IT'S A WOMAN THING 8 Health Issues That Should Concern All Lesbians by Marene Gustin

The good news: When it comes to health issues and diseases, lesbians aren't that different from heterosexual women. The bad news: When it comes to health issues and diseases, lesbians aren¹t that different from heterosexual women.

One disturbing fact does stand out, according to the Gay and Lesbian Medical Association¹s landmark 2000 study on GLBT health, in conjunction with the Columbia University L. Mailman School of Public Health Center for Lesbian, Gay, Bisexual and Transgender Health: There simply isn¹t enough research on lesbian health issues to make definitive statements. But part of that lack can be attributed to the documented fact that lesbians‹whether due to a lower social-economic status, lack of family health benefits, or fear‹don¹t access health providers to the extent that heterosexual women and gay men do. But one area has been researched, written about, and documented:

1. Breast Cancer

Lesbians may actually be at a higher risk for breast cancer than straight women, based on the GLMA research, due to ³higher rates of obesity, alcohol consumption, nulliparity, and lower rates of breast cancer screening.² Both Lucy Watson, president of the Lesbian Health Initiative, and Montrose area physician Carolyn Gardiner agree that the lesbian population isn¹t getting regular mammograms. Watson, through the LHI, offers free mammograms at health fairs in conjunction with the M. D. Anderson Cancer Center¹s mobile mammogram unit. And LHI offers coupons for The Rose, a nonprofit organization that offers free breast cancer screening, diagnosis, support, and treatment. ³But not enough of the community is taking part,² says Watson. Gardiner concurs: ³My biggest gripe is lesbians who don¹t come in for cervical exams or breast exams.² The American Cancer Association¹s statistics of one in eight women getting breast cancer don¹t indicate how many of them are lesbians. But the point is clear: If you have a history of breast cancer or are over 40, get a mammogram. And get a pap smear.

2. Gynecological Cancers

Gardiner, like many doctors, is worried about the lesbian community when it comes to uterine, cervical, and ovarian cancers. ³I see a slight increase, not huge, but slight,² she says. ³A lot of women think if they have never been sexually active with a man, they can¹t get gynecological cancers.² They could be dead wrong.

Sonna Alton, director of communications at the Montrose Clinic, has been helping compile a survey of lesbians over 35. ³Many of them couldn¹t remember when they had their last exam, or they said it was at least five years ago,² she says.

The American Family Physician , a fairly conservative publication, in a 1999 report, addressed the issue of lesbian patients, indicating ³vulnerability to ovarian cancer may be increased because of low pregnancy rates and reduced exposure to oral contraceptives.² While research is slim and inconclusive, the fact is obvious: Whether a woman is lesbian or heterosexual, a ³well woman² exam is important.

3. Colon/Rectal Cancer

Are lesbians more prone to this once rarely discussed form of cancer? Who knows? Again, little research exists in this area. But LHI¹s Watson is again proactive. ³The aging lesbian population isn¹t getting screened. By the time you¹re 50, you should be tested, but if you¹re a lesbian and you haven¹t got in the habit of regular checkups and well-women exams, you¹re not likely to have a colonoscopy.² Listen to Katie Couric, who famously got tested on-air on the Today show‹and get checked.

4. Substance Abuse

The GLMA report cites: ³Sound data about substance abuse among lesbians is even more scarce, though McKirnan and Peterson (1998) found that rates of marijuana and cocaine use were higher among lesbians than among heterosexual women.² Locally, Gardiner, who specializes in internal medicine, finds that ³I seem to see more smokers and more drinkers who are lesbians than who are heterosexuals.² Watson thinks ³a smoking cessation program for the lesbian community would be great.² Obviously, lung cancer is a concern, but so is:

5. Heart Disease

It¹s the number-one killer in women,² says Watson. And it knows no sexual preference. The Montrose Clinic¹s Alton adds,² I think, if you look at overall health, those concerns are for everyone. It¹s the general lifestyle, aging, being sedentary, and overweight. If I would say one thing to lesbians, it would be to be more proactive about preventive care.² Which again goes back to the lack of accessing health care. High risk factors‹such as lack of exercise, smoking, drinking, and not seeking regular medical attention‹can lead to a variety of diseases and health-care issues. And then, there is a fairly new concern for the lesbian community:

6. Hepatitis C

AssistHers is a nonprofit group that provides in-home health care for lesbians. Eva Geer is the vice president of client services. ³One thing I am more worried about is Hep C in the lesbian community,² she says. ³It isn¹t so much about sexual transmission but other high-risk behaviors. Tattooing and body piercing, particularly in the younger population, are increasing.² Hepatitis C is also increasing in the population at large and is just becoming a real concern in Houston. Certainly it is not being as aggressively researched or funded as other disease, like:

7. HIV/AIDS

Since the early days of the pandemic, HIV and AIDS has been the main topic of conversation when it comes to homosexual medical issues. But should lesbians be concerned? ³I¹ve been doing this for 10 to 12 years,² says Gardiner, ³and I have had very few lesbians with HIV/AIDS, and none of them were women-to-women transmission.² That doesn¹t mean it is impossible. The GLMA reports that some cases have been documented, mostly notably in instances of sex during menstrual periods.

8. Eating Disorders

More gay men and more heterosexual women have eating disorders than lesbians. Still, AssistHers¹ Geer says overall nutrition ³is a big problem² for her clients. LHI¹s Watson indicates that lesbians tend to go to extremes. ³I think there¹s a need for general nutrition information,² she says. ³It goes from vegetarians who don¹t smoke to those who smoke and eat everything in sight.²

Bottom Line

Lesbians must start taking advantage of health-care opportunities and demanding better access to health care. So far the evidence doesn¹t point to more problems, just fewer opportunities.

Marene Gustin profiled the Gay & Lesbian Switchboard Houston in the June issue.

For more tips, access the Gay and Lesbian Medical Association website at www.glma.org.