HEALTH EDUCATION

Lesbian health

This page is about the important health issues that women who have sex with women need to consider. They include:

• What it means to be healthy

• Finding the right clinician

• Coming out to your health care provider

• Your gynecological (GYN) health

• Your sexual health

• Substance use

• Intimate partner violence

• Other health risks

• Your emotional and psychological health

In general, lesbians have the same health needs as all women. But many health care providers don’t know that some health issues might be different for women who have sex with women.

Being healthy
We all deserve to be healthy — regardless of our gender, income, race, religion, level of education, or sexual orientation. Being healthy means taking care of our physical, emotional, sexual, and psychological needs.

Some of the things we can to do to become and stay healthy include

• Learning about our own bodies

• Figuring out what may be stressful for us and learning the best ways to deal with stress

• Finding personal strengths, other people, and activities that make us feel good about ourselves

• Having a healthy diet

• Getting regular exercise

Being healthy also means seeking medical attention or professional help when something is wrong. But that’s not enough. To prevent health problems, it’s important to get regular checkups.

Finding the right clinician
To find a lesbian-friendly health care provider, talk with your friends, family members, classmates, or co-workers who are also lesbian and ask them who their clinicians are.

Call a local LGBT (lesbian, gay, bisexual, transgender) community center for referrals.

Find local referrals online —

• www.glma.org/home.html (Gay and Lesbian Medical Association)
• www.lgbtcenters.org/directory.asp (National directory of LGBT community centers)

Call and interview potential providers.

• Do they have other lesbian clients?

• Is staff trained in lesbian health issues?

• Ask other questions, too — about fee scales or possible free services, for example.

•Check out the atmosphere in person.

• Does the office have lesbian — and gay-friendly posters, magazines, pamphlets, or other educational materials on display?

• Are there other symbols that indicate that it is a safe space for "coming out"?

Think about how the clinician talks with you.

• Are the questions culturally sensitive, or do they assume that you are straight?

• Are you asked about partners non-judgmentally?

• Does your clinician encourage you to talk about your concerns and ask questions?

Coming out to your health care provider
Lesbians have most of the same health concerns as other women. But lesbians have different ones, too. Coming out to your health care provider is important. The more a clinician knows about you, the better she or he will be able to help you stay healthy or get better!

Most lesbians and gay men have more satisfying experiences with their health care when they are out to their clinicians. But coming out to your health care provider can be scary. It can make some people feel vulnerable.

Who you are out to should always be your choice. If you are under 18, you may be afraid that your clinician will talk to your parents.

Maybe you aren’t out at school or work. It’s okay to ask how confidential your conversation will be.

You’ll be able to prevent many misunderstandings if you come out to your clinician. You’ll be able to

• Focus on health concerns specific to you

• Avoid unnecessary questions or discussions — about birth control, for example

• Find out about lesbian-friendly referrals for other concerns you may have

Remember — being open with your clinician about all aspects of your sexuality is ideal for the best health care possible. Keep in mind that regular checkups are essential for staying healthy — whether or not you are out to your clinician.

Your gynecological health
What is gynecology?
Gynecology (GYN) is health care for women. It protects a woman’s sexual and reproductive health.

Take control of your health. Whether you’re young or old, single or have a partner, sexually active or not — GYN care is important for all women.

Regular GYN exams include

• Talking about your personal, family, sexual, and medical history

• Laboratory tests and screenings for infections and other conditions (at your own or your clinician’s request)

• Counseling

• A breast exam

• A pelvic exam, including a pap test

Breast health
Taking care of your breasts is very important. Become familiar with the way your breasts normally look and feel. That way you will notice any changes. Some women use breast self-exams (BSE) to get to know their breasts. Ask your clinician if you want to learn how to do a BSE.

Mammograms are x-rays of the breast that can detect some cancerous tumors — up to two years before they can be felt. All women over 40 should have a mammogram once a year.

Having a child
If you are thinking about having a child, talk with a clinician about your plans. Preconception planning is always a good idea. Remember that laws about donor insemination and adoption vary from state to state.

Your sexual health
Women who have sex with women can pass certain infections through sex play:

• Bacterial vaginosis

• Hepatitis

• Herpes

• HPV

• Trichonomiasis

• Yeast infections

The transmission of HIV from one woman to another is rare but possible.

Reducing Your Risk

• Keep your partner’s body fluids out of your body — vagina, anus, or mouth. The body fluids to be most careful about are blood, vaginal fluids, and the discharge from sores caused by sexually transmitted infections.

• Don’t touch sores or growths that are caused by sexually transmitted infections.

Protecting Your Partner

• Don’t allow your body fluids to get into your partner’s body.

• Don’t have sex if you have sores or other symptoms of infection.

• Get the correct treatment if you get an infection.

Barriers Can Reduce Risks

• Latex barriers — including dental dams, Glyde dams, or even household plastic wrap — can reduce the risk of passing an infection during oral sex.

• Use condoms on sex toys — vibrators or dildos, for example — if they’re shared between partners. Be sure to follow the cleaning instructions that come with each toy.

• Any woman who has sex with men, even occasionally, needs to use barriers to reduce her risk of infection and pregnancy.

Substance use
Meeting other lesbians may not be easy — especially if you live in a small town. And many social gatherings and events for lesbians happen in bars. This can promote more alcohol use than may be healthy. Using alcohol or other drugs can lead us to take risks that we wouldn’t take if we were sober. The stresses caused by social bias against lesbians can also put women at risk for dangerous behaviors.

Lesbians are no more predisposed to alcoholism than straight women. But some studies show that alcoholism may affect more than 30 percent of lesbians. The estimate for the general population is between five and 10 percent.

Many chapters of Alcoholics Anonymous (AA) and Al-Anon now have lesbian meetings. (Al-Anon can help friends and relatives of people who are alcoholic.) For help with substance use or addiction, get in touch with your local AA chapter — look in the yellow pages or online — and ask about specific meeting times.

Intimate partner abuse
Violence and abuse can happen in any relationship. Abuse is not about how big or strong someone is, it’s about misuse of power and control. Bias against lesbians may lead them to expect and accept abuse. But it’s very hurtful. And it’s never okay.

Abuse can be:

• Verbal

• Physical

• Emotional

• Economic

• Sexual

It can also involve jealousy, mistrust, anger, threats, slapping, punching, and/or withholding things a person needs.

The target of violence may need help. Someone who is violent toward another person needs to get help, too. Trust your instincts. If you feel you are being treated badly, you probably are.

No one deserves to be in an abusive relationship. If you think you may be in one and want help, you may want to consider talking with your family, a trusted friend, or a counselor.

Contact the hotline for the Network for Battered Lesbians and Bisexual Women, 1-617-423-SAFE. Their e-mail address is info@thenetworklared.org.

Or call the 24-hour hotline for the New York City Gay and Lesbian Anti-Violence Project, 1-212-714-1141 for a local referral. They offer Spanish-speaking services.

Other health risks
Social bias against lesbians can create great pressure. It can lead to poor self-image that may make it difficult to

• Access health care

• Stop smoking

• Limit alcohol and other drug use

• Eat a balanced diet

• Get enough exercise

Studies have only begun to look at health problems and concerns that may be specific to lesbians. Although we don’t have all the answers yet, some studies suggest that lesbians may be at increased risk for heart attacks and certain cancers — not because they are lesbians but because of certain possible risk factors.

For example, some studies suggest that lesbians

• May weigh more than the general population. Being overweight is associated with an increased risk for heart attacks, and cancers of the breast, uterus, and colo.

• May use alcohol and smoke cigarettes more than the general population. Using these substances is associated with an increased risk for heart attacks, strokes, and cancers of the lung, breast, colon, and stomach.

To get and stay healthy, see your clinician regularly and be sure to talk about any problems you’re having.

Your emotional & psychological health
Internalized homophobia — negative feelings people may have for themselves because they are lesbian, gay, or bisexual.

Homophobia and internalized homophobia can be so stressful that they can damage all aspects of a woman’s health.

Some things a woman can do to cope with these stresses

• Build networks of supportive friends.

• Develop a personal interest or skill that makes you feel good about yourself.

• Join community organizations that work toward ending homophobia.

Sometimes we have a hard time adapting or coping with stress. Some people find it helpful to go to counseling. Talking to a lesbian-friendly mental health professional can help you find good ways to handle your feelings or problems.

Some lesbians seek counseling to help them with the process of coming out. Others seek it to learn how to cope with the anti-gay prejudice in their lives. But most lesbians go to counseling for the same reasons that straight women do — for help with issues regarding relationships, family, work, or school that may sometimes become overwhelming.

If you’re interested in finding lesbian-friendly mental health services, call the Gay and Lesbian National Hotline, toll-free,
1-888-843-4564. You can also visit their Web site — www.glnh.org.

The Trevor Project has a toll-free 24-hour mental health and suicide prevention helpline for youth — 1-866-4U-TREVOR.

Taking care of ourselves and each other
Lesbians have faced centuries of discrimination that posed a variety of health challenges. Today, with stronger community ties and support from LGBT community and health centers, many corporations, health organizations, and city and state ordinances and statutes, lesbians are more empowered to meet these challenges.

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