"Am I Truly Invisible?": A Qualitative Study on Black Women's Experiences of and Coping With Intersectional Invisibility in Uterine Fibroid Treatment

Abstract

Background: Black women are disproportionately burdened by uterine leiomyomas (fibroids) and face intersectional invisibility wherein their needs are ignored in health care settings due to sexism and racism. Our objective was to elucidate Black women's experiences in fibroid treatment and the strategies they use to protect their health and counter their intersectional invisibility.

Methods: We recruited participants from the Fibroids Observational Research on Genes and the Environment (FORGE) Study. We conducted semistructured individual interviews (average length 45 minutes) on Black women's experiences in fibroid treatment. We analyzed the transcripts using a thematic analytical approach and intersectionality, a critical analytical framework that allows for the examination of how sexism and racism intersect to influence health inequities.

Results: Participants were 16 Black women aged 30-52 years who were seeking fibroid treatment in Washington, DC. Our analysis revealed that participants experience gendered racism (the intersection of sexism and racism) in fibroid treatment, mirroring a historical and ongoing pattern of how Black women are treated in health care settings, and that they manage their intersectional invisibility by engaging in strategies characteristic of the superwoman schema: projecting strength, suppressing emotions, resisting being dependent, and striving to succeed despite limited resources. Participants also highlighted that their ideal fibroid-related care would include a holistic approach and social support.

Conclusions: Our findings emphasize that Black women's intersectional invisibility extends to fibroid treatment, reflecting the social-structural inequities that they face in health care settings more broadly. Attendance to Black women's voices in research and practice can help decrease their intersectional invisibility and subsequently improve their fibroid treatment and related health outcomes.