Lesbians are a unique population of women whose specific health care concerns are not often consistently met by our current health care system. Lesbians have seemed invisible within the health care system because they don't necessarily differ from heterosexual women in any obvious ways, and because they may choose not to "come out" and disclose their sexual orientation for any number of reasons. Although studies in lesbian populations are limited, there are indications that depression, substance abuse, suicide, and social isolation may occur more frequently in lesbian women than heterosexual women. Additionally, lesbians may have higher prevalence rates of certain cancers that differ from those of heterosexual women, as well as lower rates of some sexually transmitted diseases.
Lesbians are like all women in their vulnerability to illness and to the damaging effect of sexism in the health care system. Lesbians also face discriminatory barriers to health care, do not always seek treatment when they need it, and there is evidence that homophobia by providers causes lesbians to seek health care less frequently than heterosexual women.
In a recent study, 60% of the lesbians studied stated that they believed they could not disclose their sexual orientation to their physicians and close to 25% believed that their doctors had little knowledge about lesbian health issues. One study indicates that 45% of lesbians do not have regular gynecological care and another 25% have only sporadic care (O'Donnell, 214). Another indicates that one in three lesbians has no health insurance. Thus, lesbians often avoid preventive health care services and enter the health care system primarily during serious illnesses and major health crises.
Lesbians' health needs clearly differ from those of straight women in the area of reproductive health. Lesbians generally have fewer pregnancies in their life times than other women and, therefore, have...