Top 10 Things Lesbians Should Discuss with their Healthcare Provider

1. Breast Cancer

Lesbians have the richest concentration of risk factors for breast cancer than any subset of women in the world. Combine this with the fact that many lesbians over  40 do not get routine mammograms, do not do breast self-exams or have clinical breast exams, and this cancer may elude early diagnosis when it is most curable.

2. Depression/Anxiety

Lesbians have been shown to experience chronic stress from homophobic discrimination. This stress is compounded by the need that some still have to hide their  orientation from family and colleagues at work, and by the fact that many lesbians have lost the important emotional support most others get from their families due to alienation stemming from their sexual orientation.

3. Heart Health

Smoking and obesity are the most prevalent risk factors for heart disease among lesbians; but all lesbians need to also get an annual clinical exam because this is  when blood pressure is checked, cholesterol is measured, diabetes is diagnosed, and exercise is discussed. Preventing heart disease, which kills 45 percent of women, should be paramount to every clinical visit.

4. Gynecological Cancer

Lesbians have higher risks for many of the gynecologic cancers. What they may not know is that having a yearly exam by a gynecologist can significantly facilitate  early diagnosis and a better chance of cure.

5. Fitness

Research confirms that lesbians have higher body mass than heterosexual women. Obesity is associated with higher rates of heart disease, cancers, and premature  death. What lesbians need is competent and supportive advice about healthy living and healthy eating, as well as healthy exercise.

6. Tobacco

Research also indicates that lesbians may use tobacco and smoking products more often than heterosexual women use them. Whether smoking is used as a tension  reducer or for social interactions, addiction frequently follows and is associated with higher rates of cancers, heart disease, and emphysema — the three major causes of death among all women.

7. Alcohol

Alcohol use and abuse may be higher among lesbians. While one drink daily may be good for the heart, more than that can be a risk factor for cancer or osteoporosis.

8. Substance Use

Research indicates that lesbians may use illicit drugs more often than heterosexual women. This may be due to added stressors in lesbian lives from discrimination.  Lesbians need support from each other and from health care providers to find healthy releases, quality recreation, stress reduction, and coping techniques.

9. Domestic Violence

Domestic violence is reported to occur in about 11 percent of lesbian homes, about half the rate of 20 percent reported by heterosexual women. But the question is,  where do lesbians go when they are battered? Shelters need to welcome and include battered lesbians, and offer counseling to the offending partners.

10. Osteoporosis

The rates and risks of osteoporosis among lesbians have not been well characterized yet. Calcium and weight-bearing exercise as well as the avoidance of tobacco  and alcohol are the mainstays of prevention. It is also important to get bone density tests every few years to see if medication is needed to prevent fracture.

Author: Katherine A. O'Hanlan, MD, Former President, GLMA, Co-Founder, Lesbian Health Fund, Gynecologist, Portola