Impact of Race, Sexuality, and Gender on the Health of Black Lesbians: An Intersectionality Perspective

A longstanding critique of LGBT health research and intervention is the lack of attention to ethnic and gender diversity (IOM Report on Lesbian Health, 1999; IOM Report on LGBT Health, 2011). A key question that arises in the study of multiple marginalized social statuses is how these statuses are understood and negotiated. Even when this is illuminated, it remains unclear how such conceptualizations are related to health. The author address these questions with findings from a mixed-methods study on the sexual health of Black lesbians (N=28). The study focused on the ways participants conceptualized their ethnic/racial, lesbian gender, and sexual identities and how these conceptualizations were related to sexual health care access and views about sexual agency. Core themes that emerged illustrate a pattern of connections between these social statuses and social contexts that bring to the fore saliency of a variety of identities, for example, political and cultural saliency of racial identities, interpersonal saliency of sexual identities, and communal and health saliency of lesbian gender identities. In particular, lesbian gender, a term used to describe how some lesbians identify with regard to masculinity and/or femininity (e.g., stud identity), appears to be a significant social status relevant to sexual health, such as obtaining regular pap exams. Lesbian gender also structured opportunities for sexual agency within community expectations for sexual expression. The author will discuss methodological challenges of studying multiple marginalized social statuses in health disparities intervention research and implications for public health policy.