Optimizing Care of Lesbian Patients
A Clinical Tip Sheet AAPA Committee on Diversity

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A good starting point is for the provider to understand that lesbian and bisexual women have a distinct set of health concerns. Lesbians face unique challenges within the medical system, and often avoid routine health exams and even delay seeking medical care when health problems occur. Most providers lack training in understanding health issues of lesbians.

Barriers to Optimal Health Can Include:

• Fear of negative reactions from providers if they disclose their sexual orientation
• Providers lack of understanding of lesbian health issues
• Lack of health insurance because of no domestic partner benefits
• Low perceived risk of getting sexually transmitted diseases and some types of cancer

Some Steps to Make Your Clinic More Lesbian-Friendly:

Create a Welcoming Environment
Display posters showing same sex couples. Post lesbian-friendly decorations such as pink-triangle and equal-sign stickers. Let your lesbian patients know it is safe to be in your clinic.

Develop Lesbian Friendly Forms
See page 7 of http://www.glma.org/medical/clinical/lgbti_clinical_guidelines.pdf for suggestions.

Develop Appropriate Language
Use gender neutral language. Listen to how your patients describe their relationships. Follow the patient's lead about self-description.

Include Open Lesbians in Clinic Staff
This can help ensure increased patient comfort in your clinic.

Labels May Inhibit Appropriate Investigation
Women who identify as lesbian and bisexual may have had or may still be having sexual contact with a man, and deserve counseling and screening.

Know Unique Lesbian Health Concerns (Two examples):

1. While there is no evidence that lesbians have increased risk of breast cancer, they do have more risk factors for the disease.
2. Lesbians also have lower rates of health insurance coverage, and may underutilize breast, cervical, and ovarian cancer screening.

Additional Resources:

• Gay and Lesbian Medical Association
  
• UCSF Lesbian Health Research Center
  
• National Women's Health Center