1. Providing Health Care to Lesbians: Myths & Realities
Kathleen Stine, MSN, ARNP
Director of Clinician Services
Planned Parenthood of Western Washington

2. Introduction Why is this important? Sources of current information
What puts lesbians at risk?
February 2007
Kathleen Stine

3. What You’ll Learn Barriers to care Research Issues
Assessment & screening skills
How to tell when someone’s gay
February 2007
Kathleen Stine

4. Gay Man??
February 2007
Kathleen Stine

5. Yikes! More Out of the Closet!
February 2007
Kathleen Stine

6. …And the impact of TV…Yes, it helps change minds
February 2007
Kathleen Stine

7. The power of a story…& a Star
February 2007
Kathleen Stine

8. Minority Health Summary: The System Starts Out Skewed
Background
Minority Health Summary:
The System Starts Out Skewed

9. 1996 U.S. Death Rates for Leading Causes of Death Age Adjusted per 100,000 population,
for Blacks and Whites
All Causes
1. Heart Disease
2. Cancer
3. Stroke
4. Pulmonary Disease
5. Injuries
6. Flu and Pneumonia
7. Diabetes
8. HIV/AIDS
9. Suicide
Liver Cirrhosis
Causes White Black Ratio
Source: NCHS 1998
Black/White
10.
February 2007
Kathleen Stine

10. 1996 U.S. Death Rates for Leading
Causes of Death Age Adjusted per 100,000 population, for Latinos and Whites
All Causes
1. Heart Disease
2. Cancer
3. Stroke
4. Pulmonary Disease
5. Injuries
6. Flu and Pneumonia
7. Diabetes
8. HIV/AIDS
9. Suicide
Liver Cirrhosis
Latino/White
10.
Source: NCHS 1998
Causes White Latino Ratio
February 2007
Kathleen Stine

11. API/White Causes White API Ratio
1996 U.S. Death Rates for Leading Causes of Death Age Adjusted per 100,000 population, for Asian Pacific Islanders (API) and Whites
API/White
Causes White API Ratio
All Causes
1. Heart Disease
2. Cancer
3. Stroke
4. Pulmonary Disease
5. Injuries
6. Flu and Pneumonia
7. Diabetes
8. HIV/AIDS
9. Suicide
Liver Cirrhosis
10.
Source: NCHS 1998
February 2007
Kathleen Stine

12. Minority Health – Lesbian Couples
Journal of Epidemiology & Community Health Mar;60(3): What same sex civil partnerships may mean for health. King & Bartlett
Legal and social recognition of same sex relationships may reduce discrimination, increase the stability of same sex relationships, and lead to better physical and mental health for gay and lesbian people.
February 2007
Kathleen Stine

13. Definitions
February 2007
Kathleen Stine

14. …and Percentages
February 2007
Kathleen Stine

15. Barriers to Access
Invisibility: underreporting likely because of stigma of homosexuality
Myths and misinformation: despite paucity of research, many assumptions are made
Traditional health care not holistic
February 2007
Kathleen Stine

16. Barriers to Access Homophobia: Research Special issues for youth
patients
GLBT providers
GLAMA Study
BMJ ’04 Study: How does being gay affect your work?
Research
Special issues for youth
February 2007
Kathleen Stine

17. Provider Attitudes Sources:
National Lesbian Health Survey
Michigan Lesbian Health Survey
Impacts not only the sensitivity of care but the completeness of care
Provider & staff trainings appear to affect quality of care to sexual minority women
Newer research shows only slight improvements, espec amongst adherents of traditional gender roles
February 2007
Kathleen Stine

18. The Lesbian Family
Access to fertility treatment by gays, lesbians, and unmarried persons.
Statement by Ethics Committee of the American Society for Reproductive Medicine
Ethical arguments supporting denial of access to fertility services on the basis of marital status or sexual orientation cannot be justified.
February 2007
Kathleen Stine

19. Issues in Research Defining Lesbian IOM Report Politics Funding
Publishing
February 2007
Kathleen Stine

20. NIH Scientific Workshop on Lesbian Health s/p IOM Report
Workgroup Recommendations
All aspects of lesbian health
Research careers
Homophobia, lesbian life
Healthy People 2010
February 2007
Kathleen Stine

21. Why Does It Matter?
February 2007
Kathleen Stine

22. Health Risks for Lesbians
Cancers
Lung
Breast: Nurses’ Study II: nulliparity, ETOH intake
Cervical
Ovarian and endometrial
February 2007
Kathleen Stine

23. STDs: Yes they get them too!
Viral:
HSV
HPV
HIV
Other:
Syphilis
GC/CT
BV – a WSW STD?
February 2007
Kathleen Stine

24. Other Health Risks: from Nurses’ Health Study II, 2004
Cardiovascular Diseases: higher BMI, smoking
Disordered Substance Uses: higher daily ETOH intake
Psychosocial and Mental Health: higher reported depression & use of antidepressants
February 2007
Kathleen Stine

25. Preventive Health for Lesbians
Accessing the system: becoming a culturally competent provider
Nutrition & exercise
Smoking cessation & alcohol moderation
Stress management
February 2007
Kathleen Stine

26. Changes You Can Make Now
Antidiscrimination Statement
Inclusive or neutral wall art
Variety of magazines
Husbands aren’t the only spouse
Health Education Brochures
February 2007
Kathleen Stine

27. An Example
February 2007
Kathleen Stine

28. Summary WSW require culturally competent providers
More research is needed to determine the health risks of lesbians
Preventive health education (especially homophobia coping skills) is critical
February 2007
Kathleen Stine