Editing Lesbian (section)

==Health==
===Physical===
In terms of medical issues, lesbians are referred to as [[women who have sex with women]] (WSW) because of the misconceptions and assumptions about women's sexuality and some women's hesitancy to disclose their accurate sexual histories even to a physician.<ref name="King2008">Holmes, King, Sparling, P., ''et al.'', eds. (2008). ''Sexually Transmitted Diseases'', McGraw-Hill Medical. {{ISBN|0-07-141748-6}}. pp. 219, 221, 226, 229.</ref> Many self-identified lesbians neglect to see a physician because they do not participate in heterosexual activity and require no [[birth control]], which is the initiating factor for most women to seek consultation with a [[gynecologist]] when they become sexually active.<ref name="Rosser2000">{{cite encyclopedia |last=Rosser |first=Sue V. |title=Health |pages=359–362 |editor-last=Zimmerman |editor-first=Bonnie |editor-link=Bonnie Zimmerman |encyclopedia=Encyclopedia of Lesbian Histories and Cultures |date=2000 |edition=1st |publisher=[[Garland Publishing]] |location=New York |isbn=9780203825532 |url=https://archive.org/details/encyclopediaofle00bzim/page/359/mode/2up |url-access=registration}}</ref>{{rp|p=359}} As a result, many lesbians are not screened regularly with [[Pap smear]]s. The U.S. government reports that some lesbians neglect seeking medical screening in the U.S.; they lack health insurance because many employers do not offer health benefits to domestic partners.<ref name="HHS">{{cite web |url=http://womenshealth.gov/faq/lesbian-health.cfm |title=Frequently Asked Questions: Lesbian Health |archive-url=https://web.archive.org/web/20090129175054/http://www.womenshealth.gov/faq/lesbian-health.cfm |archive-date=29 January 2009 |website=womenshealth.gov |publisher=[[U.S. Department of Health and Human Services]] |access-date=12 January 2009}}</ref>

The result of the lack of medical information on WSW is that medical professionals and some lesbians perceive lesbians as having lower risks of acquiring [[sexually transmitted infection]]s or types of cancer. When women do seek medical attention, medical professionals often fail to take a complete medical history. In a 2006 study of 2,345 lesbian and bisexual women, only 9.3% had claimed they had ever been asked their sexual orientation by a physician. A third of the respondents believed disclosing their sexual history would result in a negative reaction, and 30% had received a negative reaction from a medical professional after identifying themselves as lesbian or bisexual.<ref name="mravack">{{cite journal|last1=Mravack|first1= Sally A.|date=July 2006|title=Primary Care for Lesbians and Bisexual Women|journal=American Family Physician|volume=74|issue=2|pages=279–286|pmid= 16883925}}</ref> A patient's complete history helps medical professionals identify higher risk areas and corrects assumptions about the personal histories of women. In a similar survey of 6,935 lesbians, 77% had had sexual contact with one or more male partners, and 6% had that contact within the previous year.<ref name="mravack" />{{efn|Another summary of overall surveys found that women who identify as lesbian, 80–95% had previous sexual contact with men, and some report sexual behavior that was risky.<ref name="King2008"/>}}

[[Heart disease]] is listed by the [[U.S. Department of Health and Human Services]] as the number one cause of death for all women. Factors that add to risk of heart disease include [[obesity]] and [[smoking]], both of which are more prevalent among lesbians. Studies show that lesbians have a higher [[body mass]] and are generally less concerned about weight issues than heterosexual women; and lesbians consider women with higher body masses to be more attractive than heterosexual women do. Lesbians are more likely to exercise regularly than heterosexual women, and lesbians do not generally exercise for aesthetic reasons, although heterosexual women do.<ref name="haines" /> Research is needed to determine specific causes of obesity in lesbians.<ref name="HHS" /><ref name="mravack" />

Lack of differentiation between homosexual and heterosexual women in medical studies that concentrate on health issues for women skews results for lesbians and non-lesbian women. Reports are inconclusive about occurrence of [[breast cancer]] in lesbians.<ref name="mravack" /> It has been determined that the lower rate of lesbians tested by regular Pap smears makes it more difficult to detect [[cervical cancer]] at early stages in lesbians. The risk factors for developing [[ovarian cancer]] rates are higher in lesbians than heterosexual women, perhaps because many lesbians lack protective factors of pregnancy, abortion, contraceptives, breast feeding, and miscarriages.<ref>{{cite journal |last1=Vo |first1=Christine |last2=Carney |first2=Michael E. |title=Ovarian Cancer Hormonal and Environmental Risk Effect |journal=Obstetrics and Gynecology Clinics of North America |date=2007 |volume=34 |issue=4 |pages=687–700 |doi=10.1016/j.ogc.2007.09.008|pmid=18061864 }}</ref>

Some sexually transmitted infections are communicable between women, including [[human papillomavirus]] (HPV)—specifically [[genital warts]]—[[squamous intraepithelial lesion]]s, [[trichomoniasis]], [[syphilis]], and [[herpes simplex virus]] (HSV). Transmission of specific sexually transmitted infections among women who have sex with women depends on the [[lesbian sexual practices|sexual practices]] women engage in. Any object that comes in contact with cervical secretions, vaginal mucosa, or menstrual blood, including fingers or penetrative objects may transmit sexually transmitted infections.<ref>[https://www.cdc.gov/std/treatment/2006/specialpops.htm#specialpops5 Women Who Have Sex with Women (WSW)], [[Centers for Disease Control]], 2006 (MMWR August 4, 2006 / Vol. 55 / No. RR—11). Retrieved on January 9, 2009. {{webarchive |url=https://web.archive.org/web/20140308215921/http://www.cdc.gov/std/treatment/2006/specialpops.htm#specialpops5 |date=March 8, 2014 }}</ref> [[Oral sex|Orogenital contact]] may indicate a higher risk of acquiring HSV,<ref name="Frenkl2008">{{cite journal |last1=Frenkl |first1=Tara Lee |last2=Potts |first2=Jeannette |title=Sexually Transmitted Infections |journal=Urologic Clinics of North America |date=2008 |volume=35 |issue=1 |pages=33–46 |doi=10.1016/j.ucl.2007.09.003|pmid=18061022 |s2cid=79651023 }}</ref> even among women who have had no prior sex with men.<ref name="King2008"/>

[[Bacterial vaginosis]] (BV) occurs more often in lesbians, but it is unclear if BV is transmitted by sexual contact; it occurs in celibate as well as sexually active women. BV often occurs in both partners in a lesbian relationship;<ref name="Risser2008">{{cite journal |last1=Risser |first1=Jan M.H. |last2=Risser |first2=William L. |last3=Risser |first3=Amanda L. |title=Epidemiology of Infections in Women |journal=Infectious Disease Clinics of North America |date=2008 |volume=22 |issue=4 |pages=581–599 |doi=10.1016/j.idc.2008.05.001|pmid=18954753 }}</ref> a recent study of women with BV found that 81% had partners with BV.<ref name="King2008"/> Lesbians are not included in a category of frequency of [[human immunodeficiency virus]] (HIV) transmission, although transmission is possible through vaginal and cervical secretions. The highest rate of transmission of HIV to lesbians is among women who participate in intravenous drug use or have sexual intercourse with bisexual men.<ref name="Rosser2000"/><ref>{{cite web |url=https://www.cdc.gov/hiv/topics/surveillance/basic.htm |title=HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States and Dependent Areas, 2006 |website=[[Centers for Disease Control]] |access-date=9 January 2009}}</ref>

=== Mental ===
Since medical literature began to describe homosexuality, it has often been approached from a view that sought to find an inherent psychopathology as the root cause, influenced by the theories of Sigmund Freud. Although he considered bisexuality inherent in all people and said that most have phases of homosexual attraction or experimentation, exclusive same-sex attraction he attributed to stunted development resulting from trauma or parental conflicts.<ref name="Edsall2003"/>{{rp|p=242}}{{efn|A 1966 survey of psychological literature on homosexuality began with Freud's 1924 theory that it is a fixation on the opposite sex parent. As Freud's views were the foundation of psychotherapy, further articles agreed with this, including one in 1951 that asserted that homosexuals are actually heterosexuals that play both gender roles, and homosexuals are attempting to perpetuate "infantile, incestuous fixation(s)" on relationships that are forbidden.<ref>{{cite journal |last1=Zucker |first1=Luise J. |title=Mental health and homosexuality |journal=[[Journal of Sex Research]] |date=July 1966 |volume=2 |issue=2 |pages=111–125 |doi=10.1080/00224496609550506}}</ref>}} Much literature on mental health and lesbians centered on their [[Clinical depression|depression]], [[substance abuse]], and [[suicide]]. Although these issues exist among lesbians, discussion about their causes shifted after homosexuality was removed from the ''[[Diagnostic and Statistical Manual]]'' in 1973. Instead, social ostracism, legal discrimination, internalization of negative stereotypes, and limited support structures indicate factors homosexuals face in Western societies that often adversely affect their mental health.<ref name="cochran">{{cite journal |last1=Cochran |first1=Susan D. |last2=Sullivan |first2=J. Greer |last3=Mays |first3=Vickie M. |title=Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. |journal=[[Journal of Consulting and Clinical Psychology]] |date=2003 |volume=71 |issue=1 |pages=53–61 |doi=10.1037/0022-006x.71.1.53 |pmid=12602425 |pmc=4197971}}</ref>

Women who identify as lesbian report feeling significantly different and isolated during adolescence.<ref name="cochran" /><ref name="Schlager1998"/>{{rp|p=153}} These emotions have been cited as appearing on average at 15 years old in lesbians and 18 years old in women who identify as bisexual.<ref name="rust2">{{cite journal |last1=Rust |first1=Paula C. |title='Coming out' in the Age of Social Constructionism Sexual Identity Formation among Lesbian and Bisexual Women |journal=Gender & Society |date=March 1993 |volume=7 |issue=1 |pages=50–77 |doi=10.1177/089124393007001004|s2cid=145206767 }}</ref> On the whole, women tend to work through developing a self-concept internally, or with other women with whom they are intimate. Women also limit who they divulge their sexual identities to, and more often see being lesbian as a choice, as opposed to gay men, who work more externally and see being gay as outside their control.<ref name="Schlager1998"/>{{rp|p=153}}

[[Anxiety disorder]]s and [[depression (mood)|depression]] are the most common mental health issues for women. Depression is reported among lesbians at a rate similar to heterosexual women,<ref name="Solarz1999"/>{{rp|p=69}} although [[generalized anxiety disorder]] is more likely to appear among lesbian and bisexual women than heterosexual women.<ref name="cochran" />{{efn|Lesbian and bisexual women are also more likely to report symptoms of multiple disorders that include major depression, panic disorder, alcohol and drug abuse.<ref>Cochran, ''et al.'', 2003.</ref>}} Depression is a more significant problem among women who feel they must hide their sexual orientation from friends and family, or experience compounded ethnic or religious discrimination, or endure relationship difficulties with no support system.<ref name="Schlager1998"/>{{rp|pp=157–158}} Men's shaping of women's sexuality has proven to have an effect on how lesbians see their own bodies. Studies have shown that heterosexual men and lesbians have different standards for what they consider attractive in women. Lesbians who view themselves with male standards of female beauty may experience lower self-esteem, [[eating disorder]]s, and higher incidence of depression.<ref name="haines">{{cite journal |last1=Haines |first1=Megan E. |last2=Erchull |first2=Mindy J. |last3=Liss |first3=Miriam |last4=Turner |first4=Dixie L. |last5=Nelson |first5=Jaclyn A. |last6=Ramsey |first6=Laura R. |last7=Hurt |first7=Molly M. |title=Predictors and Effects of Self-Objectification in Lesbians |journal=[[Psychology of Women Quarterly]] |date=2008 |volume=32 |issue=2 |pages=181–187 |doi=10.1111/j.1471-6402.2008.00422.x |s2cid=145638302}}</ref> More than half the respondents to a 1994 survey of health issues in lesbians reported they had [[Suicidal ideation|suicidal thoughts]], and 18% had attempted suicide.<ref name="Solarz1999"/>{{rp|p=70}}

A population-based study completed by the National Alcohol Research Center found that women who identify as lesbian or bisexual are less likely to abstain from alcohol. Lesbians and bisexual women have a higher likelihood of reporting problems with alcohol, as well as not being satisfied with treatment for substance abuse programs.<ref>{{cite journal |last1=Drabble |first1=Laurie |last2=Trocki |first2=Karen |title=Alcohol Consumption, Alcohol-Related Problems, and Other Substance Use Among Lesbian and Bisexual Women |journal=Journal of Lesbian Studies |date=2005 |volume=9 |issue=3 |pages=19–30 |doi=10.1300/J155v09n03_03|pmid=17548282 |s2cid=27973277 }}</ref> Many lesbian communities are centered in bars, and drinking is an activity that correlates to community participation for lesbians and bisexual women.<ref name="Solarz1999"/>{{rp|p=81}}