LOS ANGELES \u2014 Jonnae Thompson has felt for a long time that her dark brown skin and natural hair have made finding work in Hollywood especially hard.<\/p>\n

\u201cIt\u2019s like this negative connotation,\u201d said the 37-year-old actress, singer, and stand-up comedian, who said she is often asked to audition for villainous roles such as a bully, drug dealer, or pimp.<\/p>\n

Her quest for more equitable representation on the big screen isn\u2019t just professionally exhausting. Thompson says anxiety about her skin complexion has affected her health.<\/p>\n

\u201cIt definitely had a negative impact on my self-esteem,\u201d she said. She recalls being called \u201ccharcoal\u201d in kindergarten. \u201cIt was big, like, your skin is dark and that\u2019s a problem.\u201d<\/p>\n

The term colorism \u2014 a form of prejudice and discrimination in which lighter skin is favored over darker skin \u2014 was popularized by author Alice Walker in her 1983 book \u201cIn Search of Our Mothers\u2019 Gardens: Womanist Prose.\u201d<\/p>\n

Clinicians from various ethnic groups have recently begun to draw a direct line between colorism and poor health. A 2023 KFF survey<\/a> found that, among Black and Hispanic adults, those with self-described darker skin tones reported more experiences with discrimination in daily life compared with those who have lighter skin tones. People who feel like they experience daily discrimination can be at higher risk for depression, loneliness, increased alcohol and drug use, and anxiety, data shows.<\/p>\n

And colorism can also lead to physical health concerns<\/a>. Hair straighteners<\/a> and skin lighteners commonly used by women of color, sometimes to conform to racialized beauty standards<\/a>, increase their exposure to toxic chemicals, research shows.<\/p>\n

Jonnae Thompson, an actress, a singer, and a stand-up comedian, performs in the \u201cLadies Love Comedy\u201d show at the Ice House Comedy Club in Pasadena, California, on April 27. She says anxiety about her skin complexion has negatively affected both her physical and mental well-being.(Alics Noel)<\/span><\/figcaption><\/figure>\n
Because of the potential health implications, the health care system should pay more attention to colorism, said Regina James, a child and adolescent psychiatrist who heads the American Psychiatric Association\u2019s Division of Diversity and Health Equity.<\/p>\n
\u201cSkin color discrimination is so insidious it can literally get under your skin,\u201d she said. \u201cAnd consciously or subconsciously, it can contribute to low self-esteem and self-confidence, and even be detrimental to one\u2019s mental health.\u201d<\/p>\n
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Conversations about skin complexion can remain overlooked by mental health professionals who do not have expertise about or awareness of a person\u2019s cultural context, if the conversations happen at all, said Usha Tummala-Narra, a clinical psychologist and professor in the Department of Counseling, Developmental, and Educational Psychology at Boston College.<\/p>\n
\u201cThere\u2019s no specific training on colorism. Many people are unaware that it exists,\u201d Tummala-Narra said.<\/p>\n
$\"A$
Shannon Brown, a former college counselor from the Bronx, New York, remembers being called \u201cmidnight\u201d by classmates because of his dark complexion. He tries to find the humor in comments about his skin tone, \u201cbut the jokes get tiresome,\u201d he says.(Sam at Shun Liang Photography)<\/span><\/figcaption><\/figure>\n
But the experience can negatively affect a person\u2019s self-worth, relationships, sense of belonging, and dignity. \u201cThese are all really critically important things as human beings that we all need to secure to have good health, both physically and mentally,\u201d she said.<\/p>\n
The issue can emerge in childhood for Black and Indigenous people and other people of color, who must navigate fair skin often being seen as superior, a ramification of colonialization. Black children with the darkest complexions experience higher levels of depressive symptoms, found a 2020 study<\/a> in the journal Society and Mental Health.<\/p>\n
Shannon Brown, 34, a former college counselor from the Bronx, New York, who is Black, remembers being called \u201cmidnight\u201d by classmates and having family members joke about his skin being difficult to light in family photos. \u201cI\u2019ve just kind of accepted it and try to find the humor in it,\u201d he said. \u201cI feel like most folks aren\u2019t intentionally trying to hurt me, but the jokes get tiresome.\u201d<\/p>\n
Shakun Kaushal, a 26-year-old digital communications specialist at the Johns Hopkins Center for Gun Violence Solutions, is Indian American and has a \u201cdarker complexion.\u201d She said that in Indian culture one might hear comments like, \u201cOh, she\u2019s so light and beautiful.\u201d<\/p>\n
\u201cI sometimes feel dismissed by people,\u201d said Kaushal, who has searched for an Indian or Black therapist in hopes they might better relate to her lived experience. She believes conversations about colorism should be intergenerational, start early, and get introduced with great care.<\/p>\n
\u201cWhat you say to a child does affect them. They will remember, and it will impact how they feel about themselves and in their skin,\u201d Kaushal said. \u201cWe must talk about it.\u201d<\/p>\n
The feeling of shame and embarrassment colorism produces in people is palpable and needs to be acknowledged in health care settings, said Roopal Kundu, a dermatologist who founded and directs the Northwestern Medicine Center for Ethnic Skin and Hair in Chicago. Kundu, who is of South Asian heritage, opened the center in 2005 and notes that some cases of diseases like psoriasis, skin cancer, and eczema get diagnosed later, or misdiagnosed, because they present differently on diverse skin tones.<\/p>\n
$\"A$
Shakun Kaushal, a digital communications specialist at the Johns Hopkins Center for Gun Violence Solutions, is Indian American and has a \u201cdarker complexion.\u201d She believes conversations about colorism should be intergenerational, start early, and get introduced with great care.(Kaveh Sardari)<\/span><\/figcaption><\/figure>\n
\u201cHow can we really make sure, as a field, that we\u2019re taking care of everybody?\u201d she said. \u201cHealthy skin is beautiful skin. And beauty is across every single skin tone that there is.\u201d<\/p>\n
Therapists, doctors, and other clinicians from diverse backgrounds say that, in addition to clinical approaches that incorporate cultural competence, more efforts are needed to diversify the pool of mental health practitioners and to collaborate between disciplines.<\/p>\n
Without cultural awareness and sensitivity, \u201cyou\u2019re not going to get all the information that you need to appropriately diagnose and treat someone,\u201d James said.<\/p>\n
Black people are more likely to report difficulty finding mental health providers who understand their background and experiences, a KFF survey<\/a> found. At the same time, programs that bolster diversity, equity, and inclusion in medical schools are faltering<\/a> in the wake of the 2023 Supreme Court decision outlawing affirmative action in higher education.<\/p>\n
According to the Association of American Medical Colleges, in 2022, about 5% of active psychiatric physicians identified as Black, 16% as Asian, 6% as Hispanic, and less than 1% as American Indian or Alaska Native.<\/p>\n
Thompson, Brown, and Kaushal all said they had never been treated by a therapist who looks like them.<\/p>\n
Thompson, the LA comedian, said she drank bleach when she was 10 years old, thinking it would lighten her skin. Fortunately, it caused only nausea.<\/p>\n
If she could speak to her younger self, she would say: \u201cYou\u2019re beautiful. You\u2019re brilliant.\u201d<\/p>\n
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Jonnae Thompson, an actress, a singer, and a stand-up comedian, performs in the \u201cLadies Love Comedy\u201d show at the Ice House Comedy Club in Pasadena, California, on April 27. She says anxiety about her skin complexion has negatively affected both her physical and mental well-being.(Alics Noel)<\/span><\/figcaption><\/figure>\n
Because of the potential health implications, the health care system should pay more attention to colorism, said Regina James, a child and adolescent psychiatrist who heads the American Psychiatric Association\u2019s Division of Diversity and Health Equity.<\/p>\n
\u201cSkin color discrimination is so insidious it can literally get under your skin,\u201d she said. \u201cAnd consciously or subconsciously, it can contribute to low self-esteem and self-confidence, and even be detrimental to one\u2019s mental health.\u201d<\/p>\n
\n
\n\t\t
\n\t\t\tEmail Sign-Up\t\t<\/a>
\n\t<\/h4>\n
\n\t\tSubscribe to KFF Health News’ free Morning Briefing.\t<\/p>\n<\/div>\n
Conversations about skin complexion can remain overlooked by mental health professionals who do not have expertise about or awareness of a person\u2019s cultural context, if the conversations happen at all, said Usha Tummala-Narra, a clinical psychologist and professor in the Department of Counseling, Developmental, and Educational Psychology at Boston College.<\/p>\n
\u201cThere\u2019s no specific training on colorism. Many people are unaware that it exists,\u201d Tummala-Narra said.<\/p>\n
$\"A$
Shannon Brown, a former college counselor from the Bronx, New York, remembers being called \u201cmidnight\u201d by classmates because of his dark complexion. He tries to find the humor in comments about his skin tone, \u201cbut the jokes get tiresome,\u201d he says.(Sam at Shun Liang Photography)<\/span><\/figcaption><\/figure>\n
But the experience can negatively affect a person\u2019s self-worth, relationships, sense of belonging, and dignity. \u201cThese are all really critically important things as human beings that we all need to secure to have good health, both physically and mentally,\u201d she said.<\/p>\n
The issue can emerge in childhood for Black and Indigenous people and other people of color, who must navigate fair skin often being seen as superior, a ramification of colonialization. Black children with the darkest complexions experience higher levels of depressive symptoms, found a 2020 study<\/a> in the journal Society and Mental Health.<\/p>\n
Shannon Brown, 34, a former college counselor from the Bronx, New York, who is Black, remembers being called \u201cmidnight\u201d by classmates and having family members joke about his skin being difficult to light in family photos. \u201cI\u2019ve just kind of accepted it and try to find the humor in it,\u201d he said. \u201cI feel like most folks aren\u2019t intentionally trying to hurt me, but the jokes get tiresome.\u201d<\/p>\n
Shakun Kaushal, a 26-year-old digital communications specialist at the Johns Hopkins Center for Gun Violence Solutions, is Indian American and has a \u201cdarker complexion.\u201d She said that in Indian culture one might hear comments like, \u201cOh, she\u2019s so light and beautiful.\u201d<\/p>\n
\u201cI sometimes feel dismissed by people,\u201d said Kaushal, who has searched for an Indian or Black therapist in hopes they might better relate to her lived experience. She believes conversations about colorism should be intergenerational, start early, and get introduced with great care.<\/p>\n
\u201cWhat you say to a child does affect them. They will remember, and it will impact how they feel about themselves and in their skin,\u201d Kaushal said. \u201cWe must talk about it.\u201d<\/p>\n
The feeling of shame and embarrassment colorism produces in people is palpable and needs to be acknowledged in health care settings, said Roopal Kundu, a dermatologist who founded and directs the Northwestern Medicine Center for Ethnic Skin and Hair in Chicago. Kundu, who is of South Asian heritage, opened the center in 2005 and notes that some cases of diseases like psoriasis, skin cancer, and eczema get diagnosed later, or misdiagnosed, because they present differently on diverse skin tones.<\/p>\n
$\"A$
Shakun Kaushal, a digital communications specialist at the Johns Hopkins Center for Gun Violence Solutions, is Indian American and has a \u201cdarker complexion.\u201d She believes conversations about colorism should be intergenerational, start early, and get introduced with great care.(Kaveh Sardari)<\/span><\/figcaption><\/figure>\n
\u201cHow can we really make sure, as a field, that we\u2019re taking care of everybody?\u201d she said. \u201cHealthy skin is beautiful skin. And beauty is across every single skin tone that there is.\u201d<\/p>\n
Therapists, doctors, and other clinicians from diverse backgrounds say that, in addition to clinical approaches that incorporate cultural competence, more efforts are needed to diversify the pool of mental health practitioners and to collaborate between disciplines.<\/p>\n
Without cultural awareness and sensitivity, \u201cyou\u2019re not going to get all the information that you need to appropriately diagnose and treat someone,\u201d James said.<\/p>\n
Black people are more likely to report difficulty finding mental health providers who understand their background and experiences, a KFF survey<\/a> found. At the same time, programs that bolster diversity, equity, and inclusion in medical schools are faltering<\/a> in the wake of the 2023 Supreme Court decision outlawing affirmative action in higher education.<\/p>\n
According to the Association of American Medical Colleges, in 2022, about 5% of active psychiatric physicians identified as Black, 16% as Asian, 6% as Hispanic, and less than 1% as American Indian or Alaska Native.<\/p>\n
Thompson, Brown, and Kaushal all said they had never been treated by a therapist who looks like them.<\/p>\n
Thompson, the LA comedian, said she drank bleach when she was 10 years old, thinking it would lighten her skin. Fortunately, it caused only nausea.<\/p>\n
If she could speak to her younger self, she would say: \u201cYou\u2019re beautiful. You\u2019re brilliant.\u201d<\/p>\n
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