Lesbians & Breast Cancer (con't.)

Barriers to Early Detection
In addition, barriers to breast cancer detection, including not seeing a doctor on a regular basis, evidently occur more often in lesbians. Lesbians report receiving fewer mammograms and clinical breast exams, and we are less likely to perform regular breast self-exam than recommended by current guidelines. Cochran’s study found that lesbians and bisexual women were less likely than straight women to have had a recent pelvic examination or mammogram.

The Susan G. Komen Foundation notes that for many (heterosexual) women, reproductive health issues are a primary link to the health care system. Even when seeing a doctor about reproductive health, other health issues are often addressed, including having clinical breast exams or mammograms. Because fewer lesbians seek routine health care related to reproductive health, they may have fewer opportunities to have important tests for early detection of breast cancer.

Financial Barriers
Additional barriers to early detection for women who partner with women may include the cost of health care and lack of health insurance. A Minnesota branch of the American Cancer Society, which has a specific lesbian outreach component, notes that women overall earn less money than men and are less able to afford regular medical care—and lesbians may be affected more directly by women’s lower earning power.

In addition, many heterosexual women benefit from a spouse’s health insurance coverage—a benefit that most women who partner with women may not have. Cochran’s study found that lesbians and bisexual women were less likely than straight women to have health insurance coverage. The study concluded:

Despite the extensive public health efforts in the United States promoting weight loss, smoking cessation, reduced alcohol consumption, and use of preventive screening, lesbians and bisexual women, an apparently logical target group given our findings here, have not been a particular focus of public health interventions. Developing effective methods to reach these women raises issues in regard to providing a health care environment in which lesbians and bisexual women are comfortable seeking care and revealing their sexual orientation. At present, many of these women are not. Instead, research has repeatedly documented that lesbians report frequent negative encounters in health care settings, including inappropriate interventions, hostility from providers, and violation of confidentiality.

Summary
Although we still lack conclusive research findings about the relative breast cancer risks of lesbians or straight women, educating ourselves and our communities about breast cancer screening and early detection is nonetheless critical. Every woman—gay, straight, bisexual, or transgender—needs to look out for her own health.
When cancer is detected at an early stage, it can very often be treated successfully. Therefore, it is critical that you find a health care provider you are comfortable with and see her or him on a regular basis. Examine your breasts yourself each month and, if you are in a relationship, encourage your partner to do the same (see page 67 for breast self-exam information). If you are over 40, get a clincal breast exam and a mammogram every year. Programs such as the Cancer Detection Programs—Every Woman Counts! will pay for an annual mammogram and clinical breast exam for women who are uninsured or underinsured (see page 65 for more information).

Lesbians have long been ignored in breast cancer outreach and research. This is finally changing, and we may someday have conclusive study results about breast cancer and our community. In the meantime, it is up to us to take control of our own breast health.

Resources

Cochran, Susan D., PhD, MS, et al. “Cancer-Related Risk Indicators and Preventive Screening Behaviors Among Lesbians and Bisexual Women.” American Journal of Public Health, 2001; 91:591-597).

Dotinga, Randy, “Study sheds light on lesbians’ cancer risk,” Gay.com/Planet Out.com Network, May 2, 2002.

Lynch, Margaret A, MSN, FNP, and Richard S. Ferri, PhD, ANP, ACRN. “Health Needs of Lesbian Women and Gay Men: Providing Quality Care.” Clinician Reviews, Vol 7, No 1, January 1997.

Torassa, Ulysses. “Higher breast cancer risk for lesbians not borne out, study finds,” San Francisco Chronicle, April 8, 2002.

UCSF Lesbian Health Research Center, www.lesbianhealthinfo.org