Lesbian Health Booklet OnLine

Brought to you by UWSP Gay-Straight Alliance and Student Health Services

Topics: Introduction | Coming Out | Lesbian Health Issues | Heterosexism & Homophobia | Sexual Health | Sexually Transmitted Infections | Preventing STIs | Ch-ch-ch-changes | STI Screening and Other HealthCare | Resources | About This Booklet

Introduction

College years are a time for exploring, not only education and career possibilities, but also yourself and who you want to be in this world. One way to discover how different possibilities fit is by trying them out, and students use this self-discovery strategy with many things—a course of study, political philosophies, and even more intimate issues such as sexuality. Some women know before they come to college that they’re lesbians; others think they might be but aren’t sure; others are bisexual; still others are certain they’re heterosexual.

How do you know if you’re a lesbian? A lesbian is a woman whose primary emotional, affectional, and sexual attractions and relationships are with other women. This internal drive toward other women, as well as acting on that drive, is what distinguishes lesbians from other women. Can you still be a lesbian if you’re single or have never been in a relationship? Of course, because being a lesbian is about your identity and attractions, not just about your current relationship status.

The term lesbian has been used in Western cultures to describe women-loving-women since the early 1600s. It comes from the Greek Island of Lesbos, where the poet Sappho led a school for women and girls from 610-580 B.C.E. Different languages use other descriptive terms, such as the German mädchen Schmelker (girl taste), the Italian Donna con Donna (woman with woman), the Klamath tribe’s sawa linaa (to live as partners), and the Chinese term for lesbian couples, dui shi (paired eating).

Some lesbians they they’ve known that they were “a little queer” since they were five years old; some discover their attraction for other girls during puberty; still others come out after being involved with men and/or having children. In a culture where heterosexuality is presented overwhelmingly as the norm, and healthy representations of lesbians remain uncommon, it’s easy to understand how even a basic human drive like one’s sexual identity can become muddled.

College seems an especially opportune time for women to come out, perhaps because of new opportunities to meet other women who are out or because of being away from home for the first time. Some college-aged women express their sexuality in fluid terms that feel right to them, claiming the title lesbian one week, perhaps bisexual another week, and perhaps straight another week. This type of fluidity in a person’s sexuality is not necessarily problematic, but may cause stress to the individual or those surrounding her.

There is no right or wrong way to be a lesbian. Limited depictions of lesbians in popular culture lead some women to think that lesbians only dress or act a certain way. But lesbians are everywhere, in all races, cultures, economic classes, religions, political persuasions, and geographic regions of the world. Different surveys have found that 4% to 17% of women in the United States identify as lesbians. Applying these results to UW-Stevens Point, there may be 340 to 1,445 lesbian students enrolled.

Coming Out

Coming out of the closet, our revealing one’s sexuality to others, is a process, not a single act. It involves personally accepting and being open with others about your sexual orientation, as well as challenging internalized and societal heterosexism. Negative cultural attitudes about lesbians and gay men cause many people to fear and dismiss their own attraction for others of the same sex. This internalized homophobia or heterosexism can cause problems such as difficulty creating intimacy and becoming involved in frustrating relationships with those of another sex.

Some lesbians prefer to stay closeted all the time, while others prefer to be out all the time. Some alternate between being out and closeted, depending on the circumstances. If you decide to be out, coming out to others is a decision you’ll make repeatedly throughout your life. The only one who can determine if a certain situation or person is safe for you to share this part of your life is you.

Consider it this way: If you decide to be out, you may experience anxieties associated with being out. If you decide to stay closeted, you may experience anxieties associated with being closeted. Either way, you’ll deal with something.

Lesbian Health Issues

Lesbians have all the same health issues as other women, including the need for regular pelvic examinations, pap smears, and breast exams. Many lesbians believe that they have little or no risk of cervical cancer if they’ve had few or no male sex partners, but any advantage lesbians derive from minimal sex with men can be completely offset by other factors such as smoking cigarettes or family health history. A comprehensive, candid discussion with your primary health care provider can offer a true assessment of your risks.

Lesbians have some additional health care issues simply because they’re lesbians, such as whether or not to come out to a health care provider. In this context, it’s as important to talk about behaviors as identity. Caregivers need to know if you have sex with women only, men only, or both, because this information guides their recommendations to you. If you say you’re a lesbian, health care providers will likely conclude that you only have sex with women and will treat you accordingly.

Some health care clinics have worked to make their services culturally competent for lesbians. In such clinics, you can expect to be asked (either on forms or by a caregiver) whether you’re single or partnered—rather than single, married, widowed or divorced—and if you need birth control, rather than caregivers assuming that you must need birth control if you’re sexually active.

Student Health Services strives to create a welcoming and inclusive environment for all, with hopes that our health care providers offer services in a way that encourages you to be open about who you are and the precise nature of your health care concerns. If they should fall short of this goal, please let them know so that they can improve their services: (715) 346-4646.

Heterosexism & Homophobia

Heterosexism and what some call homophobia are two critical stressors on the mental health of lesbians, gay men, bisexuals, and transgender (LGBT) people. Psychologist George Weinberg coined the term homophobia in the late 1960s to describe the dread that some heterosexuals experience when they are in the presence of lesbians and gay men, as well as the low self-esteem that many lesbians and gay men experience because of the atmosphere created by this. Around the same time, the term heterosexism was created to describe the institutionalized beliefs and attitudes that heterosexuals are normal and natural and that lesbians and gay men are, by contrast, deviant and unnatural.

Heterosexist institutions are those that have been created for heterosexuals and are based on the assumption that everyone is heterosexual, or at the very least that lesbians and gay men should hide their identity and pretend to be heterosexual. These institutions posit that heterosexuals are inherently superior to homosexuals, which is used to justify discrimination against lesbians and gay men since only heterosexuality is considered right, good, or legitimate.

Living in a homophobic, heterosexist society, even in a more tolerant college campus atmosphere, can cause stress. While hate-based physical attacks on lesbians are probably less common than attacks on gay men, the denial of equal rights for lesbians and the invisibility or dismissal of lesbian relationships by the larger society happen every day. This can result in mental health issues such as low self-esteem, difficulty creating lasting intimate relationships, self-medicating with drugs or alcohol, and other stress-related problems.

LGBT people experience sexual assault and other forms of abuse—emotional and physical—from acquaintances, strangers, or even their partners, just as heterosexual women and men do. However, LGBT people may have more barriers to seeking supportive services, especially if they are closeted. Lesbian and lesbian-friendly counselors are available at the Student Health Services, (715)346-4646, and the Sexual Assault Victims Services, (715)343-7114. Support and information is also available at the Women’s Resource Center, located in office 30C, Lower-Level University Center or by calling (715)346-4851.

There are many positive ways to deal with these stressors, such as seeking support from family and close friends, working for equal rights, or finding a lesbian community. The list of resources at the back of this booklet may be helpful.

Perhaps in part because of the long-standing role that bars have played in lesbian and gay cultures as “safe” places to meet and because of the stress caused by living in a heterosexist society, some studies have found that LGBT people have higher-than-average rates of substance abuse (including alcohol, recreational drugs, and cigarettes). On the other hand, two recent large-scale studies of lesbians, using their biological sisters as a control group, found that lesbians are as likely as their sisters to report being mentally healthy and report higher self-esteem, especially if they are out of the closet. (E.D. Rothblum and R. Factor. 2001. Lesbians and their sisters as a control group: Demographic and mental health factors. Psychological Science 12:63-69.)

Sexual Health

We are sexual beings throughout the course of our lives, and our sexual health can change over time as we learn more about and become more comfortable with ourselves. Many factors contribute to a person’s sexual health, such as our comfort level with our sexuality, intimacy, sexual pleasure, and ability to negotiate sexuality issues with a partner.

Sexual health often begins with knowing your own body, how your body works, and what feels good to you. Masturbating is a great way to learn about your sexual self. Feeling comfortable with your body and your sexuality can help you open up to sexual pleasure and intimacy with another and negotiate your desires with a partner. When partners are of the same sex, it’s not uncommon for one or both to think that the other will naturally know what’s pleasurable and what’s not, because each has the same basic anatomy. But each woman is an individual, and different women find pleasure in many different ways.

Some people say that the most important sex organ is the brain, because our minds help us communicate desire and desirability, create a safe emotional space for developing intimacy, and negotiate our sexual desires with another, all of which are key to sexual health.

Sexually Transmitted Infections (STIs)

The general risk of woman-to-woman transmission of most sexually transmitted inflections (STIs) is low. However, some STIs are more easily transmitted than others, including herpes and the Human Papillomavirus (HPV).

Herpes
The virus most commonly associated with oral herpes (Herpes Simplex Type I) can be transmitted to a partner’s genitals if you have oral-genital sex when one partner is infected and the receiving partner doesn’t use a barrier (such as a condom, dental dam, or household plastic wrap). It’s unlikely that the virus most commonly associated with genital herpes (Herpes Simplex Type II) will be transmitted to a partner’s mouth. People with either a Herpes Simplex Type I or Type II infection in the genital area can infect a partner through skin-to-skin genital contact, although latex/plastic-wrap barriers can help protect against virus transmission. Herpes viruses can be transmitted whether or not there is a visible outbreak, although the virus is most contagious when a visible sore is present.

HPV
Genital HPV infection is a sexually transmitted disease (STD) that is caused by human papillomavirus (HPV). Human papillomavirus is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Most people who become infected with HPV will not have any symptoms and will clear the infection on their own.

Some of these viruses are called "high-risk" types, and may cause abnormal Pap tests. They may also lead to cancer of the cervix, vulva, vagina, anus, or penis. Others are called "low-risk" types, and they may cause mild Pap test abnormalities or genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped. (Source: http://www.cdc.gov/std/HPV/STDFact-HPV.htm.)


Other Infections
Most STIs, including gonorrhea and Chlamydia, are more common among lesbians if one partner has had sex with a man. Women who have contracted HIV or other infections from sex with men or from injectable drug use can pass the infection to other women, especially if they take part in higher risk sexual activities. The cervix is still developing in women ages 15 to 24, which increases the risk of transmission of Chlamydia at these ages. Other common vaginal infections, such as bacterial vaginosis (not an STI), can be spread through woman-to-woman sexual contact.

Preventing STIs

The best way to reduce the risk of contracting or transmitting HIV and other STIs is to keep your partner’s body fluids out of your body and avoid passing your body fluids on to her.

• Your partner’s blood (including menstrual blood), vaginal fluids, breast milk, and semen (from a male partner) are the critical fluids to keep out of your vagina, anus, mouth, or away from any area where you have hangnails, cuts, or other breaks in your skin, no matter how small.
• Using barrier methods such as dental dams, latex gloves, or household plastic wrap during sexual activity can help prevent STIs.
• Sex toys should be cleaned thoroughly between uses with warm, soapy water. If you share sex toys, cover the insertive part of the toy with a latex/plastic-wrap barrier, and use a fresh barrier every time a different person uses the toy or when the toy is moved between orifices.
• Consensual BDSM (bondage and discipline, sadism and masochism) activities are safe if there is no blood involved. If you pierce each other, clean the needle with bleach between users. If you shave each other, use different razors. Never let the urine or feces of another person get inside your body or in through your skin in any way.
• Trying to get pregnant can pose some risks. If you have sex with a man or use sperm donated from an individual, make sure he tests HIV negative at least three months after his last possible risk of contracting HIV. (Licensed sperm banks test their donors carefully.)