Sexual well-being, a critical part of human life, is deeply connected to physical and mental health. Despite global initiatives calling for the inclusion of multidimensional approaches to sexual health research, the dominant discourse continues to be disease and deficit focused. While multiply marginalized groups are hyper visible in the sexual health research on risk and disease, they are rarely considered in the arena of sexual well-being. Importantly, despite sexual minority women being exposed to increased sexual violence and subsequent negative mental and physical health consequences, this makes them more, not less, worthy of attention regarding the sexual well-being. In resistance to narratives that pathologize marginalized sexualities, this project focuses on the sexual well-being of queer women of color (QWOC).I designed and conducted a mixed-methods study using self-report, online survey methodology capturing cognitive and affective assessments of sexuality and sexual experiences, measures of health at the individual and structural level, and responses to open-ended survey items on their perceptions of each. Self-identified QWOC (n = 397) aged 18 – 78, (M = 28.61, SD = 6.64) living in the United States completed the study. This dissertation presents their survey findings in three stand-alone studies addressing separate but related content from these data. Study I examined the relationship between self-rated health and sexual well-being. Compared to national norms, this sample of QWOC reported lower self-rated health scores and moderately high levels of sexual self-esteem. Multiple linear regressions showed self-rated emotional well-being and general health predicted all dimensions of sexual well-being except for sexual shame, which was only predicted by emotional well-being. Sexual pride was additionally influenced by income and identifying as a survivor of sexual abuse. Racial differences emerged across dimensions of sexual well-being highlighting the need for intersectional and person-centered research that respects the heterogeneity of QWOC. Study II focused on structural determinants of health and sexual well-being. I utilized a person-centered approach to identify profiles of sexual well-being across QWOC and then examined profile membership in relation to structural determinants of health. Latent profile analyses revealed three profiles of sexual well-being: low, moderate, and high. Most participants belonged to the moderate profile, with measures of sexual satisfaction, pride, self-esteem, and shame clustering together. Higher levels of positive sexual well-being measures were associated with lower levels of sexual shame. Structural determinants of health such as income and living in the south significantly predicted membership in the high sexual well-being profile. Given the lack of agreed upon definition, Study III analyzed qualitative data to gain insight on conceptualizations of sexual well-being among QWOC. Open-ended responses to the question, “what does sexual well-being mean to you?” were analyzed using inductive content analysis. Responses (n = 346) revealed a multifaceted concept of sexual well-being involving three themes, 1) physical health and safety, 2) comfort, and 3) positivity. Findings inform a definition of sexual well-being by adding in-depth qualitative data from racialized and sexually marginalized women on how they define sexual well-being for themselves. Taken together, these three studies offer an important addition to the extant literature on sexual well-being and on QWOC, a population that is often overlooked in research. This dissertation offers empirical evidence of the complex interplay between health, sexual well-being, and overlapping systems of power and oppression. These findings also identify the need for more research examining the strengths within marginalized populations and structural factors influencing sexual well-being.
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