Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

A multi-method study of health behaviours and perceived concerns of sexual minority females in Mumbai, India

Jessamyn Bowling A F , Brian Dodge B , Swagata Banik C , Elizabeth Bartelt B , Shruta Rawat D , Lucia Guerra-Reyes B , Devon Hensel E , Debby Herbenick B and Vivek Anand D
+ Author Affiliations
- Author Affiliations

A University of North Carolina at Charlotte, 9201 University Circle Dr. Department of Public Health Sciences, Charlotte, NC, 28223, USA.

B Indiana University, Center for Sexual Health Promotion, 1025 E. 7th St, Bloomington, IN, 47401, USA.

C Baldwin Wallace University, Public Health Program, 725 Eastland Rd. Berea, OH, 44017, USA.

D The Humsafar Trust, 3rd floor, Manthan Plaza, Nehru Rd, Vakola, Santacruz East, Mumbai, India.

E Indiana University, Department of Pediatrics, 705 Riley Hospital Dr., Indianapolis, IN 46202 and Department of Sociology, Indiana University-Purdue University, 425 University Blvd., Indianapolis, IN, 46202, USA.

F Corresponding author. Email: jessamyn.bowling@uncc.edu

Sexual Health - https://doi.org/10.1071/SH17042
Submitted: 1 March 2017  Accepted: 28 June 2017   Published online: 1 September 2017

Abstract

Background: This multi-method study explores the perceived health status and health behaviours of sexual minority (i.e. self-identifying with a sexual identity label other than heterosexual) females (i.e. those assigned female at birth who may or may not identify as women) in Mumbai, India, a population whose health has been generally absent in scientific literature. Methods: Using community-based participatory research approaches, this study is a partnership with The Humsafar Trust (HST). HST is India’s oldest and largest LGBT-advocacy organisation. An online survey targeted towards sexual minority females was conducted (n = 49), with questions about sexual identity, perceived health and wellbeing, physical and mental healthcare access and experiences, and health behaviours (including substance use). Additionally, photo-elicitation interviews in which participants’ photos prompt interview discussion were conducted with 18 sexual minority females. Results: Sexual minority females face obstacles in health care, mostly related to acceptability and quality of care. Their use of preventative health screenings is low. Perceived mental health and experiences with care were less positive than that for physical health. Participants in photo-elicitation interviews described bodyweight issues and caretaking of family members in relation to physical health. Substance use functioned as both a protective and a risk factor for their health. Conclusion: Our findings point to a need for more resources for sexual minority females. Education on screening guidelines and screening access for sexual minority females would also assist these individuals in increasing their rates of preventative health.

Additional keywords: LGBT, mental health, substance use, women’s health.


References

[1]  Monro S. Transmuting gender binaries: the theoretical challenge. Sociol Res Online 2007; 12
Transmuting gender binaries: the theoretical challenge.CrossRef |

[2]  Ghosh S, Bandyopadhyay SB, Biswas R. Vio-map: documenting and mapping violence and rights violation taking place in lives of sexually marginalized women to chart out effective advocacy strategies: a feminist qualitative research report. Kolkata: Sappho for Equality; 2011.

[3]  Bowling J, Dodge B, Banik S, Rodriguez I, Rawata SM, Herbenick D, Guerra-Reyes L, Sanders S, Dange A, Anand V. Perceived health concerns among sexual minority women in Mumbai, India: an exploratory qualitative study. Cult Health Sex 2016; 18 826–40.
Perceived health concerns among sexual minority women in Mumbai, India: an exploratory qualitative study.CrossRef |

[4]  Bhattacharya S. A love that dare not speak its name: exploring the marginalized status of lesbians, bisexual women, and trans-men in India. Asian J Women Stud 2014; 20 105–20.
A love that dare not speak its name: exploring the marginalized status of lesbians, bisexual women, and trans-men in India.CrossRef |

[5]  Johnson PS, Johnson JA. The oppression of women in India. Violence Against Women 2001; 7 1051–68.
The oppression of women in India.CrossRef |

[6]  Cochran SD, Mays VM, Bowen D, Gage S, Bybee D, Roberts SJ, Goldstein RS, Robison A, Rankow EJ, White J. Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women. Am J Public Health 2001; 91 591–7.
Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women.CrossRef | 1:STN:280:DC%2BD3M3ivVKhsA%3D%3D&md5=39211ca722e7dd19e240820b9b54f700CAS |

[7]  Quinn GP, Sanchez JA, Sutton SK, Vadaparampil ST, Nguyen GT, Green BL, Kanetsky PA, Schabath MB. Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. CA Cancer J Clin 2015; 65 384–400.
Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations.CrossRef |

[8]  Dhillon P, Yeole B, Dikshit R, Kurkure A, Bray F. Trends in breast, ovarian and cervical cancer incidence in Mumbai, India over a 30-year period, 1976–2005: an age–period–cohort analysis. Br J Cancer 2011; 105 723–30.
Trends in breast, ovarian and cervical cancer incidence in Mumbai, India over a 30-year period, 1976–2005: an age–period–cohort analysis.CrossRef | 1:STN:280:DC%2BC3Mjot1yktQ%3D%3D&md5=0f89e627f5f5f12f5cc8e438873649ffCAS |

[9]  Meads C, Moore D. Breast cancer in lesbians and bisexual women: systematic review of incidence, prevalence and risk studies. BMC Public Health 2013; 13 1127
Breast cancer in lesbians and bisexual women: systematic review of incidence, prevalence and risk studies.CrossRef |

[10]  Polek C, Hardie T. Lesbian women and knowledge about human papillomavirus. Oncol Nurs Forum 2010; 37 E191–7.
Lesbian women and knowledge about human papillomavirus.CrossRef |

[11]  Matthews AK, Brandenburg DL, Johnson TP, Hughes TL. Correlates of underutilization of gynecological cancer screening among lesbian and heterosexual women. Prev Med 2004; 38 105–13.
Correlates of underutilization of gynecological cancer screening among lesbian and heterosexual women.CrossRef |

[12]  Tracy JK, Lydecker AD, Ireland L. Barriers to cervical cancer screening among lesbians. J Women’s Health (Larchmt) 2010; 19 229–37.
Barriers to cervical cancer screening among lesbians.CrossRef |

[13]  World Health Organization. Mental health atlas. New Delhi: Department of Mental Health and Substance Abuse, WHO; 2011.

[14]  Patel V, Kirkwood BR, Pednekar S, Pereira B, Barros P, Fernandes J, Datta J, Pai R, Weiss H, Mabey D. Gender disadvantage and reproductive health risk factors for common mental disorders in women: a community survey in India. Arch Gen Psychiatry 2006; 63 404–13.
Gender disadvantage and reproductive health risk factors for common mental disorders in women: a community survey in India.CrossRef |

[15]  King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, Nazareth I. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry 2008; 8 70
A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people.CrossRef |

[16]  Sivasubramanian M, Mimiaga MJ, Mayer KH, Anand VR, Johnson CV, Prabhugate P, Safren SA. Suicidality, clinical depression, and anxiety disorders are highly prevalent in men who have sex with men in Mumbai, India: findings from a community-recruited sample. Psychol Health Med 2011; 16 450–62.
Suicidality, clinical depression, and anxiety disorders are highly prevalent in men who have sex with men in Mumbai, India: findings from a community-recruited sample.CrossRef |

[17]  Hensel DJ, Newcamp J, Miles J, Fortenberry JD. Picturing sexual spaces in everyday life: exploring the construction of sexuality and sexual behavior among early adult women. Sex Res Soc Policy 2011; 8 267–81.
Picturing sexual spaces in everyday life: exploring the construction of sexuality and sexual behavior among early adult women.CrossRef |

[18]  Dedoose. Dedoose: Home n.d. Available online at: http://dedoose.com/ [verified 28 July 2017].

[19]  Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval 2006; 27 237–46.
A general inductive approach for analyzing qualitative evaluation data.CrossRef |

[20]  Marrazzo JM, Coffey P, Bingham A. Sexual practices, risk perception and knowledge of sexually transmitted disease risk among lesbian and bisexual women. Perspect Sex Reprod Health 2005; 37 6–12.
Sexual practices, risk perception and knowledge of sexually transmitted disease risk among lesbian and bisexual women.CrossRef |

[21]  Head SK, Crosby RA, Moore GR. Pap smear knowledge among young women following the introduction of the HPV vaccine. J Pediatr Adolesc Gynecol 2009; 22 251–6.
Pap smear knowledge among young women following the introduction of the HPV vaccine.CrossRef |

[22]  Grigoryeva A. When gender trumps everything: the division of parent care among siblings. Princeton, NJ: Center for the Study of Social Organization; 2014.

[23]  Alpert PT. Who’s caring for the caregiver? Home Health Care Manage Pract 2014; 26 266–8.
Who’s caring for the caregiver?CrossRef |

[24]  Cayleff S. Feeding the hand that bit you: lesbian daughters at mid-life negotiating parental caretaking. J Lesbian Stud 2008; 12 237–54.
Feeding the hand that bit you: lesbian daughters at mid-life negotiating parental caretaking.CrossRef |

[25]  Shetty PS. Nutrition transition in India. Public Health Nutr 2002; 5 175–82.
Nutrition transition in India.CrossRef |

[26]  Nandraj S, Madhiwalla N, Sinha R, Jesani A. Women and health care in Mumbai: a study of morbidity, utilisation and expenditure on health care by the households of the metropolis. Mumbai: Centre for Enquiry into Health and Allied Themes; 2001.

[27]  Ward, B.W.D.; Galinsky, A.M; Joestl, S.S. Sexual orientation and health among U.S. adults: National Health Interview Survey. Hyattsville, MD: National Center for Health Statistics; 2015.

[28]  Ranade K, Hastak Y. Growing up and sexual identity formation: mental health concerns of lesbian women. In: Davar BV, Ravindran TKS, editors. Gendering mental health: knowledges, identities, and institutions. Oxford: Oxford University Press; 2015. pp. 108–30.

[29]  International Institute for Population Sciences. National family health survey (NFHS-3), 2005–06: India: volume I and II. Mumbai: International Institute for Population Sciences. 2007.

[30]  Mimiaga M, Thomas B, Mayer K, Reisner S, Menon S, Swaminathan S, Periyasamy M, Johnson CV, Safren SA. Alcohol use and HIV sexual risk among MSM in Chennai, India. Int J STD AIDS 2011; 22 121–5.
Alcohol use and HIV sexual risk among MSM in Chennai, India.CrossRef | 1:STN:280:DC%2BC3MvgvFartg%3D%3D&md5=c6313482e4c50c1c05f7ea5a1944cda6CAS |

[31]  Chakrapani V, Newman PA, Shunmugam M, McLuckie A, Melwin F. Structural violence against Kothi–identified men who have sex with men in Chennai, India: a qualitative investigation. AIDS Educ Prev 2007; 19 346–64.
Structural violence against Kothi–identified men who have sex with men in Chennai, India: a qualitative investigation.CrossRef |

[32]  Herrick AL, Stall R, Goldhammer H, Egan JE, Mayer KH. Resilience as a research framework and as a cornerstone of prevention research for gay and bisexual men: theory and evidence. AIDS Behav 2014; 18 1–9.
Resilience as a research framework and as a cornerstone of prevention research for gay and bisexual men: theory and evidence.CrossRef |



Export Citation

View Altmetrics