ABSTRACT: Lesbians and bisexual women encounter barriers to health care that include concerns about confidentiality and disclosure, discriminatory attitudes and treatment, limited access to health care and health insurance, and often a limited understanding as to what their health risks may be. Health care providers should offer quality care to all women regardless of sexual orientation. The American College of Obstetricians and Gynecologists endorses equitable treatment for lesbians and bisexual women and their families, not only for direct health care needs, but also for indirect health care issues.
Definition and Prevalence
Sexual orientation is an enduring emotional, romantic, or sexual attraction that one feels toward men or women or both (1). Although there is no standard definition of a lesbian, common characteristics may include same-sex attraction, same-sex sexual behavior, or self-identification as a lesbian. For many women, sexual orientation falls along a continuum where a woman may not be exclusively heterosexual or homosexual, or she may develop a lesbian orientation over her lifetime. A bisexual woman is attracted to or engages in sexual behavior with both sexes or identifies herself as bisexual. Sexual orientation has not been conclusively found to be determined by any particular factor or factors, and the timing of the emergence, recognition, and expression of one’s sexual orientation varies among individuals (1).
Although prevalence statistics vary in the United States, data from the National Survey of Family Growth suggest that 1.1% and 3.5% of women identify as lesbian or bisexual, respectively (2). Lesbians and bisexual women are as diverse a population as the population of all women and are represented among all racial, ethnic, and socioeconomic groups. All obstetrician–gynecologists encounter lesbian or bisexual patients, although not all women will disclose their sexual orientation to their health care providers. Additional research is needed to assess the current state of knowledge about the health of this population as well as to identify research gaps and formulate a research agenda as outlined by the Institute of Medicine (3).
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