A lack of scientific data on basic health needs of lesbians combined with misinformation and homophobia in the health care community result in dangerously inadequate health care for many lesbians, according to the Gay and Lesbian Medical Association (GLMA).
Researchers say that lesbians appear to have higher rates of alcohol use, obesity, and smoking compared to heterosexual women. And because they are less likely to visit their health care providers for services like contraceptive counseling and pre- and post-natal care-the reasons often cited by heterosexual women for checkups-lesbians may see their health care providers less frequently than heterosexual women. These less frequent visits mean that lesbians often forfeit many preventative health services like cancer screening.
According to the Mautner Project, a Washington-based non-profit organization serving lesbians with cancer, as well as their partners and caregivers, lesbians are at higher risk of ovarian, breast, and cervical cancer because they are less likely to have children by age 30 and less likely to see their health care providers for routine screening like Pap smears.
"Most women are brought into a health-care setting on a regular basis," said Susan Cochran, an epidemiologist at UCLA. "Men go in when something goes wrong, and in some ways lesbians are like that."
Lesbians are also faced with stereotypes and assumptions in many doctor's offices. "There's a vulnerability disclosing information to someone you really don't know," said Lisa Pratt, medical director at the Lyon-Martin women's clinic in San Francisco. "Too often, the patriarchal white-coated physician doesn't engender that trust," Pratt continued.
Dr. Marion Kavanaugh-Lynch, vice president of the GLMA's Lesbian Health Fund, said that the number of physicians who claim to be sensitive to the health concerns of gays and lesbians is "awfully small in some states," according to a national database compiled by GLMA.
Advocates are concerned that without increased availability of data it is unlikely that the broader health care community will take notice. The dearth of basic information about lesbian health care can be blamed, in part, on the fact that most traditional sources of health information (like health surveys or death certificates) do not record information about sexual orientation.
"We don't know the mortality rates, we don't know the suicide rates, said Dr. Patricia Robertson of UCSF's School of Medicine and co-director of UCSF's Lesbian Health Resource Center. "Lesbians are invisible."
"We've gotten sick of having to give talks without data," said Robertson. "There's so much that needs to be done, and not enough funding. Our community is not being respected in terms of studying health."