The convergence of infertility x race. An interview with Dr. Loree Johnson

Photo courtesy of Dr. Loree Johnson

Photo courtesy of Dr. Loree Johnson

Amid protests and a long overdue breaking point resulting in a world crying out to address racial inequalities and injustices, I was incredibly moved when I came across a heartfelt video that Dr. Loree Johnson shared discussing the intersection of infertility and race trauma. Up until that point, I am embarrassed to admit that I hadn’t realized that race might play a factor in access to quality health care let alone infertility treatment. That is a privilege that I am now addressing.

After listening to Dr. Loree and many other black women in the infertility community, I was floored as I pieced together research from studies conducted relatively recently which revealed that black women have lower IVF success rates and are more likely to suffer from a pregnancy loss. According to research, infertility affects at least 12% of all women through the age of 44 and black women may be almost twice as likely to experience infertility as white women. Yet only 8% of black women between the ages of 25 - 44 seek medical help. A survey of more than 1,000 women highlighted that black women are 2x as likely to avoid talking about their fertility challenges.

During our upcoming Sunday Session on July 19th, Dr. Loree will discussing some of the drivers of these issues including harmful stereotypes that black women are hyper-fertile and a general mistrust by the black community of the medical community based on historical experiences. We will also discuss how infertility impacts relationships.

Through becoming educated, advocating for representation and research, together with the BIPOC community, non-BIPOC communities have the ability to become an ally in supporting ending the flagrant disparity that not only exists in the infertility space but also the healthcare community at-large.

As we shed light on the global impact of race and infertility trauma, I am grateful that Dr. Loree shared her personal experience which has shaped her outlook and experience on this very important topic.

Did your infertility journey impact your career? Your own relationships?

LJ: Sadly, I’m not immune to feeling the effects of fertility struggles. Being around babies has been especially hard since I experienced my first miscarriage. It has been challenging watching other couples grow their families and seeing children that would be the same age as mine. My family and friends have been as supportive as they know how to be; it’s hard when you’ve never experienced fertility struggles or pregnancy loss. 

It has also been particularly challenging being a mental health provider who is also undergoing the struggles that I treat. However, normalizing my experiences and feelings have immensely helped me heal, which has only had a positive impact on my work as a clinician and coach. I can relate to my clients as a member of their community and not simply as some “expert.”

Can you share something that you learned about yourself as a result of your fertility journey?

My fertility journey helped me find purpose in my pain.

LJ: I learned that I could wade through various stages of overwhelm and still thrive. My process didn’t always feel graceful, and I felt awkward most times, but it was mine, and I am so proud of it.

What brings you joy?

LJ: The color purple, my dog Amore, traveling to places off the beaten path with my hubby.

You have been transparent about your recurrent pregnancy loss; how did/do you cope, and do you have any words of wisdom to share with others who have also suffered loss? 

LJ: Whenever I hear about someone experiencing a pregnancy loss or child, I experience a sinking feeling in my gut. The pregnancy/child loss club is one membership that no one ever signs up for. Each grieving process is going to be different, and the process is far from linear, where you reach a place of “acceptance,” as most grief models suggest.

I usually tell others what other bereaved mothers told me, “Your grief, your journey!”

Hearing those words allowed me the freedom to feel sad for as long as I needed to, to experience joy in whatever ways I could, to honor the depths of my anger that frustrated the heck out of me and appreciate the need to vacillate between seemingly opposing feelings as part of my pattern.

What gets you out of bed every morning?

LJ: My strength and resilience get me out of bed every morning. When I was heavy in the grieving process, getting through my day felt like a chore. When I turned a corner, I felt light again in a way I never imagined.

Recognizing how far I’ve come inspires me to push forward and show others how they can too.

Recently you have shared about the intersection of racial trauma and infertility trauma. Are you open to sharing about an experience you’ve had?

LJ: While the link between stress and fertility issues have long been challenged in science, I never fully believed it was not a factor. When I think about the everyday experiences of BIPOC, I always wondered how stress- mainly stemming from racial trauma, could NOT impact one’s fertility. If we know there’s a mind/body connection that helps improve our chances of conception, how would overt or covert negative messages about one’s race/ethnicity not impact one’s ability to conceive? 

In a conversation with a colleague from graduate school years ago, I mentioned my struggles with recurrent pregnancy loss and wondered about the connection between racism and infertility. She immediately affirmed my hypothesis, citing a friend of hers, making the same assertion. There was very little data out at the time, but the concerns were there.

To understand my infertility trauma, I think it’s important to understand my experience with racial trauma. I grew up in Richmond, VA, which used to be known as the Capital of the Confederacy. I went to school with descendants of many Confederate war heroes who were memorialized throughout the city. I was called the “n-word” a few times as a child and endured questions/comments from well-meaning white people about my hair, skin color, and manner of speech, which seemed like ways to join or relate but were only veiled racist ideas about who I was. After high school, I naively left the South thinking that life would be more progressively elsewhere. 

I spent my undergraduate and graduate years in Upstate New York, where I first encountered a doctor who I later believed held assumptions about me. After months of pelvic pain, she diagnosed me with Pelvic Inflammatory Disease, when, in fact, I had grapefruit and lemon-sized fibroids growing outside my uterus. After discovering that information, I felt suspicious about why she could not feel them when she completed my pelvic exams, which also included rectal exams each time (which I had never experienced before going to her or since). I had only one sexual partner and told her such, but she floated that diagnosis for a while until I pushed for more tests. 

I moved to the Los Angeles area almost twenty years ago and was shocked to see covert racism, bubbling beneath the surface. I worked in community mental health for several years, where most of the providers were white and the communities served were of color. I continued to endure well-meaning white colleagues commenting on my hair, skin color and that just became the norm. I brushed it off, but these microaggressions persisted and still do. 

Early during the Obama era, I had a sticker on my car, and it was vandalized.

Shortly after moving in with my now-husband, I was walking to the beach when a car slowed down, and one white man yelled to me, “White Power! The KKK will rise again!” Now we live down the street from a house that proudly hangs a confederate flag in the garage.

When in a group with my white family members, I’ve been carded when making purchases, and they haven’t. 

I can’t even tell you the countless number of people who still take liberties in reaching out to touch my hair. 

I’m sure there are more experiences that I can’t recall now, but the feelings of heaviness are still there. 

I’d also like to add that being the point person for all things racial for well-meaning white people is emotionally exhausting.

It’s tiring to try to explain why someone touching your hair or being carded is tiring, especially when people look at these experiences through their lenses of privilege where it might be happening innocently.

The statistics are staggering, and clearly the health care community needs to do better. Do you have any words of wisdom to share with BIPOC women suffering from infertility prior to seeking treatment?

LJ: Rest. Give your body what it needs and block out challenging things whenever you can. Go where you feel supported and feel seen.

What are one or two ways in which the infertility community can be an ally to black women in it? 

LJ: I have been telling my white stepdaughters how much power they have as white women to change the conversation and demonstrate allyship.

Being a good ally isn’t just about providing space to discuss racial issues. It’s about recognizing your privilege and using it to support your fellow women.

For those of us who don’t have the luxury of not being subjected to racism, it’s crucial to find ways to change the system the supports and perpetuates racist ideas. I think it’s important to get educated, as many of us (including myself) need to do. Generally, we were all taught the same history, and we need to relearn how we got here to envision a different system. 

Now that more data is coming out about the impact of racism and infertility, therapists and coaches can provide more space for their BIPOC to discuss their fertility experiences from a racial lens.

To learn more about the convergence of infertility and racial trauma, read Dr. Loree’s recent published piece in Thrive Global.

Dr. Loree Johnson is a Licensed Marriage and Family Therapist (LMFT) and Coach in private practice with more than 25 years of experience as a clinician, educator, and clinical supervisor. Specializing in women’s mental health and reproductive health, Dr. Johnson helps her clients overcome the emotional challenges that come with fertility challenges - including pregnancy loss and emotional trauma. She also helps couples, who have become divided by their fertility journey, strengthen their connection. Dr. Johnson is a clinical fellow of the American Association for Marriage and Family Therapy, and has served on both its state and national boards. She lives in Hermosa Beach, CA with my husband and toy poodle. In her spare time, she enjoys salsa dancing, traveling, reading, and riding my motorcycle.

Get to know more about Dr. Loree Johnson here and find her on IG @drloreejohnson