LESBIAN HEALTH CARE - RESOURCE LIST

There has been little research in Britain in regard to lesbians. Most of the following articles are from the U.S.A. and are available through your local library.

You will have to complete an order card and it will probably take about a month as they will have to send to the British Library for a copy; this should cost you about .50p.

We are about twenty years behind the U.S.A. but it makes sense to learn from them.

AIDS & STDS

FAILURE TO IDENTIFY VENEREAL DISEASE IN A LESBIAN POPULATION, P. ROBERTSON, J. SCHACHTER, SEXUALLY TRANSMITTED DISEASES, 1981, APR-JUN, VOL 8(2), P75-76.

Venereal disease in the male homosexual population has been well studied, but little information is available about venereal disease in lesbians. A screening of 148 sexually active lesbians revealed no cases of syphilis, cervical gonorrhea, herpes simplex virus, or Chlamydia trachomatis infections. Cervical atypia, ranging from mild dysplasia to carcinoma in situ, was detected in four women (2.7%). This group of lesbians had a longer mean interval between routine Papanicolaou smears (21 months) than did other women using the same clinic facility (8 months). Results indicate that routine screening for venereal disease may not be cost-effective in a lesbian population, but routine Papanicolaou smears should be encouraged.

ETHICAL ISSUES IN PSYCHOLOGICAL RESEARCH ON AIDS, COMMITTEE FOR PROTECTION OF HUMAN PARTICIPANTS IN RESEARCH IN CO-OPERATION WITH THE COMMITTEE ON GAY CONCERNS, AMERICAN PSYCHOLOGICAL ASSOCIATION, JOURNAL OF HOMOSEXUALITY 1986, VOL 13(1) P109-116.

COMPARISON OF GYNECOLOGIC HEALTH CARE PROBLEMS BETWEEN LESBIANS AND BISEXUAL WOMEN, A SURVEY OF 2,345 WOMEN, SUSAN R. JOHNSON, ELAINE M. SMITH, SUSAN M. GUENTHER, JOURNAL OF REPRODUCTIVE MEDICINE, 1987, VOL 32, P805-811.

A survey of reproductive system problems was conducted in a large group of lesbians (n = 1,921) and bisexual women (n = 424) in a nonclinical setting. Demographically the groups were similar: the majority of respondents were white, urban and well educated. A history of heterosexual coitus was common in both groups (bisexuals, 95%; lesbians, 77%). Bisexuals were more likely than lesbians to report an abnormal Papanicolaou smear, cystisis, genital herpes, gonorrhea and vaginal infections. When sexual orientation was controlled for, most, but not all, of these differences were associated with a difference in reported frequency of (prior) coitus. Despite the lower risk of certain problems, however, the lesbians who reported no previous coitus did report the occurrence of vaginitis, abnormal Papanicolaou smears and genital herpes. There were no differences in past oral contraceptive use, endometriosis, menstrual dysfunction or breast disease. The lesbian group reported a greater percentage of hysterectomies. These data suggest that, overall, the sexual behaviors of lesbians are associated with a lower risk of most sexually transmitted diseases.

TRICHOMONAS VAGINALIS INFECTION IN A LESBIAN, LETTER, GENITOURIN MED 1989, VOL 65, P399-400.

SEXUALLY TRANSMITTED DISEASES IN LESBIANS, ANNE EDWARDS, R. NICOL THIN, INTERNATIONAL JOURNAL OF STD & AIDS, 1990, VOL 1(3), P178-181.

The limited published data support the assumption that lesbians are a low risk group for sexually transmitted diseases (STDs). However there are virtually no contemporary data and the older papers do not take into account genital wart virus infection, now the third most prevalent STD in Britain. One of the dangers in assuming that lesbians are a 'safe group' for STD and allied disorders is that patients may not attend for regular cervical cytology and could be at risk of developing cervical cancer.

In an unselected series of 27 lesbians attending a genitourinary medicine clinic, the most important findings were a relatively high prevalence of the viral STDs, herpes simplex and human papilomavirus. Additionally, 10 patients had abnormal cytology ranging from inflammation to dyskaryosis.

There is a need for more information about the true prevalence of STDs in this group and evaluation of the risk factors for female-to-female transmission of infections. Lesbians should continue to have regular cervical smears, especially as many have had earlier heterosexual intercourse.

EPIDEMIOLOGY OR REPORTED CASES OF AIDS IN LESBIANS, UNITED STATES, 1980-1989, SUSAN Y. CHU, JAMES W. BUEHLER, PATRICIA L. FLEMING, RUTH L. BERKELMAN, AMERICAL JOURNAL OF PUBLIC HEALTH, 1990, VOL 80(11), P1380-1381.

LESBIAN EXCLUSION FROM HIV/AIDS EDUCATION, TEN YEARS OF LOW-RISK IDENTITY AND HIGH-RISK BEHAVIOR, REBECCA COLE, SALLY COOPER, SIECUS REPORT, DECEMBER 1990/JANUARY 1991, P18-23.

UPDATE: EPIDEMIOLOGY OF REPORTED CASES OF AIDS IN WOMEN WHO REPORT SEX ONLY WITH OTHER WOMEN, UNITED STATES, 1980-1991, S.Y.CHU, T.A. HAMMETT, J.W. BUEHLER,
AIDS, 1992, VOL 6(5), P518-519.

WOMEN USUALLY TAKE CARE OF THEIR GIRLFRIENDS: BISEXUALITY AND HIV RISK AMONG FEMALE INTRAVENOUS DRUG USERS, STEPHEN MAGURA, JOANNE O'DAY, ANDREW ROSENBLUM, THE JOURNAL OF DRUG ISSUES, 1992, VOL 22(1), P179-190.

Thirty-eight percent of a random sample of 39 female IVDUs disclosed recent homosexual behavior. The women were interviewed in jail, but their homosexual relationships were formed and occurred primarily outside of jail. Ethnographic methods identified twice as much homosexuality as a structured research interview. The women who disclosed homosexual behavior, which reportedly had recent onset for most of them, usually did not self-label themselves as "gay" or "lesbian", perhaps "bisexuality" best characterizes their sexual histories. These bisexual women were more likely to share needles and works than the heterosexual women, placing themselves and others at higher risk of HIV transmission; their sexual partners were usually other IVDUs. No precautions were being taken to prevent possible female-to-female sexual HIV transmission. Failure to take precautions against AIDS may be attributable to unjustified feelings of "safety" in often serially monogamous homosexual relationships, as well as sheer fatalism about HIV infection.

NO EVIDENCE FOR FEMALE-TO-FEMALE HIV TRANSMISSION AMONG 960,000 FEMALE BLOOD DONORS, LYLE R. PETERSEN, LYNDA DOLL, CAROL WHITE, SUSAN CHU, AND THE HIV BLOOD DONOR STUDY GROUP, JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 1992, VOL 5(9), P853-855.

The frequency of female-to-female HIV transmission was assessed among 960,000 female blood donors at 20 large U.S. blood centers during 1990. Of 144 HIV-seropositive women identified, 106 were interviewed. None of the interviewed women reported sex exclusively with women since 1978. Three seropositive women reported sex contact with women as well as with either bisexual men or men who had used i.v. drugs. In this large population, we identified no woman who was infected with HIV from sexual contact with another woman.

LESBIANS EVOLVING HEALTH CARE: CANCER AND AIDS, JACKIE WINNOW, FEMINIST REVIEW, 1992, SUMMER, NO 41, P68-76.

LESBIANS AND HIV: CLINICAL, RESEARCH, AND POLICY ISSUES, PATRICIA E. STEVENS, AMERICAN JOURNAL OF ORTHOPSYCHIATRY, APRIL 1993, VOL 63(2), P289-294.

Sources of risk for HIV infection in members of the lesbian community are surveyed, together with factors that adversely affect access to appropraite health care by women in general and lesbians in particular. Issues of clinical practice, research, and public policy are examined with a view to promoting more effective prevention and treatment strategies.

HIV PREVENTION EDUCATION FOR LESBIASN AND BISEXUAL WOMEN: A CULTURAL ANALYSIS OF A COMMUNITY INTERVENTION, PATRICIA E. STEVENS, SOC.SCI.MED., 1994, VOL 39(11) P1565-1578.

AIDS is increasing almost four times as fast among women, yet lesbians and bisexual women are among the least studied, least understood and most elusive populations affected by the AIDS epidemic. This paper reports the results of community-level HIV prevention research designed: (a) to examine the knowledge, perceptions, social contingencies and political constraints affecting the HIV risk taking of lesbians and bisexual women; and (b) to offer them context specific HIV prevention education. The study was a peer educator-based intervention project situated in San Francisco's women's bars, dance clubs, and sex clubs to reach socially and sexually active lesbians and bisexual women in natural settings. Between June 1992 and May 1993, ethnographic interviews were conducted with 626 women attending the bars and clubs; group presentations at the locales reached 1315 women. The structure of the intervention was effective in prompting interest in HIV prevention information and intent to change behavior. The resultant cultural analysis details risk behaviors lesbians and bisexual women participate in, myriad constraints they face in trying to enact safer behaviors, gaps in knowledge, difficulties comprehending the relevance of HIV prevention, and risk reduction strategies commonly employed.

BOOKS

WOMEN AND HIV/AIDS, A BIBLIOGRAPHY, ROSIE ILETT, GLASGOW WOMEN'S LIBRARY, 1993, 109 TRONGATE, GLASGOW, GL5HD, 0141.552.8345.

ALCOHOL

See Lesbians and Alcohol Resource List.

BATTERING

See Lesbian Relationships Resource List.

BLACK AND MINORITY ETHNIC LESBIANS

See Black and Minority Ethnic Lesbians Resource List

DISABILITY

THE DEAF GAY/LESBIAN CLIENT: SOME PERSPECTIVES, DANIEL J. LANGHOLTZ, MARIE EGBERT RENDON, JOURNAL OF AMERICAN DEAFNESS & REHABILITATION ASS, 1991-92, VOL 25(3), P31-34.

The role of the gay/lesbian person in the deaf culture and communication problems which contribute to or interfere with self acceptance as well as family or community acceptance are the focal points for this article. Changes that have been made in the deaf culture and in the culture at large in respect to sexual identity issues and the comparison of communities (deaf to gay/lesbian) are also outlined. Although not addressing every aspect of the issues surrounding the deaf, gay/lesbian client, this article provides suggestions for counselors and others who may be confronted with these issues.

LESBIANS WITH DISABILITIES, CORBETT JOAN O'TOOLE, JENNIFER L. BREGANTE, SEXUALITY AND DISABILITY, 1992, VOL 10(3), P163-172.

There is a severe lack of information on sexuality for any woman with a disability. Often, what is available is limited to material on birth control and child delivery. For women who are disbled and lesbian, virtually no written information exists and health care workers seldom feel comfortable discussing the topic. Lesbians with disabilities have the responsibility to discuss sexual preference with their health care workers. Yet, there is much to lose. This paper discusses the issues of being lesbian and disabled as well as the unique problems faced by their partners. Finally, the article discusses negative attitudes of health care workers toward both disability and homosexuality.

CHAPTERS IN BOOKS

LESBIAN AND GAY ISSUES: A RESOURCE MANUAL FOR SOCIAL WORKERS, H. HILDAGO, T.L. PETERSON AND N.J. WOODMAN, NATIONAL ASSOCIATION OF SOCIAL WORKERS, 1980. INCLUDES:

PEOPLE WHO ARE GAY OR LESBIAN AND DISABLED, KIRBY WOHLANDER AND MARLA A. PETAL, P38

LESBIAN SEX, JOANN LOULAN, SPINSTERS INK, 1984 INCLUDES:

SPECIFIC ISSUES ON SEX AND DISABILITY,
P275-288.

LESBIAN COUPLES, D. MERILEE CLUNIS & C. DORSEY GREEN, SEAL PRESS, 1988, INCLUDES:

DISABILITY, P202-218.

ALIVE & WELL, A LESBIAN HEALTH GUIDE, CUCA HEPBURN WITH BONNIE GUTIERREZ, THE CROSSING PRESS, 1988, INCLUDES:

DISABILITY, P211-214.

RADICAL RECORDS, THIRTY YEARS OF LESBIAN & GAY HISTORY, ED BOB CANT AND SUSAN HEMMINGS, ROUTLEDGE, 1988, INCLUDES:

OI! WHAT ABOUT US? KIRSTEN HEARN, P116-127.

GENERAL

REPRESENTATIONS OF HOMOSEXUALITY IN HEALTH SCIENCE TEXTBOOKS, DAVID E. NEWTON, JOURNAL OF HOMOSEXUALITY, 1979, VOL 4(3) P245-254.

Discussions of homosexual behavior in 35 publications (textbooks, trade books, pamphlets) in the fields of health science and sex education were reviewed. Ten books referred to the subject. Major findings of the study were: (a) homosexual behavior receives significant attention in only 1 of the 10 publications; (b) discussions of homosexuality contain a number of hidden biases; (c) a large number of factual errors can be identified in most publications; and (d) most authors seem to believe that homosexual behavior may be tolerated during adolescence but, at the same time, should be a source of concern to teenagers.

LESBIAN HEALTH ISSUES, K. DEGEN, H.J. WAIKEVICTZ, BRITISH JOURNAL OF SEXUAL MEDICINE, MAY 1982, P40-54.

Little published information exists on lesbian health issues. The following provides such information based on experience in a voluntary clinic run by and for lesbian women.

SOCIAL WORK, TRADITIONAL HEALTH CARE SYSTEMS AND LESBIAN INVISIBILITY, SANDEE POTTER, JOURNAL OF SOCIAL WORK & HUMAN SEXUALITY, 1985, VOL 3(2-3), P59-68.

Lesbians encounter many problems in obtaining adequate health care from traditional health care systems that are organised on heterosexual assumptions. This article discusses the special health care needs of lesbians and the implications for social workers when serving lesbians in relation to illness and health care. The author's survey of social work courses in health care reveals that they are seriously deficient in content relating to lesbians and gays.

HEALTH CARE ATTITUDES AND EXPERIENCES DURING GYNECOLOGIC CARE AMONG LESBIANS AND BISEXUALS, ELAINE M. SMITH, SUSAN R. JOHNSON AND SUSAN M. GUENTHER, AMERICAN JOURNAL OF PUBLIC HEALTH, 1985, VOL 75(9), P1085-1087.

Bisexual (N = 424) and lesbians (N = 1,921) were surveyed regarding their sources of gynecologic care, utilisation patterns, openness with physicians, and assessment of quality of care. About 40% of each group believed that physicians knowledge about their sexual preference would hinder the quality of medical care and about as many believed that it would have no effect. About one-third in each group had not disclosed their sexual behaviour although they desired to do so. Physicians rarely requested this information. A lesbian physician was overwhelmingly preferred for gynecologic care (96%), particularly for problems with sexual functioning. Previous satisfaction with gynecologic care was most often described as 'adequate' but almost as often as 'variable' and 'poor'. Data suggest that quality, utilisation, and medical outcomes of gynecologic care to this group would be improved if physicians would communicate greater awareness of sexual orientation in a nonprejudicial manner and ensure confidentiality.

UNIVERSITY HEALTH SERVICES SPONSORING LESBIAN HEALTH WORKSHOPS: IMPLICATIONS AND ACCESSIBILITY, DEBRA EDELMAN, JOURNAL OF AMERICAN COLLEGE HEALTH, 1986, VOL 35(1), P44-45.

A brief discussion of the need for lesbian health workshops and goals for sensitivity for health care workers.

PREPARING COLLEGE HEALTH PROFESSIONALS TO DELIVER GAY-AFFIRMATIVE SERVICES, CAROLYN DILLON,
JOURNAL OF AMERICAN COLLEGE HEALTH, 1986, VOL 35(1), P36-40.

On every campus, there may be many gay students, faculty, and staff who might benefit from medical and mental health services sensitively developed as an integral part of the range of health services provided to the total campus. It is crucial to develop a cadre of providers from different disciplines who have a knowledge of gay lifestyles, developmental issues, and societal pressures. Staff must develop or heighten sometimes painful self-awareness engendered by empathic identification with a stigmatized minority. They must also conceptualize homosexuality as a relationship preference or lifestyle choice and appreciate the importance of same-sex attachments in normal development.

This paper reviews common presenting themes of gay patients and clients who rarely come for help to change their preference. The effects of homophobia on staff practices and attitudes are reviewed in the context of learned negative stereotyping in the larger culture. Heterophobic expecations of potential gay consumers are explored, including those of being diagnosed as deviant, mentally ill, or arrested libidinally. Suggestions are offered for the design and marketing of collaborative gay-nongay services and for services to older hidden populations. Individuals are encouraged to examine their own relationships to homosexuality and to experience new learning through enriched encounters with gays.

REDEFINING SEXUALITY FROM WOMEN'S OWN EXPERIENCES, L.A. BERNHARD, A.J. DAN
, NURSING CLINICS OF NORTH AMERICA, 1986, VOL 21(1) 125-36.

Traditionally women's sexuality has been defined and described using narrow and socially prescribed concepts. In the past 20 years new ideas about women's sexuality have emerged. At the same time, sexuality has become a legitimate concern for health professionals. Nurses and their clients can benefit from learning about the emerging woman-centred concepts of sexuality. Women's sexuality is not primarily a response to men's sexuality but has its own characteristics. A woman's sexuality is an expression of mutuality, involving not only physical gratification but also a sense of herself as a woman in the context of her life, her relationships, and emotions. Several groups of women whose sexual needs have traditionally been unmet by nurses and other health care professionals include adolescents, physically disabled women, lesbians, and older women. A self-care frame-work differentiates socially constructed definitions of sexuality from lived experience and suggests the importance of attending to individual women's experiences throughout life.

STIGMA, HEALTH BELIEFS AND EXPERIENCES WITH HEALTH CARE IN LESBIAN WOMEN, PATRICIA E. STEVENS, JOANNE M. HALL,
JOURNAL OF NURSING SCHOLARSHIP, 1988, VOL 20(2), P69-73.

Twenty-five Midwestern self-identified lesbian women were recruited through a snowball design to participate in a semistructured interview. Data were analyzed qualiatively for themes and consensus. Stigma and identifiability in lesbian women are complex issues that affect their cultural and social experience, health beliefs, interaction with health care providers and use of health care systems. The results suggest that lesbian women often do not feel comfortable seeking health care, experience nonempathetic responses when they do and even feel at risk of harm in some health care situations. Nurses are challenged to evaluate the adequacey of knowledge and reassess the quality of health care offered to lesbians.

LESBIAN PHOBIA AMONG BSN EDUCATORS: A SURVEY, CARLA E. RANDALL, JOURNAL OF NURSING EDUCATION 1989, VOL 28, P302-306.

This exploratory study identified the attitudes of BSN educators in a midwestern state towards lesbians. A 50% (N100) return rate of mailed questionnaires elicited responses to 48 statements about lesbians and lesbianism on a modified Likert scale. The questionnaire included general demographic data and responses to statements seeking information about topics of lesbianism or lesbian issues. Specific areas addressed included moral and ethical responses, knowledge statements, sexuality or sex related statements, normalness of lesbians and lesbian behavior, and social contact with lesbians. Notable findings revealed that BSN educators were not personally fearful of sexual advances from lesbians; however, they did indicate concern about lesbians molesting and caring for children as well as lesbians in the role of educators. More than half believed that lesbianism is not a natural expression of human sexuality.

ABUSIVE HEALTH CARE INTERACTIONS EXPERIENCED BY LESBIANS: A CASE OF INSTITUTIONAL VIOLENCE IN THE TREATMENT OF WOMEN, PATRICIA E. STEVENS, JOANNE M. HALL. 1990, RESPONSE, VOL 13(3), P23-27.

TRAUMATIC BRAIN INJURY REHABILITATION WITH GAY AND LESBIAN INDIVIDUALS, ROBERT L. MAPOU, JOURNAL OF HEAD TRAUMA REHABILITATION, 1990, VOL 5(2), P67-72.

Rehabilitation professionals frequently assume that an individual in a brain-injury program is heterosexual without having asked direct questions about life style. Benign neglect of issues germane to sexual orientation may impede progress and lead to depression, decreased self-esteem, and decreased self-confidence. This article provides an introduction to issues with which professionals working in brain-injury rehabilitation programs should be familiar when treating gay or lesbian individuals.

LESBIANS UNDER THE MEDICAL GAZE: SCIENTISTS SEARCH FOR REMARKABLE DIFFERENCES, JENNIFER TERRY, JOURNAL OF SEX RESEARCH, 1990, VOL 27(3), 317-339.

This paper examines research, conducted under the auspices of the Committee for the Study of Sex Variants during the 1930s in New York City, which sought to determine what characteristics distinguished lesbians from heterosexual women. Assuming that marks of difference would appear either on the body or in the mind, researchers x-rayed skeletons, inspected genitals and conducted psychiatric interviews looking for indicators of masculinity. This inquiry was intended to establish scientific ways to identify, treat and prevent homosexuality.

Although physical findings alone were inconclusive, morphological and experiential patterns were noted. Because lesbians were assumed to be masculine, the research framework failed to explain the cases of 'feminine' women who sexually pursued women or who responded favourably to sexual advances by women. Recommendations for prevention identified the family as the appropriate site for establishing and reinforcing proper gender behaviours.

ATTITUDES TOWARDS HOMOSEXUALITY IN AMERICAN HEALTH CARE LITERATURE 1983-1987, SANDRA L. SCHWANBERG, JOURNAL OF HOMOSEXUALITY, 1990, VOL 19(3), P117-136.

The purpose of this paper was to content analyze a purposive sample of American health care literature from 1983-1987 to ascertain what impact if any, the AIDS epidemic has had on the images of gay men and lesbian women in health sciences literature. Empirical studies, letters to the editor, policy statements and opinion papers expressing attitudes towards homosexuality and psychosocial aspects of AIDS in nursing, general medicine, and psychiatric literature were content analyzed. Findings indicate that although positive, neutral and negative images were found in the 59 articles which were examined, the largest proportion (61%) were negative. This reflects a change in the literature from previously neutral positions. Implications for patient care and further research are addressed.

PRELIMINARY STUDY OF LESBIAN HEALTH CONCERNS, SUSAN E. TRIPPET, JOYCE BAIN, HEALTH VALUES, 1990, VOL 14(6) P31-36.

The purpose of the study was to identify and explore the physical and mental health concerns of lesbians from their lived experiences, including family and social issues and legal issues that have not been adressed in previous studies. While the findings on the 43 subjects were parallel to the findings of other studies, the information gathered from the new areas offers additional knowledge about this little-studied population. A larger study using the revised survey should be conducted.

LESBIANS FACE UNIQUE HEALTH CARE PROBLEMS, RUTH J. SIMKIN, CANADIAN MEDICAL ASSOCIATION JOURNAL, 1991, VOL 145(12), P1620-1623.

A CRITICAL HISTORICAL ANALYSIS OF THE MEDICAL CONSTRUCTION OF LESBIANISM, PATRICIA E. STEVENS, JOANNE M. HALL, INTERNATIONAL JOURNAL OF HEALTH SERVICES, 1991, VOL 21(2) P291-307.

Lesbians are frequently treated with insensitivity, antagonism, and discrimination in health care encounters. The authors argue that contemporary health care experiences of lesbian clients cannot be understood apart from a critical examination of the historical construction of medical ideologies that pathologized lesbianism. An excavation of historical data about medical conceptualizations of lesbian women is undertaken to demonstrate how cultural and medical ideologies throughout the century have reinforced each other to shape lesbians' health care experiences and influence public policies. By illuminating both the prejudicial content of medical theories as well as the emancipatory actions of lesbian and gay communities to change stigmatizing diagnostic and treatment situations, the authors attempt to demystify ideologies about lesbians that motivate clinicians, administrators, educators, researchers, and theorists in the delivery of health services.

GPS FOR LESBIANS AND GAY MEN (LETTER) PETER J. V. WILLIS, BRITISH JOURNAL OF GENERAL PRACTICE, APRIL, 1991, P173.

LESBIAN PHOBIA IN NURSING STUDENTS, MICHELE J. ELIASON, CARLA E. RANDALL, WESTERN JOURNAL OF NURSING RESEARCH, 1991, VOL 13(3), P363-374.

EXTRACT: The goal of nursing is to provide nonjudgmental quality care to all individuals. Therefore, it is important to identify potentially negative attitudes that nurses may have toward certain groups that deviate from societal norms, as these groups may not receive the quality care that they deserve. Lesbians are "invisible" women in society because (a) they can rarely be distinguished by their appearance and (b) they are often reluctant to disclose information about their life-style in this homophobic society. Because of their low visibility and the devaluation of women in society, there has been little research focused on the factors related to lesbian phobia. Most research has combined gay men and lesbians in studies of homophobia, although research indicates differences in the life-styles that do not warrant grouping.

CARING FOR LESBIANS IN A HOMOPHOBIC SOCIETY, SUSAN E. GENTRY,
HEALTH CARE FOR WOMEN INTERNATIONAL, 1992, VOL 13 (2), P173-180.

Lesbians and gays have suffered for centuries from stigmatization by homophobic, heterosexual people in Western society. It is critical for health care providers to have an understanding of alternative life-styles and the unique health concerns of homosexual people in order to provide sensitive and knowledgeable health care. Lesbian health issues such as assessing the sexual orientation of lesbians, parenting issues, lesbian battering, and the older lesbian woman are discussed. My intent in writing this article is to increase the sensitivity, knowledge and awareness of health care providers caring for lesbians in a homophobic society.

CRITICAL RE-EVALUATION CAN OVERCOME DISCRIMINATION, PROVIDING EQUAL STANDARDS OF CARE FOR HOMOSEXUAL PATIENTS, ROBERT IRWIN,
PROFESSIONAL
NURSE, APRIL 1992, P435-438.

Many nurses find the issue of homosexuality difficult to come to terms with. Gay men and lesbians, however, have the right to the same standards of care and considerations as heterosexual people. Nurses therefore need to confront their own prejudices and those of others, and should be helped in this by the provision of education aimed at dispelling myths about homosexuality.

REASONS AMERICAN LESBIANS FAIL TO SEEK TRADITIONAL HEALTH CARE, SUSAN E. TRIPPET, JOYCE BAIN, HEALTH CARE FOR WOMEN INTERNATIONAL, 1992, VOL13(2), P145-153.

What reasons do lesbians have for not seeking health care? From three women's cultural events in 1990, a convenience sample was formed of 503 women (78% of whom were lesbians) who volunteered to complete a pretested qualitative and quantitative instrument. The reasons given for not seeking health care from traditional sources were that (a) low-cost, natural, or alternative care is not provided; (b) holistic care is not provided; (c) little preventive care and education are provided; (d) communication and respect are lacking; and (e) there are few women-managed clinics.

LESBIANS AS AN INVISIBLE MINORITY IN THE HEALTH SERVICES ARENA, M. MORAG ROBERTSON, HEALTH CARE FOR WOMEN INTERNATIONAL, 1992, VOL 13(2), P155-163.

Ten self-identified lesbians were interviewed about their health care experiences. Analysis of the data from a grounded theory approach revealed four issues: health care providers' assumption of heterosexuality, reactions to coming out, lesbians' expectations of health care, and health-care-seeking behavior. It is the invisibility of lesbians in society that lends to the continued negative experiences lesbians relate. As health care professionals, we must assess our present practices and seek ways to improve the quality of care we offer to lesbians. Some recommendations for improving care to the lesbian community are made.

HEALTH LIFE-STYLES OF LESBIAN AND HETEROSEXUAL WOMEN, JULIE A. BUENTING, HEALTH CARE WOMEN INTERNATIONAL, 1992, VOL 13(2), P165-171.

In this exploratory descriptive study, lesbian and heterosexual women's health life-style activities and health histories were investigated. Distribution of 200 written questionnaires by nonprobability snowball sampling obtained a sample of 79 heterosexual and lesbian women. The sample was predominantly white, middle class, and college educated. Responses to questions about participation in mental health counseling, birth control use, and pregancy history showed significant differences between the groups. Likert scale questions were used to identify degree of participation in various health life-style activites. Alternative diet, use of meditation-relaxation techniques, and recreational drug use had significantly higher means in the lesbian group. Fulfiling family obligations, regular Pap testing, and use of prescription drugs were significantly higher among the heterosexual group. This study represents the author's initial exploration of lesbian health life-styles and describes similarities and differences in the health life-styles of lesbian and heterosexual women.

AN INVESTIGATION OF THE HEALTH CARE PREFERENCES OF THE LESBIAN POPULATION, VICKI A. LUCAS, HEALTH CARE FOR WOMEN INTERNATIONAL, 1992, VOL 13(2), P221-228.

A descriptive study was done to explore the health care preferences of 178 self-identified lesbians. They were surveyed regarding their preferences for health care services, health care providers, clinic logistics, and identification and documentation of sexual preference. Holistic counseling, health maintenance, and disease prevention services were identified as their top priorities. Female health care providers were identified as a priority, and most of the women felt that sexual preference should be asked but not recorded in the chart.

PERSONAL RISKING: LESBIAN SELF-DISCLOSURE OF SEXUAL ORIENTATION TO PROFESSIONAL HEALTH CARE PROVIDERS, JANICE MARLAND HITCHCOCK, HOLLY SKODOL WILSON,
NURSING RESEARCH, 1992, VOL 41(3), P178-183.

Thirty three lesbians ranging in age from 18-68 participated as respondents in this qualitative, theory-generating study. Data were obtained through a written demographic questionnaire and in-depth taped inteviews. Findings revealed a two-phase basic social process (BSP) identified as personal risking that is used by lesbians to secure their physical and/or psychological safety within the health care system. In the anticipatory phase, the risk of self-disclosure is calculated using both imaginative and cognitive strategies to determine a disclosure stance. In the interactional phase, scanning and monitoring enable the lesbian client to revaluate the stance assumed. The data confirm that lesbians are uncomfortable in many health care situations and suggest provider responses to improve their comfort and the level of health care they receive.

IMAGES OF GAYS AND LESBIANS IN SEXUALITY AND HEALTH TEXTBOOKS, MARIAMNE H. WHATLEY, JOURNAL OF HOMOSEXUALITY, 1992, VOL 22(3/4), P197-211.

Photographs have become a major form of illustration in college level health and sexuality textbooks and may be more memorable than the text itself. Unlike other forms of illustration, photographs are often viewed as objective and unable to "lie." Photographs of individuals from nondominant groups, in addition to being seen as objective representations of reality, are often seen as representing the group to which they belong. To study the representation of non dominant groups in textbooks, it is, therefore, as important to analyze the photographs as the text itself. This paper examines photographs of gay men and lesbians in 14 health and 16 human sexuality college level textbooks. The photographs of individuals present an inaccurate portrait of lesbians and gay men as white, young, and physically-abled. Individual and large group photographs of activism (31% of the total photographs of gay men and lesbians) were positive images that emphasized issues of civil rights. The paper discusses various interpretations of the photographs of gay men and lesbians, subtle homophobia or heterosexism in the texts, and progress that has been made.

LESBIAN HEALTH CARE RESEARCH: A REVIEW OF THE LITERATURE FROM 1970 TO 1990, PATRICIA E. STEVENS, HEALTH CARE FOR WOMEN INTERNATIONAL, 1992, VOL 13(2), P91-120.

The author critically examines the research about health care providers' attitudes toward lesbians and the research about lesbians' experiences in health care encounters. Results of the review suggest that caregivers hold prejudiced views of lesbians and are generally condemnatory and ignorant about their lesbian clients. Lesbians frequently interpret caregivers' behaviors as hostile and rejecting and fear for their safety in health care interactions. Upon disclosure of their lesbian identity, many have been mistreated. Because of their negative experiences, they often delay seeking health care. Rather than conditions of respect and regard, lesbians report atmospheres of intimidation and humiliation which encumber their interactions with health care providers. Tables outlining the study foci, samples, methods, and findings are provided. Ramifications of findings are discussed, implications for practice and policy are identified, and directions for future research about lesbian health care are suggested.

NURSING AS A LESBIAN, THERESA M. STEPHANY,
SEXUALITY AND DISABILITY, 1992, VOL 10(2), P119-124.

Minority status within any larger group is often difficult. Lesbian nurses face a dilemma of choice - whether or not to "come out of the closet" to their colleagues and patients. This essay describes the professional reflections of one lesbian nurse.

LESBIANS WITH DISABILITIES, CORBETT JOAN O'TOOLE, JENNIFER L. BREGANTE,
SEXUALITY AND DISABILITY, 1992, VOL 10(3), P163-172.

There is a severe lack of information on sexuality for any woman with a disability. Often, what is available is limited to material on birth control and child delivery. For women who are disabled and lesbian, virtually no written information exists and health care workers seldom feel comfortable discussing the topic. Lesbians with disabilities have the responsibility to discuss sexual preference with their health care workers. Yet, there is much to lose. This paper discusses the issues of being lesbian and disabled as well as the unique attitudes of health care workers toward both disability and homosexuality.

LESBIAN STEREOTYPES, MICHELE ELIASON, CAROL DONELAN, CARLA RANDALL,
HEALTH CARE FOR WOMEN INTERNATIONAL, 1992, VOL13(2), P131-144.

The American Psychological Association's Committee on Gay and Lesbian Concerns (Herek, 1987) expressed a need for research that focuses specifically on the concerns of lesbians. To this end, we attempted to identify stereotypes about lesbians, as noted in 278 female nursing students' responses to open-ended questions. Content analysis of the responses revealed a number of consistent themes or stereotypes. The most prevalent stereotypes included lesbians' seduction of heterosexual women, lesbian "boasting," and the "masculine aura" of lesbians. None of the participant variables (age, educational level, social class, and type of nursing education) were significantly related to particular stereotypes. The impact of stereotypes on the acceptance of lesbians within society is discussed.

FACULTY SUPPORT FOR GAY AND LESBIAN NURSING STUDENTS, THERESA M. STEPHANY,
NURSE EDUCATION, 1992, VOL 17(5), P22-23.

Gay and lesbian nursing students seem to be invisible. Because the color of their skin does not reveal their minority status, the decision whether to "come out of the closet" is a choice that must be remade -renegotiated - every day of the students' lives. Nursing faculty can play a pivotal role in supporting these students by their attitudes and activism.

LESBIAN HOSPICE PATIENTS, THERESA M. STEPHANY, HOME HEALTHCARE NURSE, 1993, VOL 11(6), P65.

THE LESBIAN CHILDBEARING COUPLE: A CASE REPORT, DONNA T. TASH, JANET W. KENNEY, BIRTH, MARCH 1993, VOL 20(1), P36-40.

Increasing numbers of lesbians are choosing to bear children. Inadequate information about these women's childbearing concerns, together with discrimination and insensitivity to their needs, places these couples at risk for receiving less than optimal health care. Lesbians who desire children are faced with numerous psychosocial problems that should be addressed by open and sensitive caregivers. Providing care to a lesbian couple demonstrated the ways in which their needs were similar to and different from those of heterosexual couples.

PRIMARY CARE OF LESBIAN PATIENTS, JOCELYN WHITE, WENDY LEVINSON, JOURNAL OF GENERAL INTERNAL MEDICINE, JANUARY 1993, VOL 8, P41-47.

NO EVIDENCE FOR MENSTRUAL SYNCHRONY IN LESBIAN COUPLES, WENDA R. TREVATHAN, MARY H. BURLESON & W. LARRY GREGORY, PSYCHONEUROENDOCRINILOGY, 1993, VOL 18(5/6), P425-435.

Menstrual synchrony was investigated in a sample of 29 cohabiting lesbian couples, ranging in age from 22 to 48 years. One or both partners kept prospective daily records of variables including menses onset dates, intimate contact, and sexual activity. All women reported daily intimate interaction with their partners; none reported intimate interaction with men. Despite these potentially optimal conditions for the manifestation of synchrony, the differences between dyad members in menses onset dates were distributed randomly, and there was no evidence of convergence. In fact, most dyads exhibited divergence of onset dates. Reasons for lack of synchrony in this sample are discussed; one conclusion is that there is no solid evidence that menstrual synchrony is a stable attribute of past or contemporary human populations.

NURSES' ATTITUDES AFFECT LESBIANS' HEALTH CARE, ROBYN PARKES, AUSTRALIAN NURSING JOURNAL, OCTOBER 1993, VOL 1(4), P16.

OUT IN THE OPEN? P. ROSE, 1993, NURSING TIMES, VOL 59(30), P50-52.

How do nurses treat their patients and colleagues who are lesbians? In the first of two articles on homosexuality and health care, Pat Rose describes her survey, which investigated this contentious issue.

WHEN THE PATIENT IS ALSO A LESBIAN, MARGARET A. LYNCH
, AWHONNS-CLIN-ISSUES-PERINAT-WOMEN-HEALTH-NURSE, 1993, VOL 4(2), P196-202.

Social stigma impedes the delivery of quality health care to women who identify as lesbians. Nurses who are aware of and sensitive to women who are lesbians in their practice are able to increase the calibre of the health care they provide. This article provides examples in which a lesbian sociosexual orientation has an impact on the medical history, differential diagnosis, physical exqamination, and treatment.

PHYSICAL HEALTH PROBLEMS AND CONCERNS OF LESBIANS, SUSAN E. TRIPPET, JOYCE BAIN,
WOMEN & HEALTH, 1993, VOL 20(2), P59-70.

Using a combined qualitative-quantitative methodology, a convenience sample of 503 women revealed that the most prevalent problems lesbian women encountered for which they did and did not seek traditional health care were menstrual, sexually stransmitted diseases, reproductive, bladder or kidney, and breast problems. Reasons for not seeking health care were deduced, as was the manner in which the women partiicipated in their health care, their feelings regarding health care, and how they would like to see health care changed.

HOMOPHOBIA AND ATTITUDES TOWARD GAY MEN AND LESBIANS BY PSYCHIATRIC NURSES, GEORGE BYRON SMITH, ARCHIVES OF PSYCHIATRIC NURSING, 1993, VOL VII(6), P377-384.

CULTURAL DIVERSITY IN NURSING CARE: THE LESBIAN, GAY, OR BISEXUAL CLIENT, MICHELE J. ELIASON, JOURNAL OF TRANSCULTURAL NURSING, 1993, VOL 5(1), P14-20.

This paper examines the gay, lesbian, and bisexual persons as subcultures of the dominant Anglo-American culture in the United States of America in relation to influences on their access to and use of health care systems and resources. Nurses need to be aware of the unique health needs of such clients, and examine their own cultural belief systems about same-sex relationships. Negative attitudes or misinformation can lead to poor quality of care and disrupt nurse-client relationships.

IGNORED, OVERLOOKED, OR SUBSUMED: RESEARCH ON LESBIAN HEALTH AND HEALTH CARE, SUE V. ROSSER, NWSA JOURNAL, 1993, VOL 5(2), P183-203.

PROTECTIVE STRATEGIES OF LESBIAN CLIENTS IN HEALTH CARE ENVIRONMENTS, PATRICIA E. STEVENS, RESEARCH,IN NURSING & HEALTH, 1994, VOL 17(3), P217-229.

THE EXPERIENCE OF GAY AND LESBIAN STUDENTS IN MEDICAL SCHOOL, JILL TINMOUTH, JAMA, 1994, VOL 271(9), P714-715.

NURSING CARE OF GAY AND LESBIAN PATIENTS, HAZEL PLATZER,
NURSING STANDARD, JAN 13 1993, VOL 7(17), P34-37.

CONFRONTING PREJUDICE, GAY AND LESBIAN ISSUES, PAT ROSE, HAZEL PLATZER, NURSING TIMES, AUGUST 4-10 1993, VOL 89(31), P52-54.

CHAPTERS IN BOOKS

WOMEN-IDENTIFIED-WOMEN, EDITED BY TRUDY DARTY AND SANDEE POTTER, MAYFIELD PUBLISHING COMPANY, 1984, INCLUDES:

LESBIANS AND CONTEMPORARY HEALTH CARE SYSTEMS: OPPRESSION AND OPPORTUNITY, TRUDY DARTY & SANDEE POTTER,
P195-210.

BOOKS

LESBIAN HEALTH: WHAT ARE THE ISSUES? PHYLLIS NOERAGER STERN, EDITOR, TAYLOR & FRANCIS, 1993.

WE'RE COUNTING ON EQUALITY, MONITORING EQUAL OPPORTUNITIES IN THE WORKPLACE IN RELATION TO SEX, RACE, DISABILITY, SEXUALITY, HIV/AIDS, AND AGE, MAREE GLADWIN, 1993, CITY CENTRE, 32-35 FEATHERSTONE ST, LONDON, EC1Y 8QX.

MENTAL HEALTH/THERAPY

See Lesbians, Mental Health and Therapy Resource List; and Lesbians, Coming Out and Identity Development Resource List.

MOTHERS

See Lesbians Who Are Mothers Resource List

OLD LESBIANS

See Old Lesbians Resource List

OUT/IDENTITY DEVELOPMENT

See Coming Out and Identity Development Resource List

PARENTS

See Parents of Lesbians and Gays Resource List

RELATIONSHIPS

See Relationships Resource List

SOCIAL WORK

See Lesbians, Gays and Social Work Resource List

YOUTH

See Working With Lesbian and Gay Youth Resource List



© Lesbian Information Service, 1995