Although any woman can develop breast cancer (especially as she gets older), for several reasons lesbians are at an increased risk. Breast cancer risks for women include not having children (or having them late in life), not breast-feeding, smoking and being overweight. Lesbians are less likely to have children and thus most lesbians do not breast-feed; if they do have children, they are more likely to have them later in life. In addition, smoking and alcohol use tends to be higher among lesbians than in the population as a whole (see below), further increasing the risk of breast cancer. According to studies, lesbians are also more likely to have greater body mass and less likely to have regular screening exams like mammograms, both of which can further increase the risk of breast cancer.
Lesbians are also at an increased risk for ovarian and endometrial cancers. Risk factors for these cancers include not taking oral contraceptives and not having children. In addition the higher rate of smoking among lesbians may increase the risk for ovarian cancer.
Lesbians may also have a higher risk for colon cancer. Risk factors for colon cancer common among lesbians include a higher rate of smoking, having fewer screening exams and the greater likelihood of having a greater body mass.
Lesbians have been reported to smoke at higher rates than the general population. Because of this, it is expected that illnesses linked to smoking (lung cancer, emphysema, heart disease, etc.) would be found at a higher rate among lesbians.
It has been suggested that alcohol use may be higher among lesbians. Alcoholism is itself a health-care problem. Alcohol abuse can also lead to liver disease. In addition, alcohol use (and abuse) can also increase the risk for HIV and other STDs. While under the influence of alcohol, people tend to have sex more often, have sex with people they do not know, are less likely to use dental dams or are less likely to use dental dams correctly. In addition, while under the influence of alcohol, people are more likely to engage in high-risk sexual activities (for example sharing sex toys).
Although these are often not viewed as health concerns, they should be. Physical violence can lead to bodily harm, trauma, hospitalization, etc. Many gay/lesbian "hate crimes" never get reported, due to victims fear of further discrimination, shame, intimidation by police or similar concerns. lesbian domestic violence can also lead to significant bodily harm, and is very rarely reported, due to the victims' fears of discrimination, intimidation by police, etc. Due to the lack of reporting, the rates of gay bashing and lesbian domestic violence are likely much higher than statistics indicate.
Mental-health issues cannot be ignored. lesbians live in a world where they are often told they are "bad." Some lesbians are abandoned by their families. Discrimination against lesbians is all too common. The way that society often treats lesbians can lower their self-esteem and lead to depression. Suicide rates, for example, are higher among lesbian youth than among heterosexual youth. When a person has low self-esteem, they tend to value their life (and their health) less seriously.
Let's now review some solutions to the health problems discussed above.
The most significant ways to reduce the risk of cancer among lesbians are:
This can be best accomplished by teaching lesbians how to control drinking habits before they become alcoholics. This means teaching lesbians to stop drinking before they become drunk. In addition, local lesbian communities may want to establish programs for lesbians to meet one another outside of a bar setting. Another solution is to get women with drinking problems into alcohol-treatment programs. Doing this will not only solve drinking problems, but it will also reduce the risks of problems associated with alcoholism (liver disease, increased STD risk, relationship problems, etc.).
This is difficult to solve, since this would involve changes in how our society views lesbians. Reduction of lesbian domestic violence is another problematic issue. However, we can teach lesbians how to avoid situations where violence against them would likely occur. And when a domestic-violence situation does occur, we need to teach lesbians how to get themselves out of that situation. This would also involve teaching local domestic-violence hotlines and law-enforcement agencies about lesbian domestic-violence and hate crimes, and how to handle those types of situations.
This is another complex problem. A strong effort needs to be made to increase self-esteem in the lesbian community, especially among young lesbians. Perhaps programs using lesbian role models can be developed to teach young lesbians that they can have successful and fulfilling futures. In lesbians who suffer from depression, low self-esteem and similar issues, an effort must be made to get them into mental-health counseling with counselors who are comfortable in dealing with lesbian issues.
The lesbian community cannot depend on the straight community to solve its problems -- lesbian problems are best solved by lesbian solutions. If the incidence of various health problems is to be reduced in the lesbian community, then it is up to the lesbian community itself to take action.
If you are a lesbian, think about what you personally can do to make your community healthier. Work to keep yourself healthy. Examine your breasts frequently. Make sure you regularly have a mammogram and a Pap smear. Reduce your use of alcohol and other drugs.
If you are a lesbian, spend some time helping to keep your community healthy. Teach lesbian youth the value of their health. Encourage them to do breast self-exams. Encourage them to get regular Pap smears. Teach them to drink responsibly. Be a lesbian role model. Take pride in your community. The health of the lesbian community depends on you.
Finally, a good review of health concerns in the gay and lesbian community can be found in the following report which can be ordered from the online PubMed/Medline database: "Primary Care of Lesbian and Gay Patients: Educating Ourselves and Our Students," by A. Harrison, from Family Medicine, Vol. 28, pages 10-23 (January 1996).
Do you want more information on AIDS, STDs or safer sex? Contact the U.S. Centers for Disease Control AIDS hotline, open 24 hours a day, seven days a week, at 1-800-CDC-INFO. Or visit The Body's Safe Sex and Prevention Forum.
Until next time . . . Work hard, play hard, play safe, stay sober!