What are lesbians' unique health risks?
Because women who partner with women are rarely an identified population
in women's health research, more remains unknown about lesbians' health
risks than is known. We do know that:
- Lesbians likely weigh more and smoke more than heterosexual women,
which could put them at a higher risk for heart disease, stroke, and
cervical and (possibly) colon cancers.
- Lesbians have fewer pregnancies and live births, thus allowing for
uninterrupted estrogen over longer periods of time and putting them
at greater risk for cancers such as breast, uterine and ovarian cancers.
- Lesbians can get sexually transmitted diseases (STDs) from other
women. While more research is needed to learn how STDs are transmitted,
and which STDs are most common among women who partner with women, some
STDs have been identified as common. Bacterial vaginosis (BV), a common
vaginal infection, occurs frequently; also, if one woman in a couple
has it, it's likely her partner does too. Lesbians are at risk for human
papillomavirus (HPV, the virus that causes cervical cancer) as well.
As a woman who has sex with women (WSW), what should I know when I go
in to see my provider?
You'll receive the highest quality, most appropriate care from your health
care provider if you plan ahead for your visit, keeping these issues in
- Ask other sexual minority women to suggest a provider, or check the
Greater Seattle Business Association's (GSBA) directory.
- Come out; this is the single most significant disclosure you can make
during your visit because it focuses the care and health education you
receive, and ensures these are right for you.
- Be prepared to answer some questions about your needs as a sexual
minority woman. While it is true that your providers should educate
themselves on WSW, there are two important considerations: 1) you are
the expert on you and, 2) some providers may want to check out that
what they know about WSW is true about you as well.
- Be honest about your past sexual history. Your provider needs to know
if you have had sex with men to evaluate your risk for a variety of
sexually transmitted infections, and for cervical cancer.
- Take someone with you to your visit. It's often easier for a partner
or friend to raise questions or concerns than it is to do it yourself.
You'll also feel safer.
What sort of routine screening exams do I need?
You should have the same screenings as any other woman. The problem is
we don't have the research to tell us whether you need more or less than
other women. Until we can document that lesbians are at greater or lesser
risk for various diseases, you should follow the same screening schedules
as are indicated for heterosexual women. Your provider may require some
reminding on this point; a recent study showed that unless women complained
of relevant symptoms, WPW were not screened for common infections such
as bacterial vaginosis and chlamydia.
- STD screen: whenever you have a new partner, and before you and your
partner discuss safe sex practices.
- Pap Smears: begin screening at age 18 or when you become sexually
active. Have yearly Paps until you've had three consecutive negatives;
after discussing your risk factors with your provider, you may then
be able to have Paps every 2-3 years. Keep in mind that more recent
research is indicating that women may acquire new strains of HPV from
new partners, so a new partner may be a reason to revert to yearly Paps.
- Mammograms: every two years starting at age 40 and yearly at age 50
and older. Get an annual breast exam by a health care provider starting
at age 30. Consult your provider if you have a family history of breast
cancer (mother or sisters with it), and especially if they developed
the disease prior to age 50. Keep watch on the published lesbian research.
We may find lesbians require more frequent screening.
- Follow published frequencies for other exams. Remember that if you
smoke or are overweight, you may need more checkups for some conditions.
The national gay & lesbian newsmagazine Internet site
City of Seattle
Commission for Sexual Minorities
Policy and advocacy body for sexual minorities within City government.
Partnership Benefits at the University of Washington
A web zine from stonefemm.com.
Gay and Lesbian Medical Association. See their excellent white paper,
commissioned by HRSA, on sexual minority health issues. (Note: this Web
site opens in a new browser window since it is designed to disable the
Healthy People 2010 and
companion document on Sexual Minority Health
Human Rights Campaign
Working for sexual minorities' equal rights.
The Mautner Project for Lesbians
The only national organization dedicated to lesbians with cancer, their
partners and caregivers.
National Gay and Lesbian Task Force and
Working for sexual minorities' equal rights.
Public Health-Seattle &
King County's LGBT Web Site
Created with funds from a National Library of Medicine grant, this excellent
web site has received national attention.
Seattle Lesbian Cancer Project
A grassroots organization dedicated to providing advocacy, education,
information and referrals for women who partner with women.
Seattle Lesbian STD Research Project
Information about the NIH-funded, University of Washington-sponsored research
project investigating sexually transmitted infections among women who
partner with women.
Kathleen Stine, MSN, ARNP
Health Care Specialist
Lesbian-Bisexual Women's Study
University of Washington