"I want what the white lady gets…": Deconstructing racial disparities in gynecological cancer

Despite decades of diversity and inclusion initiatives in healthcare, racial disparities in gynecological cancer diagnosis, treatment, and outcomes persist and, in some cases, are worsening. Black women continue to experience later-stage diagnoses, diminished provider communication, and poorer survivorship outcomes. This paper presents findings from five focus groups conducted with individuals (n = 26) diagnosed with gynecologic cancers, guided by an intersectional lens rooted in Black feminist theory. Using thematic analysis, four recurring themes emerged: (1) diagnostic delays and dismissal, (2) medical racism and epistemic violence, (3) systems not designed for us (4) knowledge gaps and the need for patient-centered education. These findings reveal that the persistent disparities in gynecological cancer outcomes cannot solely be addressed by implicit bias training or access-based interventions. Instead, they require a transformation of the epistemological and structural foundations of gynecologic care, which continue to be shaped by values that do not consider Black patients. The integration of Black feminist frameworks into gynecologic oncology research offers a critical intervention, one that centers lived experience, challenges the medical-industrial complex, and prioritizes patient dignity. Our findings contribute to a greater understanding of the lived experience of gynecological cancer patients and reveal implications for praxis, including culturally rooted patient education, trauma-informed survivorship care, and the need for structural accountability within oncology practice and research.