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. Author manuscript; available in PMC: 2025 Jan 30.
Published in final edited form as: Sex Relation Ther. 2024 Jan 29;39(4):1423–1440. doi: 10.1080/14681994.2024.2303071

Minority stressors and psychological correlates of sexual distress among Black queer and heterosexual women

Shemeka Thorpe a, Natalie Malone b, Kasey Vigil b, Brenice Duroseau c, Praise Iyiewuare d, Kaylee Palomino b
PMCID: PMC11781609  NIHMSID: NIHMS2001400  PMID: 39885902

Abstract

Many women experience distress related to their sexual functioning. In fact, sexual distress is often the first sign of sexual functioning disorders. Yet, little is known about Black women’s experiences of sexual distress. The purpose of this study is to explore the correlation between psychological factors (distress, post-traumatic stress disorder, perceived stress, and financial worry), minority stressors (superwoman schema and sexual objectification), and sexual distress among Black queer and heterosexual women. A cross-sectional survey was administered to 448 Black women aged 19–67, recruited via social media and snowball sampling. The data was analyzed using bivariate correlations to explore the differences between Black queer women and Black heterosexual women. The findings of this study showed significant differences in sexual distress scores between Black heterosexual and queer women. However, there were significant differences in which factors were correlated with sexual distress between these two groups. Implications for culturally responsive treatments for sexual distress are included.

Keywords: Black women, sexual distress, sexual objectification, minority stressors, mental health

LAY SUMMARY

Sexual distress is one of the key components of sexual dysfunction yet, research on Black women’s experiences of distress has been overlooked. Minority stressors and mental health conditions influence sexual distress differently among Black queer and heterosexual women.

Introduction

Limited research exists on the complexities of sexual distress among Black women, leaving a significant gap in our understanding of how it affects this demographic. Defined as the experience of negative emotions such as anxiety, worry, frustration, and feelings of inadequacy related to sexual experiences (Derogatis et al., 2002), sexual distress has varying implications for mental health and overall sexual well-being. For many women, it serves as a symptom of sexual dysfunction (Carpenter et al., 2015), affecting their motivation for seeking therapy and treatment depending on their level of distress (Basson et al., 2003). The dearth of literature on sexual functioning among Black women reveals a complex interplay of factors that contribute to health disparities, such as racism and sexism (Pascoe & Smart Richman, 2009; Williams & Mohammed, 2013). Furthermore, mental health plays a role in sexual distress, with studies showing that depression correlates with increased levels of sexual distress (Hayes et al., 2008). Additionally, minority stressors related to race, gender, and sexual orientation may also impact various aspects of women’s sexual functioning, including sexual distress.

Despite these findings, social science research tends to isolate sexual functioning from other life circumstances, including minority stressors like racism, sexism, and sexual objectification (Schrode et al., 2022). A previous study focused on Black women living in southern Los Angeles, found that racism did not significantly impact sexual functioning (e.g., desire and arousal), but highlighted that higher stress related to sexism was associated with reduced sexual satisfaction (Schrode et al., 2022). Similarly, in another study among undergraduate women of color (16.2% Black), racism contributed to decreased sexual satisfaction (Zucker et al., 2016). Minority stressors related to race, gender, and sexual orientation have not been comprehensively studied for their potential impact on aspects of women’s sexual functioning, including sexual distress.

In addition to minority stressors, cultural-specific maladaptive coping mechanisms such as the “Superwoman Schema,” have been largely overlooked in existing research. Although it is known that the endorsement of certain stereotypes can have detrimental effects on Black women’s mental health, leading to increased stress, anxiety, maladaptive coping mechanisms, and depressive symptoms (Jerald et al., 2017; Watson & Hunter, 2016; Woods-Giscombé, 2010), their direct influence on sexual distress remains unexplored.

Purpose statement

This quantitative study aims to fill these gaps by exploring the psychological factors and minority stressors contributing to sexual distress among Black queer and heterosexual women. Minority stress theory posits that the increased social stress sexual minorities face due to their stigmatized social status produces health disparities between sexual minorities and their heterosexual counterparts (Frost & Meyer, 2023; Meyer 2003). Current conceptualizations of minority stress include consequences of and disparities due to social stigma along other axes of identity, such as race, sexual orientation, and gender. Since Black queer women are marginalized by race, gender, and sexual orientation, they face a triple jeopardy (Bowleg et al., 2003; Green, 1994) and tend to report more mental health concerns, discrimination, and stigma than other groups with marginalized identities as a result (Calabrese et al., 2015). As such, it is essential to do a within-group analysis of Black women to explore the differences between those who are heterosexual and those who are queer.

Materials and methods

Participants and procedures

The purpose of the BeWell Project was to quantitatively explore the influence of psychological well-being, minority stressors, and relationship satisfaction on Black women’s sexual functioning. To be eligible for the BeWell Project, participants had to 1) identify as a Black or African American cisgender woman, 2) live in the United States, 3) be over the age of 18, and 4) have sexual intercourse within the last 6 months. Upon IRB approval, data was collected from January to February 2023. The targeted sample was 400 participants with 200 who were in relationships and an oversample of 140 women who did not identify as heterosexual. Participants were recruited via social media postings on the principal investigator’s page that were then shared by other Black sexuality professionals’ Instagram stories and Facebook pages. Upon clicking the link to the Qualtrics survey, participants were prompted to take an eligibility screener. Those who were eligible received an online informed consent form before taking the full survey. Participants were asked to take a 20 to 25-min survey that contained questions about psychological factors, minority stressors, relationship satisfaction, and sexual functioning. After completing the survey, participants were entered into a raffle to win 1 of 40 $25 Amazon e-gift cards. The principal investigator (first author) checked the response rates daily to remove all bots and spammers from the data and raffle. Qualtrics fraud, bot, and duplicate protections were enforced; however, 230 participants were still identified as spam or bots. The final sample consisted of N = 448 participants.

Participants were between the ages of 19–67 (M = 33.6 SD = 8.71). Although all participants identified as Black, they were asked to select their race and ethnicity. Most participants identified as African American (n = 374; 82.8%), followed by Caribbean (n = 29; 6.5%), Bi-Racial (n = 22; 4.9%), African (n = 18, 4.0%), Hispanic/Latina (n = 5, 1.1%), and Multiethnic (n = 3, 0.7%). The majority of participants were highly educated and had four-year degrees (n = 143; 32.0%) or graduate/professional degrees (n = 192; 43.0%). Participants were recruited from all four regions of the US: South (n = 198; 44.2%), Northeast (n = 109; 24.3%), Midwest (n = 93; 20.8%), and West (n = 48; 10.7%). Finally, this was a sexually diverse sample with (n = 278; 62.2%) identifying as heterosexual followed by bisexual (n = 62; 13.9%), queer (n = 52, 11.6%), lesbian (n = 24; 5.4%), pansexual (n = 23, 5.1%), asexual (n = 3, 0.7%), questioning (n = 2, 0.4%), prefer to self-describe but did not provide a more in-depth response (n = 2, 0.4%), and no labels (n = 1, 0.3%).

Measures

Demographics

Participants were asked to report their age, ethnicity, and their highest level of education. They were also asked to report their sexual orientation with the response options of heterosexual, lesbian, bisexual, queer, pansexual, asexual, and prefer to self-describe. Participants who selected “prefer to self-describe” received a follow-up question prompting them to enter their sexual identity. A dichotomous variable was created for those that were heterosexual (1) and those that were not (0). For the purposes of this study, participants who did not identify as heterosexual were labeled using the umbrella term queer; however, it should be noted that some participants self-identified as queer.

Psychological factors

Psychological distress was measured using the Kessler Psychological Distress Scale (K10; Kessler et al., 2002; a =.88). Participants were asked to report how they have felt over the past 30 days on a five-point Likert scale of none of the time, a little of the time, some of the time, most of the time, and all of the time. Feelings included, “nervous,” “feeling so nervous that nothing could calm you down,” “feeling hopeless,” “feeling restless and fidgety,” “feeling so restless you could not sit still,” “feeling tired out for no good reason,” “feeling depressed,” “feeling worthless,” “feeling sad that nothing could cheer you up,” and “feel that everything was an effort.” Sum scores can range from 10–50. In the current sample, scores ranged from 10–49.

Post-traumatic stress disorder was measured using the Posttraumatic Stress Disorder Scale (PTSD-8; Hansen et al., 2010). Only participants who reported that they had experienced a traumatic event were given the scale. The 8-item scale asked participants “to answer how much the symptoms have bothered you since the trauma” on a four-point Likert scale of not at all, rarely, sometimes, and most of the time. Examples of symptoms include, “recurrent thoughts or memories of the event,” “recurrent nightmares about the event,” “feeling jumpy, easily startled,” and “avoiding activities that remind you of the event.” The scale has three subscales: 1) intrusion (4 items; a = .80), 2) avoidance (2 items; a = .79), and 3) hypervigilance (2 items; a = .75). Intrusion includes repeated, involuntary distressing memories, dreams, or flashbacks of the traumatic event. Avoidance includes avoiding places, people, or activities that may remind someone of a traumatic event. Hypervigelience results in being in a state of high alert, feeling on guard and tense, and always being on the lookout for real or presumed danger. To meet the criteria of any of the subscales, participants must report at least one item with a score of 3 or greater. Dichotomous variables were created for each of the three subscales. Participants who met the criteria with one item with a score of 3 or greater were coded as 1 and scores less than 3 were scored as 0. In the current sample, 193 (44.7%) of participants met the criteria for at least one of the subscales.

Perceived stress was measured using the Perceived Stress Scale (Cohen et al., 1994; a=.85). The 10-item scale measured participants’ thoughts and feelings during the last month. Response options were on a five-point Likert scale of never, almost never, sometimes, fairly often, and very often. Examples of questions included, in the last month how often have you “been upset because of something that happened unexpectedly,” “felt that you were unable to control the important things in your life,” felt confident about your ability to handle personal problems,” “been able to control your irritations in your life,” “angered because of things that happened that were outside of your control,” “could not cope with all the things you had to do.” Four items were reverse-scored. All items are sum scored with scores of 0–13 considered low, 14–26 moderate, and 27–40 high perceived stress. Categorical and continuous variables were created.

Financial worry was measured using the following questions: “How often do you worry about not having enough money to pay normal bills?” and “how often do you worry about not being able to maintain the standard of living you enjoy?” Response options were on a five-point Likert scale of never to always.

Minority stressors

Superwoman schema was measured using a 35-item Superwoman Schema Questionnaire (Woods-Giscombé et al., 2019) with five subscales: 1) obligation to present an image of strength (6 items; a = .81), 2) obligation to suppress emotions (7 items; a = .85), 3) resistance to being vulnerable (7 items; a = .82), 4) intense motivation to succeed (6 items; a = .72), and 5) obligation to help others (9 items; a = .88). Participants were asked to report their level of endorsement for each item. Response options were: this is not true for me, this is true for me rarely, this is true for me sometimes, this is true for me all the time. Subscales were created by summing the value of each subscale. A continuous variable of each subscale was created in addition to the categorial variables for each scale following the coding guidelines from the creators of the scale.

Sexual objectification.

The Assumptions of Beauty and Sexual Objectification stress appraisal subscale of the Gendered Racial Microaggressions Scale (Lewis & Neville, 2015; a = .88) contains 10 items. A mean score is created for this scale. Stress appraisal was measured on a five-point Likert scale of 1 (not stressful at all) to 5 (extremely stressful). Participants were asked to “think about your experiences as a Black woman please rate how stressful each experience was for you. Stressful can include feeling upset, bothered, offended or annoyed by the event.” Some examples of experiences included “objectified me based on physical features,” “negative comment about my skin tone,” “someone assumed I have a certain body type,” “imitated the way they think Black women speak,” “made a sexually inappropriate comment.” Participants were also able to select if that experience has never happened to them.

Sexual distress

The Female Sexual Distress Scale-Revised (DeRogatis et al., 2008; a = .91) consists of 13 items that measure sexual distress in the last 30 days. Response options were on a five-point Likert scale of never, rarely, occasionally, frequently and always. Examples included “distressed about your sex life,” “guilty about sexual difficulties,” “stress about sex,” “sexually inadequate.” Possible scores range from 0 to 52, with higher scores indicating higher sexual distress. A score of 11 or higher discriminates between women with sexual distress and no distress. 67.5% of the current sample met the criteria for sexual distress.

Analysis

Data were analyzed using SPSS version 29. Frequencies and descriptives were run for all demographic factors, psychological factors, minority stressors, and sexual distress . We examined the differences between heterosexual and queer participants for each analysis. Demographics are reported in text in the participant section. Chi-square analyses and independent sample t-tests were conducted to analyze if there were significant differences between heterosexual and queer women’s measures of each group of variables (see Table 1). In these analyses, the categorial version of the Superwoman Schema subscale variables as well as the perceived stress categorical variables were used to provide a deeper analysis into the difference in levels of endorsement between heterosexual and queer participants. Additionally, two correlation models were ran to explore the correlation between psychological and minority stressor variables and sexual distress for heterosexual women and queer women. Table 2 presents the first column of the correlation matrix for both groups since we were only interested in the correlation with sexual distress and not the intercorrelations of all of the variables. We chose to conduct a bivariate correlation because the relationships between some of the variables may be bidirectional and there is not foundational research to show the relationship between these variables to begin testing cause-and-effect (see Tanni et al., 2020). Continious variables of perceived stress and superwoman schema were used in these models.

Table 1.

Differences in sexual distress, minority stressors, and psychological factors.

Queer
 Heterosexual
N (%) or M ± SD (Range) N (%) or M ± SD (Range) P value
Female sexual distress 16.3 ± 10.76 (0–50) 14.9 ± 9.59 (0–48) .08
SWS - obligation to present an image of strength .13
Low 15 (9.3) 29 (11.0)
Moderate 59 (36.4) 118 (44.7)
High 88 (54.3) 117 (44.3)
SWS - motivation to succeed .02
Low 9 (5.4) 31 (12.2)
Moderate 61 (36.7) 107 (42.0)
High 96 (57.8) 117 (45.9)
SWS - obligation to suppress emotions .78
Low 28 (17.0) 47 (17.5)
Moderate 92 (55.8) 156 (58.2)
High 45 (27.3) 65 (24.3)
SWS-resistance to being vulnerable .001
Low 9 (5.5) 37 (13.8)
Moderate 66 (40.0) 128 (47.6)
High 90 (54.5) 104 (38.7)
SWS - obligation to help others .02
Low 25 (15.1) 66 (25.3)
Moderate 85 (51.2) 132 (50.6)
High 56 (33.7) 63 (24.1)
Gendered racism - beauty and sexual objectification 2.54 ± 1.14 (0–5) 2.07 ± 1.01 (0–5) .03
Psychological distress 25.15 ± 7.96 (1–38) 23.35 ± 6.97 (4–37) .07
Perceived stress .06
Low 19 (11.5) 38 (13.9)
Moderate 111 (67.3) 200 (73.3)
High 35 (21.2) 35 (12.8)
PTSD - Intrusion 129 (77.7) 202 (74.5) .45
PTSD - Avoidance 116 (69.9) 148 (54.8) .002
PTSD - Hypervigilance 116 (70.3) 154 (56.6) .004
Financial worry - Monthly bills <.001
Never 15 (8.8) 42 (15.1)
Rarely 45 (26.5) 69 (24.8)
Sometimes 48 (28.2) 107 (38.5)
Very often 34 (20.0) 44 (15.8)
Always 28 (16.5) 16 (5.8)
Financial worry - Standard of living <.001
Never 3 (1.8) 25 (9.0)
Rarely 27 (15.9) 49 (17.6)
Sometimes 50 (29.4) 112 (40.3)
Very often 55 (32.4) 65 (23.4)
Always 35 (20.6) 27 (9.7)
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Table 2.

Correlates of sexual distress for heterosexual and queer Black women.

Queer Heterosexual
(n = 170) (n = 267)
r p-value r p-value
Demographics 1. Age −0.07 .40 −0.16** .01
2. Education −0.16* .04 −0.13* .03
Minority Stressors 3. SWS-Obligation to Suppress Emotions .13 .10 .02 .74
4. SWS-Obligation to Present an Image of Strength .07 .39 −0.08 .21
5. SWS-Resistance to Being Vulnerable .07 .40 .02 .71
6. SWS-Motivation to Succeed .08 .32 −0.02 .76
7. SWS-Obligation to Help others .20** .01 .07 .27
8. Gendered Racism- Beauty & Sexual Objectification .08 .29 .23*** <.001
Psychological Factors 9. Financial Worry-Monthly Bills .11 .14 .19** .002
10. Financial Worry-Standard of Living .23** .003 .16** .01
11. Psychological Distress .26*** <.001 .43*** <.001
12. PTSD-intrusion .01 .86 .20** .001
13. PTSD-Avoidance .04 .59 .19** .003
14. PTSD-Hypervigilance .13 .11 .21*** <.001
15. Perceived Stress .27*** <.001 .34*** <.001
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†

p < .001

**

p < .01

*

p < .05

We conducted a sensitivity analysis to see if there was a correlation between sexual abuse and sexual distress because sexual abuse is often confounded with measures of psychological health, but it was not significant. Therefore, it was excluded from the models.

Results

Table 1

Results of the chi-square and t-test analysis show that there was no significant difference in sexual distress scores among Black heterosexual women and Black queer women. There were significant differences in the minority stressors superwoman schema and sexual objectification. Black queer women were more likely to be in the high endorsement category of motivation to succeed (t (419) = −3.02, p = .001), the high endorsement category of resistance to being vulnerable (t (432) = −3.71, p < .001), and the high endorsement category of obligation to help others (t (425) = −2.60, p = .01) than Black heterosexual women. There were no significant differences in the obligation to present an image of strength and the obligation to help other superwoman schema subscales. There were also significant differences in sexual objectification, with Black queer women reporting higher mean scores of sexual objectification and assumptions of beauty than Black heterosexual women (t (431) = −4.50, p < .001).

There were no significant differences in psychological distress and perceived stress. However, it should be noted that there was a higher percentage of Black queer women that reported high perceived stress (t (437) = −2.48, p = .01) compared to Black heterosexual women. Among the women that had experienced a traumatic event in their lifetime, Black queer women were significantly more likely to report PTSD-related avoidance (Χ2(1) = 9.77, p = .002) and PTSD-related hypervigilance (Χ2(1) = 8.15, p = .004) than Black heterosexual women. There were no significant differences in PTSD-related intrusion, which was the most common PTSD-related symptom for both groups. Finally, there were highly significant differences in financial worry related to monthly bills (Χ2(4) = 19.98, p < .001) and standard of living (Χ2(4) = 24.64, p < .001). Black queer women were more likely to report more frequent worry for each compared to Black heterosexual women.

Table 2

Results of the correlation analyses show that age was negatively significantly correlated with sexual distress for heterosexual women (r = .16, p = 01; see Table 2). Heterosexual women who were younger reported higher sexual distress. There were no significant differences in age for Black queer women. For Black heterosexual and queer women, education was negatively significantly associated with sexual distress (r = −0.13, p = .03 and r = −0.16, p = .04, respectively). Therefore, women who had higher levels of education reported less sexual distress.

For Black heterosexual women, none of the measures of superwoman schema were correlated with sexual distress. However, for Black queer women, the obligation to help others was positively significantly correlated with sexual distress (r = .20, p = .01). Women who endorsed a higher obligation to help others were correlated with increased sexual distress. Sexual objectification appraisal was highly significantly correlated with sexual distress for Black heterosexual women (r = .23, p < .001) but not for queer women. Black heterosexual women who reported their experiences of gendered racism related to beauty and sexual objectification as more stressful were more likely to report higher levels of sexual distress.

There are significant differences in the correlations between psychological factors and sexual distress. Despite Black queer women endorsing more frequent financial worry, financial worry related to monthly bills was only positively significantly correlated with sexual distress among Black heterosexual women (r=.19, p=.002). Financial worry about the standard of living was positively significantly correlated for Black heterosexuals (r=.16, p=.01) and queer women (r=.23, p=.003). Black women who had an increased worry about their standard of living also had increased sexual distress. Psychological distress was positively significantly correlated with sexual distress for Black heterosexual (r=.43, p<.001) and queer (r=.26, p<.001) women. PTSD intrusion (r=.20, p=.001), avoidance (r=.19, p=.003), and hypervigilance (r=.21, p<.001) were positively significantly correlated with sexual distress among Black heterosexual women but not Black queer women despite significantly more queer women reporting PTSD. Black heterosexual women who met the criteria for intrusion, avoidance, and hypervigilance had higher levels of sexual distress compared to their queer counterparts. Finally, perceived stress was positively significantly correlated with sexual distress for both Black heterosexual (r=.34, p<.001) and queer (r=.27, p<.001) women. Therefore, higher rates of perceived stress were correlated with an increase in sexual distress.

Discussion

The current study investigated the relationships between mental health, minority stressors, and experiences of sexual distress among Black heterosexual and queer women. Results showed that Black queer women in our sample were more likely to report increased mental health concerns. Among women in our sample that endorsed experiencing a traumatic event, Black queer women were more likely to report experiencing symptoms of PTSD, including avoidance and hypervigilance. Black queer women in our sample were also more likely to report experiencing worry about their financial situation via stress about monthly bills or maintaining their standard of living compared to Black heterosexual women. Additionally, Black queer women reported higher perceived stress levels than Black heterosexual women. These findings align with previous studies stating that Black women are at a heightened risk of experiencing psychological distress (Burton et al., 2022; Calabrese et al., 2015) but provide additional evidence for considering sexual orientation when investigating distress among Black women. The nexus of identity-based oppressions Black queer women navigate likely informs their increased exposure to events and circumstances deemed disparate and/or traumatic (Szymanski & Meyer, 2008). To be clear, Black heterosexual women also experience intersectional oppression that may influence their sexual functioning (Thorpe et al., 2022). However, Black queer women’s exposure to additional stressors due to their sexual minority status may warrant specific investigation (Bowleg et al., 2003). Behler and colleagues (2023) recently proposed a conceptual framework adapting the minority stress model (Meyer, 2003) to conceptualize how intersecting systems of oppression come together to increase the risk for negative psychological and physical health outcomes for Black queer women, particularly after experiencing sexual assault. Their model may be helpful in conceptualizing Black queer women’s sexual health, as this adapted conceptualization of minority stress not only takes into account the complex manners in which anti-Black racism, heterosexism, and sexism harm Black queer women, but this conceptualization also directs researchers to focus on these structures of oppression as stressors, rather than pathologizing Black queer women’s responses to these stressors (Behler et al., 2023).

Black queer women participants endorsed higher levels of sexual objectification and Superwoman Schema compared to their heterosexual counterparts. While little research examines the specific experiences of sexual objectification among Black queer women, previous research has identified unique experiences of gendered racial sexual objectification experienced among Black women (Stanton et al., 2022) and queer women of color (Chmielewski, 2017). These studies suggest that the intertwining of racism, sexism, and heterosexism influence unique sexual objectification and sexual harassment experiences of young Black bisexual and lesbian women (Chmielewski, 2017). Specifically, society may view Black women in the US through a lens of sexual deviance stemming from chattel slavery (Hammonds, 2013). Hypersexuality and promiscuity characterize gendered racial sexual stereotypes that depict Black women as willful recipients of sexual objectification (Bond et al., 2021). The addition of queer sexuality likely has an additive effect on these negative sexual stereotypes that informs our Black queer participants’ endorsements of sexual objectification.

Black queer women participants were more likely than Black heterosexual women to endorse the following components of the Superwoman Schema: motivation to succeed despite limited resources, resistance to vulnerability, and obligation to help others. While theorists’ postulate that most Black women, regardless of other identities, internalize the Superwoman Schema (Platt & Fanning, 2023), Black queer women likely have unique experiences with motivation to succeed and pressure to work harder to receive recognition due to interlocking experiences of racism, sexism, and heterosexism (Bailey & Miller, 2016). Furthermore, Black queer women likely report more resistance to vulnerability than Black heterosexual women due to higher rates of depression and social isolation (Holm et al., 2022; Nelson et al., 2022). As a result of social isolation and desire to be in community with others, Black queer women likely experience an even greater pressure to help others in an effort to preserve their community (Nelson et al., 2022).

To add, Superwoman Schema subscales were not correlated with sexual distress among Black heterosexual women. However, Black queer women who endorsed feeling obligated to help others were more likely to report sexual distress. Given that heteropatriarchal sexual norms heterosexual women may feel pressured to prioritize their male partner’s experiences and pleasure (Bowleg et al., 2004; Thorpe et al., 2023) and consequently, engage in proactive coping in anticipation of this expectation to facilitate better sexual outcomes (Malone et al., 2022). However, it was identified that appraisal of sexual objectification through a gendered racism lens was associated with greater sexual distress among Black heterosexual women. Engaging in sex with a partner with a privileged sexual or gender orientation may heighten the impact of internalized sexual objectification on sexual distress or other negative sexual outcomes (Anzani et al., 2021; Kashubeck-West et al., 2017). This finding may also indicate that many measures and conceptualizations of sexual objectification exclude understanding how heteronormativity uniquely shapes objectification for queer women (Moradi & Tebbe, 2022). These results suggest that Black queer women are reporting higher levels of psychological worry and minority stressors compared to Black heterosexual women. Despite these increased levels, these factors appear not as strongly associated with sexual distress among Black queer women as with Black heterosexual women.

While many studies specifically focus on the Superwoman Schema’s impact on heterosexual Black women (Watson & Hunter, 2016), few report differences by sexual orientation (Leath et al., 2022; Nelson et al., 2022). It is well understood that sociocultural and historical contexts inform how Black women appraise and cope with stress (Woods-Giscombé 2010; Woods-Giscobmbé et al., 2019). In fact, Superwoman Schema emerged among Black women to combat negative stereotypes, “highlight unsung attributes” (e.g., Black women’s intelligence and ability to succeed), and serve as a survival strategy (Woods-Giscombé, 2010, p. 2). It could be that these three purposes of Superwoman Schema represent the most accessible forms of effortful coping for our Black queer women participants—particularly as women are more likely to report traumatic events and PTSD symptoms. Simultaneously, although, the endorsement of Superwoman Schema by Black queer women could harm their mental health and contribute to sexual distress (Thorpe et al., 2023; Woods-Giscombé et al., 2016). Superwoman Schema in Black queer women populations should receive additional study to elucidate these findings (Platt & Fanning, 2023).

Psychological concerns and minority stressors were associated with greater sexual distress among Black women across sexual orientations. Additionally, sexual distress levels did not significantly differ by sexual orientation. This finding differs from previous research indicating that women with same-sex sexual experiences are at a higher risk of experiencing sexual distress (Burri et al., 2012). Still, Black queer women participants reported slightly higher sexual distress than Black heterosexual women, though this finding was insignificant. Appraisal and identity development of Black women’s sexual orientation may play a role in potential differences in distress by sexual orientation (Shepler & Perrone-McGovern, 2016). Alternatively, this study’s measure for sexual distress may not accurately capture sexual distress for Black queer women.

Our exploratory analyses identified several demographic predictors of sexual distress among Black women in our sample. Consistent with the literature (Shifren et al., 2008), Black heterosexual and queer women with college degrees were less likely to report sexual distress. Age was only a significant correlate of sexual distress among Black heterosexual women, but not queer women. Among Black heterosexual women, we found that both age and educational attainment were negatively correlated with sexual distress, such that Black women of older ages and those holding higher degrees reported less sexual distress. This pattern has been observed across sexuality research, with several studies postulating that younger heterosexual women are more likely to report sexual distress in response to sexual dysfunction than heterosexual women of middle and older ages (Hendrickx et al., 2015; Stephenson & Meston, 2012).

Despite our previous findings that Black queer women are more likely to report experiencing symptoms of PTSD and more frequent worry about paying monthly bills and maintaining their standard of living compared to Black heterosexual women, we did not find evidence suggesting that these specific elements of psychological distress were associated with experiences of sexual distress among Black queer women. However, we did find evidence suggesting that PTSD symptoms and financial worry were significantly related to experiencing increased sexual distress among Black heterosexual women specifically. These findings may be due to gendered power dynamics in heterosexual relationships. Previous research has identified that increased financial stress predicts higher sexual dissatisfaction (Hill et al., 2017) and that Black married heterosexual couples report that satisfactory financial management is an important component for a happy marriage (Skipper et al., 2021). Based on heteronormative gender roles, male partners are expected to serve as the primary financial provider and manager for their romantic relationship (Skipper et al., 2021). If the male partner is unable to meet these standards, it may impact not only the quality of their sexual interactions, but the frequency. For example, in more controlling heterosexual relationships, Black men often control access to spending money and exercise control over when couples have sex to exercise power to validate their masculinity (Bowleg, 2004). This pattern is even stronger among unemployed women who make less money and/or have dependents. This can increase sexual distress as Black women are worried about their sexual interactions and ability to please their partners. For example, cross-sectional scholarship suggests that wives’ financial management behaviors are indirectly associated with their own and their spouse’s sexual satisfaction (Saxey et al., 2021). Husbands’ financial management behaviors, however, were only associated with their own sexual satisfaction and not their partner’s sexual satisfaction. Such patterns may persist among Black heterosexual women who are not currently partnered due to the gendered wealth gap and gendered partner preferences. Previous research has identified the important role of financial prospects in women’s romantic partner preferences (Zentner & Eagly, 2015), which is likely due to a long history of inequitable labor and wealth division across gender. Since heterosexual men often seek out sexual attractiveness and prowess when partnering with heterosexual women (Smith et al., 2011), it is possible that sexual encounters with potential partners paired with existing stress about supporting oneself financially could induce increased anxiety about meeting sexual expectations.

Similarly, symptoms of PTSD were positively associated with sexual distress only among Black heterosexual women. PTSD symptoms may only be significantly correlated for heterosexual women due to the coital imperative, in which penile-vaginal intercourse is seen as the standard (McPhillips et al., 2001). If Black heterosexual women are experiencing PTSD because of sexual assault, sexual encounters will likely heighten their sexual anxiety (Thorpe et al., 2023) and sexual distress. On the other hand, the normalization of engaging in a wider array of sexual behaviors among queer women (Sewell et al., 2017) may allow for Black queer women to more easily find sexual actions that are less likely to trigger PTSD symptoms during sex and that lend themselves to lower sexual distress.

Additionally, increased psychological resilience may play a role in these findings. A previous study with nearly half of the sample made up of Black women identified that heterosexual women were more likely than queer women to develop a negative sexual self-schema after sexual violence (Lipinski & Beck, 2022). In the same study, the relationship between PTSD symptoms and aspects of sexual functioning were mediated by sexual self-schema, suggesting that perceptions about oneself sexually explain the process by which PTSD symptoms influence sexual experiences. However, future research is needed to understand the influence on the source of PTSD on sexual distress for both heterosexual and queer women and what buffers this effect for queer women.

Limitations

Although this study is novel, there are several limitations. First, this survey data was collected through social media postings. Online data collection leads to bots and spammers; therefore, we put all protective measures into place, including checking IP addresses, to reduce the number of bots taking the survey. Duplicate IP addresses were removed in addition to any IP addresses that were not in the United States. Second, this sample is highly educated. Therefore the findings may not be generalizable to Black women who do not have college degrees. Third, since this is a cross-sectional study, we cannot assert causality. Finally, we did not measure sexual identity-based stigma and discrimination nor internalized heterosexism. These sexual identity-related minority stressors may impact Black women’s sexual functioning. However previous research has shown that these minority stressors were not associated with sexual functioning (Cohen & Byers, 2015).

Future directions

These findings highlight the need to adapt currently existing treatment protocols for sexual distress, such as mindfulness-based interventions or brief cognitive behavioral therapy (Brotto et al., 2012), to be intentionally culturally responsive and attend to the specific distractions and stressors that Black women across diverse sexual orientations are reporting. For example, interventions aimed at facilitating mindfulness should understand the manners by which Black women may internalize aspects of the Superwoman Schema (e.g., suppression of emotions, avoiding vulnerability) and how these internalizations may be appropriate targets for mindfulness interventions (Woods-Giscombé et al., 2019; Woods-Giscombé & Black, 2010). While previous literature has begun to theorize the role of gendered racism in Black women’s experiences of sexual objectification (e.g., Stanton et al., 2022), future research would greatly benefit from intentional study of Black queer women’s experiences of sexual objectification. Due to previous research finding that sexual objectification of queer women differs from heterosexual women (Moradi et al., 2019), understanding this experience among Black women will make us more aware of the nuances of their experiences. Additionally, future research should consider the unique experiences and endorsement of the Superwoman Schema among Black women of varying sexual orientations to better understand the varying experiences of embodying Superwoman Schema as a means of coping with simultaneous racism, sexism, and heterosexism. While the findings of this paper were focused on structural factors and internalization of oppressive systems, future research would benefit significantly from understanding how factors (e.g., relationship satisfaction, sexual communication; Hendrickx et al., 2015) related to the sexual relationships and partners of Black women across sexual orientations influence their appraisals and experiences of sexual distress.

Conclusion

Our study makes a critical contribution to the existing literature by shedding light on the complex interplay of psychological and minority stressors affecting sexual distress in Black women. One of the key findings is the necessity for a nuanced understanding of within-group differences, particularly concerning sexual orientation. This insight not only calls for further targeted research but also necessitates a reevaluation of existing therapeutic interventions to be more inclusive and effective for all Black women. Furthermore, to better understand distress experienced by Black women, it is essential to question the systems underlying these stressors so that interventions can then be created to support and improve Black women’s sex lives. Thus, our findings underscore the urgency for sexual health professionals to intentionally acknowledge and center the unique challenges, like minority stressors, faced by Black women in both research and practice. This critical paradigm shift calls for an intersectional and holistic approach to how sexual distress in Black women is understood, studied, and treated.

Biographies

Shemeka Thorpe, is an assistant professor in Health Promotion at the University of Kentucky. Her research focuses on using mixed methodologies to explore the sexual well-being of Black women through sex-positive frameworks and Black feminisms.

Natalie Malone, is a counseling psychology doctoral candidate at the University of Kentucky. Her research focuses on Black women’s sexual, spiritual, and holistic wellness. Additionally, Natalie is a 200-hour registered yoga teacher who integrates holistic healing and wellness interventions into her research and clinic work.

Kasey Vigil, is a counseling psychology doctoral student at the University of Kentucky. Her research focuses on experiences of sexual pleasure and shame among plurisexual individuals with multiple marginalized identities.

Brenice Duroseau, is a Haitian-American board-certified Family Nurse Practitioner with extensive healthcare experience, who is dedicated to pioneering innovative solutions aimed at safeguarding the sexual and reproductive health of Black women across their lifespan. With expertise in infectious diseases, women’s health, and community health, she combines her knowledge and experience to inform her ongoing work as a PhD candidate at Johns Hopkins University School of Nursing. Her research focuses on community-informed interventions that enhance the sexual reproductive health of Black women from a justice and health equity framework.

Praise Iyiewuare, is a clinical psychology doctoral candidate at the University of Vermont with an interdisciplinary background in anthropology, neuroscience, and public health. Praise’s research interests include studying the interplay between trauma, the experience of pleasure, and mental health symptoms among individuals with multiple marginalized identities.

Kaylee Palomino, is a recent graduate of the Sport and Exercise Psychology Master’s Program at the University of Kentucky and is currently a Project Manager for the University of Kentucky Racial Equity Initiative Coordinating Center, funded by the National Institute on Drug Abuse as part of the National Institutes of Health. Her diverse research interests focus on sense of belonging in college, marginalized populations, and sexual well-being.

Footnotes

Disclosure statement

No potential conflict of interest was reported by the author(s).

References

  1. Anzani A, Lindley L, Tognasso G, Galupo MP, & Prunas A (2021). “Being talked to like I was a sex toy, like being transgender was simply for the enjoyment of someone else”: Fetishization and sexualization of transgender and nonbinary individuals. Archives of Sexual Behavior, 50(3), 897–911. 10.1007/s10508-021-01935-8 [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bailey M, & Miller SJ (2016). When margins become centered: Black queer women in front and outside of the classroom. Feminist Formations, 27(3), 168–188. 10.1353/ff.2016.0005 [DOI] [Google Scholar]
  3. Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, Graziottin A, Heiman JR, Laan E, Meston C, Schover L, van Lankveld J, & Schultz WW (2003). Definitions of women’s sexual dysfunction reconsidered: Advocating expansion and revision. Journal of Psychosomatic Obstetrics and Gynaecology, 24(4), 221–229. 10.3109/01674820309074686 [DOI] [PubMed] [Google Scholar]
  4. Behler AC, George N, Collibee C, Hamilton L, Oleson EB, & Thamotharan S (2023). A conceptual framework for queer, black womxn sexual assault survivors: An adaptation of the minoritised stress model. Culture, Health & Sexuality, 25(6), 791–802. 10.1080/13691058.2022.2089734 [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bond KT, Leblanc NM, Williams P, Gabriel CA, & Amutah-Onukagha NN (2021). Race-based sexual stereotypes, gendered racism, and sexual decision making among young Black cisgender women. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 48(3), 295–305. 10.1177/10901981211010086 [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Bowleg L, Huang J, Brooks K, Black A, & Burkholder G (2003). Triple jeopardy and beyond: Multiple minority stress and resilience among Black lesbians. Journal of Lesbian Studies, 7(4), 87–108. 10.1300/J155v07n04_06 [DOI] [PubMed] [Google Scholar]
  7. Bowleg L, Lucas KJ, & Tschann JM (2004). “The ball was always in his court”: An exploratory analysis of relationship scripts, sexual scripts, and condom use among African American women. Psychology of Women Quarterly, 28(1), 70–82. 10.1111/j.1471-6402.2004.00124.x [DOI] [Google Scholar]
  8. Brotto LA, Seal BN, & Rellini A (2012). Pilot study of a brief cognitive behavioral versus mindfulness-based intervention for women with sexual distress and a history of childhood sexual abuse. Journal of Sex & Marital Therapy, 38(1), 1–27. 10.1080/0092623X.2011.569636 [DOI] [PubMed] [Google Scholar]
  9. Burri A, Rahman Q, Santtila P, Jern P, Spector T, & Sandnabba K (2012). The relationship between same-sex sexual experience, sexual distress, and female sexual dysfunction. The Journal of Sexual Medicine, 9(1), 198–206. 10.1111/j.1743-6109.2011.02538.x [DOI] [PubMed] [Google Scholar]
  10. Burton WM, Paschal AM, Jaiswal J, Leeper JD, & Birch DA (2022). Gendered racial microaggressions and black college women: A cross-sectional study of depression and psychological distress. Journal of American College Health, 1–8. 10.1080/07448481.2022.2133567 [DOI] [PubMed] [Google Scholar]
  11. Calabrese SK, Meyer IH, Overstreet NM, Haile R, & Hansen NB (2015). Exploring discrimination and mental health disparities faced by Black sexual minority women using a minority stress framework. Psychology of Women Quarterly, 39(3), 287–304. 10.1177/0361684314560730 [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Carpenter JS, Reed SD, Guthrie KA, Larson JC, Newton KM, Lau RJ, Learman LA, & Shifren JL (2015). Using an FSDS-R item to screen for sexually related distress: A MsFLASH analysis. Sexual Medicine, 3(1), 7–13. 10.1002/sm2.53 [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Chmielewski JF (2017). A listening guide analysis of lesbian and bisexual young women of color’s experiences of sexual objectification. Sex Roles, 77(7–8), 533–549. 10.1007/s11199-017-0740-4 [DOI] [Google Scholar]
  14. Cohen JN, & Byers ES (2015). Minority stress, protective factors, and sexual functioning of women in a same-sex relationship. Psychology of Sexual Orientation and Gender Diversity, 2(4), 391–403. 10.1037/sgd0000108 [DOI] [Google Scholar]
  15. Cohen S, Kamarck T, & Mermelstein R (1994). Perceived stress scale. Measuring Stress: A Guide for Health and Social Scientists, 10(2), 1–2. [Google Scholar]
  16. Derogatis LR, Rosen R, Leiblum S, Burnett A, & Heiman J (2002). The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women. Journal of Sex & Marital Therapy, 28(4), 317–330. 10.1080/00926230290001448 [DOI] [PubMed] [Google Scholar]
  17. DeRogatis L, Clayton A, Lewis-D’Agostino D, Wunderlich G, & Fu Y (2008). Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder. The Journal of Sexual Medicine, 5(2), 357–364. 10.1111/j.1743-6109.2007.00672.x [DOI] [PubMed] [Google Scholar]
  18. Frost DM, & Meyer IH (2023). Minority stress theory: Application, critique, and continued relevance. Current Opinion in Psychology, 51, 101579. 10.1016/j.co-psyc.2023.101579 [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Greene B (1994). Lesbian women of color: Triple jeopardy. In Comas-Díaz L & Greene B (Eds.), Women of color: Integrating ethnic and gender identities in psychotherapy (pp. 389–427). The Guilford Press. [Google Scholar]
  20. Hammonds EM (2013). Toward a genealogy of black female sexuality: The problematic of silence. In Feminist genealogies, colonial legacies, democratic futures (pp. 170–182). Routledge. [Google Scholar]
  21. Hansen M, Andersen TE, Armour C, Elklit A, Palic S, & Mackrill T (2010). PTSD-8: A short PTSD inventory. Clinical Practice and Epidemiology in Mental Health, 6(1), 101–108. 10.2174/1745017901006010101 [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Hendrickx L, Gijs L, & Enzlin P (2015). Age-related prevalence rates of sexual difficulties, sexual dysfunctions, and sexual distress in heterosexual women: Results from an online survey in Flanders. The Journal of Sexual Medicine, 12(2), 424–435. 10.1111/jsm.12725 [DOI] [PubMed] [Google Scholar]
  23. Hill EJ, LeBaron AB, Bean RA, & Allsop DB (2017). How do money, sex, and stress influence marital instability? Journal of Financial Therapy, 8(1), 3. 10.4148/1944-9771.1135 [DOI] [Google Scholar]
  24. Holm AKJ, Johnson AN, Clockston R, Oselinsky K, Lundeberg PJ, Rand K, & Graham DJ (2022). Intersectional health disparities: The relationships between sex, race/ethnicity, and sexual orientation and depressive symptoms. Psychology & Sexuality, 13(4), 1068–1089. 10.1080/19419899.2021.1982756 [DOI] [Google Scholar]
  25. Jerald MC, Cole ER, Ward LM, & Avery LR (2017). Controlling images: How awareness of group stereotypes affects Black women’s well-being. Journal of Counseling Psychology, 64(5), 487–499. 10.1037/cou0000233 [DOI] [PubMed] [Google Scholar]
  26. Kashubeck-West S, Zeilman M, & Deitz C (2017). Objectification, relationship satisfaction, and self-consciousness during physical intimacy in bisexual women. Sexual and Relationship Therapy, 33(1–2), 97–112. 10.1080/14681994.2017.1419569 [DOI] [Google Scholar]
  27. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, Walters EE, & Zaslavsky AM (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. 10.1017/s0033291702006074 [DOI] [PubMed] [Google Scholar]
  28. Leath S, Jones MK, & Butler-Barnes S (2022). An examination of ACEs, the internalization of the superwoman schema, and mental health outcomes among Black adult women. Journal of Trauma & Dissociation: The Official Journal of the International Society for the Study of Dissociation (ISSD), 23(3), 307–323. 10.1080/15299732.2021.1989113 [DOI] [PubMed] [Google Scholar]
  29. Lewis JA, & Neville HA (2015). Construction and initial validation of the Gendered Racial Microaggressions Scale for Black women. Journal of Counseling Psychology, 62(2), 289–302. 10.1037/cou0000062 [DOI] [PubMed] [Google Scholar]
  30. Lipinski AJ, & Beck JG (2022). Sexual functioning and satisfaction among college survivors of sexual violence: Examining PTSD symptoms and sexual schemas. Journal of Interpersonal Violence, 37(3–4), NP2408–NP2427. 10.1177/0886260520935483 [DOI] [PubMed] [Google Scholar]
  31. Malone N, Thorpe S, Jester JK, Dogan JN, Stevens-Watkins D, & Hargons CN (2022). Pursuing pleasure despite pain: A mixed-methods investigation of Black women’s responses to sexual pain and coping. Journal of Sex & Marital Therapy, 48(6), 552–566. 10.1080/0092623X.2021.2012309 [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Meyer IH (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. 10.1037/0033-2909.129.5.674 [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. McPhillips K, Braun V, & Gavey N (2001). Defining (hetero) sex: How imperative is the “coital imperative”? Women’s Studies International Forum, 24(2), 229–240. ( 10.1016/S0277-5395(01)00160-1 [DOI] [Google Scholar]
  34. Moradi B, & Tebbe E (2022). A test of objectification theory with sexual minority women. Psychology of Women Quarterly, 46(2), 226–240. 10.1177/03616843211052525 [DOI] [Google Scholar]
  35. Moradi B, Tebbe EA, Connelly KE, Lenzen AL, & Flores MJ (2019). Objectification of sexual minority women. Journal of Counseling Psychology, 66(5), 519–533. 10.1037/cou0000348 [DOI] [PubMed] [Google Scholar]
  36. Nelson T, Cardemil EV, Overstreet NM, Hunter CD, & Woods-Giscombé CL (2022). Association between superwoman schema, depression, and resilience: The mediating role of social isolation and gendered racial centrality. Cultural Diversity & Ethnic Minority Psychology, 30(1), 95–106. 10.1037/cdp0000533 [DOI] [PubMed] [Google Scholar]
  37. Pascoe EA, & Smart Richman L (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135(4), 531–554. 10.1037/a0016059 [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Platt LF, & Fanning SC (2023). The strong Black woman concept: Associated demographic characteristics and perceived stress among Black women. Journal of Black Psychology, 49(1), 58–84. 10.1177/00957984221096211 [DOI] [Google Scholar]
  39. Saxey MT, Leavitt CE, Dew JP, Yorgason JB, Holmes EK, & LeBaron-Black AB (2021). The budget and the bedroom: Associations between financial management behaviors, perceptions of economic pressure, and sexual satisfaction. Journal of Financial Therapy, 12(2), 21–46. 10.4148/1944-9771.1266 [DOI] [Google Scholar]
  40. Sewell KK, McGarrity LA, & Strassberg DA (2017). Sexual behavior, definitions of sex, and the role of self-partner context among lesbian, gay, and bisexual adults. Journal of Sex Research, 54(7), 825–831. 10.1080/00224499.2016.1249331. [DOI] [PubMed] [Google Scholar]
  41. Schrode K, Poareo E, Li M, & Harawa NT (2022). Minority stress and sexual functioning among African American women with at-risk partners in South Los Angeles. The Journal of Sexual Medicine, 19(4), 603–612. 10.1016/j.jsxm.2022.02.005 [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Shepler D, & Perrone-McGovern K (2016). Differences in psychological distress and esteem based on sexual identity development. College Student Journal, 50(4), 579–589. [Google Scholar]
  43. Shifren JL, Monz BU, Russo PA, Segreti A, & Johannes CB (2008). Sexual problems and distress in United States women: Prevalence and correlates. Obstetrics and Gynecology, 112(5), 970–978. 10.1097/AOG.0b013e3181898cdb [DOI] [PubMed] [Google Scholar]
  44. Stanton AG, Avery LR, Matsuzaka S, & Espinel S (2022). Black women’s experiences of gendered racial sexual objectification, body image, and depressive symptoms. Body Image, 41, 443–452. 10.1016/j.bodyim.2022.04.014 [DOI] [PubMed] [Google Scholar]
  45. Stephenson KR, & Meston CM (2012). The young and restless? Age as a moderator of the association between sexual desire and sexual distress in women. Journal of Sex & Marital Therapy, 38(5), 445–457. 10.1080/0092623X.2011.613096 [DOI] [PubMed] [Google Scholar]
  46. Szymanski DM, & Meyer D (2008). Racism and heterosexism as correlates of psychological distress in African American sexual minority women. Journal of LGBT Issues in Counseling, 2(2), 94–108. 10.1080/15538600802125423 [DOI] [Google Scholar]
  47. Tanni SE, Patino CM, & Ferreira JC (2020). Correlation vs. regression in association studies. Jornal Brasileiro de Pneumologia, 46(1), e20200030. 10.1590/1806-3713/e20200030 [DOI] [Google Scholar]
  48. Thorpe S, Dogan-Dixon J, Malone N, & Palomino KA (2023). 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, 1–16. 10.1080/13691058.2023.2210199 [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Thorpe S, Hargons CN, Malone N, Iyiewuare P, Jester JK, & Stevens-Watkins D (2022). An interpretative phenomenological analysis of Black Women’s meaning and experiences of sexual anxiety. Journal of Sex Research, 1–15. 10.1080/00224499.2022.2156449 [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Watson NN, & Hunter CD (2016). “I had to be strong”: Tensions in the strong black woman schema. Journal of Black Psychology, 42(5), 424–452. 10.1177/0095798415597093 [DOI] [Google Scholar]
  51. Williams DR, & Mohammed SA (2013). Racism and health I: Pathways and scientific evidence. American Behavioral Scientist, 57(8), 1152–1173. 10.1177/0002764213487340 [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Woods-Giscombé CL (2010). Superwoman schema: African American women’s views on stress, strength, and health. Qualitative Health Research, 20(5), 668–683. 10.1177/1049732310361892 [DOI] [PMC free article] [PubMed] [Google Scholar]
  53. Woods-Giscombé CL, & Black AR (2010). Mind-body interventions to reduce risk for health disparities related to stress and strength among African American women: The potential of mindfulness-based stress reduction, loving-kindness, and the NTU therapeutic framework. Complementary Health Practice Review, 15(3), 115–131. 10.1177/1533210110386776 [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Woods-Giscombe CL, Allen AM, Black AR, Steed TC, Li Y, & Lackey C (2019). The Giscombe superwoman schema questionnaire: Psychometric properties and associations with mental health and health behaviors in African American women. Issues in Mental Health Nursing, 40(8), 672–681. 10.1080/01612840.2019.1584654 [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Woods-Giscombe C, Robinson MN, Carthon D, Devane-Johnson S, & Corbie-Smith G (2016). Superwoman schema, stigma, spirituality, and culturally sensitive providers: Factors influencing African American women’s use of mental health services. Journal of Best Practices in Health Professions Diversity: Research, Education and Policy, 9(1), 1124–1144. [PMC free article] [PubMed] [Google Scholar]
  56. Zentner M, & Eagly AH (2015). A sociocultural framework for understanding partner preferences of women and men: Integration of concepts and evidence. European Review of Social Psychology, 26(1), 328–373. 10.1080/10463283.2015.1111599 [DOI] [Google Scholar]
  57. Zucker AN, Fitz CC, & Bay-Cheng LY (2016). Reverberations of racism and sexism through the subjective sexualities of undergraduate women of color. Journal of Sex Research, 53(2), 265–272. 10.1080/00224499.2014.1002557 [DOI] [PubMed] [Google Scholar]

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