In talking to these ER doctors, I found that this behavior had a particularly harmful effect on a certain group among them: black men. Most of the black male doctors I interviewed for my research were the only black men in their work environments. They felt sensitive to that fact, and said they moderated their behavior when innuendo entered the conversation. The reason that black men can feel extremely uncomfortable in these scenarios has a lot to do with the history of their being represented in American culture as sexual threats to white women. Thus, it isn't surprising that none of the white male doctors I spoke to for my study identified the sexual banter in emergency rooms as problematic in quite the same way.

After slavery was abolished, white people used songs, illustrations, and stories to cast black men as threatening brutes consumed by sexual desire who were dangerous to white women. The stereotypes promoted in the 1915 film Birth of a Nation are probably the most well-known—but far from the only—example of this. (Such images were actually not very common during the antebellum era, when the prevailing stereotype about black men was that they were subhuman, docile, and contented by the order and guidance slavery provided.) White women were often represented as pure and virginal, and black women as sexually voracious whores. Each of these stereotypes was built in juxtaposition to the ‘norm’ of white male heterosexuality. Black people, especially men, have throughout American history been typecast as dangerously hypersexual.

The consequences of these cultural myths were all too real. As far back as the mid 1800s, the journalist Ida B. Wells noted that even the intimation of sexual intimacy between black men and white women could—and often did—result in the former being lynched, even when such relationships were consensual. In the post-slavery era, when lynching was a common means of social control, black men had to tread very carefully, given that any perception of sexual interest in or attraction toward a white woman could lead to their death. Emmett Till’s murder in the mid-1950s is a tragic example of this.

Regardless of people’s familiarity today with these specifics, this past inevitably shapes racial dynamics today. Going back to the ER, consider how those black male doctors must feel when white coworkers joke about sex. Responding to these interactions tactfully can be essential for black men to navigate their work environment, and the black male doctors I spoke to described feelings of deep discomfort and awkwardness.

While some black male ER doctors do experience unique discomfort on the job, what these men encounter is similar to the plight of some black professionals more generally. These doctors’ experiences parallel the isolation and marginalization that other black workers have described feeling, and keep with the notion, written about by the legal scholars Mitu Gulati and Devon Carbado, that some workers of color cultivate a “working identity” intended to offset unfavorable stereotypes that may be projected onto them by coworkers.