42-02: Health Care for Lesbian & Bisexual Women

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. Current medical literature also does not sufficiently consider the intersection of sexual orientation and gender identity to evaluate the specific health needs and concerns of lesbian and bisexual women who are of gender diverse experiences, nor is there sufficient research in the experiences of other SM women (ie, those who identify as pansexual, queer, asexual) to understand the current health needs of these individuals (although the few existing studies are included here). In the United States, women in same-sex couples are less likely to have primary care providers, get non-urgent medical care when needed, see a specialist, and feel that doctors spent enough time with them. Healthcare access is even more restricted at the intersection of sexual orientation, gender, race, and ethnicity. A 2021 study of Black and Latinx SM gender expansive women found that barriers to accessing care were linked to income and discrimination by providers. This is true worldwide with variability depending on the local sociopolitical climate. In countries with more restrictive laws and policies, health disparities are likely greater. A study in Lebanon noted that significantly more SM 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 SM women, including social exclusion and invisibility, criminalization, and systematic homophobic sexual assault. Limited clinician training likely exacerbates the lack of preparedness to care for SM women.

HEALTH DISPARITIES AFFECTING LESBIAN & BISEXUAL WOMEN

Health disparities exist across the life span for ...