Australia: Keeping Lesbians in the Loop for Pap Smears

Current Australian medical guidelines recommend that women ages 18-70 should have a Pap smear every two years to detect early warning signs of cervical cancer. A recent study concludes that non-heterosexual women access screening less frequently, delay treatment and are less likely to have a regular general practitioner than heterosexual women.

"Cervical human papilloma virus has been reported to occur in 21 percent of lesbian women with no prior sexual contact with men, dispelling the myth that lesbians are immune to HPV infection," said lead author Ruth McNair, a senior lecturer at the University of Melbourne's department of general practice. The study, "Lesbian Health Inequalities: A Cultural Minority Issue for Health Professionals," appeared in the Medical Journal of Australia (2003;178:643-645).

While research into cervical cancer among lesbians is scarce, there is evidence to suggest that abnormal cervical cells are found at a later stage in this population, according to Gerry Wain, head of gynecological oncology at Westmead Hospital and director of the New South Wales Cervical Screening Program. "The assumption that somebody is not at risk for cervical cancer is [taking away] a woman's opportunity to access an effective preventative health strategy," said Wain. "[Lesbians] probably are an underscreened population. We lack hard data but there are good grounds for recommending screening for these women."

In October 2002, the Australian Medical Association launched a position statement on sexual orientation and gender diversity, offering recommendations to GPs on providing sensitive health care. "A doctor's assumption regarding sexual orientation, or the patient's reluctance to disclose his or her sexual orientation and behavior, can lead to failure to screen, diagnose, or treat important medical problems," the AMA policy said.

Anthony Smith, deputy director of the Australian Research Center in Sex, Health and Society, was lead author of "The Australian Study of Health and Relationships." The study, based on interviews with 19,300 people ages 16-59, found that 0.8 percent of Australian women identified themselves as lesbians and 1.4 percent identified as bisexual. Nearly 9 percent of women and 6 percent of men said they had had some homosexual experience.

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