'Lesbian Health 101' seeks to open doors, minds

Years ago a lesbian friend, who would soon die of uterine cancer, told me how she hated going to her gynecologist and consistently postponed it. “I’m sitting there in the middle of all those bulging bellies and beatific smiles,” she said, “like some sort of an alien.”

How I wish she were alive, so I could send this clipping from the San Francisco Chronicle:

When Dr. Patricia Robertson held the first lesbian health clinic at San Francisco General Hospital in 1978, she decided to cover the “family planning” signs in the lobby – she didn’t want to deter patients who thought gynecologists were only for dispensing birth control and helping women get pregnant.

“We wanted to put together evidence-based research that would support clinical guidelines, so when we talk about why lesbians are different from heterosexual women we can back that up,” said Robertson, who is a professor in the UCSF department of obstetrics, gynecology and reproductive sciences. “Doctors are going to be able to legitimize their advice after they read this book.”

The article points out that although progress has been made in health care since then, “lesbians are more likely than straight women to suffer depression and drug and alcohol abuse. They may be less likely to get regular health screenings like pap smears and breast exams.

With those disparities in mind, Robertson and Suzanne Dibble, a registered nurse with the Institute for Health and Aging in the UCSF School of Nursing, have put together the first textbook on lesbian health care. ‘Lesbian Health 101’ was released this month.

The textbook is written in medical language and designed for doctors, nurses and other health care providers, although Robertson and Dibble say they’re encouraging lesbians to use it as a resource for understanding their own health issues. Most of the chapters were written by health care providers who are also lesbian.

Chapters in the nearly 600-page book focus on a wide variety of health issues, from heart disease and breast cancer to partner violence and how to decide which woman in a relationship should get pregnant.Some sections focus on the risk factors that affect lesbians more than straight women – higher smoking rates, for example, or what effect not having children might have on breast cancer risks – while others address how doctors can best meet the particular needs of lesbian patients.

Many of the health issues that affect lesbians can be tied to stress related to their sexual orientation, Dibble said. Discrimination, the stress of coming out to family and friends, or feeling ostracized and alone can all lead to health problems.

Dr. Erica Breneman, an obstetrician-gynecologist with Kaiser Permanente in Oakland, said she’s pleased to see such a textbook available to doctors now, even if it’s troubling that the book is even necessary.

“In a perfect world, we wouldn’t need this,” Breneman said. “A woman who happens to be gay shouldn’t need much that’s terribly different than a woman who is straight. But the reality is, because of the particular demographics of lesbian women, they do have other health issues.”

Perfect worlds, it seems, are slow in coming.

‘Lesbian Health 101’ seeks to open doors, minds.

Right time for gay rights?

President Obama, having repeated his promise to end “don’t ask, don”t tell” on Saturday, got an additional nudge from the National Equality March on Sunday. Tens of thousands of gay rights supporters from across the country poured through the streets of the nation’s capital to demand equal rights for LGBT citizens. They have their work cut out for them. With a few small, scattered gains having been made, there are battlegrounds shaping up everywhere from Maine to California over the issues highlighted by the events of this past weekend.

My friend Joe, who celebrated 35 years with his partner last summer, asked why I haven’t written about gay rights. Boomers and Beyonders, he says, have a unique perspective. “We have won a few battles that won’t have to be fought again, but there’s a long road ahead and the netroots now taking the lead need to have strong support from the veterans.”

So here goes.

While reiterating his promise to end “don’t ask, don’t tell,” Obama  gave no timetable for doing so. It’s time. Given everything else on his plate, those of us who support gay rights may be willing to cut the president a little slack, but this small step toward clearing some of the large injustices gays and lesbians have lived with since approximately forever is one Obama should be taking soon. 2010 sounds about right.

Other gay rights battlegrounds are active in Maine, where a ballot measure would repeal marriage rights for gays and lesbians, in Washington where a referendum must pass if full domestic partnership benefits are retained, and elsewhere. Meanwhile, according to Change.org, the U.S. Conference of Catholic Bishops “is planning a major statement on marriage in November, preparing to issue new language about how the church views same-sex marriage. Unfortunately, the new language is more of the same… hateful, tired and representative of a theology that views people who are LGBT as less than.”

Compared to the record of togetherness set by Joe and Robert, my marital history is pretty lousy. (Up until this, my final marriage, that is, and its extraordinarily happy 17 years.) So it is hard to see my marital state being threatened by theirs being legitimized. Joe and I were also part of an AIDS support group during the 1990s, and witnessed tragic injustices suffered by dying young men whose hospital doors were barred to those who loved them best. A lot more needs changing than just “don’t ask, don’t tell.”

Senate Armed Services Committee Chairman Carl Levin (D-Michigan) was quoted by Elizabeth Williamson and Neil King in Monday’s Wall Street Journal as saying it was “now possible ‘to get a buy-in from the military’ to end a policy opposed by gays and many liberals since it was passed by Congress in 1993.” The monumental pile of global problems to be solved may keep Obama from seizing this good opportunity; gay rights supporters could keep that door open until he does act.

Global issues aside, one home front fact remains: LGBT Americans have been unjustly treated in innumerable ways, for innumerable years.

Getting rid of “don’t ask, don’t tell” seems a very good way to start putting things right.