Queering and Intersectionalizing Health Services Research: Structural Influences on Minoritized Sexual and Gender Populations’ Mammogram Usage

Abstract

Breast/chest cancer screening, such as mammography, is recommended to detect breast/chest cancer in its earlier stages; a growing body of research on breast/chest cancer screening suggests that sexually and gender minoritized (SGM) populations experience unique barriers to timely detection of breast/chest cancer screening. A notable barrier to preventive health service use among SGM communities is cisheteropatriarchy, yet many SGM people also have overlapping experiences of oppression from structural racism and urbanism. Little research explores how structural oppression manifests for mammogram usage among those with minoritized sexual orientations, gender identities and races and ethnicities and marginalized by rurality. Using 2022 Behavioral Risk Factor Surveillance System (BRFSS) data, this research is among the first to explore the relationship between mammogram usage and the intersections of sexual orientation, gender identity, rurality, race and ethnicity. This dissertation presents results on mammogram usage for these populations; further, it aims to bring critical social theories, including queer theory and intersectionality, into conversation with health services research. Lastly, I construct a composite measure of state-level structural cisheteropatriarchy and examine its relationship to mammogram usage with specific attention to the impact of structural cisheteropatriarchy on SGM communities. This research proposes a structural intersectionality approach to studying inequities in mammogram usage for minoritized sexual and gender populations.