Winter Virginia Ramseyer, Hood Amanda, Sorensen Brianna L, Trout Kate E
University of Missouri, School of Social Work, Center for Body Image Research & Policy, 705 Clark Hall, Columbia, MO 65211, United States.
University of Missouri School of Social Work, United States.
Body Image. 2023 Jun;45:362-368. doi: 10.1016/j.bodyim.2023.04.001. Epub 2023 Apr 20.
The current study examines the relationship of female genital self-image, weight-related cancer screening avoidance, and internalized weight stigma among cisgender women that can provide knowledge about avoidance of life-saving preventative healthcare. This cross-sectional survey included a convenience sample of 384 U.S. cisgender women who were 18+. The sample was primarily white (n = 260, 67.7 %) with a mean age of 33.18 years. 28.4 % reported avoiding a pap smear, 27.1 % avoided a clinical breast exam, and 29.4 % avoided a mammogram. Using multivariate logistic regressions, our results show high internalized weight stigma moderates the relationship of positive genital self-image on weight-related genital and breast cancer screening avoidance. Thus, the odds of avoiding screenings are positive, where the odds of avoidance slightly decreases from the interaction term as female genital body image increases. Interventions to improve female genital body image among cisgender women may lessen the effects of internalized weight stigma on avoiding reproductive cancer screenings. BMI was only a predictor for avoiding pap tests. Further examination is warranted because BMI and sexual health behaviors are not usually associated in body image research. Clinical workforce training is needed to educate providers about the harm of weight stigma and its relationship with healthcare avoidance.
本研究调查了顺性别女性的女性生殖器自我形象、与体重相关的癌症筛查回避行为以及内化的体重耻辱感之间的关系，这有助于了解回避挽救生命的预防性医疗保健的相关情况。这项横断面调查纳入了384名年龄在18岁及以上的美国顺性别女性作为便利样本。样本主要为白人（n = 260，67.7%），平均年龄为33.18岁。28.4%的人报告回避巴氏涂片检查，27.1%的人回避临床乳房检查，29.4%的人回避乳房X光检查。通过多变量逻辑回归分析，我们的结果显示，高度内化的体重耻辱感会调节积极的生殖器自我形象与与体重相关的生殖器和乳腺癌筛查回避行为之间的关系。因此，回避筛查的几率呈正向关系，随着女性生殖器身体形象的增加，交互项导致的回避几率略有下降。改善顺性别女性的女性生殖器身体形象的干预措施可能会减轻内化的体重耻辱感对回避生殖系统癌症筛查的影响。体重指数只是回避巴氏试验的一个预测因素。鉴于体重指数与性健康行为在身体形象研究中通常并无关联，因此有必要进一步研究。临床工作人员培训对于教育医疗服务提供者了解体重耻辱感的危害及其与回避医疗保健的关系是必要的。
