J Afr Am St (2010) 14:247–262

DOI 10.1007/s12111-009-9099-0
A RT I C L E S

Diseased Race, Racialized Disease: The Story

of the Negro Project of American Social Hygiene
Association Against the Backdrop of the Tuskegee
Syphilis Experiment

Alankaar Sharma

Published online: 1 July 2009

# Springer Science + Business Media, LLC 2009

Abstract This article traces the history of the Negro Project of American Social
Hygiene Association, which began in the early 1940s and faded away into obscurity
by the middle of the decade. The article then compares and contrasts the story of the
Negro Project with that of the Tuskegee syphilis experiment, and argues that the
stereotypical and predominant notions of racial black masculinity in the United
States were at the root of the reason why the Negro Project failed while the Tuskegee
study prospered. While the Tuskegee study conformed to the grand narrative of
racial black masculinity, the Negro Project constructed itself as counter-hegemonic
to that grand narrative, contributing to its premature termination. The juxtaposition
of the two stories reveals the complexity of the narrative of African American
masculinity within the United States.

Keywords African American masculinity . Racism . Health . Syphilis . Tuskegee .

American Social Hygiene Association

The truth about stories is that that’s all we are.–Thomas King (2003:2)
Stories from the past can serve as lessons for the future. Stories of oppression,
prejudice and discrimination need to be told as much as those of courage, harmony
and hope, lest we forget. Such stories need to be told and retold to keep our
collective memories alive, to prevent those who were once relegated to the margins
from being eternally relegated to the margins, to remind us of the influences of
history on our realities today, and to help us stay conscious and conscientious so as
not to repeat similar injustices.

A. Sharma (*)
School of Social Work, University of Minnesota, 105 Peters Hall, 1404 Gortner Ave., St. Paul, MN
55108, USA
e-mail: sharm087@umn.edu
248 J Afr Am St (2010) 14:247–262

In this paper one such less-told story is narrated–that of the Negro Project of the
American Social Hygiene Association that began in early 1940s and faded into the
past soon after. A brief sketch of American Social Hygiene Association is provided,
followed by a discussion on its involvement with African Americans. The story of
the Negro Project is the compared and contrasted with the now well-known story of
the Tuskegee syphilis experiment that serves to illustrate the legacy of racism in the
United States (US). The story of Tuskegee is a story of oppression that has received
much attention for its inherent viciousness rooted in racism. The story of the Negro
project is that of hope as well as oppression. It is a story of hope, because it signified
in ways more than one a progressive departure from the perspective of racial
inequities as normal and natural, and illustrated the relevance of counter-hegemonic
efforts. At the same time it is also a story of oppression, because this newer
perspective perished while the dominant perspective that accepted and perpetuated
inequities continued to flourish.
These stories shed light on the role of race and gender in the history of public
health, and the grand discourses that served to inform and shape it.

American Social Hygiene Association

The American Social Hygiene Association (ASHA), now known as American Social
Health Association, came into being in 1913 during the Progressive Era following
the merger of the American Vigilance Association and the American Federation for
Sex Hygiene (Brandt 1985). As Charles Eliot (1914:2), the then President of ASHA
noted, the organization believed that “vice diseases… [were] without doubt the very
worst foes of sound family life, and thence of civilization.” The leaders who
championed the creation of ASHA were convinced that venereal diseases and
prostitution were inextricably linked, with the latter being the primary cause of the
former (Burnham 1973; Brandt 1985; Carter 2001). They also believed that the
organization would address the problem of venereal diseases in a scientific manner
(Brandt 1985). ASHA was led primarily by professionals from the medical field and
moral reformers, who emphasized improvement in health services for treatment of
venereal diseases, and advocated for prevention through open discussion on the
subject as opposed to treating it as a taboo topic (Burnham 1973). Much of their
advocacy in the formative years was centered on World War I, since the issue of
venereal diseases among United States soldiers emerged as an important concern
during wartime. Prostitute women were viewed as the primary vectors of venereal
diseases, and were blamed for spreading these diseases among US soldiers, thereby
allegedly diminishing the soldiers’ productivity.
ASHA leaders also focused on the civil society and promoted an active
dialogue on the subject of venereal diseases, although typically within a moralistic
framework that blamed moral degeneration within the society for the prevalence of
venereal diseases. ASHA was also actively involved in promotion of venereal
disease prevention through sex education for adolescent boys and girls. Their
efforts intensified around World War II, again because of the US participation in
the war, and concerns ensuing from venereal diseases being perceived as a major
threat to the productivity of the troops.
J Afr Am St (2010) 14:247–262 249

Involvement of ASHA with African Americans

Not much information is available in the existing literature about the involvement of
the social hygiene movement with the African American community in the United
States, except for the understanding that ASHA started its sex education and
venereal disease prevention activities within black communities in the 1920s, partly
fueled by the concern over what some now consider to be “inflated statistics on the
prevalence of venereal disease among African American troops during the war”
(Moran 2000:114). ASHA hired an African American social worker, Franklin O.
Nichols, who worked actively to carry forward the organization’s agenda by helping
black educational institutions develop sex education programs (Jones 1993; Moran
2000). Nichols was also supposed to work towards the betterment of health status
and health care for low-income black people, but his activities did not address this
job expectation to a large extent (Jones 1993).
Jones (1993) has noted that social hygienists during this time were largely
neglectful of the black community, partly due to their “general disinterest in the
lower classes” (Jones 1993:49), and also because African Americans were often
perceived as hypersexual people who suffered from venereal diseases because of
their promiscuous sexual behavior, and therefore working with them would entail a
change in “their very nature” (Jones 1993:48). The racial attitude of ASHA in its
nascent years is reflected in its President’s statement on the purpose of the
organization, in which it was stated that “among contagious diseases the most
destructive to the white race are the diseases called venereal; because they are
fearfully poisonous and corrupting, and are caused and spread by vices and animal
gratifications in which both men and women have part” (Eliot 1914:2).
Certain historians have done a careful job of bringing to the current times
important stories from the past with regard to race and sexual health and disease in
the US. Brandt (1985) has provided a seminal text on the social history of venereal
diseases in the US. Jones (1993) has written arguably the most comprehensive
historical analysis of the Tuskegee Syphilis Experiment. Both these authors in their
respective books discuss the crucial role that ASHA played in the movement against
syphilis. However, the work of ASHA for and with black communities just before
and during World War II, specifically the Negro Project, does not find mention in the
aforementioned texts.
Simmons (1993) has documented the history of African Americans with regard to
sexual Victorianism as part of the social hygiene movement by discussing the
involvement of ASHA with black communities in activities pertaining to prevention
of venereal diseases, focusing on the time period between 1910 and 1940. Since the
Negro Project began only in the early 1940s, it is not mentioned in Simmons’s essay
either. However, she wrote that “in the 1920s and 1930s… white ASHA reformers
were trying to establish a liberal position on race, separating themselves from what
they viewed as overtly racist views, including those prevalent in the medical
profession,” and therefore advocated for racial equality in health services, even as
“such liberal goals of treatment for all people existed in tension with implicit
acceptance of the traditional hierarchy of race” (Simmons 1993:62). She further
stated that “ASHA did not develop integrated or egalitarian programs but, rather,
delegated outreach among blacks to Nichols and other African American
250 J Afr Am St (2010) 14:247–262

professionals” (Simmons 1993:62). These observations suggest ASHA’s departure

from its earlier ideology on race. The Negro Project signifies a further and more
concrete advancement of such departure.

The Negro Project

ASHA launched the Negro Project (also known as the Negro Venereal Disease
Education Project) in the 1940s during World War II, which aimed at addressing the
high prevalence of venereal diseases among African American people. This project
deserves attention because although it provides important insights into the campaign
against venereal diseases by the social hygiene movement in the 1930s and 1940s, it
has not been discussed in the major scholarly literature on the subject.
The historical evidence used for this paper regarding the Negro Project can be
found in boxes 117 through 119 of the ASHA collection available at the Social
Welfare History Archives, University of Minnesota, Minneapolis. This collection
primarily comprises of minutes of various conferences and meetings, project
proposals, correspondence between ASHA and other agencies and associations,
information and awareness materials such as pamphlets and booklets, and hand-
written notes of ASHA officials.
Officials from ASHA were in correspondence with various African American
organizations regarding building partnerships for this project that they intended to
begin since the late 1930s. However, concrete steps in the direction of developing
the Negro Project can only be observed in the early 1940s, when ASHA finally
drafted a grant proposal and sent it to potential funding agencies in 1942. The
proposal began with this quote from the then Surgeon General of the US, Thomas
Parran:
The Negro is not to blame because his syphilis rate is six times that of the
white. He was free of it when our ancestors brought him from Africa. It is not
his fault that the disease is biologically different in him than in the white; that
his blood vessels are particularly susceptible so that late syphilis brings with it
crippling circulatory diseases, cuts his working usefulness in half, and makes
him unemployable burden upon the community in the last years of his
shortened life. It is through no fault of hers that the colored woman remains
infectious two and one-half times as long as the white woman. (ASHA N.d.)
This statement underscored two core ideas of the Negro Project–one, that the
higher rate of prevalence of venereal diseases among the black population was
alarming; and two, that this higher prevalence rate was not the fault of the black
community. The Project expressed concern over the losses to the army and the
industry because of high prevalence of venereal diseases in the black community.
The stated purpose of the project was the “creation of new materials and methods for
instruction of Negroes regarding syphilis, the demonstration of these materials and
methods in selected areas and the development of leadership in Negro groups to
reduce the prevalence of syphilis in their race by educational efforts” (ASHA N.d.).
With regard to educational materials, the project intended to produce a motion
picture and develop posters, charts, pamphlets, and other publicity materials aimed
J Afr Am St (2010) 14:247–262 251

specifically at the black community, and lecture syllabi for health professionals,
teachers and clergypersons. Officials at ASHA were convinced that they needed a
separate and specialized project having its own funds, in order to tackle the problem
of venereal diseases among African American people. Walter Clarke, the then
Executive Director of ASHA, noted in 1943 that “though we have been aware that
certain population groups such as the American Indians, the Spanish Americans,
Negroes and other under-privileged people have a relatively high syphilis and
gonorrhea prevalence rate, we have addressed to them the same educational
materials and offered them the same type of services and opportunities that have
been and are now available to everyone,” and wondered if it would be more
appropriate and beneficial to develop materials specifically pertinent to African
American people (Clarke 1943).
Following rejections from some private funding organizations mainly due to
unavailability of funds or because available funds had already been committed to
other projects, ASHA’s proposal finally found support from the Social Protection
Division of the Federal Security Agency, which besides providing financial support,
also lent one of its officers named John Ragland, an African American man, to
ASHA to help steer the project. Ragland assisted Raymond Clapp who headed the
project at ASHA. Clapp was the associate director of the Social Protection Division
at the time when this project was conceived, and later transferred to the staff of
ASHA to develop it further. It is likely that such funding was provided by the federal
government based on its renewed interest in checking venereal diseases among
African American troops during World War II.
The first major activity of the project was the National Conference on Wartime
Problems in Venereal Disease Control, held in New York City in November 1943.
The purpose of this conference was to form a committee based on the attendees, and
decide on a plan of action for the Negro Project. 18 black community leaders and 15
white officials and leaders attended the conference, representing various government
and non-government agencies that included defense organizations, community
service organizations and national African American organizations. A continuing
committee was formed as a consequence of the conference, whose task was to
design future programs and strategies for the project. It was decided that the project
would operate on four different levels: at the top level, the project would work with
the national leadership of African American organizations and defense agencies such
as army, navy and air force; the next level would be work with the regional
leadership on the basis of geographic regions, such as the south; the third level
would be work with local leadership in cities and towns; and finally the fourth level
would be African American individuals. Through this trickle-down approach, ASHA
officials envisaged that individual African American people would be reached
through other individuals from their communities who served in leadership roles. For
this to happen, they decided, they required information and education materials such
as leaflets and movies. While such materials were available, no black people were
represented in them and therefore their value in reaching out to the black
communities remained dubious.
Following the national conference in 1943, the project officials started holding
meetings at regional level, mainly in Southern states such as Texas, Louisiana and
Missouri. They inferred that since African American populations were higher in
252 J Afr Am St (2010) 14:247–262

these states, the prevalence of syphilis would be high as well. In these meetings, they
met with both white and black community members and leaders such as physicians,
teachers, clergypersons, and other people from different walks of life in order to
apprise them of the nature of the project, its intended aims and activities, and to
solicit their active support and cooperation.
However, the records of the project and that of ASHA about this project suddenly
go silent in 1945, after which no activity for this project is documented in ASHA
records. Since the Social Protection Division of the Federal Security Agency, and
eventually the Federal Security Agency itself, were dissolved in later years of the
decade of 1940s following the end of World War II, presumably because of their
reduced importance and the economic recession following the War, it may be
speculated that funds for this project dried up, and the project stalled and became a
thing of the past.
Some of the major themes that were at the core of the Negro Project are discussed
below:

– Race as an Active Agent

People working at ASHA on the Negro Project were keenly aware that they were
operating in a racially charged environment, and also that the racial divisions were
tilted against African American people. For obvious reasons, the African American
leaders, and organizations working with African American people, that were
partnering and cooperating with ASHA were very aware of race as a crucial aspect
of the context in which they were situated, and the marginalization that accompanied
such racial divide. Due to these reasons, the issue of race emerged prominently time
and again during the activities constituting the Negro Project.
The officials leading the Project at ASHA seemed concerned that they might not
be able to communicate effectively to the public their message of the urgent need for
venereal disease prevention among the African American people, or in other words,
rally the troops for their cause, if they failed to address the racial dimension of the
subject. This is evidenced in the “two parallel approaches” (ASHA 1944c) that they
attempted in order to communicate their message. ASHA officials created two
separate communication strategies to reach white and black people. It can be
reasonably argued that they perceived the need to do so because of their awareness
of the racial divide, which convinced them of the futility of the one-size-fits-all
approach. “To the Negro groups,” announced Clapp in 1944 while addressing a
gathering of black and white leaders in Missouri, “we are attempting to carry this
message: that the venereal diseases are serious; they are serious to the individual
who contracts one of them; they are particularly serious to the individual who lets
treatment lapse or does not go to competent medical authorities for treatment; that
venereal disease is particularly serious to the Negro because of its prevalence in his
group” (ASHA 1944c). This communication strategy also emphasized a call for
action by the African American community, stressing the important role African
American leadership needed to play in order to check the problem of venereal
disease among the community members.
The message to the white leaders and officials, in comparison, was starkly
different. This message was three-pronged. First, ASHA leaders wanted to impress
J Afr Am St (2010) 14:247–262 253

upon the white leadership and officials working in the field of venereal disease control
that the big opportunity was in the black population group. They argued that it was
“much easier to reduce a rate from what was 27% to 13% than it [was] to reduce a rate
from two and a third percent to one and one-sixth percent, and the same overall result
would come from bringing the Negro rate down to 13%... that would occur if you
brought the white rate down to one and a sixth percent” (ASHA 1944c). Secondly, they
stated that there could not be a low rate of prevalence of venereal disease among white
people in a community as long as black people in that community had high prevalence
rates. Addressing the white people, they asserted, “If you want a low general rate or a
low white rate, you cannot tolerate a high Negro rate” (ASHA 1944c). Finally, they
tried convincing the white leadership that in order to check the spread of venereal
disease, the opportunity for black leadership to play an active role was of vital
importance.
It is evident in these strategies that while the aim was the same, the routes taken to
arrive at the aim were very different. With African Americans, ASHA leaders tried to
raise awareness of the extent and magnitude of disease in their community while being
careful to do so without assigning blame. With white audiences, their idea was to
galvanize their support not by constructing the issue as a problem of the black
community, but as a problem for the white people if they wanted to stay safe against
these diseases themselves. This was clearly constructed within a framework of
delineation of the races. While it can be argued that ASHA’s appeal to white audiences
potentially furthered racial delineation, it can also be reasoned that such a
communication strategy was informed by the careful attention that ASHA officials
paid to the element of race, and their apprehensions regarding it being a major challenge
to their efforts.
Needless to say, members and representatives of the black community were also
sharply aware of the racial dimensions of this issue and its socio-political context.
Their concern regarding racial discrimination and divide appears regularly
throughout the records that document the project. This theme runs clearly and
consistently through the records of conferences held with African American leaders.
For instance, an African American bishop expressed concern during the Meeting
with Fraternal Council of Negro Churches–organized as part of the Negro Project in
1944–that while the federal government was spending a considerable amount of
money on venereal disease prevention, he had misgivings over the portion of this
amount that was being utilized to help African Americans (ASHA 1944a). The same
meeting was also the site of an open acknowledgement of the role that racial
divisions, although there was also an unequivocal and spontaneous acknowledge-
ment that such divisions were unwanted. While discussing the possibility of
developing audiovisual aids aimed at the African American community, representa-
tives from ASHA and the Fraternal Council of Negro Churches watched a movie on
venereal disease prevention and then discussed the ways in which it could be remade
to suit a more diverse viewership, since the movie in question had an all white cast.
The ensuing debate included the idea that the ideal situation would be to have a
mixed cast with both white and black patients as well as medical personnel. While
this idea was met with enthusiastic support, it was soon rejected based on agreement
within the group that such an idea was not feasible since it would not be received
favorably by the different communities.
254 J Afr Am St (2010) 14:247–262

The awareness of racial concerns was at the root of the conference with the
National Negro Insurance Association in 1944 held under the aegis of the Negro
Project. The Association was an early and strong supporter of the Project, but
demanded a focused meeting to discuss the nature of its involvement with the project
from ASHA, arguing that “there [was] still quite a bit of sensitiveness on the part of
[their] people relative to the way they [were] approached on the subject of venereal
disease and before distributing literature or placing [their] names or the name of the
Association on it, [they] must be sure that [they were] not misunderstood by [their]
policyholders” (Bradshaw 1944).
These examples illustrate the central place that race, as an active agent of social
division and power, held in the consciousness of social hygienists as well as the
leaders and representatives of the black community.

– Racial Dimensions of Syphilis

The Negro Project officials maintained, consistently and persistently, that syphilis by
itself was not a disease of the race. That is, they did not see any natural correlations
between the black race and syphilis disease. “The spirochaete does not know the color
of a person’s skin,” they declared (ASHA 1944c). They emphasized this fact
prominently in their meetings, speeches, conferences, and interpersonal, inter-agency
and mass communication. They even went to the extent of laying the blame for the
presence of venereal diseases within the black community on the shoulders of the
white people. Pointing their finger at the white community, they said, “The venereal
diseases were brought to the Negro by the white man. When the Negro came to this
country from Africa, he came free of the venereal diseases” (ASHA 1944c).
Of course, they found a deep correlation between prevalence of venereal
diseases and black population, but they recognized that African Americans
occupied a marginalized position within the socioeconomic structure, and
connected the high prevalence of such diseases to this social position. While
they believed that syphilis and other venereal diseases did not discriminate on
the basis of race, color or creed, they also recognized that “limitations of
economic, social, medical and educational opportunities and facilities [had]
conspired to give these diseases special opportunities for spread among certain
population groups including Negro groups” (ASHA 1944b). This is illustrated in
the way in which the biological differences in manifestation of syphilis among
white and black people were understood within the Negro Project:

Not only have the Negroes a higher percentage of infection than the whites,
they are apparently more susceptible to damage from that infection.
Syphilis is more prone in Negroes than in white men to damage the
cardiovascular system. Circulatory disabilities due to syphilis usually appear
in early middle life, at a period when the individual should be most
productive. The possibility of developing cardiovascular syphilis is
increased by hard labor and by lack of treatment or inadequate treatment…
As the work of Negroes is usually arduous and as medical care for Negroes
is all too frequently inadequate or absent, syphilis in this group is especially
disastrous. (ASHA N.d.)
J Afr Am St (2010) 14:247–262 255

It is evident here that the Negro Project did not see the higher prevalence of
syphilis among African Americans as a natural or unavoidable result of their
racial or anatomical makeup. Rather they attributed this prevalence to the lack of
access to health care, poor health care, and harsher and underprivileged life
circumstances than the white people. While attacking racism was not their
immediate objective or mandate, they called attention to it as an integral part of
the venereal disease problem: “The venereal diseases, then, we believe, are based
very largely in certain social and economic disadvantages, and therefore, they
can be overcome with the improvement of those conditions; but we do not need
to wait until all these problems of discrimination and of disadvantage are
corrected” (ASHA 1944c).
Even though the Negro Project is an important and interesting one from the
perspective of examining how racial identities and inequities were constructed
and understood within public health systems in the US, the scholarship on the
subject is very limited. However, the Tuskegee syphilis experiment, which is a
widely known project, has served well to illuminate this issue, albeit for different
reasons.

The Tuskegee Syphilis Experiment

The Tuskegee Syphilis Experiment, or the study on The Effects of Untreated

Syphilis in Negro Male, as it was officially titled, was a research project conducted
in Macon County in the state of Alabama between 1932 and 1972, with 600 black
men as the subjects, of which 399 had been identified as syphilitic and 201 were part
of the non-syphilitic control group (Jones 1993; Baker et al. 2005). The Macon
County was chosen because of the high rate of syphilis prevalence among the black
population there (Baker et al. 2005). Funded by the United States Public Health
Services (USPHS) and led by a team of physicians and other health care providers,
the experiment was aimed at understanding the effects of syphilis among black men,
if left untreated. While the study was originally meant to last only a few months, it
eventually became a longitudinal study that examined the effects of untreated
syphilis over a lifetime, and ended up as a 40-year long project that terminated only
when the matter was picked up and publicized by the media in 1972 (Brandt 1978;
Jones 1993). The major focus of this experiment was the interest in racial differences
between black and white men, based on the observed effects of syphilis, which at the
time was often attributed to the differences in the biological makeup of the two races
(Brandt 1978). The premise of the Tuskegee study was that the “treatment for
venereal disease among blacks was impossible, particularly because in its latent
stage the symptoms of syphilis [became] quiescent” (Brandt 1978:22). So, their
justification was that when treatment was not going to have any positive bearing on
the health outcomes for these black men, then why not study them in order to
understand better how syphilis influences them, and thereby study the disease better.
Moreover, they opined, that even if treatment was available, health services for black
men were few and far in between in the rural South, and therefore many of these
men would go untreated anyway. Therefore, as they saw it, this was an experiment
on the subjects in their natural environment, without any external interference. These
256 J Afr Am St (2010) 14:247–262

arguments helped them rationalize and defend the need for starting the experiment,
and continuing it for four decades.
Men subjected to the experiment were typically poor and illiterate (Jones
1993). This made it easier to deceive and exploit them. When they recruited the
sample of syphilitic and non-syphilitic black men, they told many of these men that
they were being treated for “bad blood” (Jones 1993). Some subjects believed they
were being treated for rheumatism or bad stomachs (Jones 1993). They were also
offered various incentives such as “free physical examinations, free rides to and
from the clinics, hot meals on examination days, free treatment for minor ailments,
and a guarantee that burial stipends would be paid to their survivors” (Jones
1993:4). However, at no point during the study did they have any intention of
providing treatment for the venereal disease, even when they knew that these men
had such a disease (Jones 1993). They used different tactics, often with the
assistance and participation of African American health care personnel, in order to
continue deceiving the research subjects and making them undergo a variety of
medical tests, many of which were excruciatingly painful. Even when the use of
penicillin for such bacterial infections had gained popularity in the 1940s, the
subjects of the Tuskegee study were denied this treatment although the patients
could have potentially benefited from it (Jones 1993). The experiment came to an
unplanned end in 1972 when a journalist broke the story in the media, and the
USPHS was forced to terminate the study due to the shock and outrage generated
by media reports (Brandt 1982; Jones 1993). Twenty-five years later, at a
ceremony in the White House in 1997, President Clinton would apologize to the
African American people affected by the study on behalf of the citizens and
government of the US.

Dueling Discourses: ‘Diseased Race’ Versus ‘Racialized Disease’

A comparison of the Negro Project and the Tuskegee Study poses a critical question:
Why did the Negro Project fade into obscurity, while the Tuskegee study continued
to flourish for nearly half a century? They both started at almost the same time in
early 1940s and operated simultaneously for a few years. Both projects were related
to venereal diseases in the African American community. Why did they follow
strikingly dissimilar trajectories in terms of their longevity? One answer is found by
juxtaposing the two projects against the backdrop of the discourse of black racial
masculinity in the United States.
With regard to such a comparison, it must be acknowledged that the Negro
Project and the Tuskegee Study are not entirely comparable vis-à-vis their stated
objectives. While the former was a project aimed at reducing the prevalence of
syphilis and other venereal diseases among the African American community, the
stated aim of the latter was to understand the effects of untreated syphilis on African
American men. Having said that, the two can be contrasted on the basis of the
ideologies and discourses that informed their approach towards the issue of venereal
diseases among African American men. In turn, these projects contributed to the
perpetuation of these ideologies and discourses. Such an analysis focusing on the
contrast between the two ideologies and approaches offers unique opportunities for
J Afr Am St (2010) 14:247–262 257

honing and complicating our understanding of the public health system in the US,
and its interrelatedness with race and gender.
The analysis that follows pays attention to not only race-based ideologies, but
also to gender-based ideologies, particularly with respect to notions of black
masculinity. The Tuskegee study was exclusively targeted at African American men,
and therefore it may be argued that notions of not only the race of these men, but
also their masculine gender played a role in their construction as subjects for the
study. The connections between the study, and race and gender are explored in the
analysis that follows. The Negro Project, on the other hand, was not exclusively
aimed at men alone, but at the entire African American population. However, a
major focus of its efforts was the prevalence of venereal diseases among African
American troops holding combative positions during the World War II, which at that
time comprised of men exclusively (for instance, the first major activity undertaken
by ASHA as part of the Negro Project was the National Conference on Wartime
Problems in Venereal Disease Control). Within this context, attention was
concentrated on the concern over sexual activity between African American soldiers
and prostitute women, and efforts towards its reduction. Moreover, nearly all the
leaders and officials from the African American community who were invited to,
and who participated in the Negro Project’s meetings and conferences, were men.
Therefore while the project was not gender-exclusive, in practice much of its work
involved working with men, and interventions aimed at men. Given these factors, it
may be argued that gender was an important part of the context, and consequently
played a significant role in shaping ASHA’s approach towards venereal diseases
among African American men through the Negro Project. While a gender-based
analysis of this project with respect to women and femininity is possible, the analysis
within this paper is limited to a discussion on men and masculinity.
It has been well argued within the scholarship on race, gender and sexuality that
the African American race has been historically and continually equated with
disease, vice and crime (Brandt 1978; Jones 1993; Simmons 1993; DeLeon 2006).
Black men have historically been perceived as people with excessive and unbridled
sexual desire (Ferber 2007) as well as overdeveloped genital organs. Within this
paradigm, they have been constructed as deviant, delinquent, and dangerous men
belonging to an inferior race. bell hooks (2004:67) has attributed this in part to “the
convergence of racist sexist thinking about the black body, which has always
projected onto the black body a hypersexuality,” to which the “idea of the black male
rapist” is central. Not only has the perceived delinquency of black men been
emphasized historically, but also their perceived inferiority and subordination has
been an important theme in the construction of black masculinity throughout history
in the US. The thrust of this viewpoint has been to emphasize that the differences
between black and white men go beyond merely skin color. Marable (1994:70–71)
has discussed that historically black men were considered in an “institutionally racist
society” as “only a step above the animals–possessing awesome physical power but
lacking in intellectual ability.”
Medical science, even while claiming to be an objective and disinterested
discipline, incorporated these racial ideologies, and mirrored them in its research and
practice (Brandt 1978; Hickey 2006). Medical science, during the time in which
these two projects were taking place, was fascinated with understanding the
258 J Afr Am St (2010) 14:247–262

differences between black and white people premised on the so-called scientific
belief that these differences were natural. This fascination was particularly acute in
matters of sexual health (Jones 1993). Against this backdrop, it can be observed that
the Tuskegee study subscribed to these aforementioned stereotypical notions of
black masculinity and sexuality.
The Tuskegee Study was clearly premised on the belief that syphilis manifested
differently in black men as compared to white men due to what it considered to be the
fundamental differences between white and black bodies. This is evidenced in the fact that
the study was conducted with an exclusive black sample as opposed to a multiracial
sample. The organizers of the study were convinced that the existing medical knowledge
about the treatment of syphilis was not applicable to black men (Brandt 1978), and
believed that “blacks, promiscuous and lustful, would not seek or continue treatment”
(Brandt 1978:23). Such belief systems are rooted in the notion of the otherness of black
race and black masculinity within a white supremacist societal structure. Spraggins Jr.
(1999:47) has argued that “masculinity is a socially constructed set of hierarchical
relations among and between men.” By locating the experiment within a white
supremacist framework that created, maintained and perpetuated the notion of black as
the other, and by believing that black men were beyond any medical help, the organizers
of the experiment were only constructing black masculinity as inferiorly distinct from
white masculinity, thereby buttressing the social order of racialized masculinities.
The Tuskegee experiment failed to take into account the crucial elements of
historical and contemporary oppression and disadvantage that the black people had
to face, which then could have had potentially adverse impact on their health
outcomes following a venereal disease infection. In fact, at least publicly, they
sometimes refused to acknowledge race as an element within the study at all. Dr.
John Heller, who had once directed the study, told the reporters when the case came
to light in 1972 that “there was no racial side to this. It just happened to be in a black
community” (Brandt 1978:27). During the time that the experiment was being
conceived and developed, Heller did not recall any “philosophical discussions”
whatsoever that might have taken place regarding the ethical dimensions of the
experiment, or lack thereof (Jones 1993:144). Even as late as 1965, the extreme
racial nature of the experiment did not warrant much attention of the USPHS, which
decided that the “racial issue… [would] not affect the study” and that “any questions
[could] be handled by saying these people were at the point that therapy would no
longer help them” (minutes of a 1965 meeting at the Center for Disease Control,
quoted in Brandt 1978:26). Such attitude can well be considered colorblind racism at
best, and preposterous racial oppression at worst.
The Tuskegee study was based on the top-down model of intervention in which
white physicians and medical administrators made the decisions for black patients,
and deceit was a core element of their approach. They did not see a role for the black
community in making decisions regarding the experiment. While the role of black
health care providers in the experiment remains unclear, it has been suggested that
many of them were not aware of the intricate details of the experiment, and did not
comprehend its dangerous and deceptive nature (Brandt 1978). Such a model
conforms to the notion of black men lacking in intellectual abilities and therefore, by
that argument, they need not have occupied any participatory role in the decision-
making or execution processes of the experiment.
J Afr Am St (2010) 14:247–262 259

Lynching and castration of black men was a common occurrence throughout the
US history, during and after the times of slavery of black men by their white masters.
Wiegman (2001:350) in her essay on the sexual economy of lynching of black men
in the US as a practice for maintaining hierarchical race relations, has observed that
“in the disciplinary fusion of castration with lynching, the mob severs the black male
from the masculine, interrupting the privilege of the phallus, and thereby reclaiming,
through the perversity of dismemberment, his (masculine) potentiality for citizen-
ship.” The fascination with black sexuality as exotic and the other is evident in the
Tuskegee experiment. At the same time, black masculinity is viewed as a
“masculinity that is sexually animalistic, deviant, and in need of regulation” (Hickey
2006:168). Historically, lynching and castration were justified through the
“mythology of the black man as rapist” (Wiegman 2001:358) of white women.
Within a context where black masculinity is hypersexualized, pathologized,
animalized, and dreaded, the Tuskegee study represents symbolic castration of
black men in order to sustain and perpetuate the unequal racial order. By portraying
racial differences in health outcomes as inherently psychological and anatomical,
and thereby pathologizing the black male bodies, and by denying treatment to black
men for sexually transmitted diseases, the Tuskegee study was a tool for
symbolically castrating black men, and thereby ensuring that black masculinity
remained inferior to its white counterpart. After all, “castration and symbolic
castration… [constitute] one of the organizing forces within white supremacist,
patriarchal culture” (Saint-Aubin 1994:1062).
So the Tuskegee study approached syphilis in black men through the discourse of
diseased race. Within the framework of this discourse, black men were inferior
people who had brought the disease upon themselves due to their uncontrolled lust
and promiscuity, and could not be helped medically because treatment would either
not work for them , or they would not seek or continue treatment. They did not have
the capacity to participate in interventions aimed at them. Their sexuality was not
just unhealthy but also dangerous, and therefore needed to be harnessed through
symbolic castrations. In a nutshell, their race was diseased.
The Negro Project, on the other hand, approached venereal diseases among black
men from a diametrically opposite perspective–that of the discourse of racialized
disease. According to this discourse, black men suffered more at the hands of
venereal diseases due to racial inequality and the corresponding social and economic
marginalization that heightened their vulnerabilities and curtailed opportunities for
timely and appropriate health care. In other words, it was the disease that was
racialized.
Like the Tuskegee study, the Negro Project agreed that syphilis manifested itself
differently among white and black men. However, as described earlier, they
attributed these differences to the disadvantaged socioeconomic status of African
Americans, since they had to perform harder labor while having far fewer
opportunities for medical care. In this way, the Negro Project departed from the
conventional medical wisdom that seemed to steer the Tuskegee study wherein
“socioeconomic explanations for the poor state of black health were generally
discounted” (Brandt 1982:37).
The Negro Project had much conviction in the belief that race and racism were
intricately and inextricably woven through the problem of venereal diseases among
260 J Afr Am St (2010) 14:247–262

black men. The Tuskegee study, however, was oblivious, or pretended to be

oblivious, to these critical concepts.
In the Negro project, the leaders and activists emphasized time and again the need
to support and promote black leadership and acknowledge the efforts of the black
community in order to address the prevalence of syphilis. The premise they set for
themselves was not that of working for the black people, but working with them by
developing and using culturally representative educational materials:
…one of the points we make, possibly our principal point, is that to accomplish
these purposes we all need the help of the organized groups among the Negroes,
that this is not something that the white man can or should undertake to do for the
Negro. It is something that he should undertake to do with the Negro and to give
the Negro an opportunity to do these things for himself, the help that he needs, and
encouragement. Therefore, the participation of Negro leadership is of the greatest
importance in any attack at venereal disease, and particularly in an attack of
venereal disease among the Negro group. (ASHA 1944c)

In these ways, the Negro Project constructed itself as a counter-hegemonic project

vis-à-vis the grand narrative of racial black masculinity. On the other hand, the
Tuskegee study fit snugly into that grand narrative. While both projects were being
funded through federal dollars, only one received continual and robust support. Is it
a surprise then, that as soon as World War II was over in 1945, and therefore the
need for health safety of African American troops did not remain as much of an
important matter as it was during the war, and finances became more limited due to
the impending recession in the economy, carpet was pulled from under the feet of the
Negro Project, while the Tuskegee experiment continued to enjoy federal funding by
the USPHS? As we now know, the Tuskegee study would continue to manipulate the
position of power and privilege accorded to it by the forces of racism for another
27 years before a journalist would blow the whistle on one of the most horrifying
examples of unethical medical intervention anywhere in the world in modern history,
even as yet another opportunity for addressing venereal diseases by acknowledging
the role of racial inequalities, in the form of ASHA Negro Project, had been lost.

Conclusion

Race and racism have had a critical influence on the public health policies and
programs in the USA, as illustrated in this comparison between of the story of the
Negro Project of ASHA with that of the Tuskegee experiment. The latter thrived for
40 years because it conformed to the dominant discourse of racial black
masculinities that tended to view African Americans as a diseased race, while the
former faded into obscurity prematurely because its approach was counter-
hegemonic to the dominant discourse. The juxtaposition of these two stories not
only reminds us of historic racial injustices, but also invites us to examine the
profound role that racism and racial inequality continue to perform with regard to
provision of, and access to, health and human services. The stories of the Negro
Project and the Tuskegee Study cannot be altered, but they contain important lessons
that can potentially sharpen and nuance our understanding, and sensitize our
J Afr Am St (2010) 14:247–262 261

approach towards race and gender issues. They also attempt to ensure that we do not
forget, and history does not repeat itself.

Acknowledgment The author is thankful to Dr. Megan Morrissey and Prof. Clarke Chambers for their
feedback on the draft versions of this paper. The author also thanks David Klaassen, Archivist, and Linnea
Anderson, Assistant Archivist, Social Welfare History Archives, University of Minnesota, for their
valuable help in identifying and accessing the relevant archival materials.

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