Healthcare Experiences of US Sexual Minority Women and Gender Diverse People of Color: Understanding Stigma, Satisfaction, and Sequelae
Open Access DepositedThere is an urgent need for healthcare provider- and system-level interventions to achieve health equity for cisgender and transgender sexual minority women of color (SMWOC): Inequities in health outcomes are a profound reality for SMWOC, but they remain understudied in health-related literature. Effective interventions need to be informed by a deep understanding of individuals’ healthcare experiences. The present study aimed to advance knowledge regarding SMWOC’s conceptualization of both positive and negative aspects of healthcare experiences as well as the sequelae of such positive and negative healthcare experiences regarding psychological well-being and future engagement in healthcare. I conducted six virtual focus groups in 2022-2023, recruiting for SMWOC. Participants were sexual minority women and gender diverse people of color 18-45 years of age living in 23 urbanized areas, across 17 states of the U.S. I thematically analyzed the data using the Framework Method, supported by an intersectionality framework to keep the focus on structural inequities and social power differentials. The sample included 34 participants (5-8 participants per group). I conceptualized participants’ healthcare experiences as a comprehensive process that encompasses an individual’s decision to seek healthcare, the visit itself, and the resulting sequelae of the visit. Thematically, progression through the stages was characterized by anxiety, driven by anticipated stigma before the healthcare visit, a feeling of powerlessness or lack of agency during the visit, and a general sense of exhaustion after the visit. System- and healthcare provider-level interventions need to focus on empowering patients in healthcare settings. Health equity for sexual and gender minority individuals of color cannot be achieved until they feel seen, heard, understood, and welcome during healthcare experiences.
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