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| Bisexual/Lesbian: The Problems When Doctors Don't Ask And Patients Don't Tell |
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| Written by Hope E. Ashby, MA, MSW, CSW | ||||
Page 1 of 2 The burgeoning attention that has been given to female sexuality, and specifically female sexual dysfunction has primarily focused on heterosexual women. However, 1.4 percent of women are lesbian or bisexual women; according to the National Health and Social Life Survey of 3432 women in 1992 by Laumann, Gagnon, et.al.
The key issue of "coming out" for gay women, as well as men, is a pertinent developmental step in claiming and accepting one's gender and sexual identity. This process can be and is fraught with significant anxiety often depression. And, even though a lesbian or bi-sexual woman "comes out", there may still be some anxiety every time tells someone new, such as a health care provider. Lesbian and bisexual women are reticent to "come out" to their health providers for fear of adverse reactions of their health providers. According to the study conducted by Lehmann, et al., (1998), 65 percent of lesbians with an identified primary care provider and 70 percent of all the participants' had never been asked by their provider about their orientation. With that percentage, it calls into question the issue of quality and comprehensive care. Unless a patient volunteers information about her sexual orientation, providers will assume that she is heterosexual and will make references to that effect or more importantly treatment interventions. At the "Women's Sexual Health Conference" in Santa Monica, CA in February, 2002, Dr. Laura Berman and I conducted a workshop to explore the various issues, including gender, that made providers uncomfortable or more importantly issues that they wanted to know how to approach their patients with. Many of the responses from these providers, which included OB/GYN, urologists, and primary care physicians, dealt with lesbian sexuality. Some of the questions and comments from the audience of professionals were:
If women who are in relationships with women, or women who are in relationships with both men and women, are uncomfortable or afraid to tell their health care providers their orientation or providers are assuming that their patients are heterosexual, it may cause the development of treatment solutions not appropriate to the patient. For example, this is what on lesbian client told he: she was prescribed birth control pills for contraception purposes. Of course there are medical instances (i.e. ovarian cysts, fibroids, endometriosis, etc) where this type of prescription is warranted, however, if this medical conditions are not a factor, then the prescription is inappropriate. It's obvious. Patients are not receiving the care they need unless providers are asking the right questions. Is it fear of not knowing how to work with this population that is stymying the health care provider? Or are moral issues the problem? Following are two questionnaires: one is for both lesbian and bisexual women and the other for health care providers. These questionnaires are anonymous, of course, and will provide pertinent information to both groups as to the areas where there are service gaps. These surveys will hopefully begin to build the foundation for healthy dialogue and education to both groups. As the results come in from both surveys, I will write a follow up article, which will report what both sides have said. |
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| Last Updated ( Monday, 26 March 2007 ) | ||||
