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to Section One | to Arts & Entertainment
posted Friday, May 17, 2019 - Volume 47 Issue 20
Lesbians, bisexual women lag in health outcomes
Section One
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Lesbians, bisexual women lag in health outcomes

by Colin Fields, MD - Kaiser Permanente

I recently saw a tweet that read:

'My doctor asked me if I was sexually active. I said yes. Then she asked if I was on birth control. I said no. Then she proceeded to lecture me on birth control which SHE DIDN'T NEED TO DO BECAUSE I HAVE SEX WITH WOMEN.'

Experiences like this are all too commonplace with heterosexism pervasive in our society and in medicine. Yet the experience isn't just frustrating - it becomes a barrier that deters lesbian and bisexual women from returning to the doctor and thus keeps them from getting the care they need.

Lesbian and bisexual women have smoking rates nearly double that of straight women and higher obesity rates. This raises concern about the possibility of higher rates of lung cancer, emphysema, diabetes, heart disease, and more. Yet we know that lesbian and bisexual women are less likely than straight women to get the healthcare they need.

For example, current guidelines recommend that all women age 21 to 65 get screened for cervical cancer. Lesbian women are 75% less likely than straight women to be up to date on cervical cancer screenings; bisexual women are 30% less likely than straight women. When a study here in Seattle dug into why this is, more than a quarter of lesbian women said they had a previous adverse experience with screening. 22% said they thought it wasn't necessary if they weren't sexually active with men.

In short, lesbian and bisexual women aren't getting the life-saving cancer screenings they need because medicine isn't welcoming and inclusive and because we're not educating about the needed screenings in an inclusive way.

A 2014 study of LBT students at universities in the Southwest found that the moment of disclosure of sexual orientation and the provider's attributes were the biggest influencers on their health care experience. This makes perfect sense - is it safe to come out to my physician? How do they react when I come out? Are they competent providers for the LGBTQ community and aware of our needs?

When a patient has an experience with a care provider that is disrespectful or not responsive to their needs, they don't come back, which can result in negative health outcomes.

Healthcare providers know we can, and must, do better for our lesbian and bisexual patients.

The medical world is working to improve. At Kaiser Permanente we train physicians on how to ask about sexuality, how to provide a welcoming environment, and how to provide a care plan that reflects the patient's sexual activity. As a whole, though, the medical world is slow to change.

For everyone in the LGBTQ community, we need to take the initiative to find friendly caregivers to make sure we get the care we need and we feel comfortable coming back. Not all providers who advertise as LGBTQ-friendly actually are in practice. A friendly provider should ask which gender/s you have sex with and be able to provide advice specific to different types of sexual activity. They should tell you about all the screenings you need based on your individualized risk factors. They should be fully comfortable listening to you and treating your whole self.

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Gilead to provide free PrEP for 200,000 Americans
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Mayor Pete Buttigieg gives keynote speech at 2019 HRC Las Vegas Dinner
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Seattle hate crime reports up 400% since 2012, city audit says
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Cuban police arrest three at LGBT parade
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Congresswoman Suzan DelBene (D-WA 1st Congressional District) speaks out to endorse the Equality Act
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Celebrate the 150th anniversary of Golden Spike Day with photographer Corky Lee at the Seattle Public Library May 19
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TAKE A TRAVEL PHOTOGRAPHY WORKSHOP AT THE SEATTLE PUBLIC LIBRARY BEGINNING MAY 28
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40th anniversary sparks nostalgia and promotes community
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Lesbians, bisexual women lag in health outcomes
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Cops routinely mistreat Trans people, NCTE says
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370,000 LGBT people in Michigan are vulnerable to discrimination
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CELEBRATE THE 150TH ANNIVERSARY OF GOLDEN SPIKE DAY WITH PHOTOGRAPHER CORKY LEE AT THE SEATTLE PUBLIC LIBRARY ON MAY 19
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