Abstract A152: Structural cisheteropatriarchal state-level policies and factors and their impact on mammogram screening across sexual orientation and gender identity

Abstract Introduction: Breast/chest cancer screening, such as mammography, is recommended to detect breast/chest cancer in its earlier stages; a growing body of research on breast/chest cancer screening suggests that sexually and gender minoritized (SGM) populations experience unique barriers to timely detection of breast/chest cancer screening. A notable barrier to preventive health service use among SGM communities is cisheteropatriarchy, yet many SGM people also have overlapping experiences of oppression from structural racism and urbanism. Little research explores how structural oppression manifests for mammogram usage among those with minoritized sexual orientations, gender identities and races and ethnicities and marginalized by rurality. This research makes a novel contribution to the literature by being the first of its kind to name structural cisheteropatriarchy as a potential key determinant of care across the breast/chest cancer continuum. Methods: Using 2022 Behavioral Risk Factor Surveillance System (BRFSS) data, this research is among the first to explore the relationship between mammogram usage and the intersections of sexual orientation, gender identity, race and ethnicity, and rurality. In addition, I constructed a composite measure of state-level sexual orientation- and gender identity- related policies and indicators to measure structural cisheteropatriarchy at the state level. I examined the relationship between structural cisheteropatriarchy and mammogram usage with specific attention to the impact on marginalized communities. Summary of data: Across all states included in the sample, SGM people have lower mammogram usage within the past two years compared to their heterosexual and cisgender counterparts. The findings suggest that mammogram usage is higher for SM people within less cisheteropatriarchal states compared to SM people living in more cisheteropatriachal states across Non-Hispanic white, Non-Hispanic Black, and Hispanic racial and ethnic groups. Interestingly, SGM rural residents in more cisheteropatriarchal states have higher mammogram usage than their SGM rural and urban counterparts in less cisheteropatriarchal states as well as heterosexual and cisgender counterparts in more cisheteropatriarchal states. Conclusion: These results have important implications for understanding how cisheteropatriarchy is constructed and its impact on mammogram usage across the intersections of those with diverse sexual orientations, gender identities, racial and ethnic identities, and geographic locations.These findings offer novel insights into preventive health services usage for those at the intersections of marginalized identities and have important implications for how systems of oppression, specifically cisheteropatriarchy, codified through policies and socioeconomic, political, and cultural constructs, influence breast/chest cancer screening. Citation Format: Courtney Sarkin. Structural cisheteropatriarchal state-level policies and factors and their impact on mammogram screening across sexual orientation and gender identity abstract. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A152.