{
  "abstract": "Background Building evidence reveals that health inequalities are informed by structural and interpersonal discrimination. Research further suggests that disabled people experience worse healthcare access and outcomes than those without a disability. Although women in the UK are more likely to have a chronic illness or disability than men, and they commonly experience disbelief about their pain and symptoms, there is sparse qualitative evidence on the healthcare experiences of disabled and chronically ill women. These data would be instructive for policy aimed at reducing health inequalities.Methods Through four focus groups (n=14) and 28 semi-structured interviews, we explored the links between discrimination and health among women in Scotland. We used intersectionality as a theoretical and applied framework to examine the unique experiences of those at the gender/disability intersection, illuminating other axes of inequality such as ethnicity and socioeconomic position, where relevant. Reflexive thematic analysis was used with NVivo to generate our themes.Results Our findings are presented across three themes: (1) Participants expressed that the very concept of being ‘healthy’ was rooted in ableism and sexism, which influenced their access to healthcare, shaped the design of services and resulted in unfair treatment by healthcare professionals and society. (2) Weight stigma was one neoliberal logic used in healthcare contexts to limit disabled women’s access to referral, diagnosis, treatment, support and dignity. Women, particularly those with chronic conditions or from ethnic minority backgrounds, felt blamed for weight gain that resulted from health issues or medications, leading to stigmatisation and inadequate care. This intersectional bias reproduced negative stereotypes and minimised the complexities of participants’ lived experiences and health conditions. (3) Finally, to navigate these discriminatory healthcare systems and get access to treatment, women had to practice self-advocacy, alter their behaviour and balance sometimes conflicting presentations of self that they had learned through years of negative interactions.Conclusion This study conveys pervasive gendered ableism that women navigate within the healthcare system, which not only induces distress and frustration, but constrains access to referrals, diagnosis and treatment and ultimately sustains health inequalities. To improve health outcomes for all women and promote equity, we must move beyond neoliberal conceptualisations of what is ‘healthy’ and challenge systemic intersectional discrimination.",
  "authors": [
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "Laura Tinner"
    },
    {
      "affiliations": [
        "School of Social and Political Sciences, University of Glasgow, Glasgow, UK"
      ],
      "name": "Ana Alonso Curbelo"
    },
    {
      "affiliations": [
        "Independent Researcher"
      ],
      "name": "Kerry Gillespie"
    }
  ],
  "title": "OP05 ‘You’ve got to fight, every time’: how women with a chronic illness or disability navigate intersectional discrimination within healthcare",
  "uid": "6c9f4480-e626-571f-b809-85ada0a373a7"
}