By Sunny Nakae

This piece is dedicated to all the phenomenal Black women in my life (you know who you are!) who teach, inspire, challenge, advocate, and slay on the daily.  I am not speaking FOR Black women here, I am speaking TO white women.

I grew up as part of many worlds: white, Japanese, religious, secular, sporty, musical, school, and manual labor – to name a few.  As an adult I view places and spaces from a lens of different perspectives of the identities and experiences I carry.  This essay is born of many conversations, witnessings, observations, personal missteps, and triumphs of the experiences of women of color in professional spaces. While I share many intersections as someone who identifies as a woman of color, I recognize that there are aspects of Black identity that I only proximally understand.  My identities give me safety to speak to white women, with whom I share experiential bandwidth.  I write this in hopes of building more bridges of trust and solidarity for all who identify as women. By centering Black women, I shift the burden onto white women to know better and do better. 

Why Black women don’t trust you:

1. You say too much.  Black women are always paying attention.  Always.  They do not have the luxury of ‘running their mouths’ to anyone but their most trusted circles.  If you’re a colleague and wondering if you’re part of that trust circle, the answer is likely no.  Black women are accustomed to small things devolving into blowback, and therefore they are careful about what they share and with whom.  If you seem like you are always talking about people’s business, you’re inherently unsafe. 
2. You criticize people of color publicly.  There is a deep and abiding solidarity that Black women have for the cause of justice.  They are keenly aware of the collective whole and therefore almost never criticize people of color in professional spaces, even when they agree behind closed doors.  I have observed that in professional spaces Black women often say more with their silence.  Black women know that racism spreads uncontrollably and any endorsement of small criticisms by people of color become wholesale indictments of competence for all people of color. 
3. You are too familiar, too fast.  Black women do not have the luxury of being goofy or overly familiar at work.  They may not be able to dress or speak casually without coming under criticism or having their authority undermined.  When you are the first to drop casual language or tone, indicating familiarity, you signal that you don’t understand how code switching impacts Black women. Do not use “sis” or “sister” or nicknames or vernacular that are culturally gratuitous or disingenuous to your usual communication.  It comes across as taking for granted that trust must be built. Assuming familiarity can feel a lot like assuming superiority.
4. You don’t name whiteness.  If you want Black women to trust you, regularly own your whiteness, and your white womanness.  Stop using whiteness as default without naming it.  Stop using women’s issues to masquerade racism.  Black women got the right to vote in 1965. White women were enfranchised in 1919, which is labeled by historians in a very exclusionary way as “women’s suffrage” while leaving out women of color.  If you benefit from whiteness, own this history of exclusion by naming whiteness without centering it.  Never use sexism to excuse racism because Black women deal with both on the daily.
5. You don’t name racism.  When acts of bias, discrimination, and mistreatment occur white women often rationalize away the racism in these acts.  Even if it’s the same person doing the harm, it does not have an equal impact because racism structurally and interpersonally mediates the realities of women of color.  If you want to build trust, work through your discomfort and label racism when it occurs, including your own.  Don’t try to reframe, genderize, or whitewash harm.  Listen and abide in the muck of non-closure. Your ability to be uncomfortable will allow you to be more proximal to Black women.
6. You perform happiness too much.  Don’t misunderstand this.  Black women aren’t distrustful of genuine joy.  But when women in professional spaces conform to smiling a lot and performing happiness to appease the white patriarchy, it makes things even more unsafe for Black women.  Black women are subject to tone policing and stereotypes around being angry or unhappy.  Your withholding of genuine emotions for the sake of peace depletes the emotional oxygen out of the room and leaves even less space for Black women.
7. You correct your subordinates but not your superiors.  This signals being invested in caste and hierarchy systems at work.  If you never speak truth to power, you tacitly endorse the status quo of misogynoir that Black women face daily.  If you’re unforgiving to those who report to you, while making excuses for those above you, you’re part of the problem.  The hierarchy does not protect Black women, so being invested in it creates mistrust.
8. You do not disrupt, you only notice or apologize after.  I heard a Black woman CEO state it best, “If one more white person comes into my office gobsmacked at how their white colleagues are treating me, I’m going to scream.  I think ‘Why didn’t you speak up in the meeting when it was happening?  What are YOU doing to disrupt the racism?’  No, I don’t want to hear you apologize for your white colleagues. I want to see you confront them.”  If you are not willing to battle white supremacism, it should be obvious why you’re not trusted. Black women don’t need your sympathy.  They need your solidarity. Intervene without needing a pat on the back.
9. You ask about or comment on hair, skin, or clothing uninvited, non-reciprocally, and/or with a patronizing admiration or dehumanizing curiosity.  Before you comment on a Black woman’s appearance, reflect on whether you are coming from a place of objectification or curiosity, or whether you have a relationship that would make it relevant that you like their hair/clothes/skin.  (Hint: Black women do not care what you think of their braids or skin, like ever.)  Black women’s appearances are often policed and judged to a far greater extent than white women. A well-meaning compliment can feel like a microaggression of being othered or objectified. 
10. You demonstrate unyielding and bottomless solidarity for white people while simultaneously applying “prove it bias” or “exception to the rule” logic for people of color.  In other words, your world revolves around confirming whiteness and the power centricity it yields.  If white people “just didn’t know any better” but people of color “should have known better” you’re not going to build trust with Black women. 

The Thin Book of Trust by Charles Feltman defines trust as, “Choosing to risk making something you value vulnerable to another person’s actions.” For Black women there is often no choice.  Because of structural and interpersonal racism, Black women often must navigate places, spaces, and dynamics where power is unequal and a great deal of their personal and financial wellbeing is at stake.  Trust without choice is risk.  Being subjected to unwanted risk depletes safety and can cause trauma.

White women, if you have not thought much about trust, I ask you to rumble with that.  Do you take trust and comfort for granted?  Do you expect trust from hierarchy, affinity, or position?  Get curious instead of defensive.  Interrogate your perspective and your privilege. If you blame Black women for not trusting you, you are contributing to the dynamic that makes life harder for Black women.  I ask you to consider what it would look like for you to take responsibility for building trust.  Honor confidentiality.  Respect boundaries.  Name whiteness, white womanness, white supremacism, and racism.  Speak truth to power.  Spend some social capital on increasing safety and inclusion at work.

Dear Dr. Wang,

Your article was recently  retracted by the editors of the Journal of the American Heart Association and was denounced by the AAMC and the American Heart Association. As researchers and leaders in selective admissions and medical education, and as Asian Americans, we are deeply disturbed and offended by your article’s lack of conceptual rigor and its perpetuation of racist tropes, namely that a race-conscious admissions process produces unqualified Black physicians and physicians of color.

A flawed paper

The crux of your argument seems to be that by using a set of holistic admissions criteria, medical schools admit unqualified applicants and therefore, produce an unqualified physician workforce. However, you seem to confuse winning a competition on a single scale with being qualified. Being competitive is not the same as being qualified.  24,127 runners qualified for the Boston Marathon.  Not all qualifying runners will finish at the top, or even within minutes of the most competitive athletes, but most will finish and all were qualified through a rigorous process to pursue the marathon course.  The tripartite mission of medicine – education, research and patient care – is served best with attention to equity, not competition.

Dr. Wang, you falsely defined “qualified” applicants using only MCAT scores, which are incomplete metrics of an applicant’s qualifications for medical school.  Aggregate national acceptance data from 2017-2020 shows that 18.1% of applicants to medical school with MCAT scores between 514-517 were not accepted.  For those scoring above 517 (95th percentile) 12.2 percent were rejected by every school.  Practitioners in undergraduate medical education (UME) admissions understand that assessing academic preparation and personal qualifications for medicine is complex, nuanced, and cannot be reduced to the MCAT, which has  limited capacity to predict academic success (and does not predict clinical outcomes).  We would no more assess cardiovascular health using only body weight than admit applicants to a profession based only on MCAT scores. There are many other factors that must be considered in context.  Among these factors is the experience of racism.

Your paper ignored structural racism, and claimed that centuries of colonization and racism, and their implications for contemporary society, vanished with the Civil Rights Act of 1964.  This is tantamount to claiming lead poisoning ended when the Consumer Product Safety Commission banned lead paint in 1977.  Medicine takes place within societal realities that cannot be ignored.

Racism affects different populations differently, and solutions must acknowledge these differences. As Asian Americans we face anti-Asian racism and xenophobia especially in the COVID era, but the inequalities we face are different from other forms of racism, especially anti-Black racism. Regardless of economic status, Black people must survive murderous state racism and deep structural inequalities, as they pursue educational goals. Similarly, and in different ways, Latinx, Indigenous peoples, and the diversity of Asian Americans including Southeast Asian and Filipinx Americans confront different forms of intersectional racism. Systems of oppression (e.g., racism + patriarchy + poverty) intersect to affect us in different ways. We are not all playing the same “game.” Unfortunately a uterine lottery pick predetermines resources produced by deep systems of inequalities that are heavily reproduced in access to education resources, supports, and outcomes.  It would be odd if a fair admissions process could somehow simply ignore that fact.

Intersectional racism-conscious admissions

Talent is universal, opportunity is not.  Many schools already employ advanced, holistic evaluation and selection methods for choosing the next generation of physicians.  Affirmative action, or race-conscious admissions in education, is a critical policy and practice to advance diversity, which has been deemed necessary for robust educational benefits.

Higher education can seek to achieve diversity necessary to facilitate educational benefits, through narrowly tailored practices. Race cannot be the reason that anyone is admitted or denied, nor can race be considered to reach quotas or “parity.” The narrowly tailored consideration of race as “one of many factors” through holistic review should center and acknowledge how intersectional structural racism shapes students’ educational contexts. Everyone, including white and Asian Americans, benefits from diversity resulting from affirmative action and race-conscious admissions that account for individual students’ whole stories and contexts of education. Medical admissions should value a wide array of applicant experience to foster an appreciation of the wide array of patient experiences.

We are calling for robust praxis in intersectional, racism-conscious admissions, which affirmative action law allows. Using an admissions approach that is conscious of intersectional racism, we center everyone’s unique human dignity in evaluating their qualifications, moving beyond checking off a particular racial box to understand the totality of the applicant’s experience and talents. It does not guarantee admission for anyone. It offers a fairer, more equitable evaluation process. Only highly qualified applicants are admitted.

Equity is fundamental to medicine living up to its ideals to “do no harm” and serve all people. Black Lives Matter.

Sincerely,

Dr. Nakae and Dr. Poon

Sunny Nakae, MSW, PhD, is a clinical associate professor of social medicine, population, and public health and Associate Dean for Student Affairs at the University of California-Riverside School of Medicine. She has previously held administrative positions at the University of Utah School of Medicine, Feinberg School of Medicine at Northwestern University, and Loyola University Chicago Stritch School of Medicine. She is the author of Premed Prep: Advice from a Medical School Admissions Dean (Rutgers University Press, 2020)

 

OiYan Poon, Ph.D. is an associate professor affiliate in the Department of Educational Policy Studies at the University of Illinois at Chicago. Her research focuses on how race-conscious holistic admissions works, and the racial politics of Asian Americans and affirmative action.