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Reality Check on Lesbian Health

Tyler LePard

A common misconception is that lesbians don't need annual exams; as a group, they may actually have higher risks for cancer and other reproductive health issues.

A friend of mine once walked into her doctor's office and was told that she didn't need to have a pap smear because she's a lesbian. This is a common misconception among uninformed health care providers. However, women who have sex with women are at risk for many of the same sexually transmitted infections as heterosexual women and should still get annual exams.

According to the American Cancer Society, the best defense against cancer is prevention and early detection. Lesbians, as a group, may have higher risks for certain types of cancer based on higher rates of some specific risk factors. In addition, they experience barriers to care that could impede early detection, such as fear of negative reactions and discrimination.

There are a few key factors that may increase risk for various cancers. Survey research and clinical experience suggest that these risk factors may be more common among women who have sex with women. Lesbians, as a group, are more likely to smoke, drink more alcohol, and be overweight, which increase the risk of cancer. They are less likely to use oral contraceptives, bear children (nulliparity) or breast feed, and to go to the doctor regularly, all of which can decrease the risk of cancer. Lesbians and bisexual women are also significantly more likely than heterosexual women to have never had a mammogram and to eat fewer fruits and vegetables daily.

Because lesbians do not usually need contraceptives, they tend to wait longer between Pap smears and general gynecological exams. By not presenting for regular Pap tests, individuals may miss the opportunity to receive other preventive care.

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Unintended pregnancy is unlikely for lesbians; those who choose to parent face other challenges. Because same-sex relationships are not legally recognized, other reproductive health issues such as health insurance, adoption and legal guardianship are more complex. Alternative insemination is generally less expensive than adoption (which may be restricted); though even after successfully creating their family, non-biological moms may not be recognized as legal parents.

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