Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disorder that affects mostly women and disproportionately Black women. Until the 1940s, SLE was rarely diagnosed in Black Americans, reflecting racist medical beliefs about Black immunity. In the 1940s and 1950s, SLE and its treatment were part of a patriarchal narrative of American industrialization. By the 1960s, newer diagnostic techniques increased recognition of SLE, especially among Black women; medical thinking about SLE shifted from external causes like infection or allergy to autoimmunity, which emphasized biological, genetically determined racial difference. In the 1970s and 1980s, an advocacy structure crystalized around memoirs by women with SLE, which emphasized the experiences of able-bodied, economically privileged white women, while Black feminist health discourse and SLE narratives by Black authors grappled with SLE's more complicated intersections. Throughout the twentieth century, SLE embodied immunity as a gendered, racialized, and culturally invested process.

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