This chapter examines how environmental racism, medical misogyny, and racialized scientific discourse shaped the diagnosis and treatment of endometriosis in the latter half of the twentieth century. Building on the eugenic frameworks established by Joe Vincent Meigs, who pathologized endometriosis as a “career-woman’s disease” afflicting only white, upper-class women, this chapter interrogates the systemic exclusion of Black women from diagnosis and care. Through archival analysis of mid-century gynecology research, the pioneering work of Black gynecologist Donald Chatman, and the development of environmental justice movements, this chapter reveals how medical racism and environmental toxicity became intertwined in the narrative of gynecological pain. Drawing from feminist disability studies and Black disability politics, it explores how toxins like dioxin and PCBs, disproportionately present in communities of color, have been linked to endometriosis, yet research and advocacy efforts have centered white women’s experiences. The chapter critiques the Endometriosis Association’s racial blind spots while calling for an anti-racist, intersectional approach to endometriosis research and care. By reframing endometriosis as both a site of environmental injury and diagnostic neglect, this chapter situates the disease within broader structures of racial capitalism, reproductive control, and ecological harm.