Women who have sex with women
Encyclopedia
Women who have sex with women (WSW) is a term used to identify women who engage in sexual activities with other women, whether or not they identify themselves as lesbian
or bisexual. The term is often used in medical literature to describe such women as a group for clinical study, without needing to consider the issues of sexual self-identity.
, which is the initiating factor for most women to seek consultation with a gynecologist when they become sexually active. As a result, these women are not screened regularly with pap smear
s because they have a lower perceived risk of acquiring a sexually transmitted disease
or types of cancer. A factor which leads to lesbians neglecting to seek medical screening in the United States is a lack of health insurance offered by employers for same-sex domestic partners.
When women do seek medical attention, medical professionals often fail to take a complete medical history. In a recent study of 2,345 lesbian and bisexual women, only 9.3% had claimed they had ever been asked their sexual orientation by a physician. A third of the respondents believed disclosing their sexual history would result in a negative reaction, and 30% had received a negative reaction from a medical professional after identifying themselves as lesbian or bisexual.
A patient's complete history helps medical professionals identify higher risk areas and corrects assumptions about the personal histories of women. In a similar survey of 6,935 lesbians, 77% had had sexual contact with one or more male partners, and 6% had that contact within the previous year.Another summary of overall surveys found that women who identify as lesbian, 80-95% had previous sexual contact with men, and some report sexual behavior that is risky.(King, p. 221.)
Heart disease
is listed by the U.S. Department of Health and Human Services as the number one cause of death for all women. Factors that add to risk of heart disease include obesity
and smoking
, both of which are more prevalent in lesbians. Studies show that lesbians have a higher body mass and are generally less concerned about weight issues than heterosexual women, although they are more likely to exercise regularly.
Lack of differentiation between lesbians and heterosexual women in medical studies that concentrate on health issues for women skews results for lesbians and non-lesbian women. Reports are inconclusive about occurrence of breast cancer
in lesbians. It has been determined, however, that the lower rate of lesbians tested by regular pap smears makes it more difficult to detect cervical cancer
at early stages in lesbians. The risk factors for developing ovarian cancer
rates are higher in lesbians than in heterosexual women, perhaps because many lesbians lack protective factors of pregnancy, abortion, contraceptives, breast feeding, and miscarriages.
, substance abuse
, and suicide
. Although these issues exist among lesbians, discussion about their causes shifted after homosexuality was removed from the Diagnostic and Statistical Manual in 1973. Instead, social ostracism, legal discrimination, internalization of negative stereotypes, and limited support structures indicate factors homosexuals face in Western societies that often adversely affect their mental health. Women who identify as lesbian report feeling significantly different and isolated during adolescence; these emotions have been cited as appearing on average at 15 years old in lesbians and 18 years old in women who identify as bisexual. On the whole, women tend to work through developing a self-concept internally, or with other women with whom they are intimate. Females (heterosexual or otherwise) also limit who they divulge their sexual identities to and more often see being lesbian as a choice, as opposed to gay men, who work more externally and see being gay as outside their control.
Anxiety disorder
s and depression
are the most common mental health issues for women. Depression is reported among lesbians at a rate similar to heterosexual women. It is a more significant problem among women who feel they must hide their sexual orientation from friends and family, experience compounded ethnic or religious discrimination, or experience relationship difficulties with no support system. More than half the respondents to a 1994 survey of health issues in lesbians reported they had suicidal thoughts
, and 18% had attempted suicide.
A population-based study completed by the National Alcohol Research Center found that women who identify as lesbian or bisexual are less likely to abstain from alcohol. Lesbians and bisexual women have a higher likelihood of reporting problems with alcohol, as well as not being satisfied with treatment for substance abuse programs. Many lesbian communities are centered in bars, and drinking is an activity that correlates to community participation for lesbians and bisexual women.
s, trichomoniasis
, syphilis
, and Herpes simplex virus
(HSV). Transmission of specific sexually transmitted diseases among women who have sex with women depends on the sexual practices
women engage in. Any object that comes in contact with cervical secretions, vaginal mucosa, or menstrual blood, including fingers or penetrative objects may transmit sexually transmitted diseases. Orogenital contact
may indicate a higher risk of acquiring HSV, even among women who have had no prior sex with men. Bacterial vaginosis
(BV) occurs more often in lesbians, but it is unclear if BV is transmitted by sexual contact; it occurs in celibate as well as sexually active women. BV often occurs in both partners in a lesbian relationship; a recent study of women with BV found that 81% had partners with BV. Lesbians are not included in a category of frequency of Human Immunodeficiency Virus (HIV) transmission, although transmission is possible through vaginal and cervical secretions. The highest rate of transmission of HIV to lesbians is among women who participate in intravenous drug use or have sexual intercourse with bisexual men.
Lesbian
Lesbian is a term most widely used in the English language to describe sexual and romantic desire between females. The word may be used as a noun, to refer to women who identify themselves or who are characterized by others as having the primary attribute of female homosexuality, or as an...
or bisexual. The term is often used in medical literature to describe such women as a group for clinical study, without needing to consider the issues of sexual self-identity.
Physical
In terms of medical issues, the sexual identification of women who consult a medical professional is usually not sought nor volunteered, due to the misconceptions and assumptions about lesbian sexuality and the hesitancy of some women in disclosing their accurate sexual histories even to a physician. Many women who do not participate in heterosexual activity do not go to see a physician because they do not require birth controlBirth control
Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...
, which is the initiating factor for most women to seek consultation with a gynecologist when they become sexually active. As a result, these women are not screened regularly with pap smear
Pap smear
The Papanicolaou test is a screening test used in to detect pre-cancerous and cancerous processes in the endocervical canal of the female reproductive system. Changes can be treated, thus preventing cervical cancer...
s because they have a lower perceived risk of acquiring a sexually transmitted disease
Sexually transmitted disease
Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
or types of cancer. A factor which leads to lesbians neglecting to seek medical screening in the United States is a lack of health insurance offered by employers for same-sex domestic partners.
When women do seek medical attention, medical professionals often fail to take a complete medical history. In a recent study of 2,345 lesbian and bisexual women, only 9.3% had claimed they had ever been asked their sexual orientation by a physician. A third of the respondents believed disclosing their sexual history would result in a negative reaction, and 30% had received a negative reaction from a medical professional after identifying themselves as lesbian or bisexual.
A patient's complete history helps medical professionals identify higher risk areas and corrects assumptions about the personal histories of women. In a similar survey of 6,935 lesbians, 77% had had sexual contact with one or more male partners, and 6% had that contact within the previous year.Another summary of overall surveys found that women who identify as lesbian, 80-95% had previous sexual contact with men, and some report sexual behavior that is risky.(King, p. 221.)
Heart disease
Heart disease
Heart disease, cardiac disease or cardiopathy is an umbrella term for a variety of diseases affecting the heart. , it is the leading cause of death in the United States, England, Canada and Wales, accounting for 25.4% of the total deaths in the United States.-Types:-Coronary heart disease:Coronary...
is listed by the U.S. Department of Health and Human Services as the number one cause of death for all women. Factors that add to risk of heart disease include obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
and smoking
Smoking
Smoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them...
, both of which are more prevalent in lesbians. Studies show that lesbians have a higher body mass and are generally less concerned about weight issues than heterosexual women, although they are more likely to exercise regularly.
Lack of differentiation between lesbians and heterosexual women in medical studies that concentrate on health issues for women skews results for lesbians and non-lesbian women. Reports are inconclusive about occurrence of breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
in lesbians. It has been determined, however, that the lower rate of lesbians tested by regular pap smears makes it more difficult to detect cervical cancer
Cervical cancer
Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. One of the most common symptoms is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer is in its advanced stages...
at early stages in lesbians. The risk factors for developing ovarian cancer
Ovarian cancer
Ovarian cancer is a cancerous growth arising from the ovary. Symptoms are frequently very subtle early on and may include: bloating, pelvic pain, difficulty eating and frequent urination, and are easily confused with other illnesses....
rates are higher in lesbians than in heterosexual women, perhaps because many lesbians lack protective factors of pregnancy, abortion, contraceptives, breast feeding, and miscarriages.
Mental
Since medical literature began to describe homosexuality, it has often been approached from a view that sought to find an inherent psychopathology as the root cause. Much literature on mental health and lesbians centered on their depressionClinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
, substance abuse
Substance abuse
A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...
, and suicide
Suicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
. Although these issues exist among lesbians, discussion about their causes shifted after homosexuality was removed from the Diagnostic and Statistical Manual in 1973. Instead, social ostracism, legal discrimination, internalization of negative stereotypes, and limited support structures indicate factors homosexuals face in Western societies that often adversely affect their mental health. Women who identify as lesbian report feeling significantly different and isolated during adolescence; these emotions have been cited as appearing on average at 15 years old in lesbians and 18 years old in women who identify as bisexual. On the whole, women tend to work through developing a self-concept internally, or with other women with whom they are intimate. Females (heterosexual or otherwise) also limit who they divulge their sexual identities to and more often see being lesbian as a choice, as opposed to gay men, who work more externally and see being gay as outside their control.
Anxiety disorder
Anxiety disorder
Anxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Conditions now considered anxiety disorders only came under the aegis of psychiatry at the end of the 19th century. Gelder, Mayou & Geddes explains that anxiety disorders are...
s and depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
are the most common mental health issues for women. Depression is reported among lesbians at a rate similar to heterosexual women. It is a more significant problem among women who feel they must hide their sexual orientation from friends and family, experience compounded ethnic or religious discrimination, or experience relationship difficulties with no support system. More than half the respondents to a 1994 survey of health issues in lesbians reported they had suicidal thoughts
Suicidal ideation
Suicidal ideation is a common medical term for thoughts about suicide, which may be as detailed as a formulated plan, without the suicidal act itself. Although most people who undergo suicidal ideation do not commit suicide, some go on to make suicide attempts...
, and 18% had attempted suicide.
A population-based study completed by the National Alcohol Research Center found that women who identify as lesbian or bisexual are less likely to abstain from alcohol. Lesbians and bisexual women have a higher likelihood of reporting problems with alcohol, as well as not being satisfied with treatment for substance abuse programs. Many lesbian communities are centered in bars, and drinking is an activity that correlates to community participation for lesbians and bisexual women.
Sexually transmitted diseases
Some sexually transmitted diseases are communicable between women, including Human Papilloma Virus (HPV)—specifically genital warts—squamous intraepithelial lesionSquamous intraepithelial lesion
A squamous intraepithelial lesion is a term that refers to abnormal growth of epithelial cells on the surface of the cervix, commonly called squamous cells. This condition can lead to cervical cancer, but can be diagnosed using a Pap smear or a colposcopy...
s, trichomoniasis
Trichomoniasis
Trichomoniasis, sometimes referred to as "trich", is a common cause of vaginitis. It is a sexually transmitted disease, and is caused by the single-celled protozoan parasite Trichomonas vaginalis producing mechanical stress on host cells and then ingesting cell fragments after cell death...
, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
, and Herpes simplex virus
Herpes simplex virus
Herpes simplex virus 1 and 2 , also known as Human herpes virus 1 and 2 , are two members of the herpes virus family, Herpesviridae, that infect humans. Both HSV-1 and HSV-2 are ubiquitous and contagious...
(HSV). Transmission of specific sexually transmitted diseases among women who have sex with women depends on the sexual practices
Lesbian sexual practices
Lesbian sexual practices are sexual activities where the participants are only women. The participants can be lesbian or bisexual women, though some prefer to refer to themselves as women who have sex with women and dispense with sexual identification...
women engage in. Any object that comes in contact with cervical secretions, vaginal mucosa, or menstrual blood, including fingers or penetrative objects may transmit sexually transmitted diseases. Orogenital contact
Oral sex
Oral sex is sexual activity involving the stimulation of the genitalia of a sex partner by the use of the mouth, tongue, teeth or throat. Cunnilingus refers to oral sex performed on females while fellatio refer to oral sex performed on males. Anilingus refers to oral stimulation of a person's anus...
may indicate a higher risk of acquiring HSV, even among women who have had no prior sex with men. Bacterial vaginosis
Bacterial vaginosis
Bacterial vaginosis or less commonly vaginal bacteriosis is a disease of the vagina caused by bacteria. The U.S. Centers for Disease Control and Prevention states it is not clear what role sexual activity plays in the development. However, it is known that BV is associated with having a new sex...
(BV) occurs more often in lesbians, but it is unclear if BV is transmitted by sexual contact; it occurs in celibate as well as sexually active women. BV often occurs in both partners in a lesbian relationship; a recent study of women with BV found that 81% had partners with BV. Lesbians are not included in a category of frequency of Human Immunodeficiency Virus (HIV) transmission, although transmission is possible through vaginal and cervical secretions. The highest rate of transmission of HIV to lesbians is among women who participate in intravenous drug use or have sexual intercourse with bisexual men.
See also
- Biology and sexual orientationBiology and sexual orientationBiology and sexual orientation is the subject of research into the role of biology in the development of human sexual orientation. No simple, single cause for sexual orientation has been conclusively demonstrated, but research suggests that it is by a combination of genetic, hormonal, and...
- Lesbian sexual practicesLesbian sexual practicesLesbian sexual practices are sexual activities where the participants are only women. The participants can be lesbian or bisexual women, though some prefer to refer to themselves as women who have sex with women and dispense with sexual identification...
- Men who have sex with menMen who have sex with menMen who have sex with men are male persons who engage in sexual activity with members of the same sex, regardless of how they identify themselves; many men choose not to accept sexual identities of homosexual or bisexual...
- Same-sex relationshipSame-sex relationshipA same-sex relationship is a relationship between two persons of the same sex and can take many forms, from romantic and sexual, to non-romantic close relationships. The term is mainly associated with gay and lesbian people...
s - Terminology of homosexualityTerminology of homosexualityThe terminology of homosexuality has been a contentious issue since the emergence of LGBT social movements in the mid-19th century. As with racial terms within the United States—such as negro, black, colored, and African American—the choice of terms regarding sexual orientation may imply a certain...