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.