Why Women of Color Get Dismissed in Fertility Care: The Medical Bias No One Talks About
If you're a woman of color who's been to a fertility doctor, chances are you've heard some version of this. Maybe your doctor pushed birth control when you came in asking about getting pregnant. Maybe they told you to "just keep trying" when a white patient would've gotten testing months earlier. Or maybe they made assumptions about whether you should even become a parent in the first place.
This isn't just bad bedside manner - it's medical bias, and it's making fertility care worse for women of color across the board.
The Numbers Behind Fertility Care Disparities
Here's what women of color actually face:
Black women face higher rates of infertility, often due to conditions like fibroids and endometriosis that disproportionately affect them.
There are significant disparities in who receives fertility treatments, with women of color less likely to access care than white women.
Black women often wait longer before seeking fertility help compared to white women. Research shows that Black women wait about two years after experiencing their first symptoms of infertility before consulting a professional, whereas white women typically wait about one year.
These aren't just statistics. They represent real women getting dismissed, delayed, and denied the care they need.
The "Hyperfertility" Myth That Hurts Women of Color
Here's one of the most damaging myths in fertility care: the idea that Black and brown women are "naturally fertile" and don't need help getting pregnant.
This stereotype has deep, ugly roots in slavery and welfare-era politics. As Dr. Rosario Ceballo, dean of Georgetown's College of Arts and Sciences, told The Guardian: "The stereotypes of Black women's reproduction all lean toward hyper-fertility--the welfare queens, not knowing when to stop having babies, not being able to afford their babies."
When doctors believe this myth, they:
Assume fertility problems must be something else
Push contraception instead of fertility testing
Dismiss concerns about irregular periods or painful symptoms
Delay referrals to specialists
The reality? Women of color actually face higher rates of infertility, often due to conditions that disproportionately affect us.
What Medical Bias Actually Looks Like in Fertility Appointments
Medical bias isn't always loud and obvious. Sometimes it sounds like doctors making assumptions or dismissing concerns that would be taken seriously for other patients.
Research shows that bias can appear as:
Assumptions about whether someone should even become a parent
Dismissing pain from conditions like endometriosis
Making assumptions about insurance coverage or ability to pay
Spending less time explaining treatment options
The Weight Bias Issue
Weight bias affects fertility care, particularly for Black women. Research shows that many major fertility clinics deny treatment to women with higher BMIs, yet there are no official guidelines from leading fertility organizations about BMI and treatment eligibility.
What's particularly concerning is research from the University of Pennsylvania that found weight loss didn't necessarily improve women's chances of conception compared to those who began treatment without trying to lose weight first. Yet some healthcare providers resort to shame rather than having nuanced discussions about health.
How Providers Dismiss Women of Color's Pain
Pain dismissal is a huge problem in healthcare generally, but it shows up big time in fertility care. Women of color are:
More likely to have their pain underestimated
Less likely to receive adequate pain management
More likely to be told symptoms are "normal" when they're not
Often required to advocate more aggressively just to get basic testing
This is especially dangerous when it comes to conditions like endometriosis and fibroids, which cause real pain and can seriously affect fertility if left untreated.
The Trust Gap in Healthcare
Research reveals important trust issues: Over half of Black people in the U.S. report negative experiences at the doctor's office. Many say they feel unheard, dismissed, or forced to advocate more aggressively than white patients just to get basic care.
Another telling statistic: When asked, "Does your doctor understand your cultural background?" nearly 84 percent of white patients said yes. Only 42 percent of Black patients agreed.
Culturally competent fertility care means:
Understanding that family planning looks different across cultures
Respecting religious or spiritual beliefs about fertility treatments
Recognizing that extended family may be involved in healthcare decisions
Not making assumptions about socioeconomic status
Acknowledging the role of historical medical trauma in current healthcare distrust
The Diagnostic Delays
Women of color face significant delays in diagnosis, which can be harmful since time matters in fertility care. Research shows that Black women are 50 percent less likely to be diagnosed with endometriosis compared to their white counterparts.
The Insurance and Access Barriers
Even when women of color want fertility treatment, accessing it is often harder:
Fertility treatments can cost $15,000-$30,000+ per cycle
Only a few states mandate fertility coverage
No Medicaid programs cover IVF
Many clinics don't take insurance at all
Time off work for appointments can mean lost wages
These barriers hit communities of color harder because of existing wealth gaps and employment situations with less flexibility.
What Needs to Change in Fertility Care
The fertility care system needs serious changes to serve women of color better:
For medical providers:
Better training on implicit bias and cultural competency
Understanding of conditions that disproportionately affect women of color
Taking pain and symptoms seriously regardless of patient race
Equal time and attention for all patients
For the system:
More diverse healthcare providers in fertility care
Better insurance coverage and payment options
Clinics in more diverse communities
Research that includes diverse populations
Finding Better Care When You're a Woman of Color
While the system is flawed, there are ways to advocate for yourself:
Do your research: Look for providers with experience treating women of color. Ask about their patient demographics and outcomes.
Prepare for appointments: Write down your symptoms, questions, and concerns. Bring someone with you for support if possible.
Trust your instincts: If something feels wrong with your care, get a second opinion. You know your body best.
Document everything: Keep records of your appointments, test results, and conversations with providers.
Know your rights: You have the right to ask questions, request tests, and seek second opinions.
The Bottom Line
Medical bias in fertility care is real, it's harmful, and it's making it harder for women of color to build the families they want. While individual advocacy is important, we also need systemic changes to make fertility care truly equitable.
Your fertility concerns are valid. Your pain is real. You deserve care that takes you seriously, treats you with respect, and gives you the same standard of treatment regardless of your race or ethnicity.
The fertility journey is hard enough without having to fight for basic respect and care. But until the system changes, knowing what to look for and how to advocate for yourself can make the difference in getting the help you need.
For resources on finding culturally competent fertility care and support navigating the system as a woman of color, visit Oshun Griot.