Lesbians Have Same Gynecologic Health Needs as Heterosexuals

April 23, 2012

Washington, DC -- Ob-gyns should provide the same comprehensive gynecologic health care to lesbians and bisexual women as they do to heterosexual women, including Pap tests, according to a new Committee Opinion issued today by The American College of Obstetricians and Gynecologists (The College). All ob-gyns see lesbian or bisexual patients in their practices; they just may not know it because not all women disclose their sexual orientation.

Lesbian and bisexual women should receive the same health screenings and counseling as heterosexual women, but certain behaviors are common among this population that may increase the risk for certain health problems. Studies have shown that lesbians have a high prevalence of obesity, tobacco use, and alcohol and drug abuse. These factors may increase their risk of developing type 2 diabetes, lung cancer, and heart disease. In fact, lesbians have higher rates of heart attack than other women. Given these increased risks, routine office visits should include counseling for weight control and smoking cessation, as needed, and screening for cardiac risk factors such as diabetes and lipid status as appropriate for the patient’s age and medical history.

Many physicians incorrectly believe that lesbian patients do not need cervical cancer screening, assuming that because they don’t have sex with men they are low risk. However, many lesbians have been sexually active with men at some point in their lives. Some sexually transmitted infections (STIs), such as bacterial vaginosis, candidiasis, herpes, and human papillomavirus infections (the cervical cancer-causing virus), can be transmitted by exclusive lesbian sexual activity. The College says all women, regardless of orientation, should be encouraged to practice safe sex to reduce the risk of transmitting or acquiring STIs.

In addition to routine cervical cancer screening, ob-gyns should also follow the general recommendations for mammography, colorectal cancer screening, hormone therapy, and osteoporosis screening, along with mental health and intimate partner violence screening regardless of their patient’s sexual orientation.

The College encourages ob-gyns and their staff to ensure that their health care setting is receptive and appropriately addresses the needs of lesbian and bisexual patients. Suggestions include modifying patient intake forms to include relationship and behavioral status; using inclusive language and neutral terms such as “partner” or “spouse”; and being a resource for health-related information about sexual orientation and gender issues for patients and their families.

Committee Opinion #525 “Health Care for Lesbian and Bisexual Women” is published in the May issue of Obstetrics & Gynecology.

Other recommendations issued in this month’s Obstetrics & Gynecology:

Committee Opinion #523 “Re-entering the Practice of Obstetrics and Gynecology” (NEW)
ABSTRACT: Re-entering the practice of obstetrics and gynecology after a period of inactivity can pose a number of obstacles for a physician. Preparing for the leave of absence may help reduce the difficulties physicians may face upon re-entering practice.

Committee Opinion #526 “Standardization of Practice to Improve Outcomes” (NEW)
ABSTRACT: Protocols and checklists have been shown to improve patient safety through standardization and communication. Standardization of practice to improve quality outcomes is an important tool in achieving the shared vision of patients and their health care providers.

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 55,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization.


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