Access Type

Open Access Dissertation

Date of Award

January 2017

Degree Type


Degree Name




First Advisor

Andrea Sankar


This dissertation is an exploration of the role African American women’s feminine hygiene practices, namely vaginal douching, plays in the creation and reproduction of race. Compared to their white and Latina counterparts, African American women are the most likely to engage in this practice. Vaginal douching is associated with myriad reproductive and sexual health problems. These problems include but are not limited to recurrent yeast infections, bacterial vaginosis, disrupting healthy vaginal microbiomes, and spontaneous preterm birth; of which African American women experience disproportionately. Although racial differences in vaginal douching are well documented, little is known about the impetus for African American women’s vaginal douching practices. I argue that African American women’s vaginal douching practices are mutually informed by hegemony and resistance to the historical stigmatization of their sexuality as hyper and deviant. I assert that race is created and reproduced through acts of resistance that are informed by hegemonic thoughts and transmitted through intergenerational familial sexuality and domestic discourse. Through in-depth interviews and targeted self-care narratives of thirteen self-identified African American women (from various communities in Michigan and between 19-69 years old), I examine women’s knowledge, attitudes, and behaviors that women have surrounding vaginal douching. Special attention is paid to conduits of knowledge (i.e. history, family and community members) regarding feminine and domestic hygiene practices. Responses indicate that vaginal douching among African American women may constitute a performance of moral personhood that subtly and overtly challenges socially legitimated discourses about their unequal humanity. Exploring vaginal douching among African American women as an act of resistance to gendered racism, illustrates how concerns about perceptions of their equal humanity, move them to incorporate deleterious practices into their feminine hygiene routines as a means of affirming their morality. However, this act of resistance facilitates the reification of deviant African American female sexuality by placing women at greater risk of negative sexual and reproductive health outcomes. Knowledge gained from this research will provide a foundation on which to build culturally appropriate sexual/reproductive health promotion interventions that empower African American women to challenge their ideals about female cleanliness. In addition, increased awareness of the deleterious consequences related to vaginal douching may encourage African American women to replace this harmful practice with healthful practices that serve the same function. I posit that anthropological research that focuses on the biology of racism - rather than race or racism - provides avenues to explore differential health in human populations by centering the processes of stigmatization and exclusion. Biology of racism reveals historical and structural processes that inform unequal health, explores how these processes guide health behaviors and practices, and affirms the importance of employing a biocultural approach to examine the human condition.