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Health issues for lesbians: Tips to stay healthy

Tackle depression

Lesbians and bisexual women may be at higher risk of depression, suicidal thoughts and self-harm. Contributing factors may include social alienation, the threat of or loss of family support, discrimination, abuse, and anti-gay violence. The problem may be more severe for lesbians who remain in the closet, aren't traditionally "feminine," aren't in satisfying relationships or lack social support.

Left untreated, depression may lead to a downward spiral of emotional, behavioral, health, and even legal and financial problems. If you think you may be depressed, talk to your doctor or seek help from a mental health provider. If you're reluctant to seek treatment, confide in a trusted friend or loved one. They can help you take the first steps toward getting treatment.

Recognize domestic violence

Domestic violence can affect lesbians, as well as heterosexuals. You may be experiencing domestic violence if you're in a lesbian relationship with someone who:

  • Intimidates you or threatens you with violence
  • Tries to keep you from seeing friends or family
  • Uses finances to control you
  • Threatens to tell friends, family, colleagues or community members your sexual orientation or gender identity
  • Tells you that authorities won't help a homosexual, bisexual or transgendered person
  • Tells you that leaving the relationship means you're admitting that homosexual relationships are deviant
  • Tells you that abuse is a normal part of homosexual relationships or that domestic violence can't occur in homosexual relationships
  • Justifies abuse by telling you that you're not "really" homosexual, bisexual or transgender
  • Says women can't be violent
  • Portrays the violence as mutual and consensual
  • Depicts the abuse as part of a sadomasochistic activity

Staying in an abusive relationship may leave you depressed, anxious and hopeless. If you don't want to disclose your sexual orientation, you may be less likely to seek help after an assault. Still, the only way to break the cycle of domestic violence is to take action — the sooner the better. If you're a victim of domestic violence, tell someone about the abuse, whether it's a friend, relative, health care provider or other close contact. Consider calling a domestic violence hot line and creating a plan to leave your abuser.

Protect yourself from HIV/AIDS and STDs

Many lesbians are unaware that certain sexually transmitted diseases (STDs) — such as human papillomavirus (HPV), bacterial vaginosis and trichomonas — can spread between women. Oral sex and sexual behavior involving digital-vaginal or digital-anal contact, particularly with shared penetrative sex toys, can spread infections as well. Female sexual contact is also a possible means of contracting HIV. To protect yourself:

  • Get tested and have your partner tested. Don't have unprotected sex unless you're certain you and your partner aren't infected with HIV or other STDs. Testing is important because many people don't know they're infected, and others may not be honest about their health.
  • Use protection. During oral sex use a split-open condom, dental dam — a small piece of latex — or plastic wrap. Keep sex toys safe by cleaning them and protecting them with a condom. Don't share sex toys. If you have sex with a male partner, use a new latex or polyurethane condom or dental dam every time you have sex.
  • Be monogamous. Stay with one sex partner who has tested negative for HIV and other STDs and who won't have sex with anyone but you.
  • Limit the amount of alcohol you drink and don't use drugs. If you're under the influence, you're more likely to take sexual risks. If you choose to use injectable drugs, don't share needles.
  • Get vaccinated. Vaccinations can protect you from HPV and the serious liver infections hepatitis A and hepatitis B, which can spread through sexual contact.
  • Remain vigilant. Remember, there isn't a cure for HIV/AIDS and many STDs, such as HPV. The best way to stay healthy is to protect yourself.

Seek routine health care

Many lesbians struggle to find a doctor knowledgeable about lesbian health issues and with whom they feel comfortable discussing their needs and concerns. In addition, some lesbians are reluctant to use mainstream health care services — but don't let the stigma associated with homosexuality prevent you from taking charge of your health. Look for a doctor you feel comfortable talking to. Identify yourself as lesbian or bisexual, and ask about routine screenings recommended for women in your age group. If you're not in a long-term, mutually monogamous relationship, schedule regular screenings for STDs. Share any other health concerns you may have with your doctor as well. Early diagnosis and treatment is often the key to long-term health.

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References
  1. Ten things lesbians should discuss with their healthcare providers. Gay & Lesbian Medical Association. http://www.glma.org/_data/n_0001/resources/live/Top%20Ten%20Lesbians.pdf. Accessed May 21, 2009.
  2. A provider's introduction to substance abuse treatment for lesbian, gay, bisexual and transgender individuals. Substance Abuse and Mental Health Services Administration. http://kap.samhsa.gov/products/manuals/pdfs/lgbt.pdf. Accessed May 21, 2009.
  3. Sexually transmitted diseases: Treatment guidelines 2006. Centers for Disease Control and Prevention. http://www.cdc.gov/std/treatment/2006/specialpops.htm#specialpops5. Accessed June 23, 2009.
  4. HIV/AIDS among women who have sex with women. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/topics/women/resources/factsheets/pdf/wsw.pdf. Accessed June 23, 2009.
  5. Marrazzo JM. Barriers to infectious disease care among lesbians. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/EID/vol10no11/04-0467.htm. Accessed June 23, 2009.
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  11. Smoking cessation. The American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4731. Accessed June 24, 2009.
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  13. Pitt EL, et al. Violence and trauma: Recognitions, recovery and prevention. In: Makadon HJ, et al. The Fenway Guide to Lesbian, Gay, Bisexual and Transgender Healthcare. Philadelphia, Pa.: American College of Physicians; 2008:253.
  14. Issues: Domestic violence. National Coalition of Anti-Violence Programs. http://www.ncavp.org/issues/DomesticViolence.aspx. Accessed June 24, 2009.
  15. Torpy JM. Intimate partner violence. The Journal of the American Medical Association. 2008;300:754.
  16. Understanding adult obesity. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.win.niddk.nih.gov/publications/understanding.htm. Accessed June 24, 2009.
  17. Breast cancer prevention (PDQ): Patient version. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/prevention/breast/patient/allpages/print. Accessed June 25, 2009.
  18. Treatment works: Get help for anxiety and depression. Centers for Disease Control and Prevention. http://www.cdc.gov/Features/Depression/. Accessed June 26, 2009.
  19. HPV vaccine — Questions & answers. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm. Accessed June 26, 2009.
  20. STD/STI prevention tips. American Social Health Association. http://www.ashastd.org/learn/learn_prevention.cfm. Accessed June 26, 2009.
  21. Hepatitis. American Social Health Association. http://www.ashastd.org/learn/learn_hepatitis.cfm. Accessed June 26, 2009.
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  23. Monson SK (expert opinion). Mayo Clinic, Rochester, Minn. July 27, 2009.

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