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Ericka Hart is changing the face of health education.

The sex education expert and professor of Human Sexuality at the Columbia School of Social Work is not one expects to see when she shows up in the classroom or at a speaking engagement. She鈥檚 鈥渁 millennial,鈥� and she鈥檚 a Black, queer, nonbinary, femme. At 28 years old, the breast cancer awareness and representation advocate was diagnosed with breast cancer, and now in her mid- 30s, she is challenging institutionalized racism in the medical industry鈥攌nown as medical racism.

How?

Hart has built her platform on speaking up about her own experiences with health care professionals and insurance companies, uplifting other marginalized people鈥檚 experiences, and ensuring that people understand how racism and other forms of oppression show up in the medical field.

Medicine has a long history of exploiting Black people鈥檚 bodies for research and gains. It鈥檚 a legacy that Hart says endures to this today. But her work intentionally makes space for Black women and nonbinary people who have traditionally been ignored or not taken seriously by their doctors, leading to delayed diagnoses of breast cancer and other illnesses. Tina Sacks, author of Invisible Visits: Black Middle-Class Women in the American Healthcare System, writes how many Black people are brushed off by their doctors.

Medicine has a long history of exploiting Black people鈥檚 bodies for research and gains.

Hart has firsthand experience with this, having had to navigate the health care system when she received her own breast cancer diagnosis. This only motivated her work further.

Now she takes her teaching outside of the classroom to women鈥檚 rights and reproductive justice health spaces across the country. I recently caught up with her just before her talk to an audience of more than 300 people on a rainy Seattle night for Planned Parenthood鈥檚 47th anniversary celebration of the Supreme Court鈥檚 Roe v. Wade decision, which ruled the constitutional right to privacy includes a right to abortion.

This interview has been edited for clarity and length.

Ananya Garg: Planned Parenthood has a controversial history with Black and Brown communities. Do you think it鈥檚 changed over the years?

Ericka Hart: I don鈥檛 think it has changed. I think that they鈥檝e tried to put Black people in a space of white supremacy without actually dealing with white supremacy. I think that is something that they have to address internally, and also with all the privilege that they have, because people give a lot of money to Planned Parenthood.

There are other clinics that exist, and I think Planned Parenthood has a huge responsibility鈥攃onsidering they are a household name鈥攖o deal with their racism鈥擺specifically] anti-Black racism. Margaret Sanger was eugenicist. So, it鈥檚 important to be talking about it. Oftentimes, there is a desire is to shy away from it.

Garg: You do a lot of different work, as a professor, a sexuality educator and advocate for cancer awareness and representation. What鈥檚 the story behind how you got to where you are?

Medical racism is the institutionalized, unjust ways that [the system] discriminate[s] against Black, Indigenous, Latinx, people of color in the medical field and in medical institutions.

Hart: I have always had questions about sex and sexuality that were not being answered in my abstinence-only education [classes]. The questions were disregarded; I was told no, we don鈥檛 need to talk about that, or we鈥檙e going to talk about that at another time, or you talk about that when you get married.

[There] was always something I just wanted the answers to, and a lot of my friends were sexually active. They were [also] looking for the answers to their questions. I just used [the internet] to help them. When I was in high school, one of my friends [said I was] like Dr. Ruth. I was like, 鈥淲ho the hell is Dr. Ruth?鈥�

Garg: You say you鈥檙e working to dismantle medical racism. What is it?

Hart: Medical racism is the medical industry institutionalizing racism, whether [it鈥檚] believing across the board that Black people don鈥檛 feel pain and then not providing the accurate medical care, or ignoring race in general and not even including it in a dialogue in medical school[s]. [It鈥檚 the high rate of] Black people dying in childbirth. The rates of [mortality from] breast cancer among Black [women and nonbinary people] are much higher than they are among white women. If a Black person were to [have] a mastectomy and not get the accurate information about their body, that has a lot to do with medical institutions not caring about Black people.

It鈥檚 not genetic. It鈥檚 a function of racism.

In plain and simple terms, medical racism is the institutionalized, unjust ways that [the system] discriminate[s] against Black, Indigenous, Latinx, people of color in the medical field and in medical institutions.

Garg: Why is it important to dismantle medical racism?

Hart: So [that] people live. So [that] people survive. So [that] people are actually cared for, that they鈥檙e able to go to the doctor and be cared for and not have to worry about having to advocate for themselves. It鈥檚 already exhausting to your body to be diagnosed with something, not really know what鈥檚 going on, but doctors really have all the answers, and [for them to] not actually provide you with any sort of support [is] incredibly frustrating.

The intention behind my work is to end systems of oppression, and in particular, anti-Black racism.

This causes more health problems because now you鈥檙e having to do more labor rather than just getting well. A lot of people die because they don鈥檛 have the means to fight a doctor [who won鈥檛 take them seriously], or insurance companies. Insurance companies actively find ways not to treat Black people or not to treat people of color. And that just contributes to us also dying because we don鈥檛 get insurance. For example, when I was [diagnosed], my doctor approved medical treatments that I needed, and then my insurance company was like, oh, you don’t actually need those. And just denied the treatment.

[Had it not been for me calling them out on Twitter], I probably wouldn’t have gotten the treatment that I needed. 鈥� Also, I was married to a White person at the time, which is another privilege. And her family had political ties in D.C. They reached out to their senators and all these people who could directly talk to the insurance company and say, 鈥淗ey, this is wrong.鈥� You know, which is wild that it took that much power just to get the fucking treatment that my body was supposed to have. Isn鈥檛 that ridiculous?

Garg: Yeah, that鈥檚 messed up. Can you speak to the historical implications of medical racism?

Hart: The historical implications include things like the Tuskegee syphilis experiment, birth control experiments, chattel slavery is absolutely historical example of medical racism, the way that the medical field [was] built using Black people鈥檚 bodies without their consent, Henrietta Lacks. There are all these examples that we don鈥檛 even know about.

They鈥檙e just now being unearthed in a lot of ways. And people are talking about them, and medical institutions, for example, with the case of Henrietta Lacks, John Hopkins is going to build a monument or a plaque or something to Henrietta Lacks that her family is still not going to receive any financial assistance for the money that鈥檚 owed to them for her body, which contributed to the medical field without her consent.

So it continues where racism has no consequences across the board.

Garg: You already spoke to this a little bit, but you were diagnosed with breast cancer at age 28. How was it different for you as a young, queer, nonbinary Black femme?

Hart: It鈥檚 frustrating because you feel like you鈥檙e the only one but there are many people who are diagnosed with breast cancer under the age of 30. [And] it was just jarring as a nonbinary person, having people always talk about breast cancer as a cisgender women issue because you feel like your gender doesn鈥檛 matter.

As a queer person, there鈥檚 nothing [that talks about] about relationships in the medical field, let alone sex. They鈥檙e just now recently talking about co-survivors, and people who support cancer survivors also having very, very challenging time, supporting people and being there for them and it being a huge shift in a relationship and not really knowing how to navigate and especially if this is the first time that a disability or a diagnosis has been present in the relationship just not really considered.

Garg: What鈥檚 the intention behind your work, what inspires you to keep going, and what is the takeaway that you want your audience, be it in the classroom or an auditorium to have?

Hart: The intention behind my work is to end systems of oppression, and in particular, anti-Black racism, which I think is the crux of what informs a lot of the oppression that people experience, [and] I think is the blueprint for any structure of oppression.

What is on the other side of that is Black liberation. Black people being free. Black people being free means everybody gets free.

I鈥檝e been mulling over what that looks like, and how liberation, even among Black people is diverse and different. Considering that the way I see liberation may not be how another Black person [sees] liberation. For me, it鈥檚 important to look at and honor what that is for people, and not impose what freedom looks like for me and have that be for everybody.

It looks like the end of transphobia in particular. Black trans femmes thriving and being able to exist without being everybody’s gender educator solely, but actually being employed and living their lives and dating and [having sex] and experiencing pleasure in the ways that works for them.