‘Getting in the Door’ vs. ‘Living in the House’: Racialized Experiences of BIPOC Child Life Specialists in a Predominantly White Profession and Implications for Anti-Racist Leadership

The historical and systemic reproduction of White privilege in the United States results in the oppression and marginalization of Black, Indigenous, and People of Color (BIPOC) individuals based on socially constructed characteristics. Within the healthcare context, racial discrimination is ubiquitous for BIPOC patients, families, and professionals, widening medical disparities and perpetuating racial bias, stereotypes, and microaggressions. Scholarship on BIPOC healthcare professionals documents persistent, pervasive racism across occupations and a corresponding lack of belonging within medical settings. However, little is known about the racialized experiences of BIPOC child life specialists in the healthcare context. Using a heuristic phenomenological approach framed by selected tenets of Critical Race Theory, this study explored the racialized experiences of BIPOC child life specialists alongside formal child life leaders’ conceptualizations of anti-racist leadership practices. A demographic screening survey and semi-structured interviews were employed to gain insight into how racial identity shapes professional relationships, perceptions of organizational culture and climate, leadership practices, and, ultimately, sense of belonging in child life and healthcare institutions. The counter-narratives constructed through qualitative interviews with 21 BIPOC child life specialists illustrate the salience of racialization as an embedded feature of the child life profession and broader healthcare environment, expressed through assumptions about clinical competence, intelligence, and behavior grounded in racial stereotypes and tropes. These experiences prompted impression management strategies that precipitated racial battle fatigue. Interviews with 15 formal child life leaders revealed race-dependent divergence in perceptions of racial climate within child life and individual healthcare institutions, as well as variation in leaders’ racial consciousness and understanding of anti-racism. These findings highlight a gap between the intent and impact of child life leaders’ support strategies for BIPOC child life specialists and underscore the need to center BIPOC counter-narratives in the profession. Further, these findings indicate a need for education and sustained self-reflection toward a unified conceptualization of anti-racist leadership praxis.