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LESBIAN HEALTH

Roughly 4-10% of women in the United States identify themselves as lesbians. Lesbians are women who are mainly emotionally and sexually attracted to other women. Lesbians need the same health care as other women. However, they may be less likely to receive regular care because they may not trust the health care system or do not think they need the same kind of care as women who have sex with men.

Sexual Orientation

Sexuality is part of every human being. No one really knows why a person develops a certain sexual orientation - that is, whether a woman is a lesbian or homosexual (attracted only to women), bisexual (attracted to both men and women), or heterosexual (attracted only to men). Some experts think that sexual orientation is set before birth.

Every woman does not express her sexuality in the same way. Also, a woman may express her sexuality in different ways over her lifetime. Many lesbians have had sex with men at some time in their lives. Many factors affect sexual behavior.

Preventive Health Care

Obstetrician-gynecologists (OB-GYNs) provide preventive health care and promote wellness for women. All women, including lesbians, should see their doctors regularly for preventive health care. Such care includes routine tests and exams that all women need, regardless of their sexual orientation. Preventive care can help detect health problems before they become serious. It provides a chance to learn ways to stay in better health.

You and Your Doctor

Talking about your sexual orientation with your doctor may be hard to do. You should be able to discuss with your doctor anything that affects your well-being. This includes your sexuality.

Many doctors don't ask about sexual orientation. It can be hard for you to reveal because you may be unsure about the doctor's response. The risk is worth it, though. Trust your doctor. If you don't, you may not tell your doctor things he or she needs to know about your health.

Sharing information about your sexual orientation with your doctor also helps him or her to be more aware of your health care needs. For instance, questions about your health may be phrased in a different way if your doctor knows you are a lesbian.

Women who have not told their families or coworkers they are lesbians may not want to discuss it with their doctor. They may worry that it will not be kept private. Doctors are required by law to keep your health information confidential (private). If you do not want information about your sexuality in your medical record because you think it is likely to be seen by insurance companies or others, simply say so.

The Well-Woman Exam

All women - whether they have sex with other women or men or do not have sex - should have a well-woman visit at least once a year. This visit includes a general check of your health and an exam of your breasts and pelvic (reproductive) organs. During the exam your doctor will:

  • Obtain a health history. This includes asking questions about your past illnesses, family health history, your menstrual periods, use of medications, and whether you have ever been pregnant.
  • Do a physical exam. This begins with a check of your weight and blood pressure. The doctor will also check your breasts for lumps and examine your pelvic organs.
  • Perform routine tests. A Pap test and perhaps others, such as mammography or some blood tests, may be done. It depends on your age and other risk factors.
  • Provide counseling. You will be given information to help you stay healthy. The doctor will answer any questions you may have.

Gynecologic Health Concerns

Lesbians do have gynecologic problems. Because lesbians may avoid seeing a doctor, health conditions such as infections and cancers may not be noticed or treated.

Sexually Transmitted Diseases

Sexually transmitted diseases (STDs), including HIV (human immunodeficiency virus), are less common in lesbians than in heterosexual women. These diseases can, however, be passed from woman to woman. Sex can pose a risk. You may be at greater risk if you or your partner have had sex with men or are having sex with other partners.

There are steps you can take to protect yourself from STDs:

  • Do not allow body fluids of another woman, including menstrual blood and vaginal fluids, to enter your body through cuts or other openings.
  • During oral sex, make sure none of your partner's fluids get in your mouth. Cover her entire vagina with plastic food wrap, a dental dam (a square sheet of latex), or a cut-open condom or latex glove.
  • Place a latex barrier or plastic wrap between your vaginas during vulva-to-vulva sex.
  • Avoid sharing sex toys. If you do, always wash them in hot, soapy water or put a fresh condom on the toy before switching users.
  • If you think you might have an STD, or have had sex with someone who has an STD, seek medical care. Do not have sex until both you and your partner have been tested and treated.

Cancer

Cancer of the cervix appears to be less common among lesbians than among heterosexual women. You still should be tested for it regularly. The risk of cancer of the cervix is higher in women who

  • Began having sex with men at a young age
  • Have had more than one male sexual partner
  • Have been infected with human papillomavirus (HPV)
  • Smoke cigarettes
  • Have been treated for an abnormal Pap test result

Regular Pap tests can detect changes in the cervix that could be a sign of cancer or changes that could lead to cancer. When cancer of the cervix is caught early, there is a high cure rate.

Lesbians may be at an increased risk for certain other cancers. Women who have never given birth and have not used oral contraceptives (birth control pills) have a higher risk of cancer of the ovary and uterus. Exams for these two cancers are included in a gynecologic exam.

Women who have never had children and have never breastfed are at a higher risk of breast cancer. Having routine breast exams and mammograms can help detect breast cancer early. Women older than age 40 should have a mammogram every 1-2 years until age 50, and then annually after that. Mammograms may pick up tumors before they can be felt.

You also should examine your breasts every month (known as a breast self-exam).

Emotional Health

An important health issue facing lesbians is emotional well-being. Revealing your homosexuality to family, friends, and coworkers is hard to do. Some people have a hard time accepting that a person is homosexual. Because of this, you may worry about how your family and friends will react. You may fear or experience rejection. Lesbians who keep their sexual orientation to themselves, though, often become anxious, fear discovery, and may not get the support they need.

Your feelings and experiences can lead to isolation and depression. In a survey of nearly 2,000 lesbians, more than one third said they had suffered a long depression or sadness. This may make lesbians more open to alcohol and drug abuse.

The teen years can be a very hard time for many lesbians. Emotions change quickly. Sexual feelings awaken. There is intense pressure to "be like everyone else." For lesbian teens, adolescence can be trying and lonely.

Although there is no set time when a woman realizes she is lesbian, many women become aware of it during their adolescence. Lesbian teens may struggle with their sexual orientation and keep the truth secret until they are older. They may become depressed, do poorly in school, or even think about killing themselves.

If you feel sad or depressed, get help as soon as you can. Your doctor or nurse can refer you to a counselor or support group. You also can call a local gay or lesbian service center for information on support services. Gay or lesbian centers in your area are listed in the phone book.

Parenting

Many lesbians are parents. Lesbians may have children from previous relationships with men, adopt, become pregnant by artificial insemination or by having sex with a man, or serve as foster parents.

Laws about artificial insemination and adoption vary from state to state. If you are thinking about becoming a parent in this way, talk with your doctor about your plans. A preconceptional visit with your OB-GYN to plan for any pregnancy is a good idea.

Finally...

Regular health care is key for all women. You and your doctor both play key roles in keeping you well. It's vital to find a doctor you can trust and who can give you complete information. He or she can work with you to develop a health care plan based on your own needs.

Staying healthy means eating right, getting regular exercise, avoiding tobacco and illegal drugs, drinking moderately, and getting regular checkups from a doctor you trust. The fact that your doctor has given you this article shows that he or she cares about your health. If you find this article useful, you may want to share it with your friends.

Helpful Resources:

Keeping you a Secret, by Julie Anne Peters

Rubyfruit Jungle, by Rita Mae Brown

 

 





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