Constructing and Contesting Race in Medicine

Skin shapes how individuals experience the world and how they are perceived by others (Jablonski 2013). Skin color has also been the primary means by which racial categories have been constructed and maintained (Dixon and Telles 2017). Skin color has been central in shaping diagnosis and treatment within dermatology. Historically, people of color have been underrepresented in dermatological practice (Xierali et al. 2020). Dermatological education and practice have also centered white skin as the norm (Louie and Wilkes 2018). This article attends to how skin has been central to understandings of racial categories in medicine. I ask: How is race discussed and understood in classroom settings and textbooks? In the United States, medical education is an important site of socialization for physicians-in-training, where professional norms are constructed and negotiated. The creation and spread of scientific theories about race in the US, and specifically, Blackness, took place in medical institutions (Willoughby 2022). Previous sociological scholarship set in the 1950s and 60s, including the aptly titled ethnographic work “boys in white,” have not adequately accounted for the racial and gender diversity of medical students (Becker et al 1961; Merton, Reader, and Kendall 1957). My analysis draws on research in medical archives, interviews with dermatologists, dermatology residents, and medical students and textual and visual analysis of the dermatology textbooks. I find that race is constructed as a biological category through the racialization of medical conditions via their representation in educational materials. I show that medical textbooks often associate sexually transmitted diseases (such as syphilis) with darker skin, while lacking representations of darker skin in other diseases (such as skin cancer).