Research has shown that the following are some of the most common health concerns faced by lesbian and bisexual women. While they may not all apply to everyone, they are important concerns for lesbian and bisexual women and their health care providers to be aware of.

Breast Exams

Lesbian and bisexual women have a greater risk of developing breast cancer than heterosexual women, but they are less likely to obtain regular cancer screenings, like mammograms, which are used to diagnose the condition in its early stages. This is very problematic because early detection is key to the treatment of the disease and increases the woman’s chances of remission.

Intimate Partner Violence

While people may not associate same-sex relationships with intimate partner violence, the statistics show that it is a major concern for lesbian and bisexual women. The National Coalition Against Domestic Violence reports that compared to 35 percent of heterosexual women, 43.8 percent of lesbian women and 61.1 percent of bisexual women have experienced rape, physical violence and/or stalking by an intimate partner. Compounding this problem are barriers accessing support services, lack of training on the part of the service providers and discrimination in shelters.

Substance Use Disorder

On average, lesbian and bisexual women drink more than heterosexual women and have a higher occurrence of alcohol-related problems. Research has also discovered higher rates of smoking, cocaine and marijuana use among lesbian and bisexual women than heterosexual women. The use of these substances is linked to multiple forms of cancer and conditions of the heart and lungs, which are the top three causes of death among women.

Like some of the other health concerns common among lesbian and bisexual women, rates of substance use disorder may be tied to stress resulting from discrimination, homophobia and sexism.

Obesity

Lesbian and bisexual women suffer from higher rates of obesity than heterosexual women. Obesity is linked to other conditions, like heart disease and cancer, which are among the leading causes of death for women.

Regular activity and a healthy diet can lower a person’s chances of obesity, but women should always talk with their health care providers before jumping into an exercise routine or making extreme changes to their diet.

Sexual Health

Because of heteronormativity — the notion that heterosexuality is the norm — some health care providers may assume lesbian and bisexual women are heterosexual when discussing their sexual health. It may also be assumed that a woman in a current same-sex relationship has never or will never have sex with a man. Because of these and other stereotypes, it is important that providers not make assumptions about their patients’ identities and behaviors, and that lesbian and bisexual women be open and honest with their providers about their identity — whether their provider asks them or not — so they receive the adequate, comprehensive care they need. This is especially essential when discussing sexual behavior, practices and partners.

For health care providers not as knowledgeable about LGBT health, lesbian and bisexual women’s health concerns may go under the radar due to the perception that women in same-sex relationships have lower cases of sexually transmitted infections (STIs). But lesbian and bisexual women’s sexual health encompasses a number of issues, and these women deserve and need the same level of education and screenings around sexual health as heterosexual women.

Pap Tests

Lesbian and bisexual women have an increased risk of developing certain gynecologic cancers, but at the same time, they are less likely to receive regular gynecological health care, including pelvic exams and Pap tests. It is important for lesbian and bisexual women to obtain these exams and procedures on a regular basis because they are used to diagnose cancers and other gynecological conditions early, when they have the highest treatment success rates.

HPV

HPV has the potential to develop into cervical, vulvar, vaginal, anal or oral cancer. And while HPV is more common among women who have sex with men, a majority of women who identify as lesbian have had previous sexual relationships with men and are still able to spread HPV by same-sex, skin-on-skin contact. As previously stated, the false idea that same-sex female relationships cannot spread STIs, linked with the fact that lesbian and bisexual women are less likely to receive regularly gynecological screenings, means HPV may go undiagnosed in lesbian and bisexual women and develop into a more life-threatening condition.

Contraception

While this may be surprising to some, lesbian and bisexual women have higher rates of teen pregnancy than heterosexual women. Women who identify as lesbian or bisexual may also still have sex with men and should be aware of the types of contraception available to them.

Pregnancy and Fertility

Many lesbian and bisexual women in same-sex relationships aspire to have children. It’s important for them to find a provider or center that understands their specific needs and offers services in a caring and compassionate environment for their family. Today, there are many options available for women in same-sex couples to get pregnant, including:

• Donor insemination through intrauterine insemination (donor sperm are introduced to the uterus using a small tube)

• In vitro fertilization (an egg is fertilized outside of the body using donor sperm then implanted in the woman’s uterus)

• Egg donation (one partner may donate her egg while the other partner carries the child)

• Embryo donation (a fertilized embryo may be donated to the couple)