Representation Matters

Written by B.J. Woodstein, PhD


I don’t think anyone would argue against the idea that representation matters. We know how important it can be to, for example, see people who look like you or who you share other traits with and to know they are being treated how you would like to be treated, or that they are achieving things that one day you’d like to achieve. If you don’t see people like you in jobs you want to have, or in positions of authority, or on TV, or in books, it can be hard to believe that one day you could do those things too. When there’s representation, there’s inspiration. And furthermore, when there’s representation, you feel included and acknowledged.

But another important aspect of representation is that it can actually save someone’s life.

I was heartened by a recent short news piece about medical students who have developed a website that depicts skin conditions on a variety of skin tones. Since textbooks and other materials frequently resort to white skin as the “norm”, medical students and healthcare professionals don’t get the chance to see the way that skin conditions or other illnesses might look on black or brown skin. And if they don’t learn that, then it is very possible they might not understand what they’re seeing when they are examining a non-white patient, and they could misdiagnose the issue or tell someone they are well, when in actual fact they are not. In the worst possible circumstances, that could result in death. So depicting different ethnic groups and skin tones is vital from a medical perspective, but it also is vital when it comes to countering the inequalities experienced by many minority groups. Seeing people like you depicted in a textbook shows you that you matter and that people care about you and your well-being. You’re not an afterthought and you’re not seen as a challenge to the norm; instead, you change what people perceive to be the norm.

I personally learned this lesson some years back when I was training to become a lactation consultant (IBCLC). Nearly all our books and websites showed breastfeeding positions solely on white skin. Similarly, they only talked about breast conditions as they applied to white skin; an example would be focusing on whether an area of tissue has turned swollen and red in order to help diagnose mastitis, but unfortunately mastitis could be missed if a practitioner focuses on the redness, as it does not present in the same way on darker skin. Thankfully, an IBCLC recognised this gap in knowledge and developed the Melanated Mammary Atlas, which is a huge help to healthcare professionals because it depicts breasts and breastfeeding in brown and black skin. Now we just have to hope that our lactation textbooks are updated to likewise include a range of ethnic groups in their images of breastfeeding and that they explain the differences in words as well.


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