We’re going to start with some basics: the united states is fueled by oppression. Every aspect of this nation runs on oppression, which means the united states’ institutions run on oppression. The united states healthcare systems and its minions are no different.
The idea of health is based on a white supremacist patriarchal capitalist ideology that there is a perfect human specimen, and that perfect human is white, male, able-bodied, not fat, and is cisgender and heterosexual. Generally speaking, they are not short, preferably blond with blue eyes, of a particular class and nationality, but those characteristics are flexible. When it comes to healthcare, anyone not embodying these traits is “Other”.
Being Other in healthcare means you will be subjected to oppressive violence at every turn. Your race, gender, size, and ability are pathologized and assumptions will be made about you that will affect how medical staff treats you. It will affect whether clinicians will listen to you. It will determine whether they believe you. Medical staff will decide whether or not they will allow you access to care based on their assumptions and will outright deny you care should you not measure up to their biased standards. In many scenarios, they have the power to decide whether you live or die.
These standards are taught in every sphere of health — paramedic training, nursing school, medical school, schools of public health. They have built these biases into testing protocols, medical equipment, even medical clothing. There are cases of paramedics, nurses, and doctors who have refused to help patients, sometimes resulting in disability and death. The lesson for those deemed Other is always, “if you don’t conform to our predetermined standards, you don’t belong here and if you can’t conform, be grateful that you have any access at all.” Because in the united states, anything other than that white ideal is fuel meant to be consumed by that white ideal — especially when it comes to a characteristic that people choose to see as controllable like fatness.
I have been fat most of my life. I didn’t think I was a chubby kid until I had a birthday party and one of the invitees asked for my clothing size. I was nine, so of course I had to ask my mom. When I…