Exploring the Cervical Cancer Screening Experiences of Black Lesbian, Bisexual, and Queer Women: The Role of Patient-Provider Communication

Abstract

Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, focus group discussions were conducted in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, the authors enrolled 18 black LBQ women who participated in one of four focus groups. Using thematic analysis, patient-provider communication was identified, which consisted of four sub-themes—health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and sociodemographic background—as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women’s health care, and increasing the presence of LBQ women of color in health care settings.

KEYWORDS:

• bisexual
• cervical cancer screening
• discrimination
• lesbian
• race
• racism
• sexual orientation

Acknowledgments

The authors are grateful to the focus group participants for their time and willingness to share their experiences. Thanks also go to the individuals and organizations who helped recruit participants for this study, especially the Hispanic Black Gay Coalition and the YWCA Boston and Women’s Center for hosting the focus groups.

Notes

1. Although used in a derogatory manner only a few decades ago, “queer” has been reclaimed by many lesbian, gay, bisexual, and transgender individuals as an umbrella term that captures all persons whose identities, experiences, attractions, and/or expectations do not conform to heteronormative sexual and/or gender norms and roles.

Additional information

Funding

This research was supported by a grant from The Open Gate of the Harvard Gender and Sexuality Caucus, awarded to M. Agénor. M. Agénor was also supported by the Stephen B. Kay Family Public Health Scholarship and the Horace W. Goldsmith Fellowship at Harvard T. H. Chan School of Public Health. S. Bryn Austin is supported by the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services training grant MC00001 and Leadership Education in Adolescent Health grant 6T71-MC00009.