Health Equity| Volume 31, ISSUE 3, P263-270, May 2021

Black Women's Psychosocial Experiences with Seeking Surgical Treatment for Uterine Fibroids: Implications for Clinical Practice

Published:February 18, 2021DOI:



      Black women are more likely to undergo surgery for uterine fibroids compared with non-Black women. However, few studies have characterized the psychosocial experiences of Black women seeking fibroid treatment. We aimed to identify factors that shape Black women's fibroid management decisions; explore how discrimination based on race, class, and gender feature in treatment-seeking experiences, and compare experiences across age and socioeconomic status.


      We conducted semistructured interviews with 37 Black women undergoing surgery for fibroid management. We used a thematic analysis to code transcripts and identify themes.


      Participants were predominately single, college educated, and insured. Respondents reported that patient–doctor interactions, support from social networks, fertility consequences, and fear of fibroid malignancy influenced their fibroid management decisions. Knowledge and perceptions of fibroids were also influenced by community norms and differed by socioeconomic status; women of higher socioeconomic status had greater fibroid awareness than women of lower socioeconomic status. Discrimination was discussed in the context of historical inequity against Black women, with one participant questioning whether Black women were valued less in clinical settings compared with non-Black women. Although several women discussed positive experiences seeking fibroids care, others expressed medical mistrust or said that alternative management options were not offered by clinicians.


      Fibroid management decisions were influenced not only by interactions with clinicians and social networks, and concerns about fertility and fibroid malignancy, but also by broader social and historical conditions. These findings suggest that clinicians should deliver intersectional gynecologic care that centers the voices of Black women seeking fibroid treatment.
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      Brianna N. VanNoy, MPH, is a rising public health scholar interested in advancing environmental health equity for marginalized communities. She holds a BS in Environmental Public Health (Ohio State University) and an MPH in Environmental Health Science and Policy (George Washington University).


      Lisa Bowleg, PhD, MA, Professor of Psychology, George Washington University, is a leading scholar of intersectionality, focusing on the effects of social context on Black men's sexual HIV risk and protective behaviors, and stress and resilience among Black lesbian, gay, and bisexual people.


      Cherie Q. Marfori, MD, is a board-certified surgical gynecologist and Assistant Professor with the George Washington University. She specializes in minimally invasive gynecologic surgery and cares for patients with problems across the entire surgical gynecologic spectrum, including fibroids, endometriosis, and gender dysphoria.


      Gaby Moawad, MD, board-certified surgical gynecologist and Associate Professor (George Washington University), specializes in minimally invasive gynecologic surgery, providing a wide range of gynecologic services, including treatment of menstrual disorders and fibroids, endometriosis and pelvic pain, and pelvic organ prolapse.


      Ami R. Zota, ScD, MS, Associate Professor (Department of Environmental & Occupational Health, George Washington University Milken Institute School of Public Health) seeks to secure environmental justice and improve health equity through advancements in science, policy, and clinical practice. Her research identifies novel pathways linking social disparities, environmental exposures, and reproductive and children's health.