Lesbian Health Current Assessment and Directions for the Future (1999) / Chapter Skim
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1 Introduction
1 Introduction
Pages 17-34
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From page 17... ...
STUDY PROCESS AND REPORT ORC;ANIZATION The Institute of Medicine (IOM) Committee on Lesbian Health Research Priorities was established in 1997 to assess the strength of the science base regarding the health problems of lesbians (i.e., women who have sex or primary emotional partnerships with women)
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As part of the workshop study the committee conducted an invitational workshop on the physical and mental health concerns of lesbians and the methodological issues involved in conducting research in these areas. At the workshop, information was presented to the committee on the strength of the science base, methodological challenges in conducting research on lesbian health, and gaps in what is known about specific health problems for which lesbians may be at risk.
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, to collect extensive data for analysis, to conduct detailed analyses of specific studies, or to set specific research priorities within fields of study. Nonetheless, the committee was able to conduct a broad workshop and literature review of the field and to assess the general state of knowledge across a wide range of issues for lesbian health.
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Chapter 2 provides several frameworks for thinking about lesbian health: lesbians in the context of the greater society, women in general, and the health care system; lesbian health across the life span; and lesbian health with respect to specific health problems. The chapter reviews what is currently known about lesbian health, discusses the limitations of the existing literature base, and suggests health issues that should be targeted for additional research.
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They include, for example, perceptions that lesbians do not need regular Pap tests or routine gynecological care, that lesbians do not contract HIV/AIDS, and that there is an epidemic of breast cancer in the lesbian community (Council of Scientific Affairs, 1996~. · To identify health areas in which lesbians are at risk or tend to be at greater risk than heterosexual women or women in general.
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. Most of the literature reviewed by the committee was about lesbians, although it is likely that bisexual women, or even heterosexual women, have been included in some of the research samples.
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In particular, it should not be assumed that racial and ethnic minority cultures share views of lesbian sexual orientation identical with the dominant culture. Numerous factors influence views of homosexuality among racial and ethnic minority cultures, including traditional views of family, the predominant religions within the culture, and traditional gender roles.
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For example, African-American cultures typically have a strong religious and spiritual orientation that sometimes reinforces homophobic attitudes Gavin-Williams, 1996~. At the same time, traditionally strong family ties can make it less likely that a family member will be rejected because of sexual orientation, even if the family does not approve of one being lesbian Gavin-Williams, 1996~.
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Religious influences, primarily Catholicism, are likewise strong in Latino cultures. Historically, Native American cultures appear to have been relatively accepting of varied gender roles, including a lesbian sexual orientation, although contemporary attitudes, which are more influenced by the larger multicultural American culture, may be less accepting (Greene, 1994~.
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In this sample, 3.8% of the women reported having had at least one same-sex sexual partner since puberty, 4.3% indicated that they had engaged in specific sexual activities with another woman, 7.5% reported that they currently experienced desire for a female sexual partner, and 1.4% identified themselves as homosexual or bisexual (Laumann et al., 1994~.4 Variations in the way sexual orientation dimensions interact are also illustrated in Figure 1.1. Of the women in the survey who reported some aspect of same-sex orientation, 58.7% reported that although they found sex with another woman to be desirable, they had never had a female sexual partner and did not identify themselves as homosexual or bisexual.
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From page 27... ...
These data are useful for this purpose because the study used probability sampling methods, included women from throughout the country, and included enough women in the sample (n = 1,719) to support a minimal level of analysis.6 For the purpose of this illustrative analysis, sexual identity was categorized as homosexual, bisexual, or heterosexual, and desire or attraction was measured by the reported appeal of same-sex behavior from not appealing to very appealing.7 As seen later in this report, there are many measuring behavior would include number of lifetime female partners or percentage of sexual events in a given time period that were with same-sex partners.
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ct a' a' 1 a' ct o Go o · - ~ of a' · - ~ no o · so · - ~ be o a' a' o o ct · - ~ by ad · - ~ ct lo a' O ~t a., a' be a' · - ~ · o _ a' ad 4= o .
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(1994~. ways in which researchers have measured same-sex behavior, usually assessing the gender of sexual partners during a certain period of time (e.g., never, ever, since age 18, during past five years)
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attraction, the committee used a measure of history of cohabitation with a same-sex partner to assess lesbian sexual behavior from no same-sex part ners to cohabitation with a same-sex partner. Among a total of 1,719 women represented in Table 1.3,8 1,699 (98.8%)
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All self-identified lesbians reported that they had had a female sexual partner and that they found sex with females to be very appealing; most (81.8%, or 9 of 11) had cohabited with a female sexual partner.
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For a researcher designing a study on lesbian health, the recommended course is to develop measures that gather information about the aspects of lesbian orientation that are relevant to the specific project at hand (see Chapter 3~. Adopting this approach does not avoid the issue of lesbian definition.
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From page 34... ...
1996. Gender roles among Latino gay and bisexual men: Implications for family and couple relationships.
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