An Interpretative Phenomenological Analysis of Black Women's Meaning and Experiences of Sexual Anxiety.

Participants were recruited from the larger Pain and Pleasure Study , which included n = 294 Black women who completed online Qualtrics surveys in Phase 1 of the explanatory, sequential, mixed methods study ( Creswell & Clark, 2017 ). Participants were recruited through convenience and snowball sampling, including word of mouth and social media postings. Phase 1 inclusion criteria were: 1) premenopausal, 2) under the age of 50, 3) identify as a cisgender Black woman, and 4) live in the Southern region of the US. Women who were menopausal were excluded from the study because menopause is highly correlated with increased sexual pain ( Nappi & Lachowsky, 2009 ). Additionally, the sample was restricted to women who lived in the Southern US due to the sexual and reproductive health disparities that Black women living in the South face ( Centers for Disease Control and Prevention [CDC], 2020 ). For example, in 2019, Black women accounted for 67% of all new HIV diagnoses among all women living in the South ( Centers for Disease Control and Prevention [CDC], 2019 ). At the end of the survey, participants were invited to enter their e-mail addresses if they wanted to participate in a 60-minute Zoom interview. A mixed-methods, sequential, explanatory design consists of two phases: quantitative followed by qualitative ( Creswell & Clark, 2017 ). The qualitative data (e.g., interviews) are used to explain the quantitative results to provide general understanding of sexual pain, pleasure, and anxiety. The qualitative data can be collected from type cases or outlier/extreme cases ( Creswell & Clark, 2017 ; Ivankova et al., 2006 ). For the purposes of the present study, outliers/extreme cases were chosen due to their heightened experiences of sexual pain, sexual anxiety, absence of orgasm, and/or reproductive healthcare diagnoses. Although the overall project design is mixed methods, the qualitative phase data were used for this phenomenological study. Participants who reported higher levels of sexual pain and anxiety were prioritized, and then participants who had an absence of orgasm and/or reproductive healthcare diagnosis were invited. A total of 97 participants met the eligibility criteria for an interview, but only 48 included their e-mail and indicated an interest in completing an interview. The 48 participants were contacted, and the first 25 that responded were interviewed. Previous research has shown that a sample size of 9 is needed to reach in-depth interview coding saturation, but 16–25 are needed to reach meaning saturation ( Hennick et al., 2017 ); therefore, we chose a final sample size of 25 participants. Most participants identified as heterosexual ( n = 21), one participant identified as gay/lesbian, two as pansexual, and one as queer. All participants were between the ages of 23–44. Most participants were single (n = 15), followed by in a relationship (n = 5), married (n = 2), dating (n = 2), and cohabitating (n = 1) (see Table 1 ). Semi-structured interviews were conducted and audio-recorded on Zoom by the principal investigator (first author), three doctoral students, and a postdoctoral research scholar between January and March 2021. Four interviewers were Black cisgender women, and one was a biracial (White and Black) cisgender woman. Three interviewers identify as heterosexual, one as queer and one as bisexual. The interview protocol was informed by the results of the descriptive analysis from Phase 1 of the study. All interviewers had previous experience with qualitative research or received training at the beginning of their doctoral program on how to conduct interviews. The principal investigator listened to the interviews of those that had less experience and provided feedback on how to elicit richer responses from participants. The semi-structured protocol allowed the interviewers freedom to ask in-depth questions about interesting experiences of sexual anxiety revealed during the interviews. Participants were asked two questions related to sexual anxiety: 1) How do you define sexual anxiety? 2) Have you ever experienced sexual anxiety? If yes, give us an example, and if it helps, tell it like a story. Despite the simplicity of the initial questions, participants were invited to describe their sexual anxieties through detailed, rich accounts via a conversational, culturally relevant interview style. Pseudonyms were chosen by participants before the interview began. After each interview, initial reactions were memoed by the interviewers and shared as updates in weekly lab meetings. Audio interviews were transcribed verbatim using Rev.com . Empirical phenomenology is a rigorous systematic study of structures that produce meaning of people’s lived experiences ( Hein & Austin, 2001 ). This phenomenological study sought to explicate the meaning and lived experience of sexual anxiety among Black women. Participants in a phenomenological study provide descriptions of their experience of some phenomenon ( Osborne, 1990 ), in this case sexual anxiety. Whereas classic phenomenological studies require researchers to bracket their biases, perspectives, and experiences and allow the data to speak for itself ( Munhall, 2012 ), this project used an interpretative phenomenological analysis (IPA, Smith, 2011 ; Smith & Shinebourne, 2012 ) through an intersectional paradigm, meaning our interpretations were informed by Black feminist thought, as we attend to the socio-structural impositions of gendered racism impacting these Black women. IPA assumes that a phenomenon (sexual anxiety) should be understood through multiple lenses and accounts for everyday lived experiences and socio-structural contexts that influence the interpretation and experience of sexual anxiety ( O’Mullan et al., 2019 ). Researchers have asserted that IPA is an appropriate methodology for studying women’s experiences of sexual difficulties because it allows researchers to account for social and contextual factors and moves away from the biomedical model of disease and illness ( O’Mullan et al., 2019 ). IPA involves focusing on common experiences reported across the data corpus while noting the particular ways these experiences manifest for individual cases, most commonly through in-depth individual interviews ( Smith, 2011 ). IPA is founded on the belief that there is a chain of connection between people’s embodied experiences, talking about that experience, meaning making, and emotional reactions to said experience ( Smith, 2011 ). IPA values the researchers’ experiences (i.e., as Black women sexologists who have also experienced sexual anxiety) and believe they shape the process and interpretation of the research and are intentionally not avoided or minimized ( Lopez & Willis, 2004 ). Similar to Munhall’s (2012) phenomenological methods, we identify our reasoning for studying Black women’s sexual anxiety. The first author, principal investigator, has experienced sexual anxiety within the last five years. Additionally, all coauthors who analyzed the data have experienced sexual anxiety in their lifetimes. It is impossible for us to “decenter” ourselves from our assumptions and biases and “unknow” the phenomenology that many of us experienced. In fact, through an intersectional lens it reduces our credibility, should we attempt to do so. Therefore, personal knowledge, according to interpretative phenomenology, is useful and necessary ( Geanellos, 2000 ). Given the larger project was focused on sexual pain, participants mentioned sexual anxiety throughout the transcripts when discussing experiences with sexual pain and pleasure. Therefore, all transcripts were read thoroughly multiple times by the research team and coded by hand for mentions and experiences of sexual anxiety. These segments of the data corpus were read through a Black feminist lens ( Collins, 2002 ; Evans-Winters, 2019 ), meaning the inductive coding process included situating Black women’s sexual anxieties in intersecting socio-structural contexts of gendered racism. All members familiarized themselves with the data, initially coded the transcripts, and then verbally processed their findings with other teammates ( Berends & Johnston, 2005 ; Nowell et al., 2017 ). During the inductive coding process, the first, third, and fourth authors were asked to read each transcript without note-taking then conduct exploratory coding. During lab meetings the coding team discussed any follow-up questions about what participants said, to explore underlying messages and interpretations of the data. Once the coding team agreed that there were three overall components of sexual anxiety (I.e., causes, characteristics, and coping strategies), the data were recoded using these overall codes. The coding team was asked to write reflexive memos throughout the second round of coding and take any notes on discrepancies or questions to discuss in the research team meetings. IPA differs from thematic analysis in that it seeks to explain how lived experiences connect to create a phenomenon, rather than reporting separate themes as factors in a construct ( van Manen, 1990 ). Differences in coding were discussed between the coding team, enriching the analysis with multifaceted Black women’s insights and interpretation. Final codes were sorted into three larger components (i.e., causes, characteristics, and coping strategies) of sexual anxiety to map out the lived experience of Black women’s sexual anxiety. Three rounds of coding were completed to ensure in-depth analysis and interpretation of the messages. The second author provided guidance and assistance with refining data interpretation and assisted when there were discrepancies in the ways the coding team members interpreted individual quotes. An exploration of how the components connected across and between participants was undertaken to develop the overarching results. Applicability, rather than generalizability, served as a criterion of rigor for the current study. Applicability refers to the ability to use inferences drawn from study participants (in this case Black women in the current study) to people of other populations who may also experience sexual anxiety. The focus of phenomenological research is the description and understanding of lived experience; therefore, the more accurately the experience is understood (empathic validity), the more applicable the findings are to other people with similar experiences ( Osborne, 1990 ). Trustworthiness was established a posteriori and a priori. Conducting the study about Black women by Black women scholars affirmed baseline credibility. Further, employing a Black feminist lens assured that the structural and intersecting sociostructural (i.e., gendered racism) impositions upon Black women’s sexual lives informed the interpretation of results. Additionally, identifying counter-narratives, as well as similarities, across diverse women within the data enhanced trustworthiness. Therefore, the applicability of the study findings is not limited just to the study sample (cisgender Black women in the south). Instead, anyone that has experienced sexual anxiety gets to determine if the study results are applicable to them ( Morse, 1999 ).

Participants reported three components of sexual anxiety as a phenomenon: 1) causes of sexual anxiety, 2) characteristics of sexual anxiety, and 3) coping strategies (see Figure 1 ). Each component included three to six elements. Causes of sexual anxiety contained six elements (partner unfamiliarity, rape culture and sexual violence, oppressive body standards, fear of confirming racist-sexist sexual stereotypes, pressure to meet societal sexual expectations, and anticipation of sexual pain), most of which these participants etiologically related to intersecting systems of oppression. Characteristics of sexual anxiety included psychosomatic elements, such as somatic, emotional, and cognitive symptoms, as well as resultant behaviors. Coping strategies ranged from individual-level strategies (e.g., affirmations, therapy, meditation, and substance use) to partnered coping strategies (e.g., affirming and supportive partners), which reflect the ways these Black women feel “allowed” to cope in the context of the socio-structural experience of gendered racism. Additionally, we composed a working description of sexual anxiety based on participant and coauthor meaning making. To date, there are clear definitions of sexual performance anxiety ( Masters & Johnson, 1980 ), but not broader descriptions for sexual anxiety overall, which for Black women includes distinct socio-structural factors. Most women reported familiarity with their partner, specifically new and/or male sex partners, was important in reducing their odds of experiencing their sexual anxiety (n = 19). Women who were engaging in casual sex or had not known their sex partner for a long time felt heightened anxiety due to communication barriers and safety concerns grounded in living in a sexist system. Serena (age 28) stated that her anxiety made it difficult to communicate her needs and what she found pleasurable to a casual sex partner: I didn’t really feel comfortable or like it was a free-flowing space for me to say whatever came to mind or exactly what I wanted or exactly how my experience was. And so that created -for me- this feeling of a little bit of pent up resentment about the experience and me not being able to effectively communicate what I did like, what I didn’t like. Participants who knew their male partners longer often felt less anxiety around discussing their sexual needs because they knew their needs would be well received. Pea (age 23) felt “freer” when she was comfortable with a partner and “secure in our relationship.” Lack of partner security, trust, comfort, and familiarity were salient elements of partnership that exacerbated how Black women experienced sexual anxiety. Elements of trust, comfort, and familiarity often decreased somatic symptoms for participants. For example, Jhene (age 35) mentioned that sexual anxiety often occurred when she wasn’t familiar with a sex partner because she was not sure if they could be trusted, if they were safe, and if she wouldn’t be assaulted or harmed, “Because there’s no trust or full trust, so feeling a little unsure if I’m completely safe. You know? You don’t know if this person is who he says he is or who he seemed to be.” Zeena (age 24) described the first encounter with a new partner as awkward and anxiety-filled due to anticipation of what the sex would be like: I think I experienced the most sexual anxiety, it’s either with a person that I really liked, and I’m about to have sex with for the first time or … Yeah, that’s probably how I would say that I experienced it the most. When you’re talking to someone, and you met someone, and maybe you’ve been hanging out or something, and you haven’t really had sex yet, and you’re about to have sex with them. I experience so much sexual anxiety in those situations, just because you’ve never had sex with that person, and obviously you want it to be good, but you don’t really know what to expect. Participants experienced sexual anxiety with less familiar partners, because they were aware that we live in a rape culture and are at increased risk of sexual violence as well as disbelief in the face of said violence based on their Blackness. Participants identified mental health concerns, such as the effects of sexual trauma and depression, that precipitated or exacerbated their sexual anxiety. For some women who experienced sexual trauma, they expressed how symptoms of anxiety and depression co-occurred with those of post-traumatic stress disorder (PTSD) (n = 5). PTSD is a condition in which the experience or witnessing of a particular event (such as sexual trauma) precipitates a prolonged reaction that involves intrusive thoughts (e.g., flashbacks, distressing dreams), avoiding reminders of the traumatic event, and changes in thoughts, mood, physiological arousal, and activity ( American Psychiatric Association, 2013 ). Additionally, rape culture also heightened their sexual anxiety (n = 2). Within rape culture, social institutions protect rapists, shame victims, and expect that women will make sacrifices to avoid sexual assault versus blaming and prosecuting the perpetrators ( Taub, 2014 ). Although one in five Black women are sexually assaulted in their lifetime, only 35% report their assault due to reasons including racism, failure of law enforcement to protect Black women, and disbelief ( Decker et al., 2019 ; The National Center on Violence Against Women in the Black Community, 2018 ). Janelle (age 31) expressed how her sexual anxiety increased after she was sexually assaulted in 2020 by someone she knew, “my level of anxiety, of sexual anxiety, pre-trauma, I would say about a four or five. I think a lot of times, post-trauma right now, my sexual anxiety generally stays at about a six or a seven [out of 10], which is extremely high. And it shouldn’t be.” Michelle (age 27), Nikki (age 23), and Denise (age 35) all reported having flashbacks to their sexual assault during sexual intercourse, which caused them an overwhelming amount of anxiety. However, they were able to advocate to end sexual intercourse. Nikki reflected on how she was triggered during sexual intercourse with her long-term female partner. She also asked to end it due to intense emotions. So my partner and I like to use toys. So there was, I don’t know, it was probably maybe a year ago we were using toys, and I don’t know what happened, but I got a huge pain, and it sent me into tears. But, it wasn’t like I was crying because of the pain. It just sent me into a weird anxious spot to where I was like, “I need you to leave. I need this moment to myself.” … We talked about whether it could have been sexual assault. There’s a lot of different triggers. I’ve been through a lot, so there could have been a trigger for anything. Additionally, Denise (age 35) stated that she had similar flashback experiences; however, her response to these flashbacks went beyond ending sexual intercourse to more physical contact, such as hitting her male sex partner if she was triggered and concerned that her male partner wouldn’t listen to her when she told him to stop. I was raped when I was 16. So, after that, certain things that a partner would do that would remind me of that would cause me to hyperventilate, really spazzed out. I mean, spazz out, start fighting type situation because either they were too rough or something like that … So I’ve just recently had an experience that this happens often as well, where they’re too aggressive, and they don’t listen to me when I’m telling them, like they don’t have to be aggressive or whatever, and it just, because I suffer from anxiety anyway. And, so it makes me feel uncomfortable that they’re not listening to me. And it takes me back to that situation. Kris (age 23) talked about the sexual anxiety she felt when she feared for her safety because, due to rape culture, she believed that her male partner would pressure her into having sexual intercourse even if she did not want to and would not respect her boundaries. So, I guess, a time where I’ve experienced sexual anxiety is with there being kind of an expectation of participation in sexual encounters or behaviors, especially undesired ones. If you were like, “Oh, I’ll come over, but I’m not having sex with you. I don’t want to have sex tonight. That’s not what we’re doing.” Oh, it’s fine, you can come over. And then, you’re in the situation where you’re like, I know there’s an expectation of me to do this … I had no desire to participate in this. And so, now I know there’s an expectation of me to perform almost, you know? And I don’t want to. I don’t feel like it. I’m just not in the mood. I don’t want to even put myself in the position that something can go wrong, you know? The fear of possibly being assaulted and having her boundaries disrespected limited Kris’s willingness and comfort to try new sexual activities in fear that her partner would not respect her consent. Participants mentioned that body image, weight gain, and vaginal odor all created sexual anxiety, informed by oppressive (e.g., racist, sexist, fatphobic) body and hygiene standards for cisgender women (n = 6). Kris (age 23) noted that “there’s just a lot of things that are put on women, like clean shaved, smell good, everything is supposed to be in order. So, I think that definitely contributes to anxiety as well.” Specifically, the socio-structural conditions of intersecting capitalist-sexist-racist marketing about feminine hygiene are imposed, or “put on,” Black women, which then increases their sexual anxieties. For example, Naomi (age 25) noted the pressures that women often feel to live up to society’s standards of cleanliness and for their genitals to smell floral, based on myths and unrealistic expectations: The obsession kind of been put on women about being squeaky clean, having the perfect vagina for whatever activities kind of has been a negative effect on women, because now sometimes the products we’re using, we’re putting things up there just to get that perfection. We may stick a douche up there. You don’t know what it’s doing, because no one told you. Nobody told me that [vaginal] discharge is normal, so if you’re looking at your underwear like you’re this gross, disgusting thing, and you feel like you have to scrub yourself all the time, that can lead to anxiety because now you can’t really have spontaneous sex, because you’re concerned about your natural self. You know what I’m saying? You’ve always got to have the candles lit, and you’re smelling like roses and pineapples. It’s just not realistic. Especially if your diet is not giving roses and pineapples, it’s okay. Nicole (age 35) reported that internalized fat phobia played a major role in her sexual anxiety as she felt undesirable even to her wife, whom she had been with for seven years. She gained weight after her polycystic ovary syndrome diagnosis and as a result, over the last four years, she felt increased sexual anxiety. “Just feeling, just wondering if I’m still desirable, even though she tells me I am, and I can trust her opinion and her telling me that, but just feeling self-conscious.” Socio-structural conditions that emphasize slim bodies as more desirable negatively affected her self-esteem and made her feel more self-conscious, causing sexual anxiety. T (age 26) also mentioned that partner perceptions of her body size were a source of sexual anxiety. Although she was confident with her body size, she was anxious about how someone might react to her body size and possibly use her as a sexual experiment or be awkward. She stated, Yes, it feels a little different when it’s more anxiety about my body and the way that it would be perceived. I’m not even necessarily sure if I can explain it in a way other than, I guess it’s always like, “Have you done this with someone that has my body shape before? Are you going to start asking me questions and saying weird stuff about it? If you’re going to say weird stuff, I don’t really want to do this. The objectification of Black women’s bodies has led to these oppressive body standards in which their bodies should be a certain size in order to be considered appealing and sexy. Additionally, racism undergirds Black women’s pressure for their genitals to smell flowery and fresh due to the stereotype from slavery that Black people have foul odors ( Ferranti, 2011 ). Racist-sexist sexual stereotypes were explicitly reported as sources of sexual anxiety for five participants, although other participants noted aspects of gendered racism without using the language. Brittany (age 32) mentioned that since she was newly divorced, she wanted to have more casual sex as a form of stress relief, but she often felt sexual anxiety about how she would be perceived by men and society. All these stereotypes that are given to women, especially Black women, cause we’re hyper-sexualized anyway. Yes, just a fear of one, being like those stereotypes and two, kind of protecting your emotional world. Because when you talk about that I have sexual anxiety and stuff, it’s things like that I feel are causing me anxiety. Like, “Damn, is he going to think I’m a ho?” By reminding herself that she was engaging in sex to release stress, she was able to recenter and have sex without the pressure of confirming stereotypes of being a “hypersexual ho”. This double standard regarding premarital sex predominantly exists for women and not men. In combination with other racist-sexist stereotypes, this double standard precipitated and/or exacerbated sexual anxiety among these Black women. Additionally, two participants grew up in the Southern Black Christian church – often a perpetuator of said racist-sexist respectability politics (the belief that conforming to prescribed standards of appearance and behavior will protect Black women and gain respect from White people) commonly imposed on Black women. They mentioned how religious shame often created sexual anxiety when they would engage in sex, because they grew up hearing that premarital sex was morally wrong. Engaging in premarital sex is often linked to stereotypes, such as being fast, promiscuous, easy, or a Jezebel ( Lomax, 2018 ). Also, not hearing the positive benefits of sex or having a space to talk about sex openly created more sexual anxiety when they engaged in sexual intercourse, because they felt sexually inexperienced, specifically for Michelle (age 27) who felt like her religious upbringing taught her that sex was morally wrong and made her feel sexually inadequate. Participants reported pressure to sexually perform like people on television (n = 3), social media (n = 2), and pornography (n = 3), as well as the pressure to impress sex partners (n = 11). For these Black women, the societal expectations and pressure may have been due to internalized hypersexualization and sexual prowess stereotypes (e.g., Jezebel). For example, Naomi (age 35) stated: So, when I was finally kind of out of my funk, getting it going was, I was just anxious because I was like, “what if I’m trash? I don’t know how do this.” I was definitely anxious before we started doing it again. I felt like I was thinking about it too much, and I just wanted it to be a positive experience. That was the part that was kind of making me feel anxious. The pressure to live up to these gendered-racist standards caused anxiety for this participant. Additionally, feelings of being sexually inexperienced often created anxiety for participants as they attempted to meet these standards. For example, Kayla (age 30) mentioned that with new partners she felt that she had to perform like people on television, even if it was inauthentic to her. When Kayla was younger, having sex with a new partner was “when [my] sexual anxiety is at its peak” as well as her first sexual encounter. Honestly it feels like pressure. I would say when you are first having sex with a new partner, or first having sex, your only experience is what you’ve seen or what you’ve talked about with someone else. More than likely, I know at least for me in my household, wouldn’t talk about it. It’s what you saw on TV or what your friend told you, or something like that. It’s like you’re trying to be this person that maybe you saw on TV or supposed to be, when that may be what’s authentic to you. Similarly, Jhene (age 35) mentioned her sexual anxiety was rooted in the fear of looking “silly or stupid” doing certain sex positions to please her sex partner. She furthered her response by describing a situation where she had sex with a man her age that she had known since childhood. He was more sexually experienced and directly communicated his sexual desires, which made her anxious. He’s definitely more experienced than I was. I was kind of late to the whole sexual thing, so I felt a little … I had a lot of anxiety because I know I wasn’t as experienced as him. Oral sex, I didn’t feel like I was as experienced, and he would make comments too. He would give me feedback during, and that would make me anxious … I had anxiety and even being on top, I had a little bit of anxiety, but we would kind of joke about it, or he would kind of give me pointers. He’s like, “Why don’t you try this?” I still had anxiety about it, but we ended up being more comfortable with each other but because I knew he was more experienced, I always had a little anxiety. Similarly, Regina (age 41) mentioned feeling anxious about having sex with someone she knew from her hometown because his “level of sexual experience was greater” and she did not know if she could “match up.” Similarly, Pea (age 23) mentioned that the age of her sexual debut made her feel like she was a “late bloomer,” inexperienced, and often caused her to question her sexual abilities and skills, especially compared to women in pornography. Finally, Michelle (age 27) discussed how her religious upbringing was the fuel of her sexual anxiety because she had a late sexual debut as she was trying to wait until marriage. Her commitment to her religious belief of abstinence created anxiety when she started having sex because she didn’t feel prepared and questioned her abilities. Therefore, she faced an internal battle between society’s sexual expectations and religious shame and abstinence teachings. As I got older and realized that waiting until marriage was probably not going to happen for me, there was still a lot of anxiety that came with it … on the mental side is it right and wrong, and then two, just like do I know what I’m doing … does the other person know what they’re doing, is it going to be right, is it going to hurt, and even today, it’s still one of those things that I’m like, I don’t know if I’m doing this right. The need to get sex “right” or be good at it is a function of oppressive systems that suggest that sex has to serve a purpose other than enjoyment. Additionally, heterosexual Black women in the current study may have felt pressure to be good at sex due to fear of abandonment that their partner will leave them if they are not good enough sexually, therefore, putting them at risk of being single due to partner scarcity. All of the participants in this study reported experiencing sexual pain at some point in their lives. For the six participants who experienced sexual pain more frequently or intensely, the anticipation of sexual pain caused sexual anxiety and dread. Keisha (age 25) dreaded sexual encounters with her partner who she had been with for over four years, because she anticipated that the sex would be painful and could not stop thinking about the discomfort before or during the sexual encounter. The anticipation of discomfort during sexual intercourse often diminished her desire to engage in sex. Kids love to go to the park. So, if every time your parent gets ready to take you to the park, it’s like, “Hmm, do we have to go? I don’t really want to go,” they should really understand that, well, something must really be going on if this kid doesn’t want to go to the park. And that’s kind of the same feelings that I was having towards sexual encounters. Like, I kind of don’t want … It’s not that I didn’t want to do it, but it was just thinking about the discomfort. It wasn’t enjoyable. Keisha’s metaphor to describe her anxious anticipation of sexual pain and discomfort by comparing the intensity and magnitude of her pain to that of a child being bullied speaks to the gendered expectation to comply with painful sex and the anxiety it perpetuates. Additionally, Alexandra mentioned that the “uncertainty” and “uncomfortableness” of sexual pain made her anxious, because she feared having to experience pain again and wasn’t sure if it would occur when she had sex. Amina (age 29) mentioned fear of pain and of her partner abandoning her were sources of anxiety, “So I start getting these shakes, because I’m like I don’t know if it’s going to hurt, if it’s not going to hurt. Is this person going to take the time to make sure that everything’s okay? Or are they just going to leave and what-not?” Finally, Black Velvet (age 28) mentioned that having sex with her husband brings her anxiety, especially when they start engaging in foreplay. Her heart begins to race, and her palms sweat, wondering if she will actually be able to engage in sexual intercourse because “there have been times where I can’t be penetrated because it hurts” due to her vaginismus and fibroids. Similarly, Candy (age 26) and Nikki (age 23), mentioned that their endometriosis caused sexual anxiety due to uncertainty and anticipation of experiencing sexual pain. For these participants, the combined fear of pain and fear of communicating said pain induced sexual anxiety, because they believed they would be abandoned. This belief is often born of perceived and actual partner scarcity in Black sexual networks. Overall participants reported three characteristics of overlapping sexual anxiety symptoms: somatic, cognitive, emotional. These elements explain how sexual anxiety manifested within the bodies of these Black women, through a negative appraisal process and subsequent negative emotions and/or exacerbated physical symptoms. We argue that the negative, rather than compassionate, appraisal of sexual anxiety is itself born of internalized gendered racism, meaning that the socio-structural imposition that Black women must be strong may lead these participants to believe they are inadequate or weak for experiencing any symptoms of sexual anxiety. Therefore, the characteristics of sexual anxiety are presented discretely for organization purposes, but they theoretically work interactively in participants’ descriptions of the causes of sexual anxiety and their coping strategies. Thirteen participants displayed somatic, or physical, symptoms of anxiety, including rapid heartbeats, feeling “flustered” (T, age 26), sweaty palms or clammy hands (Janelle, age 31), and crying during sex (Amina, Pea, & Nikki). Black Velvet (age 28) said, “I’m just noticing the physiological signs. My heart’s racing, and I’m like, ‘oh my goodness.’” Because she appraised her somatic symptoms negatively, rather than compassionately, it exacerbated accompanying emotional symptoms like embarrassment. As another example, Pea (age 23) described how uncomfortable crying – a somatic symptom of her sexual anxiety – made her feel during sex: “I remember crying, because I just felt like, I don’t know, not good. […] I think he said, ‘are you crying?’ I was like, ‘no, let’s just keep playing,’ kind of like that. Like, ‘no, I’m not crying.’ Oh gosh, weird.” Additionally, Amina’s (age 29) sexual anxiety manifested as somatic symptoms, but her concomitant emotional embarrassment led to the behavior of avoidance. In her story about having sex with someone she met during an international trip, she stated: He was like, “To be honest, I was really hoping that you would be open to maybe sharing the bed with me.” And as soon as he said that the shakes started. And I had told him, “You know what? It’s been a very long time since I’ve been in this predicament, so I don’t know if anything will happen.” He was like, “If you need a massage or you need to take a shower or there’s a separate room, you’re more than welcome to go do that first.” I said, “Okay let me go take a shower.” So, I ended up taking a shower and I kid you not, I was in the shower literally for two hours. For two hours because I was so nervous and I was shaking because I was like okay, let me take a shower, let me see if the shower will help relax me. It didn’t. Almost tripped and fell in the shower because I was shaking so much that the soap dropped into the tub. Shaking and cold sweats happened to Amina again when she had sex with another person while abroad; however, somatic symptoms did not occur the second time they had sex. She stated that once she felt comfortable with her partner (usually by the second encounter), she was “fine.” Sometimes women were not aware of their somatic symptoms, like Rita (age 44), whose partner told her: “In times when I have been unaware of my tension or anxiety, he will ask me, ‘hey, are you doing ok?’ It signals to me, oh, ok, there’s something that I am not paying attention to that’s happening, that I’m giving off an anxious sort of vibe.” Thus, a mind-body, or cognitive-somatic, connection between symptoms was evident. Cognitive symptoms of sexual anxiety were any symptoms stemming from mental processes like thinking, attention, awareness, and insight. The 21 participants who experienced cognitive symptoms reported their anxious thoughts as a hindrance to sex and talked about the importance of “getting in the right mind” (Michelle, age 27) or not giving thoughts too much power. Thoughts as a cognitive symptom had a temporal component, meaning women experienced anxiety related to thoughts before, during, and after sex. Naomi (age 25) said, “your thoughts before you have sex, you kind of lose the spontaneity because you’re thinking about it so much.” Regina (age 41) said, “thoughts that prevent you from having sex or feeling sexually aroused or excited, or participating.” Regina went on to discuss how being “more in her head and not in the moment” about doubting her ability to “match up to her partner sexually” hampered sex. Some women, like Nicole (age 35) and Nia (age 33), provided descriptors for their thoughts: “[sexual anxiety] is to the point where you’re not able to enjoy it, and you have intrusive thoughts” (Nicole), and “[my] mind is just racing, and I am trying to be more present and stuff” (Nia). Lola (age 24) provided an example of what racing thoughts were like for her: And then even in initiating touch is kind of like, “okay this is the right time to touch you,” the movie’s kind of on pause. What should I do first? Should I just touch you? Should I try to kiss you? Should I try to give you a blow job. Like, what do I do? How do I try to initiate? And then even doing it was just like, “well are you doing this because you want to? Are you doing this because I initiated it? Do you want to? How long is this gonna last?” It is “are you enjoying this?” As a counternarrative, some women said they were unaware of their thinking processes while experiencing sexual anxiety. For example, Kris (age 23) said, “I think for me, it [sexual anxiety] puts up mental blocks.” Other women, like Michelle (age 27), learned through therapy that they blocked or compartmentalized their thoughts and feelings: “And so now with my therapist, and we’ve talked about the trauma, we’ve talked about all of that, and she’s like, ‘This makes sense for you to put up that block to not enjoy it, or to stop, prevent yourself from enjoying that climax or enjoying anything like that.’” Associated with cognitive symptoms was the appraisal process where participants evaluated their thoughts and the sexual experiences negatively. As indicated by Michelle’s therapist, the symptoms of her sexual anxiety were typical consequences of prior trauma, so understanding and seeing herself non-judgmentally was an important intervention. Similarly, socio-structural expectations about how a sexual experience should be, rather than how it is, often served as the benchmark by which many participants’ thoughts were being evaluated. For these Black women, the cognitive symptom of negative self-appraisal mirrored gendered racism’s oppressive impact on their sexual lives. Twenty-two participants mentioned managing emotional symptoms associated with their sexual anxiety. Most often, women talked about worry, nervousness, fear, and uncertainty. Alexandra (age 25) said, “worries or fears, specifically related to sexual interactions.” Butta P (age 44) said, “feeling fearful of the [sexual] encounter with a partner, trepidation around performance, or pleasure.” The second most common emotions included distress (e.g., “Just a level of distress associated with participating in sexual activity” [Kris, age 23]) and dread (e.g., “I will often dread sexual encounters. Even though I’m a person who has one partner … I’ve been dating the same person for a little over four years now” [Keisha, age 25]). Other emotions were embarrassment (e.g., “during any type of sexual interaction or experience, there could be some angst based on embarrassment, shame, guilt, trauma.” [Janelle, age 31]) “awkwardness” (Pea, Zeena, & Amina), and “feeling weird” (Pea, age 23). Overall, their feelings of embarrassment, awkwardness, and fear were related to how they perceived they looked during sexual intercourse, how pleasurable the sexual encounter would be, and how their partner would perceive their performance related to trying out new sex positions or initiating sex. Women expressed coping with sexual anxiety in four ways: having a reassuring and supportive sex partner, supporting themselves with affirmations and mindfulness, attending therapy, and using substances. Not all participants identified coping strategies; however, this does not mean they did not have any. The most important coping strategy was having an assuring and supportive sex partner. Six participants reported this coping strategy. For Jhene (age 35), who was not as sexually experienced as her male partner, his constructive feedback often brought anxiety, because she was afraid that he would reaffirm her sexual inexperience, but the good feedback was helpful in making her feel more sexually confident. For Nicole (age 35), who experienced body image issues, having a supportive and reassuring wife was helpful in reducing her anxiety, but she still felt self-conscious. Additionally, for Amina (age 29) who suffered from vaginismus, having a partner that took the time to assure her they would take care of her and take things slow was important, “ … getting that reassurance on, ‘Don’t worry, it’s going to be okay. We can take the time. You don’t have to if you don’t want to. Don’t worry about it,’ stuff like that.” For Amina, when she experienced her physical shakes during a sexual encounter, her partner offered to give her a full body massage, which helped her relax and stopped her from shaking and sweating. Four participants reported coping through reassuring themselves and practicing mindfulness. Participants affirmed and encouraged themselves with self-talk: “they are ok,” “just relax,” “go with the flow.” Also, participants discussed practicing mindfulness by being present in the moment and focusing less on having an orgasm but rather enjoying the experience: “Yeah, also I still have issues with trying to calm my mind down, because sometimes I wonder about my performance. I would try to focus too much on orgasm. Just mind is just racing, and I’m trying to be more present and stuff” (Nia, age 33). Additionally, three participants (Michelle, Janelle, & Brittney) mentioned attending therapy to address their mental health concerns, including sexual anxiety and PTSD from sexual trauma. Therapy provided the opportunity to “work through” (Brittney, age 32) their sexual anxiety and get to the root cause so they could stop “repressing” (Janelle, 31) and compartmentalizing difficult emotions. In effect, they needed to actively disrupt scripts of Black women’s strength and stoicism to feel relief from sexual anxiety. Additionally, despite Michelle’s (age 27) initial hesitancy to attend therapy in fear that her medical doctors were just dismissing her pain, she actually found therapy helpful in reducing her anxiety: I’ve gone to the doctor. I’ve gone to OB/GYNs, and I’m just like, “Hey, when I have intercourse it hurts, and I don’t know what’s going on.” And they’ve run tests, and they’re like, “You’re fine, it’s probably a mental thing. It’s probably you’re emotionally blocking yourself from allowing yourself to enjoy it, basically” … I think at first I thought they were just trying to get an easy way out. They couldn’t find the problem, so they were just like, oh, we’re just going to ship you off to a therapist, and you deal with it. But now that I’m actually in therapy, and I am working through a lot of that, I’m like, okay, the doctors are probably right, because there isn’t anything … I’ve gone to several doctors, OB/GYNs, and they’re like, “Physically your body is fine”. Still, Michelle declined anxiety medication prescribed by her psychiatrist, because she did not believe it was the best treatment for her sexual anxiety. She believed medication would not address the root cause to prevent sexual anxiety from happening in the future. And so the theory was, if I knew I was going to have sex tonight, then I would take it that day to help ease me or calm me down. And I’m like, “I don’t have anxiety.” I think I got where she was coming from, it’s like, “Oh, you’re tensing up, I’m going to give you anxiety meds to throw down.” But I’m like, “Is that really going to solve the issue, at the end of the day?” And it didn’t. It was just like I’m popping pills right now. I’m like, that’s not helping. In advocating for herself, she was able to better attend to the origins of her sexual anxiety to treat it, rather than simply cope. Only two participants mentioned using substances, such as alcohol, cannabis, and CBD products to ease their anxiety. Janelle (age 31) reportedly knew other people who used a combination of alcohol, cannabis, and CBD, but CBD was the most helpful for her. Pea (age 23) specifically mentioned how alcohol provided a confidence boost, despite her anxiety around being sexually inexperienced, “when you’re under the influence of alcohol, it makes you a little more confident.” If participants become dependent on alcohol and cannabis as a primary coping strategy to help them relax, it could become problematic and result in substance use disorders; however, substances were an adjunct to other coping, rather than their sole or primary coping strategy. Additionally, considering the socio-structural barriers in treatment, Black women are more easily able to access these substances than medical or therapeutic services. Thus, their intersectional experiences of gendered racism were impactful across all three components of sexual anxiety.

Given that sexual anxiety is a core component of sexual dysfunction ( Barlow, 1986 ), understanding Black women’s experiences of sexual anxiety is critical to addressing sexual dysfunction within this population. As such, this interpretative phenomenological study explored 25 Black women’s lived experiences of sexual anxiety. For these Black women, sexual anxiety was a persistent worry or fear that could occur before, during, or after sexual intercourse. Sexual anxiety was more likely to occur with casual sex partners or partners the participants were less familiar with. However, sexual anxiety also occurred for some participants with long-term partners. For these participants, sexual anxiety featured somatic (e.g., tense, crying, shaking), cognitive (e.g., racing thoughts, catastrophizing), and emotional (e.g., frustration, dread, panic) symptoms that happened simultaneously or individually. Most women described cognitive and emotional symptoms of sexual anxiety, which may suggest a mind-body disconnect. Still, the rich descriptions of sexual anxiety present in this study humanize the participants and provide insight into how these women make sense of their thoughts, feelings, and bodily sensations while navigating societal sexual expectations and possibly other expectations related to their strength and emotions (e.g., Superwoman Schema; Woods-Gisombé, 2010 ). Participants connected their sexual anxiety to past sexual experiences, non-sexual stressors, partner dynamics, sexual performance, sexual trauma, fears of stereotyping, and issues of pain and/or reproductive health. Additionally, they experienced sexual anxiety across a spectrum of severity. Social contexts like sexual stereotypes and cultural upbringing influenced the women’s sexual anxiety. To alleviate or cope with their sexual anxiety, participants shared numerous strategies, including practicing mindfulness, using affirmations, having supportive sex partners, going to therapy, and using substances such as CBD. Although sexual anxiety is experienced at the individual level, this study shows that some Black women’s experiences of sexual anxiety are informed by an intersecting sociostructural context, gendered racism, and other forms of oppression. Gendered racism informed participants’ experiences of sexual anxiety and translated to either pressure to “live up to” stereotypical images and societal expectations (e.g., being sexually liberated, experienced, and freaky) or conversely, led to concerns about confirming sexual stereotypes (e.g., being seen as promiscuous and judged for being sexually liberated). Participants felt pressured to be good sex partners and try different sex positions so their male partner was pleased, despite their feelings of anxiety. Additionally, the women wanted to engage in casual sex, but feared being labeled as a “ho” for exploring their sexuality. Similar to previous research, our findings show that some Black women’s internalizations of these controlling images and racist-sexist sexual stereotypes inform their sexual decision-making and sexual experiences ( Bond et al., 2021 ; Davis & Tucker-Brown, 2013 ; Jerald et al., 2017 ). One of the most harmful impacts of these controlling images and stereotypes is in how it may restrict Black women’s expression of what sexuality can be. This pressure may hinder Black women from being fully present and enjoying their sexual experiences; thus, their anxiety decreases the likelihood of them experiencing sexual pleasure ( Birnbaum & Gillath, 2006 ). Previous research on White mixed-sex cohabiting couples has shown that body dissatisfaction is directly associated with sexual anxiety ( Bowsfield & Cobb, 2021 ). Similarly, in our study participants confirmed that body dissatisfaction caused by oppressive body standards precipitated sexual anxiety, even for women participants with same-sex partners. Although Black women’s cultural markers of beauty are different than White women’s ( Robinson-Moore, 2008 ; Watson et al., 2019 ), components such as body image, sexist body standards, genital grooming, and genital hygiene were causes of sexual anxiety. For example, a curvy body type is more idealized in Black culture ( Awad et al., 2015 ; Watson et al., 2019 ), yet one participant’s shame toward her weight gain made her more self-conscious during sexual intercourse, resulting in feelings of sexual anxiety. Additionally, racist sexual stereotypes, such as the Mammy have historically portrayed fat Black women as undesirable, unattractive, desperate, unworthy, and lacking sensuality ( Strings, 2019 ; Williams, 2021 ). Because fatphobia is often linked to anti-blackness ( Strings, 2019 ), the discrimination against fat Black bodies may decrease sexual functioning by way of sexual anxiety. Participants also expressed societal pressures regarding genital hygiene and grooming contributed to their sexual anxiety. These pressures impacted participants’ genital self-image (e.g., self-perceptions of the size, appearance, smell, and or taste of one’s genitals; Fudge & Byers, 2020 ). During and before sexual intercourse, some participants were focused on how their genitals smelled and if they were groomed properly, particularly to the standards that they perceived their male partner desired. Qualitative work has found that some women’s narratives about their vaginas range from dirty, to frustrating, to affirmative, and that negative genital self-concept may be informed by sexism, racism, and homophobia ( Fahs, 2014 ). Some Black women’s views of their genital self-image are not only related to current societal standards, but racist and misogynist views of Black women’s bodies that have been passed down over generations ( Ferranti, 2011 ; Tinsley, 2016 ), impacting their ability to have anxiety-free sex. Given that Black women navigate life under a unique set of systems of oppression such as gendered racism, additional work is needed to specifically examine Black women’s genital self-image and how it relates to sexual anxiety, sexual self-consciousness, and other psychological components of sexuality. It is often difficult to be mentally present and focus on receiving pleasure during sexual intercourse, when sex has often been the site of harm for some Black women ( DiMauro et al., 2018 ). Several study participants disclosed how their experiences of sexual trauma and fear of their male partners’ not respecting boundaries or consent were a major cause of sexual anxiety. Their safety concerns were informed by their past experiences of sexual violence, as well as messages they received about the critical need to be aware of their safety during sexual situations. Black girls are often taught by older Black women to watch their surroundings and be aware of the people they choose to have sex with and to have their guard up in order to reduce the likelihood of them being victimized ( Crooks et al., 2020 ). These messages may be sources of anxiety among Black women in the sample during sexual intercourse with men, especially those they are less familiar with. Our results reiterate the role of partners in women’s experiences of sexual anxiety. Incidents of rape culture, sexual violence, fatphobia, and other key intersections like ability and socioeconomic status in our sample emphasize the importance of partners (particularly male sex partners), investigating how they uphold and contribute to oppressive social attitudes and norms that harm Black women and contribute to their sexual anxiety. Additionally, open communication about sex could help alleviate sexual anxiety and allow them to find other pathways to intimacy (e.g., sensate focus, non-sexual touch; McCarthy & Wald, 2013 ). However, partners need to be open and receptive, while seeking to understand how they can support their partner throughout this process ( McCarthy & Wald, 2013 ). As Black women liberate themselves from internalized attitudes and norms that may influence their sexual anxiety, clinicians and educators should assert the importance of partners conducting the same internal work. If women arrive at sexual relationships with sexual trauma, clinicians and educators can rely on the Afrocentric value of communal care ( Johnson & Carter, 2020 ) to invite all members of the relationship to assist in alleviating women’s sexual anxiety. Though the current study is the first to examine the phenomenon of sexual anxiety among Black women, it is not without limitations. First, our sample was intentionally recruited to consist of women who reported having a reproductive health diagnosis (e.g., endometriosis, fibroids, etc.) and/or frequent and pervasive sexual anxiety and pain. However, we did not explore how sexual pain may have a distinct impact on Black women’s sexual anxiety and their conceptualization of its definition. Therefore, a comparative study examining a possible unique impact of sexual pain on the pervasiveness of sexual anxiety may contribute substantially to the limited research exploring sexual anxiety among Black women. Also, because we did not provide a definition of pre-menopausal, the range of people’s definitions may possibly impact the study. However, the purpose of having participants that were premenopausal was to ensure that menopause was not a contributing factor to their sexual pain (the main focus of the parent study). Although Black women may face similar sociostructural barriers, the results of our study may not be generalizable to Black women outside of the Southern region of the US. However, the goal of IPA research is not generalizability but to provide a detailed exploration of experiences from multiple perspectives ( O’Mullan et al., 2019 ). Finally, an analysis exploring differences between Black women who had heterosexual versus same-sex sexual relations may have revealed more in-depth findings about sexual anxiety. Future research should recruit a more sexually diverse sample to investigate these differences. The results of this study have implications for researchers and clinicians who study and treat female sexual dysfunction broadly and specifically for Black women. The relevance of intersecting sociostructural contexts for the women in this study reinforces the importance of situating female sexual dysfunction within culture, identity, and structural inequality. Often, Black women’s experiences are reduced to a single-axis approach that treats Black women’s positions (e.g., race, gender, class) as mutually exclusive ( Lewis & Neville, 2015 ). Instead, Black women’s sexual dysfunction, including sexual anxiety, should be viewed, studied, and treated using a Black feminist/Womanist-centered approach that recognizes the multiplicative impact of racism, sexism, and heterosexism ( Barlow & Johnson, 2021 ; Bowleg, 2012 ; Collins, 2000 ; Lindsay-Dennis, 2015 ). Our results mirror Black feminism/Womanism by first providing a credible description and approach to sexual anxiety informed by the target population’s responses and created by Black women (i.e., a collective definition). Second, our description attends to how intersecting social factors manifest in Black women’s sexual lives (e.g., sexual stereotypes, cultural upbringing) and influence their sexual anxiety. Third, our description includes coping (e.g., mindfulness, partners, therapy), which empowers Black women by viewing them as resourceful and agentic. Applying this study’s sexual anxiety description and using the aforementioned approaches in sexuality research and practice will be beneficial for these women. Calls have been put forth by clinical communities and associations ( American Counseling Association [ACA], 2022 ; American Psychological Association [APA], 2017 ; Ratts et al., 2016 ; Singh et al., 2020 ; Sue et al., 2019 ) for increased multicultural competency when working with clients. Guidelines have been created for multicultural clients and sexual minority populations ( APA, 2017 ; American Psychological Association, APA Task Force on Psychological Practice with Sexual Minority Persons, 2021 ), for example, yet many of these guidelines assume a single-axis approach and minimally center Black women. The results of this study support a need for more intersectional guidelines specific to Black women. Guidelines should encourage clinicians to maintain a continued practice of cultural humility and competency development. Clinicians should seek to understand Black women’s sociopolitical context and address their own implicit biases about Black women ( Hargons et al., 2022 ). For example, clinicians may reflect on whether they endorse assumptions related to Black women’s strength (e.g., Black women should appear strong, Black women do not experience emotions). These assumptions, among others, can prevent clinicians from effectively collaborating with and diagnosing Black women in sex therapy ( Pappas, 2021 ). Additionally, clinicians may use culturally relevant assessments like Lewis and Neville’s (2015) Gendered Racial Microaggressions Scale for Black women to complement existing sexual anxiety measures. Using culturally relevant assessment will support clinicians in inviting conversations about the impact of intersectional oppression on Black women’s sexual lives. Not only does this study explicate Black women’s anxiety, but it provides insight into their coping strategies. Findings demonstrate that Black women have diverse and active strategies like mind-body modalities (e.g., mindfulness; see Malone & Hargons, 2021 ), partner support, and sister circles (e.g., time to talk with other Black women about their problems and strategize solutions; see, Bryant-Davis et al., 2021 ) to cope with sexual concerns. Existing therapeutic models should be adapted to highlight and include coping strategies relevant to Black women. Making this Black feminist/Womanist-informed modification to sex therapy models will be useful to Black women experiencing sexual anxiety. Also, having interventions created by and for Black women and their sexual concerns is necessary. Black sexualities specialists comprise a small percentage of scholars traditionally recognized for their contributions to human sexuality, theories, and more. Their work, both academic and non-academic, should be prioritized as viable and noteworthy. Individuals working with or educating Black women with sexual anxiety should use a strengths-based and sex-positive approach ( Hargons et al., 2021 ; Kimmes et al., 2015 ) that encourages Black women to rely on and continue identifying active coping strategies for their anxiety. Doing so serves as a reminder that Black women are not inherently lacking in strengths (much like harmful stereotypes imply). Rather, they are resourceful and able to overcome their anxiety and other possible sexual dysfunctions – no matter how debilitating. Beyond this, it is deficit-based to strictly focus on sexual anxiety or dysfunction itself. While discussing the components of sexual anxiety, individuals should invite Black women to envision what it means to harness their erotic power ( Lorde, 1978 ). Educators should also invite Black women to identify their strengths and resources in sex therapy and provide education on methods for tapping into erotic power like pleasure mapping and masturbation.

The present study explored Black women’s lived experiences of sexual anxiety. Results revealed that there are a multitude of reasons Black women may experience sexual anxiety that are informed by sociostructural factors and gendered racism. Women in this study expressed how sexual anxiety resulted in several physical, emotional, and psychological symptoms that prevented them from having pleasurable sex. This study highlights the importance of investigating, preventing, and treating barriers that exacerbate sexual difficulties, such as sexual anxiety, so Black women can engage in pleasurable sex and feel safe, mentally present, and confident during sexual experiences.

For Black women, there may be additional socio-structural factors affecting their experiences of sexual anxiety that White women do not face. For decades, Black feminist scholars have highlighted how controlling images, such as the Jezebel, Sapphire, and Mammy, have negatively impacted Black women’s sexuality in the US ( Collins, 2004 ; Jerald et al., 2017 ; Leath et al., 2022 ; Lomax, 2018 ; Stephens & Phillips, 2003 ). Interlocking systems of oppression often position Black women at the margins through racist and sexist stereotypes ( Jerald et al., 2017 ) or controlling images (often used interchangeably, see Collins, 2000 ). The Jezebel image labels Black women as hypersexual, promiscuous, and deviant with sexual appetites as “at best inappropriate and at worst insatiable” ( Collins, 2000 , p. 83). This stereotype was created during US slavery to justify sexual assault of enslaved Black women by White men ( Collins, 2004 ). The Jezebel stereotype significantly affects Black women’s sexual decision making ( Crooks et al., 2019 ; Jerald et al., 2017 ), yet little research has focused on how this stereotype might contribute to sexual anxiety. The pressure to live up to promiscuous stereotypes and be good sex partners, or the fear of being labeled as a Jezebel, may cause Black women to spectate and become more anxious during sex. The Mammy image represents Black women as larger bodied, dark-skinned caretakers who lack sexual desire ( Stephens & Phillips, 2003 ). Women who are overweight and darker skin may experience fatphobia intersecting with colorism, sexism, and racism that impacts their experiences of sexual anxiety. Other socio-structural factors specific to Black women include partner scarcity due to mass incarceration, gun violence, and poverty ( Boyd et al., 2021 ; Dauria et al., 2015 ) and higher rates of sexual trauma compared to their White counterparts (J. N. Barlow, 2020 ), both of which may impact their experiences of sexual anxiety. For example, Black women who have sex with men may engage in unwanted sexual intercourse, despite their anxiety, to please their male partners for fear of losing them to another woman ( Bowleg, 2004 ). Additionally, experiences of sexual assault increase the likelihood of Black women experiencing posttraumatic stress disorder ( Bryant-Davis et al., 2010 ), which could facilitate sexual anxiety and spectatoring during sexual intercourse ( Thorpe et al., 2022a ). To investigate these socio-structural influences on Black women’s lived experiences of sexual anxiety, intersectional and Black feminist approaches are needed. Intersectionality, a critical theoretical or analytic framework, explores how interlocking systems of oppression (e.g., racism, sexism, homophobia) create hierarchical social positions through power to enact inequalities and socio-structural discrimination ( Crenshaw, 1989 ). That is, in the most recent half millennium, wealthy White cishet men have held the most privileged intersection and highest place in the human hierarchy, despite being a global minority, through building and violently sustaining discriminatory, exploitive structures that have health consequences for other humans, especially multiply marginalized humans like Black women. Black feminist scholars have specifically used intersectionality as a theoretical framework for Black women’s sexual health ( Bowleg, 2012 ; Collins, 2000 ). Intersectionality rejects the single axis lens that focuses solely on race or gender and is founded on the analysis of the various ways race and gender and other social locations intersect and impact the multiple dimensions of Black women’s sexualities ( Hargons et al., 2021 ; Nash, 2008 ). Intersectionality sees Black women, a multiply marginalized group, as a value added to the literature and knowledge creation ( Nash, 2008 ). Additionally, Black feminist thought allows scholars to center the needs, voices, and knowledge of Black women through lived experiences within the context of social injustice and intersecting systems of oppression ( Collins, 2004 ). To counter the deficit-based narratives of Black women’s sexualities ( Hargons et al., 2021 ; Thorpe et al., 2022b ), this study took an intersectional approach and was rooted in Black feminist perspectives to center the meaning making of Black women in sex science and advance the research on Black women’s sexuality through a holistic lens. Specifically, we contextualize Black women’s meaning making about sexual anxiety within the micro- and macro-level oppressive forces of gendered racism to add more nuance to existing research on sexual anxiety. The purpose of this study was to understand Black women’s experiences and meaning of sexual anxiety using a phenomenological approach, or the systematic qualitative research process that situates meanings within social structures ( Hein & Austin, 2001 ). This study makes a unique contribution to the literature by being the first study to our knowledge to 1) reflect the meaning of Black women’s experiences with sexual anxiety, including how they understand its etiology and their coping options and strategies, and 2) develop a working description of sexual anxiety for Black women that captures the nuances of this phenomenon among them.