Tackling Unknown Biases & Being an Inclusive Family of Allies in a Country with Oppression

Cindi  

Thanks, Kyrsten. Well, HER Health Collective is not known to shy away from difficult conversations. We like to bring it to our community straight. And this is no different. Today is a difficult topic to talk about. We will be tackling unknown biases and talking about being an inclusive family of allies in a country with historic and ongoing oppression. Oppression is often defined as the social act of placing severe restrictions on an individual group or institution. This often causes prolonged, cruel, or unjust treatment or control and is a combination of prejudice and institutional power. In an article from the National Museum of African American History and Culture, which is titled social identities and systems of oppression, it states “We are all assigned multiple social identities, whether we are aware of it or not. Within each category, there is a hierarchy, a social status with dominant and non dominant groups, a person of the non dominant group can experience oppression in the form of limitations, disadvantages, or disapproval.” The article goes on to say, “in the United States, systems of oppression, like systemic racism, are woven into the very foundation of American culture, society and laws. Other examples of systems of oppression are sexism, heterosexism, ableism, classism, ageism, and anti semitism.” Even though this is a difficult topic, it is important to have open discussions in order to develop a deeper understanding of the issues and dismantle the systems of oppression. How are you seeing historical oppression being reflected in the industry that you are in?

LaToshia Rouse  

I will say, in my industry of maternal child health, I see it in the hospitals where if I run into a person of color that’s working there, they really do have a hard time getting their point across. The people who I work with, who are mostly women of color, have a really hard time being seen and heard. And I think that is something that has persisted and probably will persist for a while in healthcare.

Cindi  

LaToshia, have you seen it influence your mission of what you strive to do with your work?

LaToshia Rouse  

It can. I try to safeguard against as much as I can with prep work and having people understand what the steps are and the disparities, helping people understand that sometimes you need to actually do some research on your own. You can’t rely fully on every word, you have to understand health care for yourself and for your situation.

Jessika Shields  

And I would have to say it’s pretty clear in the field of education, we can pull up numbers right now across the nation, we can look at the disparities between achievement, just achievement alone, and compare. We can look at achievement for children of color, English language learners, compared to white and Asian counterparts and we can already see those disparities. We can see the disparities in discipline rates. I always tell people, I say you know what, the black population is number one in all the bad statistics. In my industry it’s hard getting that point across that it’s not the child, it’s the system that is set up to have these disparities. It’s the systems. It’s the resistance to change, for education. Some people don’t want to deal with their own bias. Some people would rather just teach the way they’ve been teaching, do the things that they have been doing, and not change at all. Because they’re okay, they’re doing fine. But the change is the hard part. And then really just looking at yourself and how you’re practicing is where I see that resistance, and there is a lot of resistance. And, again, we have the numbers to prove that something else needs to happen. But the underlying piece is the bias is the racism is how we’re how we’re doing business in schools. So that’s definitely clear across the nation.

Cindi  

Now, Jessica, being in the educational system, Has it shaped your approach to how you are doing your work? And does it shape your choice of entry into the field that you’re in?

Jessika Shields  

Well, as a person who does work in schools, it definitely shapes everything that I do. I do a lot of assessments for special education, talk about ableism, talk about looking at a child’s label, and a teacher already making assumptions and already treating that child as if they can’t do something because they see a label. And sometimes the labels aren’t true. So you know, just having that bias instantly. So what I do is, because I do a lot of assessments, and I get a lot of referrals, often from English language learners, I have to be careful with the assessments that I choose. I had to make sure that I’m choosing assessments that are going to not be so language loaded, so culturally loaded, so that I can get the best out of that child. And if they’re not disabled, then I’m not going to label them disabled, it could be language acquisition. So I have to be extra careful about the tools that I choose. And it definitely shapes everything that I do and how I help parents navigate the school systems as well.

Charryse Johnson  

I also see an element of all of those things in the mental health field when it comes to much of what LaToshia and Jessika were talking about, and others can probably resonate with. The biggest overtone of historical oppression has been judgment, has been labeling, which allows for your denied full participation. So because this is who the world believes you are, or this is who the system that you’re in believes you are, we’re going to pull you out of here. And we’re going to do XYZ. Yes, there are certain times and situations where that may be beneficial. But it also creates and adds to children, young adults, adults feeling othered. And it adds to people going well, I don’t want to let someone know that something’s wrong with me because I don’t want to be seen that way. And as a result in mental health, I believe people then minimize or dismiss or not want to change and address the things that would be helpful to them, but also because it hasn’t been taught to them in the right way. I am a former educator. And I remember one of the things that I would constantly see as I was working with families around fourth or fifth grade was students would come to me labeled as oppositional defiant. Whereas now that I’m in the mental health field, I can look back and go, they were experiencing adverse childhood experiences and impacted by trauma. And as a result didn’t have the developmental skills to know how to self regulate when they were in an environment that was dysregulated. And their parents weren’t getting that information. And a lot of these various systems don’t work together. So we kind of symptom check and label a child this way. And then once you get under that label, it creates a domino for a lot of people that you begin to identify if this is what people believe about me. Why try? So, it definitely has impacted the way I want to show up in the mental health field, which is why I get out of my office and I do a lot of work in the community, with school systems, with universities, at news stations, anywhere that’s open. I want to bridge that gap. So that we can know about the resources and help people understand that there’s always a bigger picture than that one behavior that you see that is now kind of a weight on the person who it’s being projected towards.

LaToshia Rouse  

And I think a lot of times people don’t know what they don’t know. You know, racism is like air, we breathe it, we experience it, but we don’t know it’s there all the time. It’s important for people to be exposed and to hear some of the experiences that people are having, and also be educated on what biases and typically, when you say bias, people think about the person who’s screaming at someone or someone who’s blatantly displaying racism. But a lot of times, it’s very subtle. It is how people are seen in that moment. That judgment that happens, and it’s those little moments that matter the most. They really do shape how people experience things and the care that they get. So I want people to recognize that while we talk about bias, we’re not talking about the type that anybody could see. We’re talking about those moments when you decide that a resource is not not going to be given to someone because they may not be able to afford it because they’re black. All of those things go together for people sometimes. We’re talking about when people decide it’s not worth it to go the extra mile for someone because they’re of a certain color. They don’t always know they’re doing it. They don’t know they’re always doing it. So another thing for people to think about is always have a way to make sure someone else understands what’s happening. I always tell people, when you go to your doctor’s appointment, you go with someone. If you can’t take someone, take your phone and have it on speaker. Let someone else hear it. Because in your upset, you may even miss some of it and not recognize, oh, wow, I didn’t even know it happened that way. I didn’t even recognize it in the moment. And then somebody can help you navigate and recognize what’s really going on.

Jessika Shields  

LaToshia brought up a good point, I did teach a class at the University for upcoming school psychologists and it was a class based on culturally responsive assessments and bias. So looking at your own biases, and one thing that all the students had to do at the very beginning was take the Harvard Implicit Association test. That is a good start to uncover some of your unconscious bias because LaToshia just talked about that unconscious piece. Sometimes you don’t even know that it’s happening. And so I think it’s so important that we work to uncover some of the unconscious bias that we may have. All of us whether it’s based on race, or based on ability level, whatever it may be.  That is a really good assessment to start with. And it’s free, and it gives you a lot of good feedback. So I just wanted to put that out there.

Maris Feeley  

Yes, to all of that. I also want to lift up, as a white doula and birth worker in this field, that sometimes it’s very easy for folks working to disrupt these institutions to also feel like we aren’t supposed to do, or we’re not really a part of that. And not having to examine that implicit bias. And also that, well, racism was something that happened. Well, what does that have to do with me? I think a lot of white folks distance themselves from the history of white supremacy and the way that it’s internalized within our fields. And I’ll say at least for birth workers in this field, I would definitely point people to Dr. Dorothy Roberts book, Killing the Black Body, which is a deep dive history into the way that reproductive health care in particular, is rooted and founded in a lot of control, coercion, oppression, particularly of black women in this country. And that as a white doula or white birth worker, anyone in this field, I think everyone to your point, has internalized oppressions to examine. I’ll say for myself and informing our perspective at Carolina Birth and Wellness, it’s doing that work with us first, and recognizing that it’s all interconnected. Dr. Kimberly Crenshaw’s theory of intersectionality that all of these identities are in the room with us. To really support women and families and parents, it’s not just about any of these one off issues. It’s not just about birth, or it’s not just about postpartum or their children going into schools.  It’s reproductive justice. To define that it’s the right to maintain personally, personal bodily autonomy, to have children, to not have children, to parent those children in safe and sustainable ways. And so, fighting that internalized oppression and unlearning that and fighting that within these institutions, really weaves through all of these issues, and weaves through the schools that our children are in, or our OB appointments, or our prenatal care, or our mental health care. And so I think that’s very much informing our mission. And something that I just want to really lift up for white folks in this field too, when it comes to unlearning, and battling racial oppression.

Cindi  

Maris, have you seen it shape your approach to the way that you do your work? It sounds like you have started educating yourself more, but has it done anything for the way you practice being a doula, the way you run your business? Your choice of entry into the field you’re in.

Maris Feeley  

I think, to lift up LaToshia’s points, right, a lot of it comes down to understanding how it looks and insisting on witnessing and lifting up the way that this happens. And so that can look like everything from lifting up black doulas, or providers of color, or folks in this field that have lived experience. When it comes to racism, or different abilities or ableism, or class, centering the voices, I think first and foremost, who have lived experience. But then also, I think, to your point, of making sure at least like as a practicing doula that our patients or clients  — bearing witness to their experiences thus far, and also making sure that we are willing to unlearn internal values of white supremacy in order to protect and empower patients as well. So an example of this I love, like, having someone with you for the appointment. So you mentioned LaToshia, and I think another example I would say is that pain is very layered in identity. And I feel like I heard echoes of that in Dr. Johnson’s words too in the way that we are believing in people and their experiences. And when it comes to labor and delivery, the reporting of pain is very layered, and coded in medical racism. And so the way that we’re taking pain seriously, and ensuring that our patients have access to the support, the medicine, the care that they deserve, and need based on what they are reporting feeling in their bodies, is a really clear cut example of how needing to have an anti racist lens and an informed lens going into this field or in this work to ensure that we are supporting our patients and what they need. With the maternal mortality crisis,  saving lives to a degree too. It’s one thing to do the internal theory work, and it’s another to be like, how does this look in practice? And I think not excluding ourselves as white birth workers or repro health workers.  I think it’s really easy for me to be like, Well, I’m not an OB. I’m not a doctor. I don’t have like the power in this scenario. But it’s like, I’m still coming into the room with white privilege and with internalized white supremacy and where am I in the system? And how am I disrupting that within myself and within the room?

Cindi  

Thanks, Maris. We’re going to move now into discussing the development of biases and how they have been passed down through generations. And we’re also going to talk about the way biases continue to affect the people that you’re working with. The article we cited earlier mentions that an effective way to begin having difficult conversations and move towards advancements that will break through oppression is by looking at and understanding how each of us has been socialized to play certain roles. There’s a diagram made up of three arrows, three circles, and a core center. And we will be putting all of this in the show notes. So listeners, you’ll have access to all that we’re discussing. This is called the cycle of socialization, which describes how our biases, ideas, beliefs and behaviors are developed. These biases, such as preferences in favor of certain people, groups, things or against certain people, groups or things, then reinforce the cycle of oppression. We are born without biases, but we all have them. And they’ve developed and they are all part of humans. The ways we are affected by issues of oppression, the messages we receive from institutions and culture, as well as the choices we make, continue to maintain an oppressive system based upon power. Getting clear on our conscious and unconscious biases, and how they are rooted in inaccurate information or reason, and are potentially harmful is important. So let’s talk now about the biases that exist within your industries. What are some common biases that you hear from the women that you treat? And are there specific biases associated within your professional field of expertise?

Erin Baute  

I’d love to jump in on this from a framework of identity and personality and behavior. We understand in personality psychology, that a lot of the behaviors that we develop are protective out of childhood development. And so much of the tools that get created around assessing behavior or personality or identity are primarily focused through the lens of white cisgendered, educated men. And so these measurement tools, while held up by empirical science in some flimsy way, lack the depth of perspective that captures the human condition and misses trauma, and oppression, and gender, and access, and ability, and disability, and neuro divergence. And yet we hold them up, especially in academic and business and, psychology industries as the standard. And often, these more nuanced tools or perspectives get filtered off because they can’t follow this scientific rigor. I’m a PhD candidate, I love science, and also as Maris said, our work as a privileged body to disrupt that work and bring in more perspective and more voices. And so I see it wholeheartedly in my work. I use the Enneagram as a tool. When people want to understand their personality, their identity better, a lot of folks that I work with that don’t fit into this, you know, accessible body, this white male view, can’t find themselves easily, and we’ve conditioned them to believe it’s them, and not the tool. And so I think really questioning the tool becomes a more effective strategy.

Kyrsten Spurrier  

So, last night, I was able to be a part of the Below the Belt film in Chapel Hill. If you haven’t heard about this, please go and watch it. It follows four women that experience pelvic pain and endometriosis and their journeys through finding health care. On average, it takes 10 years for somebody to get diagnosed with endometriosis. The research in this country is very like the money that’s going towards research. For a female-only diagnosis it’s very small compared to for example, diabetes which has like $1 billion going to research for that diagnosis.  It’s the same prevalence. So one in every nine women in the world experience endometriosis, and that’s the same amount that experienced diabetes. And so  it just sheds light on how we don’t look at women in the same way and how then we add on taboo topics, like painful periods and painful sex and these issues that are happening in high school and college age females, they just get discredited when they go and seek medical care, they get diagnosed with GI issues, or it’s something else. And it’s never something that has to deal with them as their female body. So it’s, it’s a great awareness, in terms of where those biases live, even through our healthcare system. And I see that in my practice. A lot of people are just searching for answers and not getting the answers that they really want, and therefore not getting the care that they need.

Cindi  

Well, thank you for participating in that film. I’m sure that that was a way for you to help challenge and bring to light the negative and harmful biases within your clients and the country. So thank you for doing that.

LaToshia Rouse  

I’ll say, in my field of being a doula, I find that a lot of people don’t recognize that there are tools that people use to determine whether or not a person is favorable for a vaginal delivery. They do some checks and I put the information into a calculator that anybody can Google. And when they put it in there are some questions of race. And if you put in the same stats, and you change the race, the favorability changes. So baked into the tool, it says that you’re not as likely to have a vaginal birth if you are black. And you can clearly see it. And so understanding that it’s not just the people. It’s the tools, as were mentioned, that are being used. And those tools were created by people who are growing up in a society where the default is white. We’re not the default. The default is white. The default is white. And so recognizing that is important, because people don’t think that far, they don’t know that it even exists. But it’s impacting care every day.

Cindi  

LaToshia, how do we, like we just talked about with Kyrsten, how do we challenge the negative or harmful biases within our clients as well as within ourselves?

LaToshia Rouse  

I think the test is helpful, because a lot of people find out that they’re not as inclusive as they thought they were when they take the test. I think everyone needs to get out of their bubble. And it’s easy to tell. So a lot of times I can hear people in conversations like this, who are devoted to the cause. But, let me see your Facebook page, who you’re talking to, who’s at your house, who’s going on field trips, who are your kids playing with? They look just like you. So we got to get to a place that we recognize that we need to have people intermingle. We gotta get there. If we can’t get there, it’s just talking till we get there.  I will say this also, as far as kids go around four or five, they start noticing. They know who’s the cat and who’s the mouse. You can’t hide it from them. If you don’t have the discussion — It starts there. When you wait until they’re teenagers to have this discussion, they’ve already digested so much information that tells them where they are in this totem pole, and how people are to be treated on this totem pole. That is very difficult to make a dent, and they’re carrying that all their lives. And I’ve had people say to me, how do I make sure my child’s not racist? And I’m like honey bun! How do you make it better? How you make it better? Because they have been taught. They’re reading the books, they’re seeing the movies, they’re in an environment that says they are the default. That’s a lot of privilege to hold. And so it takes conscious effort every day to help make that better, to help make them see things through a different lens because they get fed it and they can’t help it. They’re in this environment. Like I said, it’s the air. So it’s a conscious effort, you have to really work at it for everybody, not just the kids. But I think it’s very impactful when I see people not just do one training and know it all, not just read a book. You have to continuously feed yourself this diet. Have something different from what you’re being you’re absorbing every day. 

Jessika Shields  

I have to agree with Latasha. She just brought up so many things that kind of triggered my memory. I think about what’s going on in Florida. There’s this ban against teaching black history, like, what is going on? Then I think about everything that you said, LaToshia, and it reminds me of the book White Fragility, by Robyn D’Angelo, great book. I highly recommend it. Now, if it’s too much for you to swallow, then you already know you’re not ready for change. That is a tough book to read. And you have to be open to have that type of dialogue and to listen to someone else’s perspective. So that’s the first thing but when you were talking, I was thinking about how we have so many barriers. If you think about the books you read in sixth grade, seventh grade, maybe eighth grade, right? Maybe you read books, like Where the Red Fern Grows, or you might have read The Outsiders. So those are the popular books. But think about in your own education. The books that were highlighted and chosen, whose story was being told? And if it was To Kill a Mockingbird? Was that really a story that highlighted empowerment in the black community? No, it did not. So if you think about even that, even on that level, it’s so subtle, the books that we choose in the curriculum. Whose stories are being told? What is being considered the standard, and whose story is not being told? So even the subtleness of that can make an impact on how kids see themselves, how they see their peers who are not white, how they see the world. So all of that has a trickle effect.