The White Body Standard in Healthcare: Implications for Women’s Health and Violence Against Women and Girls
The healthcare system’s reliance on the white body as the default for medical education, diagnosis, and treatment perpetuates deep-rooted disparities and minoritised women are disproportionately affected by this issue. This bias not only compromises the quality of care for diverse populations but also contributes to the systemic violence experienced by women and girls. This can further worsen the inequalities they face, contributing to intersectional discrimination.
Historically, medical education has centred around white male bodies, creating alarming gaps in understanding how diseases manifest across different racial groups. Medical textbooks and training materials overwhelmingly depict white skin tones.1,2 This makes it difficult for healthcare professionals to identify symptoms or conditions in patients with darker skin. A 2023 study highlighted this bias, showing that medical students were significantly more likely to accurately diagnose conditions like shingles, cellulitis, and eczema, on white skin compared to non-white skin.3 Furthermore, students were significantly more confident diagnosing certain conditions like chickenpox on white skin.3 This generational gap in medical knowledge is deeply concerning, as it reinforces the white body standard and ensures that disparities in healthcare persist for years to come.
A glaring example is Lyme disease: the well-known bullseye rash is primarily illustrated on white skin in the medical literature. As a result, patients with darker skin are often misdiagnosed or diagnosed too late, leading to severe neurological complications, such as meningitis.4,5 This delay in diagnosis is more than a medical oversight—it is a reflection of systemic neglect that directly endangers lives. The white body standard also obscures the detection of violence against women, particularly women of colour. Bruises, scratches, and other signs of domestic abuse are less visible on darker skin. This can result in many cases being overlooked or improperly documented. This is not just a missed opportunity for intervention—it’s a pathway to continued suffering. When medical records, which may serve as crucial evidence in criminal investigations, fail to document these injuries, abusers can continue their violence unchecked. These failures rob women of the chance for justice and protection.
This racial bias is further worsened by gender bias in healthcare, where women, especially women of colour, often experience medical gaslighting. Their pain is dismissed or attributed to psychological issues rather than treated as legitimate health concerns. The devastating outcomes of this dismissal are evident in the maternal mortality crisis, where Black women are three to four times more likely to die from childbirth complications than their white counterparts.6 Even Serena Williams, a world-class athlete with so much access to resources, faced life-threatening complications because her concerns were initially ignored. These stories are not isolated, they show how the intersection of race and gender bias leads to fatal consequences.
Addressing these systemic issues requires a transformation in healthcare practices. Medical education must diversify its materials to reflect a wide range of skin tones and body types. A recent dermatology textbook showcasing conditions in black and brown skin called ‘Mind the Gap’ is an example of just how we can do that. The inclusion of people of colour in research studies is essential, along with cultural competency training and bias awareness programmes for healthcare professionals. Moreover, developing diagnostic tools that account for diverse populations is crucial for equitable care. Research is currently being done to use alternative light sources to better detect bruises on darker skin tones.7 This could be a game changer for those vulnerable to violence.
The Vavengers are leading efforts to confront these injustices, particularly through our focus on Female Genital Mutilation/Cutting (FGM/C). By centring the voices of survivors and migrants, we provide invaluable insights that help shape more inclusive systems and safeguarding practices. Our workshops equip individuals and organisations to better support survivors of violence against women and girls (VAWG) and to prevent further harm. When we put together our informational booklet on Gender-Based Violence to educate our communities, we realised there weren’t that many medical illustrations of FGM/C although there are more than 230 million survivors today. We commissioned our designers to create racially inclusive and well-detailed medical sketches of different types of FGM/C and made it ‘copyright free’ and open-access for everyone to use in their medical journals, books and informational booklets to address medical education inequality facing FGM/C survivors. We also are proud to lead a campaign ‘One Question Campaign’ where we ask every woman to be surveyed whether they have been subjected to FGM/C to address data poverty which causes resource poverty such as lack of specialised mental health care and the reconstructive surgery being available in the UK and beyond.
By dismantling the white body standard in healthcare, we take critical steps towards creating an equitable system that serves all patients with dignity, compassion, and respect. This is vital not only for improving health outcomes but also for combating violence against women and girls, ensuring that signs of abuse are recognised and addressed across all communities. In doing so, we advance the feminist cause and move closer to true health equity.
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References
Trabilsy M, Roberts A, Ahmed T, Silver M, Manasseh DM, Andaz C, Borgen PI, Feinberg JA. Lack of Racial Diversity in Surgery and Pathology Textbooks Depicting Diseases of the Breast. Journal of Surgical Research. 2023 Nov 1;291:677-82.
Anderton LC, Johnson MG, Frawley CA, Chan J, Garcia CA, Waibel BH, Schenarts PJ. Visual Misrepresentations: The Lack of Skin Tone and Sex Equity in General Surgical Textbooks. Journal of Surgical Education. 2023 Nov 1;80(11):1675-81.
Dodd RV, Rafi D, Stackhouse AA, Brown CA, Westacott RJ, Meeran K, Hughes E, Wilkinson P, Gurnell M, Swales C, Sam AH. The impact of patient skin colour on diagnostic ability and confidence of medical students. Advances in Health Sciences Education. 2023 Oct;28(4):1171-89.
Starke SJ, Rebman AW, Miller J, Yang T, Aucott JN. Time to Diagnosis and Treatment of Lyme Disease by Patient Race. JAMA Network Open. 2023 Dec 1;6(12):e2347184-.
Gould LH, Fathalla A, Moïsi JC, Stark JH. Racial and ethnic disparities in Lyme disease in the United States. Zoonoses and Public Health. 2024 Apr 24.
Gillette‐Pierce KT, Richards‐McDonald L, Arscott J, Josiah N, Duroseau B, Jacques K, Wilson PR, Baptiste D. Factors influencing intrapartum health outcomes among Black birthing persons: A discursive paper. Journal of advanced nursing. 2023 May;79(5):1735-44.
Scafide KN, Sheridan DJ, Downing NR, Hayat MJ. Detection of inflicted bruises by alternate light: Results of a randomized controlled trial. Journal of forensic sciences. 2020 Jul;65(4):1191-8.
