Black sexual minority women (SMW) are disproportionately impacted by negative health outcomes, healthcare discrimination, and provider bias. Therefore, the purpose of this study was to investigate which sexual identity characteristics and minority stressors are associated with healthcare stereotype threat and healthcare access for Black SMW. Using secondary data from the Generations Study data, N = 142 Black and/or biracial cisgender women were analyzed using bivariate correlations and stepwise regression models. Healthcare stereotype threat was positively associated with higher perceptions of stigma, sexual identity concealment, and reports of sexual identity centrality. Healthcare access was affected by bisexual identity, masculine gender presentation, and sexual identity concealment. Improving Black SMW's healthcare utilization and experiences in healthcare settings is crucial for promoting health equity. Implications for healthcare providers and discussed.