title: Factors associated with Taiwanese lesbians' breast health-care behavior and intentions: Qualitative interview findings.
abstract: This article presents the qualitative findings of a mixed-methods study that explored factors influencing lesbians' breast health-care 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 health-care behavior and their intentions, namely, gender identity, gender role expression, partners' support, and concerns about health-care providers' reactions. Important barriers to the women's breast health-care behavior and intentions were masculine identity ("T-identity" in Taiwan), masculine appearance, concerns about health-care 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 health-care 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.
authors.affiliation: a Department of Nursing, College of Nursing , Tzu Chi University of Science and Technology , Hualien City , Taiwan.
authors.forename: Ya-Ching
authors.initials: YC
authors.lastname: Wang
authors.affiliation: b School of Nursing, Midwifery and Social Work , University of Manchester , Manchester , UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Griffiths
authors.affiliation: b School of Nursing, Midwifery and Social Work , University of Manchester , Manchester , UK.
authors.forename: Gunn
authors.initials: G
authors.lastname: Grande
mesh_terms: D000328:Adult; D016504:Breast Self-Examination; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D018452:Homosexuality, Female / Q000208:ethnology / Q000523:psychology; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013624:Taiwan; D016387:Women's Health
keywords: Breast cancer; breast health; breast screening; lesbians