Racism and sexual health are closely linked. Discrimination based on race and ethnicity may result in difficulties accessing effective treatment for sexual health conditions among Black, Indigenous, and people of color (BIPOC). This can result in higher rates of illness or harm.
Sexual health refers to the physical, emotional, mental, and social well-being regarding sexuality.
Sexual health-related issues are wide-ranging and may include sexually transmitted infections, family planning, sexual relationships, unintentional pregnancy, sexuality, and abortion.
Racism plays a role in preventing people from receiving adequate care due to health inequity, or healthcare providers neglecting, disbelieving, or actively discriminating against patients.
This article explores some of the ways racism may affect sexual health and where people may find support.
Racism describes the oppression and unequal distribution of privileges between certain racial groups.
Some people may also refer to racial prejudice, the belief that a particular race is superior to another. However, this differs from racism, which involves one group having the power to carry out discrimination through racist policies and practices.
Racism often entails the marginalization of people of color due to a socially constructed racial hierarchy that privileges people of white populations.
Unfortunately, research notes that racism exists in healthcare systems, which can have a detrimental effect on a person’s sexual health.
Access to, and routine use of, sexual healthcare services is vital for well-being. However, a 2017 report notes that many people in the United States continue to struggle to afford full, routine access to healthcare.
Even when healthcare is available to ethnic minority populations, fear and distrust of healthcare institutions may negatively affect their experience.
Social and cultural discrimination, language barriers, provider bias, or the perception that these exist may discourage people from seeking care.
For example, the Centers for Disease Control and Prevention (CDC) note that inequities in STI healthcare may result from systemic, societal, and cultural barriers to diagnoses, treatment, and preventative services.
Health equity is the idea that everyone should have the chance to be as healthy as possible. Factors such as discrimination or a lack of resources may prevent health equity.
Health inequities affect all of us differently. Visit our dedicated hub for an in-depth look at social disparities in health and what we can do to correct them.
The CDC suggest that there are higher rates of STIs among some racial or ethnic minority groups compared to white people.
Research also notes that social, economic, and behavioral factors affect the spread of STIs. They note that these factors can present obstacles in STI prevention due to the influence on:
- social normals and stigma regarding sexuality
- social and sexual networks
- access to care
- willingness to seek care
They also state that race and ethnicity in the U.S. correlate with other factors affecting a person’s health. These include:
- limited access to healthcare
- fewer attempts to gain medical treatment
- living in communities with a higher rate of STIs
This may be due to:
- high levels of distrust in the healthcare system
- fearing discrimination from healthcare professionals
- difficulty accessing quality sexual health services
In a 2018 report, the CDC explored the prevalence of the below STIs in the U.S.
The statistics regarding chlamydia were as follows:
- Black: 1,192.5 cases per 100,000 people. Cases among Black females were five times more than the rate among white females. Cases among Black males were 6.8 times the rate among white males.
- American Indian and Alaska Natives: 784.8 cases per 100,000 people, 3.7 times the rate among white people.
- Native Hawaiian and Other Pacific Islander: 700.8 cases per 100,000 people, 3.3 times the rate among white people.
- Hispanic: 392.6 cases per 100,000 people, 1.9 times the rate among white people.
- Asian: 132.1 cases per 100,000 people. The rate among white people is 1.6 times the rate among Asians.
The statistics regarding gonorrhea were as follows:
- Black: 548.9 cases per 100,000 people, 7.7 times the rate among white people.
- American Indian and Alaska Native: 329.5 cases per 100,000 people, 4.6 times the rate among white people.
- Native Hawaiian and Other Pacific Islander: 181.4 cases per 100,000 people, 2.6 times the rate among white people.
- Hispanic: 115.9 cases per 100,000 people, 1.6 times the rate among white people.
- Asian: 35.1 cases per 100,000 people, half the rate among white people.
Primary and secondary syphilis
The statistics regarding syphilis were as follows:
- Black: 28.1 cases per 100,000 people, 4.7 times the rate among white people.
- American Indian and Alaska Native: 15.5 cases per 100,000 people, 2.6 times the rate among white people.
- Native Hawaiian and Other Pacific Islander: 16.3 cases per 100,000 people, 2.7 times the rate among white people.
- Hispanic: 13 cases per 100,000 people, 2.2 times the rate among white people.
- Asian: 4.6 cases per 100,000 people, 0.8 times the rate among white people.
In 2018, of the 37,668 new HIV diagnoses in the U.S.:
Females may further experience discrimination and health inequity due to gendered racism, a form of oppression that occurs as a result of the social constructs of race and gender.
This is a form of intersectionality, referring to how social identities can combine to create different modes of discrimination and oppression.
Race and gender inequality and discrimination put the sexual health and well-being of BIPOC females at risk.
For example, a 2018 study suggests that gendered racism may play a role in differences in women’s sexual and reproductive health outcomes.
They found that, compared to white females, Black and Latinx females reported a greater frequency of gendered racism. They also had a greater mistrust of the medical systems and government relating to birth control.
Females also appear to have a high chance of contracting STIs and experiencing sexual violence.
The World Health Organization (WHO) suggest that around 1 in 3 females worldwide experience physical and sexual violence in their lifetime.
Acts of sexual violence can lead to serious health consequences. A 2015 study notes that those who have experienced sexual assault are at risk of contracting STIs.
The Office of Disease Prevention and Health Promotion define the term health disparity as a particular type of health difference closely linked with social, economic, or environmental disadvantage.
They also note that health disparities affect those who have experienced systematic obstacles to their health based on their ethnic or racial group.
Evidence also indicates health disparities in teenage pregnancies.
In 2017, the birth rates for Hispanic and non-Hispanic Black teenagers were more than two times higher than white teenagers.
Research from 2017 notes the disparities in teenage pregnancy and birth rates are due to a lack of ability to access healthcare services and contraception. Social determinants, such as income, also affect them.
The study states that African American and Latinx teenagers are less likely to have insurance and access to routine healthcare services.
Additionally, they are more likely to receive inadequate care compared to white teenagers. This can impact the social norms surrounding reproductive healthcare services and contribute to a reluctance to access these services.
Bacterial vaginosis (BV)
The prevalence rates are as follows:
- Black females: 51.6%.
- Mexican American females: 32.1%.
- White, non-Hispanic females: 23.2%.
The study states that those who experience high psychological stress levels were 2.2 times more likely to develop BV.
African American females experience exposure to higher psychological stressors than white females.
Stressors that may have links with an increased chance of developing BV include racial discrimination and lower socioeconomic status.
People can look for inclusive sexual health services using the following resources:
- Hospital for Special Surgery
- National Partnership for Women & Families
- Ford Foundation
- San Francisco AIDs Foundation
- National Health Law Program
- Urban Institute
Organizations based in the United Kingdom include:
Racism can have an impact on a person’s mental health. A person who has experienced racism may wish to seek help from organizations that understand its impact.
Some organizations include:
- Therapy for Latinx: A mental health resource for the Latinx community.
- Therapy for Black Girls: An online space that encourages the mental well-being of Black females.
- Black Emotions and Mental Health Collective: An organization that provides a list of Black therapists who can provide telemental health services.
- Black Mental Health Alliance: Providing information and resources to help support the health of Black people and other communities.
Many studies identify racial disparities in how marginalized groups may access and receive sexual healthcare in the U.S. Social, economic, and behavioral factors may also contribute to these inequities.
Bias and stereotypes may also create barriers for diagnoses, treatment, and preventative services.
Seeking support from people and organizations that understand what it is like to experience racism may help reduce the negative impact of racism on sexual health.