Celebrating the semi quincentennial while owning our history

As a child of Indian immigrants, I always felt placeless in time and history in a way.  I could not relate to the Sepoy Mutiny of 1857 that my father spoke about, nor really relate to the Trail of Tears in 1839 that I learned about in AP US History.  I could empathize and acknowledge the pain and weight that history carried, but I could never quite identify with it directly.

My relationship and views with history have changed with time, realizing that I am now part of the history that I studied.  More tangibly, I have been thinking as our nation, and specifically my city of Philadelphia celebrate the Semiquincentennial marking 250 years since the Declaration of Independence.  Just blocks away, at the corner of Sixth and Market Streets, sits the President’s House memorial — built on the site where George Washington lived during his presidency and where he held at least nine enslaved people. For years, interpretive signs at the site told their stories alongside Washington’s, acknowledging that the birth of American liberty and the practice of American slavery occupied the same space.

Recently, those signs were removed.

Reasonable people can disagree about how public spaces should present complicated history. But as a physician, I find myself unable to look away from the parallel. In medicine, we have learned — painfully, and too slowly — that progress built on the suffering of the voiceless does not become less true when we stop talking about it. The fistula repair still works whether or not we name Anarcha. HeLa cells still divide whether or not we remember Henrietta Lacks. But something essential is lost when we allow the story to be told without the people who paid for it.

The man most often called the “father of modern gynecology” is J. Marion Sims. He trained at Jefferson Medical College, right here in Philadelphia, graduating in 1835. Between 1845 and 1849, working in Montgomery, Alabama, Sims developed surgical procedures for vesicovaginal fistulas by operating repeatedly on enslaved Black women.  Three of these women — Anarcha, Betsey, and Lucy — are known to us by name. These surgeries were performed without anesthesia, even though ether anesthesia was available during the majority of the period of his experimentation.

It was not until 2018 that Sims’ statue was removed from Central Park in New York City. The American Urogynecological Society retired its eponymous lecture. I still find myself slipping and asking for the “Sims Speculum” during my cases.

In 1951, a young Black woman, Henrietta Lacks was treated for cervical cancer at Johns Hopkins. Cells from her cervical biopsy were send without her knowledge or permission to become the first immortal human “HeLa” cell line. They have been used in more than 74,000 published studies, contributed to the development of the polio vaccine, and remain foundational to cancer research today.

Henrietta Lacks died that same year at the age of 31. Her family did not learn about the existence of HeLa cells for decades. They received no compensation. Her story, brought to wide public attention by Rebecca Skloot’s 2010 book, became a catalyst for national conversations about consent, ownership of biological materials, and the exploitation of Black patients in medical research.

The violations in our field’s history extend well beyond the operating room and the research lab. Throughout the twentieth century, forced sterilization was wielded as a tool of population control against the most vulnerable members of American society.

Indiana passed the first eugenic sterilization law in 1907. By 1927, the Supreme Court had upheld compulsory sterilization in Buck v. Bell, with Justice Oliver Wendell Holmes infamously writing, “Three generations of imbeciles are enough.” Over the following decades, more than 60,000 Americans were forcibly sterilized under state-organized programs. The targets were disproportionately women of color, immigrants, people with disabilities, and those living in poverty.

The practice was so common in the South that Black communities coined the term “Mississippi appendectomy” a phrase popularized by civil rights leader Fannie Lou Hamer, who was herself sterilized without her consent. In Puerto Rico, Law 116 made sterilization legal and free while offering no alternative contraception, resulting in the sterilization of approximately one-third of Puerto Rican women by 1968. The Indian Health Service sterilized one in four Native American women in the 1960s and 1970s without their knowledge or consent.

These are not ancient wrongs. Coerced sterilizations in California prisons were documented as recently as 2010. In 2020, a whistleblower reported that hysterectomies were being performed on women in the custody of U.S. Immigration and Customs Enforcement.

Whether the signs stay up or come down at Sixth and Market, the history remains. The question is whether we choose to teach it.

The history of gynecology is a history of extraordinary medical achievement. It is also a history of extraordinary harm. Holding both truths at once is not comfortable but is necessary.

The legacy of these violations is not abstract. It lives in the well-documented mistrust that Black, Indigenous, and Latino communities hold toward the medical system. It lives in the racial disparities in gynecologic cancer outcomes that persist today. It lives in the implicit biases that studies continue to demonstrate in how providers counsel patients about contraception based on race and socioeconomic status.

It is a privilege to practice in a field that has advanced remarkably over the last century.

Modern gynecology has given us effective cervical cancer screening, minimally invasive surgery, fertility preservation, targeted therapies, and increasingly personalized cancer care. Every day, I benefit from generations of physicians, scientists, nurses, and patients who have advanced our understanding of women’s health.

As physicians, we inherit not only the discoveries of those who came before us but also the ethical obligations created by their mistakes.

The best way to honor the future of women’s healthcare is not to pretend our past was flawless. It is to acknowledge it honestly, learn from it humbly, and practice medicine in a way that ensures every patient—regardless of race, ethnicity, or background—is treated with the dignity, autonomy, and compassion they deserve.

History cannot be rewritten.

But it can shape the kind of physicians we choose to become and the history we continue to create.