Abstract
Objective
Health care discrimination contributes to medical mistrust among marginalized communities.
Sexual minority women of color (SM-WOC) are marginalized because of the intersection
of their sexual orientation, gender, and race/ethnicity and regularly report poor
health care experiences at the intersection of these identities. However, research
has yet to quantify differences in the prevalence of reported health care discrimination
across SM women of various racial/ethnic backgrounds. As such, this study compared
the rates of discriminatory treatment during the most recent medical appointment between
SM-WOC (Black, Hispanic, Asian American, Native American) and White SM women.
Methods
We used nationally representative data from the Association of American Medical Colleges
survey of health care services. Data were collected from 2010 to 2019 from N = 1,499 SM women (n = 458 SM-WOC). Binary logistic regressions compared frequencies of reported identity-based
discrimination between each minoritized racial/ethnic group to White SM women.
Results
Across the sample, 33% of SM-WOC reported discrimination during their last medical
appointment compared with 19% of White SM women. Discriminatory treatment was more
common among every minoritized racial/ethnic group of SM women compared with White
SM women, with variability in frequency of specific forms of identity-based discrimination
across minoritized racial/ethnic groups.
Conclusions
Although discriminatory treatment during the last medical appointment was common for
all SM women, prevalence was higher for SM-WOC compared with White SM women. Findings
have important implications for policy and practice to reduce health disparities such
as targeted interventions for SM-WOC and provider trainings in cultural humility,
implicit bias, and common microaggressions.
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Biography
Shelby B. Scott, PhD, is an Assistant Professor of Psychology at the University of Texas at San Antonio and a Licensed Clinical Psychologist. Her research interests include health disparities and intimate relationships among marginalized populations (e.g., LGBTQ, women of color).
Biography
Karie Gaska, PhD, MSW, is an Assistant Professor of Behavioral Sciences at Ross University School of Medicine. Her research interests are in health equity, building empathy within medical education, and community-based approaches to mental health and wellbeing.
Biography
Kayla C. Knopp, PhD, is a Clinical Research Psychologist at the VA San Diego Health care System. Her specialty is intimate relationships, with a focus on diversity, mental health, and increasing access and efficacy of relationship interventions.
Biography
Quyen A. Do, MEd, is a PhD Candidate in Psychology at the University of Texas at San Antonio (UTSA). Her research interests include psychological trauma and interpersonal violence in marginalized communities examined within an intersectionality framework.
Biography
Joyce P. Yang, PhD, is an Assistant Professor of Psychology at the University of San Francisco. She uses community-based participatory research methods to examine issues of mental health equity and identity-related oppression such as race-based stress and trauma.
Article info
Publication history
Published online: December 12, 2022
Accepted:
October 31,
2022
Received in revised form:
October 5,
2022
Received:
May 18,
2022
Publication stage
In Press Corrected ProofFootnotes
Data for this project were granted by the Association of American Medical Colleges to the authors. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. There are no conflicts of interest that may influence the research or the interpretation of the findings.
Identification
Copyright
© 2022 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.
