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Thorpe S, Dogan-Dixon J, Malone N, Palomino KA. 'Just be strong and keep going': the influence of Superwoman Schema on Black women's perceived expectations of coping with sexual pain. CULTURE, HEALTH & SEXUALITY 2024; 26:346-361. [PMID: 37226881 PMCID: PMC11214806 DOI: 10.1080/13691058.2023.2210199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 05/01/2023] [Indexed: 05/26/2023]
Abstract
Superwoman Schema, a conceptual framework that reflects Black women's ability to overcome gendered racism and stress, affects the way Black women choose to cope with health-related issues. The purpose of this study was to investigate how Black women perceive they should cope with sexual pain using the Superwoman Schema as an analytic and interpretative guide. Data were derived from participants who completed an individual interview on sexual pain and pleasure. Deductive thematic analysis was conducted. Results indicated whereas some Black women endorsed all five components of Superwoman Schema as coping strategies for sexual pain, other Black women resisted SWS completely. Additionally, one participant was an outlier and did not endorse or resist SWS. Implications for generational sexual health interventions for Black women are discussed.
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Affiliation(s)
- Shemeka Thorpe
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Jardin Dogan-Dixon
- Department of Educational, School & Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Natalie Malone
- Department of Educational, School & Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Kaylee A. Palomino
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
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Connor JJ, Abdi C, Chen M, Salad M, Pergament S, Afey F, Hussein I, Robinson BBE. Our Body Our Health (Jirkeena, Caafimaadkeena): Somali Women's Narratives on Sexual Health. JOURNAL OF SEX RESEARCH 2023:1-15. [PMID: 38047877 PMCID: PMC11147957 DOI: 10.1080/00224499.2023.2288077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Women across the globe have been subject to female genital cutting (FGC), with the highest rates in Somalia. FGC can result in sexual concerns, especially sexual pain and lower pleasure. Due to ongoing civil war and climate disasters, there is a large number of Somali immigrants and refugees living in countries where healthcare providers may be unfamiliar with the impact of FGC. In this qualitative study, sixty Somali women between the ages 20 and 45 and living in the U.S. shared their perspectives on how FGC has affected their sexual lives, including how they have coped with any complications attributed to FGC. Participants were recruited through convenience sampling and interviewed by a bilingual community researcher in either Somali or English. Data were analyzed through a participatory analysis process by academic and community researchers. Themes included sexual desire, arousal, and pleasure; sexual satisfaction; sexual pain at first intercourse; coping with sexual pain at first intercourse; long-term sexual pain, coping with long-term sexual pain. Results are discussed with a focus on agency of the participants, role of partners, and implications for healthcare professionals.
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Affiliation(s)
- Jennifer Jo Connor
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Cawo Abdi
- Department of Sociology, University of Minnesota
| | - Muzi Chen
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Munira Salad
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Shannon Pergament
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Foos Afey
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Intisar Hussein
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Beatrice Bean E Robinson
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
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Mathur VA, Payano Sosa JS, Keaser ML, Meiller TF, Seminowicz DA. The social context of burning mouth syndrome: an exploratory pilot study of stigma, discrimination, and pain. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:1213-1218. [PMID: 37314981 PMCID: PMC10628978 DOI: 10.1093/pm/pnad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/24/2023] [Accepted: 06/12/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND The social context of burning mouth syndrome (BMS) has received little attention in the scientific literature. However, social psychological theory and insights from those with lived experiences suggest that people living with BMS experience compounding effects of stigma related to their pain, diagnosis (or lack thereof), and intersectional identities. OBJECTIVE Our aim is to provide initial evidence and to motivate new directions for research on BMS. Here, we present the results of an exploratory pilot study (n = 16) of women living with BMS in the United States. METHODS Participants completed self-report measures of stigma, discrimination, and pain, as well as laboratory assessments of pain through quantitative sensory testing. RESULTS Results indicate a high prevalence of internalized BMS stigma, experience of BMS-related discrimination from clinicians, and gender stigma consciousness in this population. Moreover, results provide initial evidence that these experiences are related to pain outcomes. The most robust pattern of findings is that internalized BMS stigma was related to greater clinical pain severity, interference, intensity, and unpleasantness. CONCLUSION Given the prevalence and pain-relevance of intersectional stigma and discrimination identified in this pilot study, lived experience and social context should be incorporated into future research on BMS.
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Affiliation(s)
- Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX 77843, United States
| | - Janell S Payano Sosa
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, United States
| | - Michael L Keaser
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, United States
| | - Timothy F Meiller
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, United States
| | - David A Seminowicz
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, United States
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
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Najor A, Melson V, Lyu J, Fadadu P, Bakkum-Gamez J, Sherman M, Kaunitz A, Connor A, Destephano C. Disparities in Timeliness of Endometrial Cancer Care: A Scoping Review. Obstet Gynecol 2023; 142:967-977. [PMID: 37734095 PMCID: PMC10510803 DOI: 10.1097/aog.0000000000005338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE We use the person-centered Pathway to Treatment framework to assess the scope of evidence on disparities in endometrial cancer stage at diagnosis. This report is intended to facilitate interventions, research, and advocacy that reduce disparities. DATA SOURCES We completed a structured search of electronic databases: PubMed, EMBASE, Scopus, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials databases. Included studies were published between January 2000 and 2023 and addressed marginalized population(s) in the United States with the ability to develop endometrial cancer and addressed variable(s) outlined in the Pathway to Treatment. METHODS OF STUDY SELECTION Our database search strategy was designed for sensitivity to identify studies on disparate prolongation of the Pathway to Treatment for endometrial cancer, tallying 2,171. Inclusion criteria were broad, yet only 24 studies addressed this issue. All articles were independently screened by two reviewers. TABULATION, INTEGRATION, AND RESULTS Twenty-four studies were included: 10 on symptom appraisal, five on help seeking, five on diagnosis, and 10 on pretreatment intervals. Quality rankings were heterogeneous, between 3 and 9 (median 7.2) per the Newcastle-Ottawa Scale. We identified three qualitative, two participatory, and two intervention studies. Studies on help seeking predominantly investigate patient-driven delays. When disease factors were controlled for, delays of the pretreatment interval were independently associated with racism toward Black and Hispanic people, less education, lower socioeconomic status, and nonprivate insurance. CONCLUSIONS Evidence gaps on disparities in timeliness of endometrial cancer care reveal emphasis of patient-driven help-seeking delays, reliance on health care-derived databases, underutilization of participatory methods, and a paucity of intervention studies. SYSTEMATIC REVIEW REGISTRATION Given that PROSPERO was not accepting systematic scoping review protocols at the time this study began, this study protocol was shared a priori through Open Science Framework on January 13, 2021 (doi: 10.17605/OSF.IO/V2ZXY), and through peer review publication on April 13, 2021 (doi: https://doi.org/10.1186/s13643-021-01649-x).
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Affiliation(s)
- Anna Najor
- Department of Obstetrics and Gynecology, Montefiore Medical Center, Bronx, New York; the Alix School of Medicine and the Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota; the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and the Department of Laboratory Medicine and Pathology and the Department of Obstetrics and Gynecology, Mayo Clinic, and the University of Florida College of Medicine, Jacksonville, Florida
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Dogan JN, Thorpe SY, Malone N, Jester J, Stevens-Watkins D, Hargons C. 'My partner will think I'm weak or overthinking my pain': how being superwoman inhibits Black women's sexual pain disclosure to their partners. CULTURE, HEALTH & SEXUALITY 2023; 25:567-581. [PMID: 35533710 PMCID: PMC11214807 DOI: 10.1080/13691058.2022.2072956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/28/2022] [Indexed: 05/10/2023]
Abstract
Black women experience persistent sexual pain that may often last longer than White women. Despite the value of sexual communication to alleviate sexual pain concerns, many women do not disclose sexual pain to their partners. Limited research explores barriers to disclosing sexual pain to partners among Black women. This study seeks to fill this gap. Relying on an integration of Sexual Script theory and Superwoman Schema, the study explored the barriers that premenopausal, cisgender Black women from the Southern USA perceived when disclosing sexual pain to their primary partners. We identified five common themes from women's open-ended responses to an online survey: (a) distressing emotions associated with disclosure; (b) limited knowledge and communication skills; (c) protecting partner's feelings and ego; (d) invading privacy; and (e) taking sole responsibility for managing sexual pain. Findings suggest a combination of intrapsychic, interpersonal and cultural factors influence Black women's perceived ability to have direct and open dyadic communication about sexual pain with their partners. Implications for Black women's sexual health and relationship outcomes are discussed.
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Affiliation(s)
- Jardin N Dogan
- Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Shemeka Y Thorpe
- Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Natalie Malone
- Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Jasmine Jester
- Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | | | - Candice Hargons
- Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
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Azim KA, Happel-Parkins A, Moses A, Haardoerfer R. Racialized differences across experiences and measurements of pain in genitopelvic pain/penetration disorder. J Sex Med 2023; 20:224-228. [PMID: 36763925 DOI: 10.1093/jsxmed/qdac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Despite a growing body of research on genitopelvic pain/penetration disorder (GPPPD), few studies have examined racial and ethnic differences. AIM The goal of this study was to examine differences across racial groups pertaining to GPPPD with sexual vaginal intercourse in young college women at 2 public US universities. METHODS Data were collected from 1197 students from 2 public US universities. We limited our sample to 667 sexually active participants aged ≥18 years (mean, 19.21). Participants responded to survey items on their sexual history, wellness, and practices and to the Female Sexual Function Index. Data were analyzed through standard bivariate and regression analyses. OUTCOMES Participants were asked, "In general, do you feel pain with sexual intercourse?" and categorized into 1 of 3 pain groups: occasional (10%-25% of the time), frequent (≥50%), and no pain (<10%). RESULTS GPPPD was prevalent among young college women, with 162 (24.3%) reporting pain occasionally, 119 (17.8%) frequently, and 386 (57.9%) never or very seldom. While there were no differences in pain between Latina and non-Latina participants, our analysis indicated that pain was significantly higher among all other minoritized racial groups as compared with White women but particularly high in Black women, who had 2.15-higher odds of reporting pain than White women. Differences persisted when adjusting for socioeconomic status. Specific descriptors for pain sensation were more aligned with traditional descriptors of GPPPD (eg, burning, stinging, cramping, and pinching) in the White sample than among participants of color. Pain intensity did not differ among racial groups. We also found that a significant number of participants, particularly Black women, reported experiencing painful sex occasionally. No differences were noted across racial groups when assessing sexual function with the Female Sexual Function Index. CLINICAL IMPLICATIONS Existing surveys and physician intake forms should be critically examined for usability with patients of color. As evidenced, Black women's GPPPD seems to go underdetected/undetected by current measures. STRENGTHS AND LIMITATIONS This study is the first to explicitly compare racial differences among adolescents/young adults. The most notable limitation is the reliance on participant self-report and the absence of gynecologic examination to determine pain-contributing etiologies. CONCLUSION Painful intercourse affects young Black women at a higher rate than White women. Further research is needed into categories and metrics that capture their experiences of pain.
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Affiliation(s)
- Katharina A Azim
- California Institute of Integral Studies, San Francisco, CA 94103, United States
| | | | - Amy Moses
- MOJO Pelvic Health, Memphis, TN 38104, United States
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Bennett-Brown M, Adams OR, Campbell JT, Moscovici Z, Gesselman AN. Chronic Vulvovaginal Pain in Patients of Color: Benefits of Partner Supportiveness in Relation to Sexual Dissatisfaction and Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073975. [PMID: 35409658 PMCID: PMC8997366 DOI: 10.3390/ijerph19073975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023]
Abstract
Within the social support literature, individuals who experience chronic pain have shown many positive outcomes and benefits when receiving the appropriate level of emotional support. In the current study, individuals who experience chronic vulvovaginal pain (CVVP) were asked about their partner’s supportiveness, other sources of emotional support, and their satisfaction and stress surrounding sexual activity. The participants (n = 333) also identified as people of color, with a majority identifying as African American or Black (n = 227). The participants indicated that their partners were overall supportive of their diagnoses and found other emotional support sources through medical professionals, vulvar/vaginal pain-specific medical information websites, and family or friends. After conducting linear regressions, results showed the partner supportiveness was associated with less distress and less dissatisfaction surrounding sexual activity. Future research is suggested to further examine social support’s role for minority patients who experience chronic vulvovaginal pain.
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Affiliation(s)
- Margaret Bennett-Brown
- The Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (O.R.A.); (J.T.C.); (Z.M.); (A.N.G.)
- Department of Communication Studies, Texas Tech University, Lubbock, TX 79409, USA
- Correspondence:
| | - Olivia R. Adams
- The Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (O.R.A.); (J.T.C.); (Z.M.); (A.N.G.)
| | - Jessica T. Campbell
- The Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (O.R.A.); (J.T.C.); (Z.M.); (A.N.G.)
| | - Zoe Moscovici
- The Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (O.R.A.); (J.T.C.); (Z.M.); (A.N.G.)
| | - Amanda N. Gesselman
- The Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (O.R.A.); (J.T.C.); (Z.M.); (A.N.G.)
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Meana M, Binik YM. The Biopsychosocial Puzzle of Painful Sex. Annu Rev Clin Psychol 2022; 18:471-495. [PMID: 35216521 DOI: 10.1146/annurev-clinpsy-072720-014549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Genital pain associated with sex is a prevalent and distressing problem with a complex research and clinical profile. This article reviews the historical context of the "sexual pain disorders" and the circuitous trajectory that has led from the first mention of painful sex in ancient documents to the latest diagnostic category of genito-pelvic pain penetration disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders as well as in other existing and proposed nomenclatures. Prominent etiologic research and emergent theoretical models are critically assessed, as is the latest treatment outcome research of note. Finally, the review points to a number of extant needs in the research and clinical effort, including an integrated biopsychosocial and multidisciplinary approach, randomized clinical trials, targeting of treatment barriers, and expansion of the entire enterprise to include populations that have not been considered. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Marta Meana
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA;
| | - Yitzchak M Binik
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Malone N, Thorpe S, Jester JK, Dogan JN, Stevens-Watkins D, Hargons CN. Pursuing Pleasure Despite Pain: A Mixed-Methods Investigation of Black Women's Responses to Sexual Pain and Coping. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:552-566. [PMID: 34903143 PMCID: PMC11210547 DOI: 10.1080/0092623x.2021.2012309] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The current mixed-methods study is the first to explore Black women's (N = 153) cognitive (e.g., worry about being perceived as sexually unresponsive) and emotional (e.g., sadness) responses to sexual pain based on age and relationship status, and coping strategies. Findings indicated significant differences in younger and single Black women's cognitive and emotional responses to sexual pain compared to older and coupled Black women. Qualitative responses revealed Black women engage in several proactive coping strategies to mitigate their sexual pain, including non-penetrative activities, foreplay, tools for increasing arousal, making physical adjustments, and intimacy and sexual communication. Implications for sexual health providers are discussed.
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Affiliation(s)
- Natalie Malone
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Shemeka Thorpe
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Jasmine K Jester
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Jardin N Dogan
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Candice N Hargons
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
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