Factors associated with Taiwanese lesbians’ breast healthcare behavior and intentions: qualitative interview findings

This paper presents the qualitative findings of a mixed-methods study that explored factors influencing lesbians’breast healthcare behavior and intentions. A total of 37 semi-structured face-to-face interviews were conducted among women who self-identified as lesbians or women who partnered with the same gender who were aged 20 years or above in four areas of Taiwan (North, Central, South and East Taiwan) between August 2012 and October 2012. Interviews were audio-recorded with participants’ consent. The interviews were analyzed using constant comparative analysis with Nvivo audio-coding support. Four themes were identified to be strongly associated with the lesbians’ breast healthcare behavior and their intentions, namely gender identity, gender role expression, partners’ support and concerns about healthcare providers’ reactions. Important barriers to the women’s breast healthcare behavior and intentions were masculine-identity (“T-identity” in Taiwan), masculine appearance, concerns about healthcare providers’ lack of knowledge of multiple gender diversity and their attitudes toward lesbians. Conversely, their partners’ support was a factor facilitating the women’s breast healthcare behavior and intentions, particularly for the T-identity lesbians. These findings suggest the significance of and need for culturally competent care and are important for improving Taiwanese lesbians’ breast health