DEVELOPMENT AND HEALTH-CARE NEEDS OF LESBIANS

Lesbians have complained about the lack of awareness and sensitivity o f their health care providers, resulting in unnecessary examinations a nd inappropriate focus on reproductive issues. This study attempted to identify psychosocial and health care needs of lesbians, to assess re lationships with primary care providers and disclosure of sexual orien tation, and to describe the chronologic features of a sexual identity and lifestyle. An anonymous, self-administered, written questionnaire was distributed through a campus lesbian organization. Fifty-three wom en (median age 23 years) completed the questionnaire. Whereas 60% had disclosed their sexual orientation to their parents, only 31% had ''co me out'' to their health care provider. Of participants who had disclo sed their sexual preference to a provider, 27% reported a negative eff ect on their health care, 57% of participants who never had penile int ercourse had annual Papanicolaou smears, and 16% felt pressured in the past to accept birth control from a physician. Lesbian sexuality was associated with several risk factors, such as childhood abuse (20%), a lcohol or drug problems (39%), suicide attempts (27%), depression (49% ), and physical or verbal abuse at school (34%). Average age of awaren ess of sexual orientation was 15 years, and average age of first homos exual activity was 17 years. Lesbians are at risk for depression, subs tance abuse, and suicide attempts. Although most would like to confide in their physician, few do because of fears of negative reactions. Co mmunication must be improved to better address their specific health c are needs.