The 130th Annual Meeting of APHA

Abstract #38835

Cheryl B Pearson-Fields, MPH, Mautner Project for Lesbians with Cancer, 1707 L Street, NW, Suite 500, Washington, DC 20036, (301) 332-5536, cfields@mautnerproject.org

Background: Barriers to care for lesbians have long been documented. However, there exists a lack of comparable health behavior and access information on butch lesbians. Women whose gender expression is incongruent with their sex may face additional barriers in accessing healthcare. Describing those barriers is the first step overcoming them.

Methods: The Mautner Project conducted focus groups with African American, White, and Asian butch lesbians, 25-45, who were DC residents. None identified as transgendered or transsexual. Participants were recruited through various avenues including the Project’s newsletter, and website, etc. Participants were consented. Groups were taped and later transcribed and analyzed using standard qualitative methodologies. Discussion focused on internal identity, construction of an outward butch expression, external perception, healthseeking behaviors and barriers to healthcare.

Findings: Gender presentation was carefully constructed. Discrimination or harsh treatment related to external gender perception was a common theme. Consequences of being read as male included a perceived sexual assault. Barriers to healthcare were related to homophobia and lack of insurance coverage, among others factors. Participants expressed reluctance to seek gynecologic care. Most participants described childhood gender atypical behavior.

Discussion: Butch identity seemed to strongly impact their health seeking behavior. Participants described a stoicism regarding their healthcare similar to that expressed by heterosexual males. This suggests that targeted health strategies may be useful for this population.

Learning Objectives: