Addressing Barriers to Black Women’s Disclosure of Sexual Pain to their Medical Providers
By Shemeka Thorpe
Studies estimate that roughly two-thirds of women distressed by sexual problems do not seek medical help, leading to them being undiagnosed or receiving delayed diagnosis and treatment. Black women who experience chronic pain, pain related to reproductive health, and pain related to sexual difficulties all face the risk of being judged, misunderstood, and misdiagnosed by medical providers. Additionally, a 2012 study found that only 40% of OBGYNs discuss sexual difficulties with their patients. When providers initiate conversations about sexual health, they are more likely to discuss contraceptives, sexual risk behaviors, and family planning than sexual functioning and sexual difficulties. Combined with the fact that Black women often experience more healthcare discrimination, judgment, and lower quality of care it is not surprising that they are hesitant to disclose their sexual pain to medical providers. The goal of this study was to explore the pathway from sexual pain disclosure to treatment among Black women living in the Southern United States.
From our recently published study, we found that Black women face several barriers to disclosing their sexual pain to their provider including:
Limited access to Black women providers.
Minimizing and dismissing their own pain due to perceived societal expectations that Black women have a higher pain tolerance.
Desire to do their own research and feel extremely knowledgeable before an appointment so their doctors will listen to them.
Medical mistrust
Fear of affirming racist stereotypes of being hypersexual and promiscuous.
Historical trauma of medical experimentation and reproductive coercion on Black women (see the founding mothers of modern gynecology).
Provider implicit bias and discrimination.
Provider’s fatphobia toward their patients.
The provider’s spent a short amount of time with them and did not ask questions about difficulties during their appointments.
Racist encounters.
Only half of the participants disclosed their sexual pain to their medical providers. Among those that reported treatment, it ranged from invasive to non-invasive methods including not treating the problem at all/ignoring their complaints, telling women to have hysterectomies, encouraging the use of lubricant, telling a woman to have a baby to relieve the pain, encouraging one woman to just hold onto the side of the bed when sex became painful and finally, some encouraged biopsychosocial treatment plans which included physical therapy and mental health therapists.
We encourage providers to:
1) Initiate conversations about sexual pain and difficulties
2) Recognize the biases they have toward Black women and work to mitigate their impact on patient care by undergoing training on gendered racism in healthcare
3) Add questions about sexual pain and difficulties in intake forms
4) Follow up with patient responses to the intake forms during the actual visit
Additionally, medical programs and healthcare settings should intentionally recruit, retain, and ensure equitable treatment and pay for Black women physicians.
Article Details
“Why Would I Talk To Them About Sex?”: Exploring Patient-Provider Communication Among Black Women Experiencing Sexual Pain
Shemeka Thorpe, Praise Iyiewuare, Samuella Ware, Natalie Malone, Jasmine K. Jester, Jardin N. Dogan, Candice N. Hargons
First Published June 25, 2022 Research Article
DOI: 10.1177/10497323221110091
Qualitative Health Research
