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Intersectional Stigma and Sexual Health Among Sexual and Gender Minority Women

  • Female Sexual Dysfunction and Disorders (A Stanton, Section Editor)
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Abstract

Purpose of Review

The purpose of the current review is to provide a summary of the recent research published on the relationships between intersectional stigma and sexual minority women’s experiences of sexual health. Given the emerging stage of this body of work, we employed a narrative review to both elicit this summary as well as identify gaps in the current work.

Recent Findings

We found that intersectional stigma affects sexual and gender minority women’s sexual health across multiple domains of health, including intersectional social determinants of health, sexual healthcare experiences and barriers to care, STI/HIV testing and prevention, cancer screening, and sexual violence. We also found that intersectional research remains the minority of sexual health research currently produced and that sexual health researchers operationalize intersectionality and intersectional research design in varied ways.

Summary

Intersectionality remains a critical framework for eliciting more representative sexual health data among multiply minoritized populations among sexual and gender minority women.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Bowleg L. The Problem with the phrase women and minorities: intersectionality—an important theoretical framework for public health. Am J Public Health. 2012;102(7):1267–73.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Braveman P, Egerter S, Williams DR. The social determinants of health: coming of age. Annu Rev Public Health. 2011;32:381–98.

    Article  PubMed  Google Scholar 

  3. Bowleg L, Bauer G. Invited reflection: quantifying intersectionality. Psychol Women Q. 2016;40(3):337–41.

    Article  Google Scholar 

  4. Else-Quest NM, Hyde JS. Intersectionality in quantitative psychological research: II. methods and Techniques. Psychol Women Q. 2016;40(3):319–36.

    Article  Google Scholar 

  5. Bauer GR, Scheim AI. Methods for analytic intercategorical intersectionality in quantitative research: discrimination as a mediator of health inequalities. Soc Sci Med. 2019;1(226):236–45. Publication provides an overview of quantitative intersectional research design.

    Article  Google Scholar 

  6. Crenshaw K. Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. Univ Chic Leg Forum. 1989;8(1):31.

    Google Scholar 

  7. Crenshaw K. Mapping the margins: intersectionality, identity politics, and violence against women of color. Stanf Law Rev. 1991;43(6):1241–99.

    Article  Google Scholar 

  8. Collins PH. Black feminist thought: knowledge, consciousness, and the politics of empowerment. Hyman 1990;p 384

  9. The Combahee River Collective Statement [Internet]. Library of Congress, Washington, D.C. 20540 USA. [cited 2022 Jun 9]. Available from https://www.loc.gov/item/lcwaN0028151/

  10. Purdie-Vaughns V, Eibach RP. Intersectional invisibility: the distinctive advantages and disadvantages of multiple subordinate-group identities. Sex Roles. 2008;59(5):377–91.

    Article  Google Scholar 

  11. Keuchenius A, Mügge L. Intersectionality on the go: The diffusion of Black feminist knowledge across disciplinary and geographical borders. Br J Sociol. 2021;72(2):360–78.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Szymanski DM. Heterosexism and sexism as correlates of psychological distress in lesbians. J Couns Dev. 2005;83(3):355–60.

    Article  Google Scholar 

  13. Ghabrial MA. “Trying to figure out where we belong”: narratives of racialized sexual minorities on community, identity, discrimination, and health. Sex Res Soc Policy. 2017;14(1):42–55.

    Article  Google Scholar 

  14. Herek GM. Sexual stigma and sexual prejudice in the United States: a conceptual framework. In: Contemporary perspectives on lesbian, gay, and bisexual identities. New York, NY, US: Springer Science + Business Media; 2009. p 65–111. (Nebraska Symposium on Motivation).

  15. Major B, Dovidio JF, Link BG. The Oxford handbook of stigma, discrimination, and health [Internet]. The Oxford Handbook of Stigma, Discrimination, and Health. Oxford University Press; 2018 [cited 2022 May 19]. Available from https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780190243470.001.0001/oxfordhb-9780190243470

  16. Sovacool BK, Axsen J, Sorrell S. Promoting novelty, rigor, and style in energy social science: towards codes of practice for appropriate methods and research design. Energy Res Soc Sci. 2018;1(45):12–42.

    Article  Google Scholar 

  17. James SE, Herman JL, Rankin S, Keisling M, Mottet L, Anafi M. The report of the 2015 U.S. Transgender Survey. Washington (DC): National Center for Transgender Equality. 2016.

  18. Gattamorta KA, Salerno JP, Castro AJ. Intersectionality and health behaviors among US high school students: examining race/ethnicity, sexual identity, and sex. J Sch Health. 2019;89(10):800–8.

    Article  PubMed  Google Scholar 

  19. Santos CA, Williams EC, Rodriguez J, Ornelas IJ. Sexual health in a social and cultural context: a qualitative study of young Latina lesbian, bisexual, and queer women. J Racial Ethn Health Disparities. 2017;4(6):1206–13.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Turner CM, Ahern J, Santos GM, Arayasirikul S, Wilson EC. Parent/caregiver responses to gender identity associated with HIV-related sexual risk behavior among young trans women in San Francisco. J Adolesc Health. 2019;65(4):491–7.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wilson EC, Dhakal M, Sharma S, Rai A, Lama R, Chettri S, et al. Population-based HIV prevalence, stigma and HIV risk among trans women in Nepal. BMC Infect Dis. 2021;21(1):128.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Gessner M, Bishop MD, Martos A, Wilson BDM, Russell ST. Sexual minority people’s perspectives of sexual health care: understanding minority stress in sexual health settings. Sex Res Social Policy. 2020;17(4):607–18.

    Article  PubMed  Google Scholar 

  23. Ejaife OL, Ho IK. Healthcare experiences of a Black lesbian in the United States. J Health Psychol. 2019;24(1):52–64.

    Article  PubMed  Google Scholar 

  24. Agénor M, Pérez AE, Wihoit A, Almeda F, Charlton BM, Evans ML, Borrero S, Austin B. Contraceptive care disparities among sexual orientation identity and racial/ethnic subgroups of U.S. women: a national probability sample study. J Women’s Health. 2021;30(10):1406–15.

    Article  Google Scholar 

  25. Cerezo A, Ching S, Ramirez A. Healthcare access and health-related cultural norms in a community sample of black and Latinx sexual minority gender expansive women. J Homosex. 2021;29:1–24. Publication provides an in-depth qualitative analysis of how intersectional identity and discrimination affect Black and Latinx women’s interactions with sexual healthcare services.

    Article  Google Scholar 

  26. Bastos JL, Harnois CE, Paradies YC. Health care barriers, racism, and intersectionality in Australia. Soc Sci Med. 2018;199:209–18.

    Article  PubMed  Google Scholar 

  27. McNulty MC, Acree ME, Kerman J, Williams HHS, Schneider JA. Shared decision making for HIV pre-exposure prophylaxis (PrEP) with black transgender women. Cult Health Sex. 2021;13:1–20.

    Google Scholar 

  28. Logie CH, Lys CL, Dias L, Schott N, Zouboules MR, MacNeill N, et al. “Automatic assumption of your gender, sexuality and sexual practices is also discrimination”: Exploring sexual healthcare experiences and recommendations among sexually and gender diverse persons in Arctic Canada. Health Soc Care Community. 2019;27(5):1204–13.

    PubMed  Google Scholar 

  29. Grant R, Nash M, Hansen E. What does inclusive sexual and reproductive healthcare look like for bisexual, pansexual and queer women? Findings from an exploratory study from Tasmania, Australia. Cult Health Sex. 2020;22(3):247–60.

    Article  PubMed  Google Scholar 

  30. Agénor M, Pérez AE, Koma JW, Abrams JA, McGregor AJ, Ojikutu BO. Sexual orientation identity, race/ethnicity, and lifetime HIV testing in a national probability sample of U.S. Women and Men: An Intersectional Approach. LGBT Health. 2019;6(6):306–18. Publication provides an example of a population-level intersectional design highlighting HIV testing access across intersectional identity.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Logie CH, Gibson MF. A mark that is no mark? Queer women and violence in HIV discourse. Cult Health Sex. 2013;15(1):29–43.

    Article  PubMed  Google Scholar 

  32. Harvey TD, Opara I, Wang EA. Role of the intersections of gender, race and sexual orientation in the association between substance use behaviors and sexually transmitted infections in a national sample of adults with recent criminal legal involvement. Int J Environ Res Public Health. 2022;19(7):4100.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Abubakari GM, Dada D, Nur J, Turner D, Otchere A, Tanis L, et al. Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review. BMJ Open. 2021;11(8):e047280.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Agénor M, Pérez A, Peitzmeier SM, Potter J, Borrero S. Human papillomavirus vaccination initiation among sexual orientation identity and racial/ethnic subgroups of Black and White U.S. women and girls: an intersectional analysis. J Womens Health. 2018;27(11):1349–58.

    Article  Google Scholar 

  35. Zubizarreta D, Beccia AL, Trinh MH, Reynolds CA, Reisner SL, Charlton BM. Human papillomavirus vaccination disparities among U.S. college students: an intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA). Soc Sci Med. 2022;301:114871.

    Article  PubMed  Google Scholar 

  36. Dean LT, Greene N, Adams MA, Geffen SR, Malone J, Tredway K, et al. Beyond Black and White: race and sexual identity as contributors to healthcare system distrust after breast cancer screening among US women. Psychooncology. 2021;30(7):1145–50.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Poteat TC, Adams MA, Malone J, Geffen S, Greene N, Nodzenski M, et al. Delays in breast cancer care by race and sexual orientation: results from a national survey with diverse women in the United States. Cancer. 2021;127(19):3514–22.

    Article  PubMed  Google Scholar 

  38. Chen J, Walters ML, Gilbert LK, Patel N. Sexual violence, stalking, and intimate partner violence by sexual orientation, United States. Psychol Violence. 2020;10(1):110–9.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Canan SN, Jozkowski KN, Wiersma-Mosley JD, Bradley M, Blunt-Vinti H. Differences in lesbian, bisexual, and heterosexual women’s experiences of sexual assault and rape in a national U.S. sample. J Interpers Violence. 2021;36(19–20):9100–20.

    Article  PubMed  Google Scholar 

  40. Whitfield DL, Coulter RWS, Langenderfer-Magruder L, Jacobson D. Experiences of intimate partner violence among lesbian, gay, bisexual, and transgender college students: the intersection of gender, race, and sexual orientation. J Interpers Violence. 2021;36(11–12):NP6040–64.

    Article  PubMed  Google Scholar 

  41. Flanders CE, VanKim N, Anderson RE, Tarasoff LA. Exploring potential determinants of sexual victimization disparities among young sexual minoritized people: a mixed-method study. Psychology of Sexual Orientation and Gender Diversity [Internet]. 2021 Sep 2 [cited 2021 Sep 22]; Available from http://proxy.mtholyoke.edu:2048/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=pdh&AN=2021-81526-001&site=eds-live&scope=site

  42. Gilmore AK, Walsh K, López C, Fortson K, Oesterle DW, Salamanca NK, et al. Sexual assault victimization: Latinx identity as a protective factor for sexual minorities. J Interpers Violence. 2021;10:0886260521999122.

    Google Scholar 

  43. Hawkey AJ, Ussher JM, Liamputtong P, Marjadi B, Sekar JA, Perz J, et al. Trans women’s responses to sexual violence: vigilance, resilience, and need for support. Arch Sex Behav. 2021;50(7):3201–22.

    Article  PubMed  Google Scholar 

  44. Sanger N, Lynch I. ‘You have to bow right here’: heteronormative scripts and intimate partner violence in women’s same-sex relationships. Cult Health Sex. 2018;20(2):201–17.

    Article  PubMed  Google Scholar 

  45. Tam MW. Queering reproductive access: reproductive justice in assisted reproductive technologies. Reprod Health. 2021;18(1):164.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Bilge S. The fungibility of intersectionality: an Afropessimist reading. Ethn Racial Stud. 2020;43(13):2298–326.

    Article  Google Scholar 

  47. Bilge S. Intersectionality undone: saving intersectionality from feminist intersectionality studies 1. Du Bois Review: Social Science Research on Race. 2013 ed;10(2):405–24.

  48. Balsam KF, Molina Y, Beadnell B, Simoni J, Walters K. Measuring multiple minority stress: the LGBT people of color microaggressions scale. Cultur Divers Ethnic Minor Psychol. 2011;17(2):163–74.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Scheim AI, Bauer GR. The intersectional discrimination index: development and validation of measures of self-reported enacted and anticipated discrimination for intercategorical analysis. Soc Sci Med. 2019;1(226):225–35.

    Article  Google Scholar 

  50. Singer M, Bulled N, Ostrach B, Mendenhall E. Syndemics and the biosocial conception of health. Lancet. 2017;389(10072):941–50.

    Article  PubMed  Google Scholar 

  51. Sexual and Gender Minority Research Office. Bisexual health research workshop: identifying research opportunities in bisexual health research [Internet]. National Intitutes of Health. Available from https://dpcpsi.nih.gov/sites/default/files/Summary_BisexualHealthResearchWorkshopv2_508.pdf

  52. Brenick A, Romano K, Kegler C, Eaton LA. Understanding the influence of stigma and medical mistrust on engagement in routine healthcare among Black women who have sex with women. LGBT Health. 2017;4(1):4–10.

  53. Greene MZ, Hughes TL, Hanlon A, Huang, L, Sommers, MS, Meghani SH. Predicting cervical cancer screening among sexual minority women using classification and regression tree analysis. Preventative Medicine Reports. 2019;13:153–9.

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Authors and Affiliations

  1. Department of Psychology & Education, Mount Holyoke College, South Hadley, USA

    Corey E. Flanders, Saachi Khandpur & Rose Fitzgerald

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  1. Corey E. Flanders
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Correspondence to Corey E. Flanders.

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Flanders, C.E., Khandpur, S. & Fitzgerald, R. Intersectional Stigma and Sexual Health Among Sexual and Gender Minority Women. Curr Sex Health Rep 14, 190–199 (2022). https://doi.org/10.1007/s11930-022-00338-7

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