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Article title: Lesbian-Health: NWHIC_1
Fundamentally, lesbian health concerns are women's health concerns and as such lesbians need access to the same high quality health screening and preventive care that is appropriate for all women throughout the life cycle. Unfortunately, the unique health care needs of lesbians are often ignored by a medical world that assumes heterosexuality. Lesbians and their providers often remain uninformed about important health issues including the need for: cervical and breast cancer screening, reducing the risk of sexually transmitted diseases and HIV, caring for mental health issues including depression, diagnosing and treating substance abuse, lesbian pregnancy and parenting assistance, and understanding domestic/intimate violence.
Two substantial barriers to care include (1) lack of financial resources or insurance, including no access to coverage under their partner's policy, and (2) past negative experience in the health care setting. As such, the unique health care needs of lesbians can only be met by increasing access to important health care services and informing lesbians and health care providers of the importance of obtaining appropriate care. Finding a provider that is lesbian-sensitive, seeking lesbian-specific health information, and supporting research on issues of relevance to the lesbian population are important steps to ensuring that the unique health care needs of lesbians are addressed. Several resources exist to promote these goals.
Research has shown that lesbians are less likely to receive pap smears than heterosexual women are. Reasons for this include lack of access to health care services and lack of information among both lesbians and health professionals about lesbian health needs. It is also possible that lesbians seek obstetrician-gynecologists less frequently than do heterosexual women, so they have less exposure to screening services traditionally offered by ob-gyn. Many health care providers and patients share the false assumption that because lesbians are not currently sexually active with men, they are not at risk for developing dysplasia (abnormal cells in the cervix). As a result of this misinformation, lesbians may avoid medical services and health care providers may give incorrect advice and underutilized appropriate health screenings for these patients. However, lesbians, like all women, need regular pap smears.
Pap smears are one of the most effective methods of cancer prevention for women. The Pap smear tests for abnormal changes in the cells of the cervix that may become cancerous if left untreated. If detected early, these changes can be treated with minimal intervention, discomfort, and cost. While it is thought that lesbians who have never had heterosexual intercourse have less cervical cancer, no research has been conducted to quantify the actual risk to this population. We know that one of the viruses that are associated with cervical cancer, the human papilloma virus (HPV), can be transmitted from woman to woman. Also, lesbians who have had heterosexual intercourse at some point in their lives may have been exposed to HPV. Therefore, lesbians need Pap smears on a regular basis, even if they have never or have rarely been sexually active with men.
Lesbians are at risk for many sexually transmitted diseases, as well as for HIV.
Genital warts, usually associated with the Human Papilloma Virus (HPV), can be transmitted sexually from woman to woman. The Herpes virus can be transmitted when a lesion from one woman comes into contact with the oral mucosa or the genital mucosa of her female partner. Hepatitis B can also be transmitted between women. Any sexually active person should be immunized against Hepatitis B (a three shot series).
There is no evidence at this time that gonorrhea, syphilis, or chlamydia is sexually transmitted between women who are sexually active with women, but large studies have not been done. The majority of lesbian women are sexually exclusive with women (although 90% have been heterosexually active at some time): however, there are some lesbians who do have male partners, and this subpopulation of lesbians are at risk for gonorrhea, chlamydia and syphilis.
At this time, we have no documentation of HIV transmission between lesbians, and HIV does occur in lesbians, usually due to two factors 1) sharing of needles and 2) when lesbians sleep with men who have been exposed to HIV. However, because there is a theoretical risk of HIV transmission between lesbians, safe sex guidelines are recommended. Small studies are currently underway to study the risk of HIV infection in lesbians.
The Institute of Medicine, affiliated with the National Academy of Sciences, issued a report in January, 1999 that supported the need for more research.
You can find out more about lesbian health by contacting the following organizations:
National Lesbian and Gay Health Association, 1407 S. St. NW;
Washington, D.C. 20009
Phone: 202-939-7880 / Fax: 202-234-1467
National Center for Lesbian Rights, 870 Market Street, Suite 570; San
Francisco, CA 94102
Contributing to this FAQ on Lesbian Health: University of California at San Francisco, a National Center of Excellence in Women's Health, sponsored by the Office on Women's Health in the Department of Health and Human Services.
All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.
Publication date: 1998
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