 (1): 39–45. https://doi.org/10.1111/jmp.12027. Judd, Bettina. 2014. patient. Mount Vernon, NY: Black Lawrence Press. Kafer, Alison. 2013. Feminist, queer, crip. Bloomington: Indiana University Press. Kistner, Robert W. 1971. Gynecology: Principles and practice. Chicago: Year Book Medical Publishers. Lorde, Audre. 1980. The cancer journals. New York: Penguin. McKittrick, Katherine. 2006. Demonic grounds: Black women and the cartographies of struggle. Minneapolis: University of Minnesota Press. Meigs, Joe V. 1934. Tumors of the female pelvic organs. Macmillan surgical monographs. Boston, MA: Center for the History of Medicine, Countway Library Rare Books, Harvard Medical School. Meigs, Joe V. 1938. Endometriosis, a possible aetiological factor. Surgery, Gynecology & Obstetrics 67:253–255. Meigs, Joe V. 1949. The medical treatment of endometriosis and the significance of endometriosis. Surgery, Gynecology & Obstetrics 89 (3): 317–321. Center for the History of Medicine, Joe Vincent Meigs Reprints, Harvard Medical School, Boston, MA. Meigs, Joe V. 1960. An interest in endometriosis and its consequences. American Journal of Obstetrics and Gynecology 79 (4): 625–635. Missmer, Stacey A., et al. 2004. Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors. American Journal of Epidemiology 160 (8): 784–796. https://doi.org/10.1093/aje/kwh275. Nelson, Alan. 2002. Unequal treatment: Confronting racial and ethnic disparities in health care. Journal of the National Medical Association 94 (8): 666–668. Novak, Edmund R., and Georgeanna Seegar Jones. 1961. Novak’s textbook of gynecology. 6th ed. Baltimore: Williams & Wilkins. Outmoded Eugenics. 1948. New York Times, October 31, 1. Owens, Deirdre Cooper. 2017. Medical bondage: Race, gender, and the origins of American gynecology. Athens: University of Georgia Press. Puar, Jasbir K. 2017. The right to maim: Debility, capacity, disability. Durham, NC: Duke University Press. Ranney, Brooks. 1971. Endometriosis. IV. Hereditary tendency. Obstetrics and Gynecology 37 (5): 220–227. Ridley, John H. 1968. The histogenesis of endometriosis: A review of facts and fancies. Obstetrical and Gynecological Survey 23 (1): 1–35. Rier, S. E., D. C. Martin, R. E. Bowman, W. P. Dmowski, and J. L. Becker. 1993. Endometriosis in rhesus monkeys (Macaca mulatta) following chronic exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Fundamental and Applied Toxicology 21 (4): 433–441. Roberts, Dorothy E. 1997. Killing the Black body: Race, reproduction, and the meaning of liberty. New York: Pantheon. Samani, Elham N., et al. 2017. Micrometastasis of endometriosis to distant organs in a murine model. Oncotarget 10 (23): 2282–2291. https://doi.org/10.18632/oncotarget.16889. Schalk, Sami. 2022. Black disability politics. Durham, NC: Duke University Press. Scott, Roger B., Richard W. Te Linde, and Lawrence R. Wharton. 1953. Further studies on experimental endometriosis. American Journal of Obstetrics and Gynecology 66 (5): 1082–1103. Sims, J. Marion. 1886. The story of my life. London, UK: Forgotten Books. The Endometriosis Association. n.d. About the Endometriosis Association. https://endometriosisassn.org/about/. Tremblay, Lyse M. 1995. Is your home a health hazard? In The endometriosis sourcebook, ed. Mary Lou Ballweg, 399–407. Chicago: Contemporary Books. United States Congress. 1992. 102nd Congress, 2d session, resolution 321. Subcommittee on Census and Population, Barbara Mikulski. United States Congress. 2003. 108th Congress, 1st session, bill 373. House Committee on Government Operations. Washington, Harriet A. 2008. Medical apartheid: The dark history of medical experimentation on Black Americans from colonial times to the present. New York: Knopf Doubleday. Wright, W. J. 2021. As above, so below: Anti-Black violence as environmental racism. Antipode 53:791–809. https://doi.org/10.1111/anti.12425. Xu, Jinming, et al. 2016. Association between dioxin and cancer incidence and mortality: A meta-analysis. Scientific Reports 6:38012. https://doi.org/10.1038/srep38012. Yearby, Ruqaiija. 2018. Racial disparities in health status and access to healthcare: The continuation of inequality in the United States due to structural racism. American Journal of Economics and Sociology 77:1113–1152. https://doi.org/10.1111/ajes.12230. Author information Authors and Affiliations Corresponding author Rights and permissions Copyright information © 2026 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Rovito, M. (2026). (Anger) The Cycle of Pain: Endometriosis, Medical Racism, and the Violence of Gynecological Knowledge. In: Cripping Endometriosis. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-032-15681-5_3 Download citation DOI: https://doi.org/10.1007/978-3-032-15681-5_3 Published: Publisher Name: Palgrave Macmillan, Cham Print ISBN: 978-3-032-15680-8 Online ISBN: 978-3-032-15681-5 eBook Packages: Social SciencesSocial Sciences (R0)