UCLA Needs Lesbians!

Date: Monday, March 20th, 2000 9:35PM
From: “Dr. Susan Cochran and Dr. Vickie Mays” <cochran@ucla.edu>
Subj: Lesbian Health — Please Post

To  : chingusai@writeme.com, glarp@earthlink.net, homan-la@geocities.com,
      labormac@aol.com, laapis@aol.com, qmugla@aol.com, retter@usc.edu,
      TWOradio@aol.com

 

LESBIANS IN LOS ANGELES COUNTY WANTED TO PARTICIPATE IN A STUDY ON LESBIAN HEALTH CARE.  JOIN THE 900 WOMEN WHO HAVE FILLED OUT A QUESTIONNAIRE SO THAT MAJOR HEALTH CARE PROVIDERS IN LOS ANGELES CAN LEARN THE HEALTH CARE NEEDS OF LESBIANS.  IF YOU’RE INTERESTED IN RECEIVING A QUESTIONNAIRE PLEASE CALL Dr. Susan Cochran of UCLA’s School of Public Health at (310) 206-5160 and request a questionnaire.  If you want to learn more, read the information below!!!

LESBIAN HEALTH CARE: MAKING A DIFFERENCE
Dr.  Susan Cochran (cochran@ucla.edu)

Are there any real differences between the health care of lesbians and heterosexual women?  Ideally, there shouldn’t be.  However, research studies have indicated that lesbians sometimes have had negative experiences with their health care providers.  Take for example a lesbian’s gynecological exam.  It has been recommended that women over the age of 20 and/or sexually active have gynecological exams every year.  Imagine you, as a lesbian, going to your gynecologist for your routine exam.  As the doctor begins to ask you about your past sex partners, you begin to think “lying isn’t so bad.  Does s/he really need to know that I’m a lesbian?”  Non-disclosure may be fine for routine check-ups but in more serious cases where accurate descriptions of sexual practices are concerned, sexual identity may become an important factor.

Lesbian health has long been a neglected topic in mainstream research. This lack of information makes it almost impossible to assess the health concerns, attitudes and experiences of the diverse lesbian population.  It masks the community’s health needs by allowing health care providers to assume heterosexuality of all their patients.  This ignorance may be detrimental to the lesbian community because the role of a primary health care provider is not only to diagnose and treat illnesses, but also to advise in preventive health measures.  How can one’s provider recommend the use of a dental dam when s/he doesn’t even know that it is dental dams rather than condoms that are most effective in HIV/STD prevention because their patient is a lesbian?

This concern about the lack of information on the health status and health concerns of lesbians is shared by the Office of Research on Women’s Health at the National Institute of Health and the Institute of Medicine. The Institute of Medicine convened an expert workshop to examine the status of lesbian health and methodological considerations to conduct such research.  Dr. Susan Cochran, a Professor of Epidemiology in the School of Public Health, was one of the main presentors at the Institute of Medicine meeting.  She shared her concern that even when research on lesbian health is conducted seldom does it include the voices of all women in the community.  She is still disheartened that a national study of approximately 600 African-American lesbians she conducted with other UCLA professors 15 years ago is still one of the largest minority lesbian studies.  As she notes, “We need to know more about the health concerns of all lesbians, particularly those under 30, over 50, and women of color.”

Lesbians are as diverse as the general population — they cross all economic, racial, ethnic, and age boundaries.  Yet gay men and women have been described and treated as misfits and mentally ill in the medical field throughout the 20th century.  Even though the American Psychiatric Association officially lifted the diagnosis of homosexuality from its descriptions of mental illness in 1974, stigmatized beliefs about homosexual behavior are still prevalent in the medical education of health care providers.  These prejudices directly affect the quality of health care provided by health care professionals and the institutions where they hospitalize their patients.  E.J. Rankow, a nurse practitioner, identifies one of the main reasons lesbians do not seek health care is the prevailing standard of heterosexuality compromises the quality of health care for lesbian patients.  The patient must decide if she wants to “come out” and then be prepared, if the provider is unable to give optimum health care, to change providers or to seek ways outside of the traditional health care system to get appropriate lesbian affirmative health care. 

The standard of assumed heterosexuality has caused some lesbians to have negative experiences in the health care setting which prevents them from seeking care in the future.  These experiences include patronizing treatment, intimidation, attempts to change the patient’s sexual orientation, hostility toward the patient’s partner, breach of confidentiality, invasive and inappropriate personal questioning, neglect, denial of care and undue roughness in physical exams.  These experiences pressure many lesbians to either conceal their sexual orientation from medical providers or to refuse help from traditional health care systems altogether.  In fact, for many lesbians the actual or perceived risk and associated fear of entering a homophobic and potentially abusive medical system outweigh the perceived risk of illness, resulting in an increased morbidity and mortality associated with delayed or inadequate care.  This is particularly problematic as private practitioners join HMO and managed care groups in which the choices of practitioner may be limited.

In a 1994 survey of membership of the American Association of Physicians for Human Rights, 67% of respondents reported knowing of lesbian, gay, or bisexual patients who had received substandard care or been denied care because of sexual orientation.  Many lesbians do not disclose their sexual orientation because they fear professional, social, and legal repercussions should their confidence not be respected.  Despite these obstacles, a majority of lesbians agree that, given an environment where they feel safe enough to do so, sharing information about their sexual orientation would enhance the medical care they received.

Health care providers are responsible for creating a comfortable environment for all clients regardless of age, sex, gender, religion, ethnicity, class, or sexual orientation.  If compassionate care cannot be given because of homophobic attitudes and assumptions, providers need to be willing to make appropriate referrals.  Increased research on lesbian health topics undoubtedly will help health practitioners be prepared to care for lesbian patients and to treat lesbian patients from an adequate knowledge base.  It is time that those concerned about equity in the health care of special and vulnerable populations advocate for a lesbian health agenda to be recognized and addressed by the medical, public health, and policy communities.  As an example, Professor Cochran is working with researchers across the country examining responses from a sample of over 12,000 lesbians describing their health habits and patterns of health care utilization whether they receive preventive cancer services. 

In order to assess the current status of health concerns, attitudes and experiences of lesbians in Los Angeles County since the advent of managed care Dr. Cochran and Dr. Vickie Mays along with a team of other Professors, graduate and undergraduate students from UCLA and local universities are conducting this survey.

The survey will focus on lesbian and bisexual women of any age but you must live in Los Angeles County.  While we want to hear from all of you, we ask that you help us to make an extra effort to reach those who may not hang out and be as visible but who will need health services.  So please help us by committing yourself and at least three other people you know to complete the survey.  Once we send you the survey we won’t contact you anymore.  Since much of the study is being done through volunteer efforts and with little funds, please help us by completing the survey, passing it on to others who will complete it or returning it to us.  Each survey with its mailing, printing, and return postage costs us an average of $7.  So, if for whatever reason, you don’t want to fill it out, pass it on and make sure that someone else fills it out, or send it back to us so that some other lesbian can fill it out.  The survey is anonymous, and will arrive in an envelope with no identifying information about its content or the project. 

If you are committed to completing the survey and would like us to send you a survey, please call (310) 206-5160.  Also if you are interested in volunteering to help us to outreach also give us a call.  To allow us to send you a survey, please leave us your name, address, city and zipcode.  You may use a nickname, and we can mail to a P.O. box.  Your participation will be a direct benefit to the health of all lesbian and bisexual women through the anonymous information you provide but even more importantly will help us to document in particular the health care needs and experiences of lesbians.

THANK YOU

Dr. Susan Cochran
cochran@ucla.edu