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Key Clinical Updates in Health Care for Lesbian & Bisexual Women

Data from the National Health and Nutrition Examination Survey showed that sexual minority women, compared with their heterosexual counterparts, had increased modifiable cardiovascular disease risk factors of mental distress, current tobacco use, binge drinking, increased likelihood of obesity, and glycosylated hemoglobin consistent with prediabetes.

Data from the Chicago Health and Life Experiences of Women study found cardiometabolic risk factors (hypertension, diabetes, and obesity) varied by sexual orientation and race/ethnicity, calling for intersectional assessments and interventions that account for sexual orientation, race, and ethnicity.

A population-based study from the United Kingdom found higher rates of cancer among gay and bisexual men but no difference in cancer diagnoses between lesbian and bisexual women and their heterosexual counterparts except for a higher rate of oropharyngeal cancer.

A 2019 study concluded that sexual orientation clearly plays a role in sexual victimization risk when they found that compared with heterosexual women, bisexual women had 3.7 times the odds of initial victimization and 7.3 times the odds of repeat victimization, and lesbian women had 3.2 times the odds of repeat victimization even after controlling for other sociodemographic factors.

Cisgender lesbian and bisexual women are addressed together in this section since most medical literature does not delineate clearly enough between lesbian and bisexual cisgender women and current medical literature does not consider the intersection of sexual orientation and gender identity explicitly enough to evaluate the specific health needs and concerns of lesbian and bisexual women who are of transgender experience. In the United States, women in same-sex couples are less likely to have primary care providers, get nonurgent medical care when needed, see a specialist, and feel that doctors spent enough time with them. This is true throughout the world with variability depending on local sociopolitical climate. In countries with more restrictive laws and policies, health disparities are likely greater. A study in Lebanon noted that significantly more sexual minority women reported having trouble accessing health care than heterosexual women, and a meta-analysis of southern African countries outlined the unique health challenges faced by sexual minority women, including social exclusion and invisibility, criminalization, and systematic homophobic sexual assault. Limited provider training likely exacerbates the lack of preparedness to care for sexual minority women.

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Gereige  JD  et al. The sexual health of women in Lebanon: are there differences by sexual orientation? LGBT Health. 2018 Jan;5(1):45–53.
[PubMed: 29130791]
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Muller  A  et al. Making the invisible visible: a systematic review of sexual minority women’s health in Southern Africa. BMC Public Health. 2016 Apr 11;16:307.
[PubMed: 27066890]
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Obedin-Maliver  J  et al. Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education. JAMA. 2011 Sep 7;306(9):971–7.
[PubMed: 21900137]

HEALTH DISPARITIES AFFECTING LESBIAN & BISEXUAL WOMEN

Health disparities exist across the life span for lesbian and bisexual women compared to heterosexual women. The following are increased ...

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