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Letters to the Editor

The Unambiguous Bias in Saying “Racially Ambiguous Babies”

Tennermann, Nikki MSSW

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doi: 10.1097/ACM.0000000000003069
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To the Editor:

Hsu and colleagues recently published an Invited Commentary1 about the problematic history of racial and ethnic (R/E) demographic categories in the United States and chose the moniker of “racially ambiguous” to describe children who fit into more than 1 of 5 prescribed R/E groups. However, categorizing individuals as “racially ambiguous” perpetuates the very race narrative that this Invited Commentary was trying to refute.

As the authors purport, the R/E narrative of any individual is a dynamic process influenced by intersections, time, and intentions. Therefore, we can presume that individuals who identify as biracial, multiracial, or “another category” are not ambiguous about their R/E group at all, but rather the ambiguity is forced upon them by the perception of others.

The authors argue that R/E traits are not biological but social constructs that have shifted in tandem with changing societal values in the United States. Yet in choosing the term “racially ambiguous,” the authors inadvertently contradict themselves by insinuating that R/E traits should be blatantly clear despite also arguing that such traits are unable to be reduced into finite categories.

Implying that multiracial or multiethnic heritages are somehow ambiguous harkens back to a history in the United States of using “white” as a reference category for all “others.” Race and ethnicity are perceived by others based on phenotype—and often through the lens of bias. Labeling children as “racially ambiguous” only furthers the ideology that whiteness is the unequivocal standard against which all other R/E groups are judged. There is nothing ambiguous about the multiracial/multiethnic experience in the United States, as discrimination and bias impact multiracial and multiethnic children just as they affect monoracial and monoethnic children. And the bias of these authors shows through in their derogatory categorization of R/E groups in this article.

Individuals clearly have R/E identities that are not accurately captured by the predominant demographic fields in the United States, yet there is nothing ambiguous about how multiracial and multiethnic individuals view themselves or how the lens of discrimination and bias sees them. As champions of equitable health care, we must be cognizant of the terms that we use in literature and of the insidious nature of the history of racism and white supremacy in the United States.

Nikki Tennermann, MSSW
Administrative director, Office of Health Equity and Inclusion, Boston Children’s Hospital, Boston, Massachusetts;


1. Hsu P, Bryant MC, Hayes-Bautista TM, Partlow KR, Hayes-Bautista DE. Racially ambiguous babies and racial narratives in the United States: A growing contradiction for health disparities research. Acad Med. 2019;94:1099–1102.
Copyright © 2019 by the Association of American Medical Colleges