She chemically straightened her hair to feel accepted. Now she's learned of the increased risk of uterine cancer

As a teenager, Candicia John was made to believe that straight hair would help her be accepted in society. It would help her feel seen, she thought.

In the early 2010s, John was a high-school student in Oshawa, Ont., and her mostly-white peers did not have the bouncy curls she was born with.

“I definitely wanted to fit in with that standard of beauty. Being at that age, you want boys to look at you, you want people to look at you differently, and I felt I needed to do these things to fit in,” said the 27-year-old who now lives in Cavan Monaghan, Ont.

John also saw her mother, aunts, and sister, all Black women, chemically straighten their hair

“I really felt like this was the right choice for me,” she told CTVNews.ca in a phone interview on Tuesday.

But the damage the chemical straightening products would do to her body, and how she felt about herself, would leave her “traumatized,” she said.

That pressure to chemically straighten hair stems from racism and European beauty standards, several academics and researchers told CTVNews.ca.

And new research from the U.S. indicates that potential adverse impact of chemically straightening hair is harming the health of Black women more than any other group.

The U.S. House passed an act earlier this year that bans discrimination based on hair texture or hair style. The Create a Respectful and Open World for Natural Hair (CROWN) Act passed in March makes it explicit that Black people who choose to wear hairstyles like Afros, cornrows, or tightly coiled twists should not face discrimination in society, school or the workplace. Several states have incorporated the legislation, though the U.S. Senate has not passed the law yet.

And although legislation won’t stop all discrimination overnight, experts in race and health told CTVNews.ca that would be an important first step in Canada, especially as studies continue to come out about the impact of chemical straighteners on Black women specifically.

John’s experience with chemical straighteners, she says, reflects the pressure that Black people face to use chemicals on their natural hair, to make it straighter.

“The chemical straightener was so potent, that when we started rinsing out my hair, my hair started falling out in the sink, in chunks. My scalp was so irritated, red, and raw. My hair smelled fried for weeks,” she said.

Candicia John works as a content creator in the hair, beauty, and lifestyle space. (Supplied)

She began the process of regrowing her hair, entering a “journey of self love” and trying to recognize how eurocentric beauty standards that deemed whiteness to be superior had impacted her, and how she saw herself.

But John said didn’t know at the time about the increased risk of uterine cancer that is now associated with chemical straighteners.

WHY ARE CHEMICAL STRAIGHTENING PRODUCTS A CONCERN?

An October study by the U.S. National Institutes of Health examined the hair-care routines of more than 33,000 women. The research found that those who used chemical straightening products at least four times a year were more than twice as likely to develop uterine cancer.

While the risk still remains low overall, the increased risk for Black women is a concern, researchers note.

According to the study authors, hair products may contain “endocrine-disrupting and carcinogenic properties.” The endocrine system helps to regulate hormones, and that’s why the risk of uterine cancer could increase if the system is disrupted.

CTVNews.ca asked the U.S. Food and Drug Administration why these products are available on the market if there is research that indicates some of them may be dangerous. The FDA did not respond by publication time.

Research published Monday in the Journal of the National Cancer Institute found a connection between using certain hair straighteners, such as chemical relaxers and pressing products, and an increased risk of uterine cancer -- the most common cancer of the female reproductive system.The association between hair-straightening products and uterine cancer cases was most pronounced for Black women, who made up 7.4% of the study participants but almost 60% of those who reported ever using straighteners. (Pexel)

Health Canada states on its website that it regularly reviews ingredients in cosmetic products to ensure safety.

The chemicals that are associated with the increased risks are parabens and phthalates that are part of the chemical hair straighteners, the research states.

Health Canada is continuing to work on an assessment of parabens and are evaluating the potential risk. In Canada, there are restrictions on some parabens, which limit the amount that can be used in natural health products and as food preservatives, the agency states on its website.

Almost 60 per cent of the study participants who reported using straighteners were Black women (a total of 1,852) and tended to be younger in age.

Researchers said chemical straighteners “could be more concerning than other personal care products” as the chemicals are more likely to be absorbed through the scalp.

“Straightener use may cause scalp lesions and burns, which facilitates the permeability of chemicals through the scalp,” they added. “The adverse health effects associated with straightener use could be more consequential for African American and/or Black women because of the higher prevalence and frequency of hair product use, younger age of initiating use, and harsher chemical formulations.”

The October study is one of several published in the last decade that has connected the use of chemical straighteners to concerning health outcomes. Other research has found that exposure to chemical hair straighteners is linked to breast and ovarian cancer, interferes with hormone receptors, and causes early periods along with the risk of uterine fibroids.

In May, a study by researchers from the U.S. and Denmark found that rates of uterine cancer have been increasing, and more aggressive types of the cancer are more prevalent in Black and non-Black Hispanic women.

BLACK WOMEN FACE ‘PRECARIOUS CATCH-22’

The latest study reaffirms “the reality of Black women who may be risking their lives when conforming to a systemic, global pressure and often a requirement in our personal, professional, and educational spheres to maintain straightened hair,” said Wendy Greene, a law professor at Drexel Kline School of Law in Pennsylvania whose research focuses on Black hair discrimination.

Greene is also one of the legal architects behind the CROWN Act that the U.S. House passed in March.

There is what Greene calls “invisible harms” from the types of discrimination the act targets.

Wendy Greene, a law professor at Drexel Kline School of Law in Pennsylvania , focuses her research on Black hair discrimination. (Supplied)

The stigmatization of the natural hair of Black women and girls translates into “straight hair expectations or mandates”, she told CTVNews.ca in an emailed statement. That’s what leads Black women to feel they must use chemical straighteners, she explained.

Black women are placed in a “precarious Catch-22” where they either risk the loss of an educational, or work opportunity, or they use chemical straighteners that could not only harm their health, but cause them to lose their lives, said Greene.

“As I always say to those who may not appreciate at first glance, the importance of legal reforms like the CROWN Act to prevent and redress race-based natural hair discrimination: if you care about Black women and girls’ health, you have to care about their hair,” she said.

To understand the roots of hair discrimination, it’s important to delve into the history behind Black people’s hair and how they have been treated, explained Greene.

“African-descended people have long been wearing natural hairstyles like Afros, Bantu knots, locs, curls, and twists as a positive expression of their cultural, racial and religious identities and simply because it is the way their hair grows, since eras of racial slavery and colonization,” she said.

Natural hairstyles have been stigmatized as “unkempt,” “unattractive,” “unprofessional” and other negative stereotypes “because of their association with Blackness or African ancestry,” said Greene.

Hair has severed as a basis for racial discrimination, and straight hair has been deemed “good” due to its proximity to whiteness, she said. This is why Black people have felt ongoing, immense pressure to cut, cover or straighten their natural hair.

LACK OF DATA OR LEGAL PROTECTIONS ON HAIR DISCRIMINATION IN CANADA

Those stereotypes are extremely prevalent in Canada as well.

There have been multiple incidents of hair discrimination that have made headlines in recent years, including that of server Akua Agyemfra, a Toronto woman who was told by a boss at a Jack Astor’s restaurant in 2016 that she needed to wear her hair down, despite the fact that Agyemfra insisted her hair wouldn’t fall straight.

In another case in 2014, the Quebec Human Rights Commission found that Lettia McNickle was a victim of racial and gender discrimination after she was told to leave work, because she was wearing her hair in braids.

In Canada, hair is not directly protected on its own, instead falling under the category of race. The lack of explicit protection around hair leaves too much space for nuance and makes it more difficult for victims of discrimination based on their hair to seek justice, argues Annaëlle Barreau, a JD Candidate at McGill University in the McGill Journal of Law and Health.

in 2014, the Quebec Human Rights Commission found that Lettia McNickle was a victim of racial and gender discrimination after she was told to leave work, because she was wearing her hair in braids.

Additionally, the knowledge that chemical straighteners are hazardous has long been understood, but the lack of research into Black health in Canada has exacerbated the issue, said Cheryl Thompson, an assistant professor at the Creative School at Toronto Metropolitan University.

A decade ago, while writing her book Beauty in a Box: Detangling the Roots of Canada’s Black Beauty Culture,Thompson said the health concerns around chemical straightening products were well on her radar and she addressed them in her writing.

“There’s been a solid 10 years of research and media attention on the fact that Black hair-care products…if they’re not going to cause cancer, they’re going to cause you to be bald. And nobody seemed to pay much attention to it,” said Thompson in an interview with CTVNews.ca

Studies like the one published in October put a spotlight on an issue that has long been discussed, but still, the chemical straightening industry will continue to thrive, even with a looming recession, Thompson said. Beauty products tend to be an investment for many households even during economic downturns, she explained.

Another reason that it’s no surprise these products continue to be used, she said, is that it's tough to find a hair routine that is comfortable and works. Thompson says she purchases products from Florida, because those products worked the best for her.

“That’s another reason why people stick with [chemical straightening]. Because it’s secure,” she said. Sticking with a personal hair routine that has long been established for an individual can be difficult to give up, she said.

Dr. Aisha Lofters, an associate professor in the department of family and community medicine at the University of Toronto, said that she’s glad to see studies like the most recent one published by the U.S. National Institutes of Health as the more that is understood about who is at higher risk for cancers, the better the issues can be addressed.

But Canada does not have similar research currently and she hopes that the discussion around hair discrimination and health can encourage further studies in the northern context.

“We’re not going to be able to truly eliminate health disparities until we get to the root of the problem,” she said. “Often when we see racial disparities in health, what it comes down to tends to be structural racism, and structural discrimination,” she said.

Lofters, who is also the chair of implementation science at the Peter Gilgan Centre for Women's Cancers at Women’s College Hospital, said it’s also important to emphasize that women should be able to make the choices they want to make with their hair without being shamed.

“You just want to be able to make an informed choice about that,” she said.

And race-based data can’t just be collected, it has to be followed up with action, and not used for harm, she said.

“The real change needs to come from the health-care community, from policy makers and from those in positions of power,” she said. That includes changing what is viewed as “professional” in the workplace, she said.

“The onus shouldn’t be on [Black women] to make those changes.”

For Candicia John, who works as a content creator in the hair, beauty, and lifestyle space, she wants to use her own experiences to empower other women of colour to make the choices they feel are best for themselves.

The knowledge around the studies on chemical hair straighteners is something she plans to take forward into her business, especially when it comes to the health of women of colour, she said.

“Being open and vocalizing our stories, hopefully other women are inspired to share stories in their personal lives and this conversation becomes not so foreign,” she said.