Lesbian sex and disease-Barriers to Infectious Disease Care among Lesbians

Despite the considerable number of women in the United States who identify as lesbian, few data exist that address lesbians' health needs. The Institute of Medicine emphasized that data on sexually transmitted infections, Pap smear screening, and cervical dysplasia among lesbians were needed to guide clinical practice, policy development, and patient education. Use of surveillance data for this purpose is limited because risk classifications exclude same-gender sex among women or subsume it under behavior considered as higher risk. However, sexual transmission of human papillomavirus, HIV, Treponema pallidum , and Trichomonas vaginalis between women has been reported. Data indicate that lesbians receive routine Pap smear screening less frequently than is optimal.

Lesbian sex and disease

Lesbian sex and disease

Lesbian sex and disease

Lesbian sex and disease

Lesbian sex and disease

Human papillomavirus-associated cervical intraepithelial Lesbian sex and disease following lesbian sex. Sex Transm Infect. All women face certain health risks. Cunnilingus and vaginal Lesbian sex and disease are risk factors for herpes simplex virus type 1 acquisition in women. InSingh et al [ 7 ] examined chlamydia positivity among WSW aged 15—24 years tested at family planning clinics participating Lesbian sex and disease the Infertility Prevention Project in the northwestern United States from to Despite the observations that support probable sexual transmission of HPV between women, many lesbians undergo routine Pap smear screening less frequently diseaee national guidelines advise. Association between acquisition of herpes simplex virus type 2 in women and bacterial vaginosis. Among 6, respondents in the National Lesblan and Bi Women's Health Survey, conducted in the early s, women reported Couple in pantie hose an STI from a female partner including herpes by persons, chlamydia bygenital warts bygonorrhea by 16, hepatitis by 9, and HIV by 1 Suggested citation for this article : Marrazzo JM. Suppressive antibacterial therapy with 0.

Open sweaty ass. Sexual Behavior and STIs

Further information: History of lesbianism. The article declined to include desire or attraction as it rarely has bearing on measurable health or psychosocial annd. Single women Lesbian sex and disease the highest prevalence of homosexual activity, followed by women who were widowed, divorced, or separated. In some cases, it was not acknowledged to exist. Use latex or vinyl gloves and lubricant for any manual sex that might cause bleeding. In terms of gonorrhea research, scientists have determined the sequence of the Neisseria gonorrhoeae Office for National Statistics. Thank you. Some women were able Lesbian sex and disease arrive Fly control pregnant cow the recruiting station in a man's suit, deny ever having been in love with another woman, and be easily inducted. Biology Diseease order Demographics Environment Heterosexual—homosexual continuum Homosexuality and psychology Kinsey scale Klein Grid Lesbian sex and disease Prenatal hormones Sexual inversion Sexual orientation change efforts Conversion therapy Sexual orientation identity Timeline of sexual orientation seex medicine. All rights reserved. SUNY Press.

Linda M.

  • Lesbians are at the same risk for many of the STDs heterosexual women are at risk for.
  • Lesbian and bisexual women are part of a diverse community with various health concerns.
  • A lesbian is a homosexual woman.

Linda M. Gorgos, Jeanne M. Women who have sex with women WSW are a diverse group with variations in sexual identity, sexual behaviors, sexual practices, and risk behaviors. WSW are at risk of acquiring bacterial, viral, and protozoal sexually transmitted infections STIs from current and prior partners, both male and female. WSW should not be presumed to be at low or no risk for STIs based on sexual orientation, and reporting of same-sex behavior by women should not deter providers from considering and performing screening for STIs, including chlamydia, in their clients according to current guidelines.

Effective delivery of sexual health services to WSW requires a comprehensive and open discussion of sexual and behavioral risks, beyond sexual identity, between care providers and their female clients. Using measures of both self-reported sexual identity and sexual behavior, it was estimated that 1.

Lifetime same-sex behavior is commonly reported by women in large population-based surveys, ranging from Although extensive data are available regarding sexually transmitted infections STIs among men who have sex with men, relatively little has been published about STI prevalence and risks among other sexual and gender minorities, including women who have sex with women WSW.

Health care providers and their female clients would benefit from increased knowledge of STI risks and testing guidance for women who have same-sex partners. Key questions were developed based on review of these sources and in consultation with experts in the fields of infectious disease and gender minority health. Chlamydia trachomatis and Neisseria gonorrhoeae infections among WSW have been considered uncommon.

Earlier studies that included women from STD clinics and sexual health centers reported a prevalence of chlamydial infection among WSW ranging from 0.

However, no data on C. In , Singh et al [ 7 ] examined chlamydia positivity among WSW aged 15—24 years tested at family planning clinics participating in the Infertility Prevention Project in the northwestern United States from to Chlamydia positivity was 7. Chlamydia positivity during the same time period for women reporting only male partners in the 12 months prior to testing was 5.

Other STIs can be passed between female partners, including trichomoniasis [ 8 ], syphilis [ 9 ], and hepatitis A [ 10 ]. Although it is presumably rare, sexual transmission of human immunodeficiency virus HIV may also occur in this manner [ 11 ]. Prior data suggesting potential HIV transmission between female partners is based on case reports where presumed female-to-female transmission was based on a lack of other identified risk factors [ 12—14 ]. Increasing age was predictive of higher seroprevalence of both HSV-1 and 2, and HSV-2 seropositivity was associated with having a male partner with genital herpes.

HSV-1 seroprevalence increased with higher numbers of female partners [ 21 ]. In a separate study of HSV-1 prevalence and acquisition among young women, receptive oral sex was associated with HSV-1 acquisition [ 22 ]. HSV-2 seroprevalence among women self-identifying as homosexual or lesbian was 8. In addition, in a longitudinal study of HSV-2 acquisition among women, the presence of bacterial vaginosis BV was associated with an increased risk of acquiring HSV-2 hazard ratio [HR], 2.

There are no published studies to date to show if the treatment of BV could reduce acquisition of HSV-2 in women. Prior case reports highlighted the presence of cervical neoplasia and HPV among women who had no history of sex with men [ 28 , 29 ].

Despite these findings, WSW, particularly those with a history of having only female partners, are less likely to report having had Pap smear screening and frequently believe they have less need for cervical cancer screening [ 25—27 , 30 ].

WSW are at risk from acquiring HPV both from their female partners and from current or prior male partners, and thus are at risk for cervical cancer.

Some identify women based on self-identified sexual orientation homosexual, lesbian, bisexual, heterosexual whereas others utilize reported sexual behaviors and partner choices over time female partner ever in a lifetime, female partner in the past year, history of male partners , alone or in combination with measures of sexual orientation, making comparability across studies somewhat limited. Use of consistent and expanded methods to detail same-sex behavior that includes measures of sexual identity, sexual orientation, partner choices, and sexual behaviors are needed to better understand the epidemiology and risks for STIs among WSW and to allow comparability across studies over time.

Prior studies have suggested a higher prevalence of BV among WSW, although these studies had previously been limited to specific populations such as STD clinics or sexual health centers [ 3—6 , 35—37 ]. A cross-sectional survey of female community volunteers aged 16—50 years in the United Kingdom conducted from to demonstrated a BV prevalence of In the largest sample to date, the NHANES —, a nationally representative sample of the US civilian population, women who reported a history of a female sex partner had a prevalence of BV of Many studies have also shown a high level of concordance of BV between a woman and her female sex partner both partners with BV and without BV [ 35 , 38 , 40 ].

A systematic review and meta-analysis examining the association between BV and female sexual partners found that having a history of female sex partner s conferred a 2-fold increased risk of BV relative risk [RR], 2. Exchange of vaginal fluid or other shared behaviors among female partners may contribute to the initiation of BV.

Among WSW, prior studies have found an association of BV with a higher lifetime number of female sexual partners, a history of receptive oral-anal sex, not always cleaning an insertive sex toy between uses, and smoking [ 38 , 40 ].

No association was seen with age, race, smoking, hormone use, douching, vaginal intercourse, receptive oral or anal sex, or number of partners [ 42 ]. Detailed analysis of behavioral data suggested a direct dose-response relationship with increasing number of episodes of receptive oral-vulvovaginal sex HR, 1. These studies have thus continued to support, though have not proven, the hypothesis that sexual behaviors that facilitate the transfer of vaginal fluid and possibly exchange of extravaginal microbiota eg, oral bacterial communities between partners may be involved in the pathogenesis of BV.

With the advent of new molecular-based methods, there has been a greater appreciation of the microbial diversity and complex nature of BV [ 44—46 ]. Using both culture methods and strain typing with repetitive element sequence-based polymerase chain reaction rep-PCR fingerprinting, Marrazzo et al [ 47 ] examined Lactobacillus colonization at vaginal and rectal sites and whether unique Lactobacillus strains are shared by female sex partners.

Among women, Relative to L. Detection of L. Within this study, both members of monogamous partnerships were enrolled. No similarities in lactobacilli strains were seen between control partners matched for age and date of enrollment to the study. There was a trend toward an association of reported use of shared vaginal sex toys and shared identical lactobacillus strains OR, 1.

The likelihood of sharing identical lactobacilli was not related to mean age of the couple; number of lifetime male sex partners; or to practice, frequency, or timing of other types of sexual behaviors, including oral or anal sexual practices. Despite an initial treatment response, BV commonly recurs or persists in both the short term [ 48 -- 50 ] and long term [ 51 , 52 ]. One study found that a past history of BV, a regular sex partner throughout the study, and female sex partners were significantly associated with recurrence of BV and abnormal vaginal flora [ 51 ].

A recent study of young WSW with BV treated with vaginal metronidazole gel examined behavioral and microbiologic correlates of persistent BV and abnormal vaginal flora at 1 month after therapy. Vaginal fluid samples at baseline and 1 month after therapy were studied using species-specific 16S recombinant DNA PCR assays targeting 17 bacterial species. Persistent BV was associated with the presence of specific bacteria in vaginal fluid at baseline including BVAB types 1, 2, and 3; Peptoniphil us lacrimalis ; and Megasphaera phylotype 2.

Persistence was not related to any specific sexual activity, including male or female partners, use of sex toys, condom use, receptive oral or anal sex, or a sex partner with BV [ 53 ]. Several prior clinic-based studies have examined the role of treatment of partners of females with BV in reducing persistent or recurrent BV. These trials enrolled women with male sex partners and involved treating women and their male partners with clindamycin [ 54 ], metronidazole [ 55 , 56 ], or tinidazole [ 57 ] with follow-up ranging from 3 to 12 weeks.

None of these trials have shown any benefit in reducing persistent or recurrent BV by treating male sex partners. The only proven interventions that have demonstrated an effect in preventing the development or recurrence of BV are chronic suppressive metronidazole therapy [ 52 ] and circumcision of male partners [ 58 ].

To date there have been no reported trials examining the potential benefits of treating female partners of women with BV, and thus no data on which to base a recommendation for partner therapy in WSW. Enrolled women were randomized to an intervention designed to reduce sharing of vaginal fluid on hands or sex toys following treatment for BV. Shared vaginal use of sex toys was infrequent among both groups.

Current data show that women can share strain-specific genital bacteria with their female partners and that specific bacterial species are associated with treatment failure in BV.

In the interim, encouraging awareness of signs and symptoms of BV in women and encouraging healthy sexual practices such as cleaning shared sex toys between uses may be helpful to women and their partners. WSW are a diverse group with variations in sexual identity, sexual behaviors, sexual practices, and risk behaviors. Sexual identity is not necessarily in concordance with sexual behaviors and gender of sexual partners. It cannot be presumed that women who self-identify as lesbian do not or have not had male partners.

Some women who have both female and male partners may also evidence increased risk-taking behaviors compared with their heterosexual or exclusively same-sex-partner peers. A population-based survey conducted in northern California reported on the prevalence of sexual and drug use behaviors among WSMW ages 18— A stratified probability sample of the British general population in examined behavioral and health-related factors among WSW.

These associations remained significant even after adjusting for numbers of sexual partners. WSW in this population also reported a higher prevalence of smoking, high alcohol intake, and injecting nonprescribed drugs [ 64 , 65 ].

Issues of sexual identity and behavioral risks also extend to adolescents and young adults. The inconsistency between sexual identity and choice of sexual behaviors and sexual partners was demonstrated in adolescent women in grades 9 through 12 who were surveyed as part of the Massachusetts Youth Risk Behavior Survey from to Among the nearly 30 female students surveyed in the Spring National College Health Assessment, female students who reported having both male and female sex partners during the past year were 3.

In summary, many early studies of risk behaviors among WSW were based on convenience samples or on women attending STD clinics and are not necessarily generalizable to all WSW. Health care providers assessing any woman for her risk of STIs must incorporate an open discussion of all aspects of sexuality, and not just those limited to preconceptions or stereotypes on the part of providers.

Sexual and reproductive health services that are sensitive to gender-minority women across a wide range of ages and populations are needed, including adolescents and college-aged women.

WSW are at risk of acquiring bacterial, viral, and protozoal STIs from both female and male partners. Effective screening requires a comprehensive and open discussion of sexual and behavioral risks, beyond sexual identity, between health care providers and their female clients. Report of same-sex behavior in women should not deter providers from considering and performing screening for STIs, including C. Routine cervical cancer screening should be offered to all women, regardless of sexual orientation or partner choice, and women should be offered HPV vaccine according to current guidelines.

Encouraging awareness of signs and symptoms of BV in women and encouraging healthy sexual practices such as cleaning shared sex toys between uses may be helpful to women and their partners.

The evaluation of WSW who present with symptoms concerning for STIs is no different than that for women with male-only partners. Specifically, further research is needed to identify risks that may predispose to the acquisition and transmission of C. In addition, future research is needed to identify behavioral and medical interventions that can reduce the occurrence, persistence, and recurrence of BV among WSW.

An improved understanding of the dynamics of the health care interaction between WSW patients and providers would be extremely useful. Little is known about the knowledge, attitudes, and behaviors that contribute to STI screening and health care access among WSW, either from the perspective of women themselves or from the providers who serve them.

These data are essential to inform both women and their health care providers about STI risks and prevention and to foster a dialogue that could support sexual health in general.

Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account.

Sign In. Advanced Search. Article Navigation. Close mobile search navigation Article Navigation. Volume

These were members of the " third sex " who rejected the roles of women to be subservient, feminine, and domestic. Studies have also reported that emotional bonds are closer in lesbian and gay relationships than heterosexual ones. But this sort of evidence is not 'proof'. However, Seward continued to write about Sneyd long after her death, extolling Sneyd's beauty and their affection and friendship. In terms of gonorrhea research, scientists have determined the sequence of the Neisseria gonorrhoeae The risk of STD transmission between women is compounded by the fact that many lesbians and bisexual women consider sex between women to be a low-risk activity and so do not practice safer sex. Leave a Reply Cancel reply Your email address will not be published.

Lesbian sex and disease

Lesbian sex and disease

Lesbian sex and disease

Lesbian sex and disease

Lesbian sex and disease

Lesbian sex and disease. Continue Learning about STDs

General Resources. Get Email Updates. To receive email updates about this page, enter your email address: Email Address. What's this? Links with this icon indicate that you are leaving the CDC website. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.

You will be subject to the destination website's privacy policy when you follow the link. An Italian nun named Sister Benedetta Carlini was documented to have seduced many of her sisters when possessed by a Divine spirit named "Splenditello"; to end her relationships with other women, she was placed in solitary confinement for the last 40 years of her life.

Ideas about women's sexuality were linked to contemporary understanding of female physiology. The vagina was considered an inward version of the penis; where nature's perfection created a man, often nature was thought to be trying to right itself by prolapsing the vagina to form a penis in some women.

Medical consideration of hermaphroditism depended upon measurements of the clitoris ; a longer, engorged clitoris was thought to be used by women to penetrate other women. Penetration was the focus of concern in all sexual acts, and a woman who was thought to have uncontrollable desires because of her engorged clitoris was called a "tribade" literally, one who rubs. For a while, masturbation and lesbian sex carried the same meaning. Class distinction, however, became linked as the fashion of female homoeroticism passed.

Tribades were simultaneously considered members of the lower class trying to ruin virtuous women, and representatives of an aristocracy corrupt with debauchery.

When Churchill was ousted as the queen's favorite, she purportedly spread allegations of the queen having affairs with her bedchamberwomen. Hermaphroditism appeared in medical literature enough to be considered common knowledge, although cases were rare. Homoerotic elements in literature were pervasive, specifically the masquerade of one gender for another to fool an unsuspecting woman into being seduced.

If found, punishments ranged from death, to time in the pillory , to being ordered never to dress as a man again. Henry Fielding wrote a pamphlet titled The Female Husband in , based on the life of Mary Hamilton , who was arrested after marrying a woman while masquerading as a man, and was sentenced to public whipping and six months in jail. Similar examples were procured of Catharine Linck in Prussia in , executed in ; Swiss Anne Grandjean married and relocated with her wife to Lyons, but was exposed by a woman with whom she had had a previous affair and sentenced to time in the stocks and prison.

Queen Christina of Sweden 's tendency to dress as a man was well known during her time, and excused because of her noble birth. She was brought up as a male and there was speculation at the time that she was a hermaphrodite. Even after Christina abdicated the throne in to avoid marriage, she was known to pursue romantic relationships with women.

Some historians view cases of cross-dressing women to be manifestations of women seizing power they would naturally be unable to enjoy in feminine attire, or their way of making sense out of their desire for women. Lillian Faderman argues that Western society was threatened by women who rejected their feminine roles.

Outside Europe, women were able to dress as men and go undetected. Deborah Sampson fought in the American Revolution under the name Robert Shurtlieff, and pursued relationships with women.

During the 17th through 19th centuries, a woman expressing passionate love for another woman was fashionable, accepted, and encouraged. Documentation of these relationships is possible by a large volume of letters written between women. Whether the relationship included any genital component was not a matter for public discourse, but women could form strong and exclusive bonds with each other and still be considered virtuous, innocent, and chaste; a similar relationship with a man would have destroyed a woman's reputation.

In fact, these relationships were promoted as alternatives to and practice for a woman's marriage to a man. I put in your lovers, for I don't allow it possible for a man to be so sincere as I am. When Sneyd married despite Seward's protest, Seward's poems became angry. However, Seward continued to write about Sneyd long after her death, extolling Sneyd's beauty and their affection and friendship. Writing to another woman by whom she had recently felt betrayed, Wollstonecraft declared, "The roses will bloom when there's peace in the breast, and the prospect of living with my Fanny gladdens my heart:—You know not how I love her.

Butler and Ponsonby eloped in , to the relief of Ponsonby's family concerned about their reputation had she run away with a man [66] to live together in Wales for 51 years and be thought of as eccentrics. Some of it was written in code, detailing her sexual relationships with Marianna Belcombe and Maria Barlow.

Romantic friendships were also popular in the U. Enigmatic poet Emily Dickinson wrote over letters and poems to Susan Gilbert, who later became her sister-in-law, and engaged in another romantic correspondence with Kate Scott Anthon. Anthon broke off their relationship the same month Dickinson entered self-imposed lifelong seclusion. Around the turn of the 20th century, the development of higher education provided opportunities for women.

In all-female surroundings, a culture of romantic pursuit was fostered in women's colleges. Older students mentored younger ones, called on them socially, took them to all-women dances, and sent them flowers, cards, and poems that declared their undying love for each other. Nicholas , and a collection called Smith College Stories , without negative views. Women who had the option of a career instead of marriage labeled themselves New Women , and took their new opportunities very seriously.

For some women, the realization that they participated in behavior or relationships that could be categorized as lesbian caused them to deny or conceal it, such as professor Jeannette Augustus Marks at Mount Holyoke College , who lived with the college president, Mary Woolley , for 36 years.

Marks discouraged young women from "abnormal" friendships and insisted happiness could only be attained with a man. From the s to the s, American heiress Natalie Clifford Barney held a weekly salon in Paris to which major artistic celebrities were invited and where lesbian topics were the focus.

Combining Greek influences with contemporary French eroticism, she attempted to create an updated and idealized version of Lesbos in her salon. Clubs varied between large establishments so popular that they were tourist attractions to small neighborhood cafes where only local women went to find other women. Homosexuality was illegal in Germany, though sometimes tolerated, as some functions were allowed by the police who took the opportunity to register the names of homosexuals for future reference.

The novel's plot centers around Stephen Gordon, a woman who identifies herself as an invert after reading Krafft-Ebing's Psychopathia Sexualis , and lives within the homosexual subculture of Paris. The publicity Hall received was due to unintended consequences; the novel was tried for obscenity in London, a spectacularly scandalous event described as " the crystallizing moment in the construction of a visible modern English lesbian subculture" by professor Laura Doan.

When British women participated in World War I, they became familiar with masculine clothing, and were considered patriotic for wearing uniforms and pants. However, postwar masculinization of women's clothing became associated with lesbians. In the United States, the s was a decade of social experimentation, particularly with sex. This was heavily influenced by the writings of Sigmund Freud , who theorized that sexual desire would be sated unconsciously, despite an individual's wish to ignore it.

With the well-publicized notion that sexual acts were a part of lesbianism and their relationships, sexual experimentation was widespread. Large cities that provided a nightlife were immensely popular, and women began to seek out sexual adventure.

Bisexuality became chic, particularly in America's first gay neighborhoods. White "slummers" enjoyed jazz , nightclubs, and anything else they wished. Across town, Greenwich Village also saw a growing homosexual community; both Harlem and Greenwich Village provided furnished rooms for single men and women, which was a major factor in their development as centers for homosexual communities. Bohemians —intellectuals who rejected Victorian ideals—gathered in the Village.

Homosexuals were predominantly male, although figures such as poet Edna St. Vincent Millay and social host Mabel Dodge were known for their affairs with women and promotion of tolerance of homosexuality. The primary component necessary to encourage lesbians to be public and seek other women was economic independence, which virtually disappeared in the s with the Great Depression.

Independent women in the s were generally seen as holding jobs that men should have. The social attitude made very small and close-knit communities in large cities that centered around bars, while simultaneously isolating women in other locales.

Speaking of homosexuality in any context was socially forbidden, and women rarely discussed lesbianism even amongst themselves; they referred to openly gay people as "in the Life".

Homosexual subculture disappeared in Germany with the rise of the Nazis in The onset of World War II caused a massive upheaval in people's lives as military mobilization engaged millions of men. Women were also accepted into the military in the U.

Unlike processes to screen out male homosexuals, which had been in place since the creation of the American military, there were no methods to identify or screen for lesbians; they were put into place gradually during World War II.

Despite common attitudes regarding women's traditional roles in the s, independent and masculine women were directly recruited by the military in the s, and frailty discouraged.

Some women were able to arrive at the recruiting station in a man's suit, deny ever having been in love with another woman, and be easily inducted. As women found each other, they formed into tight groups on base, socialized at service clubs, and began to use code words. Women had to broach the subject about their interest in other women carefully, sometimes taking days to develop a common understanding without asking or stating anything outright. The increased mobility, sophistication, and independence of many women during and after the war made it possible for women to live without husbands, something that would not have been feasible under different economic and social circumstances, further shaping lesbian networks and environments.

Lesbians were not included under Paragraph , a German statute which made homosexual acts between males a crime. The United States Holocaust Memorial Museum stipulates that this is because women were seen as subordinate to men, and that the Nazi state feared lesbians less than gay men.

However, the USHMM also claims that many women were arrested and imprisoned for "asocial" behaviour, a label which was applied to women who did not conform to the ideal Nazi image of a woman: cooking, cleaning, kitchen work, child raising, and passivity. These women were labeled with a black triangle.

Many lesbians also reclaimed the pink triangle. Following World War II, a nationwide movement pressed to return to pre-war society as quickly as possible in the U.

Homosexuals were thought to be vulnerable targets to blackmail , and the government purged its employment ranks of open homosexuals, beginning a widespread effort to gather intelligence about employees' private lives. The U. Attitudes and practices to ferret out homosexuals in public service positions extended to Australia [] and Canada.

Very little information was available about homosexuality beyond medical and psychiatric texts. Community meeting places consisted of bars that were commonly raided by police once a month on average, with those arrested exposed in newspapers. In response, eight women in San Francisco met in their living rooms in to socialize and have a safe place to dance.

When they decided to make it a regular meeting, they became the first organization for lesbians in the U. Inside the front cover of every issue was their mission statement, the first of which stated was "Education of the variant".

It was intended to provide women with knowledge about homosexuality—specifically relating to women and famous lesbians in history. However, by , the term "lesbian" had such a negative meaning that the DOB refused to use it as a descriptor, choosing "variant" instead. The DOB spread to Chicago, New York, and Los Angeles, and The Ladder was mailed to hundreds—eventually thousands—of DOB members discussing the nature of homosexuality, sometimes challenging the idea that it was a sickness, with readers offering their own reasons why they were lesbians and suggesting ways to cope with the condition or society's response to it.

As a reflection of categories of sexuality so sharply defined by the government and society at large, lesbian subculture developed extremely rigid gender roles between women, particularly among the working class in the U. Although many municipalities had enacted laws against cross-dressing, some women would socialize in bars as butches : dressed in men's clothing and mirroring traditional masculine behavior.

Butch and femme modes of socialization were so integral within lesbian bars that women who refused to choose between the two would be ignored, or at least unable to date anyone, and butch women becoming romantically involved with other butch women or femmes with other femmes was unacceptable.

Butch women were not a novelty in the s; even in Harlem and Greenwich Village in the s some women assumed these personae. Many wealthier women married to satisfy their familial obligations, and others escaped to Europe to live as expatriates. Regardless of the lack of information about homosexuality in scholarly texts, another forum for learning about lesbianism was growing.

A paperback book titled Women's Barracks describing a woman's experiences in the Free French Forces was published in It told of a lesbian relationship the author had witnessed. After 4. Between and over 2, books were published using lesbianism as a topic, and they were sold in corner drugstores, train stations, bus stops, and newsstands all over the U. Coded words and images were used on the covers. Instead of "lesbian", terms such as "strange", "twilight", "queer", and "third sex", were used in the titles, and cover art was invariably salacious.

Bannon, who also purchased lesbian pulp fiction, later stated that women identified the material iconically by the cover art. As a result, pulp fiction helped to proliferate a lesbian identity simultaneously to lesbians and heterosexual readers.

The social rigidity of the s and early s encountered a backlash as social movements to improve the standing of African Americans, the poor, women, and gays all became prominent. Of the latter two, the gay rights movement and the feminist movement connected after a violent confrontation occurred in New York City in the Stonewall riots. The sexual revolution in the s introduced the differentiation between identity and sexual behavior for women.

Women who previously identified as heterosexual tried sex with women, though many maintained their heterosexual identity. A militant feminist organization named Radicalesbians published a manifesto in entitled " The Woman-Identified Woman " that declared "A lesbian is the rage of all women condensed to the point of explosion".

For women who subscribed to this philosophy—dubbing themselves lesbian-feminists —lesbian was a term chosen by women to describe any woman who dedicated her approach to social interaction and political motivation to the welfare of women. Sexual desire was not the defining characteristic of a lesbian-feminist, but rather her focus on politics. Independence from men as oppressors was a central tenet of lesbian-feminism, and many believers strove to separate themselves physically and economically from traditional male-centered culture.

In the ideal society, named Lesbian Nation, "woman" and "lesbian" were interchangeable. Although lesbian-feminism was a significant shift, not all lesbians agreed with it. Lesbian-feminism was a youth-oriented movement: its members were primarily college educated, with experience in New Left and radical causes, but they had not seen any success in persuading radical organizations to take up women's issues. The Daughters of Bilitis folded in over which direction to focus on: feminism or gay rights issues.

As equality was a priority for lesbian-feminists, disparity of roles between men and women or butch and femme were viewed as patriarchal. Lesbian-feminists eschewed gender role play that had been pervasive in bars, as well as the perceived chauvinism of gay men; many lesbian-feminists refused to work with gay men, or take up their causes. In , poet and essayist Adrienne Rich expanded upon the political meaning of lesbian by proposing a continuum of lesbian existence based on "woman-identified experience" in her essay " Compulsory Heterosexuality and Lesbian Existence ".

Such a perception of women relating to each other connects them through time and across cultures, and Rich considered heterosexuality a condition forced upon women by men. Female homosexual behavior may be present in every culture, although the concept of a lesbian as a woman who pairs exclusively with other women is not.

Attitudes about female homosexual behavior are dependent upon women's roles in each society and each culture's definition of sex. Women in the Middle East have been historically segregated from men.

In the 7th and 8th centuries, some extraordinary women dressed in male attire when gender roles were less strict, but the sexual roles that accompanied European women were not associated with Islamic women.

The Caliphal court in Baghdad featured women who dressed as men, including false facial hair, but they competed with other women for the attentions of men. It is unclear to historians if the rare instances of lesbianism mentioned in literature are an accurate historical record or intended to serve as fantasies for men. A treatise about repression in Iran asserted that women were completely silenced: "In the whole of Iranian history, [no woman] has been allowed to speak out for such tendencies To attest to lesbian desires would be an unforgivable crime.

Although the authors of Islamic Homosexualities argued this did not mean women could not engage in lesbian relationships, a lesbian anthropologist in visited Yemen and reported that women in the town she visited were unable to comprehend her romantic relationship to another woman. Women in Pakistan are expected to marry men; those who do not are ostracized.

Women, however, may have intimate relations with other women as long as their wifely duties are met, their private matters are kept quiet, and the woman with whom they are involved is somehow related by family or logical interest to her lover. The United Nations estimate for the number of honor killings in the world is per year.

Some Indigenous peoples of the Americas conceptualize a third gender for women who dress as, and fulfill the roles usually filled by, men in their cultures. In Latin America , lesbian consciousness and associations appeared in the s, increasing while several countries transitioned to or reformed democratic governments.

Harassment and intimidation have been common even in places where homosexuality is legal, and laws against child corruption, morality, or "the good ways" faltas a la moral o las buenas costumbres , have been used to persecute homosexuals. Lesbian rights groups have gradually formed since to build a cohesive community that works to overcome philosophical differences with heterosexual women. While groups try to promote lesbian issues and concerns, they also face misogynistic attitudes from gay men and homophobic views from heterosexual women.

In , Lesbos , the first lesbian organization for Mexicans, was formed. Several incarnations of political groups promoting lesbian issues have evolved; 13 lesbian organizations were active in Mexico City in Ultimately, however, lesbian associations have had little influence both on the homosexual and feminist movements. The lesbian movement has been closely associated with the feminist movement in Chile, although the relationship has been sometimes strained. State persecution prevented the formation of associations until AIDS became a concern, when educational efforts forced sexual minorities to band together.

The first lesbian organization was Nosotras , founded in The meetings of feminist lesbians of Latin America and the Caribbean, sometimes shortened to "Lesbian meetings", have been an important forum for the exchange of ideas for Latin American lesbians since the late s. With rotating hosts and biannual gatherings, its main aims are the creation of communication networks, to change the situation of lesbians in Latin America both legally and socially , to increase solidarity between lesbians and to destroy the existing myths about them.

Cross-gender roles and marriage between women has also been recorded in over 30 African societies. The Hausa people of Sudan have a term equivalent to lesbian, kifi , that may also be applied to males to mean "neither party insists on a particular sexual role".

Lesbian relationships are also known in matrilineal societies in Ghana among the Akan people. In Lesotho , females engage in what is commonly considered sexual behavior to the Western world: they kiss, sleep together, rub genitals, participate in cunnilingus , and maintain their relationships with other females vigilantly. Since the people of Lesotho believe sex requires a penis, however, they do not consider their behavior sexual, nor label themselves lesbians.

In South Africa, lesbians are raped by heterosexual men with a goal of punishment of "abnormal" behavior and reinforcement of societal norms. Corrective rape is reported to be on the rise in South Africa. China before westernization was another society that segregated men from women. Historical Chinese culture has not recognized a concept of sexual orientation, or a framework to divide people based on their same-sex or opposite-sex attractions.

Outside their duties to bear sons to their husbands, women were perceived as having no sexuality at all. This did not mean that women could not pursue sexual relationships with other women, but that such associations could not impose upon women's relationships to men. Rare references to lesbianism were written by Ying Shao , who identified same-sex relationships between women in imperial courts who behaved as husband and wife as dui shi paired eating.

The liberty of being employed in silk factories starting in allowed some women to style themselves tzu-shu nii never to marry and live in communes with other women.

Other Chinese called them sou-hei self-combers for adopting hairstyles of married women. These communes passed because of the Great Depression and were subsequently discouraged by the communist government for being a relic of feudal China. In Japan, the term rezubian , a Japanese pronunciation of "lesbian", was used during the s.

In India, a 14th-century Indian text mentioning a lesbian couple who had a child as a result of their lovemaking is an exception to the general silence about female homosexuality. According to Ruth Vanita , this invisibility disappeared with the release of a film titled Fire in , prompting some theaters in India to be attacked by religious extremists.

Women's rights groups in India continue to debate the legitimacy of including lesbian issues in their platforms, as lesbians and material focusing on female homosexuality are frequently suppressed.

The Kinsey Report's dispassionate discussion of homosexuality as a form of human sexual behavior was revolutionary. Single women had the highest prevalence of homosexual activity, followed by women who were widowed, divorced, or separated. The lowest occurrence of sexual activity was among married women; those with previous homosexual experience reported they got married to stop homosexual activity.

Fifty-one percent of women reporting homosexual experience had only one partner. Twenty-three years later, in , sexologist Shere Hite published a report on the sexual encounters of 3, women who had responded to questionnaires, under the title The Hite Report.

She found it "striking" that many women who had no lesbian experiences indicated they were interested in sex with women, particularly because the question was not asked. Lesbians in the U.

The government of the United Kingdom does not ask citizens to define their sexuality. However, polls in Australia have recorded a range of self-identified lesbian or bisexual women from 1. 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.

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 diseases or types of cancer. When women do seek medical attention, medical professionals often fail to take a complete medical history.

In a study of 2, lesbian and bisexual women, only 9. Heart disease is listed by the U. Department of Health and Human Services as the number one cause of death for all women. Reports are inconclusive about occurrence of breast cancer 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.

Some sexually transmitted diseases are communicable between women, including human papillomavirus HPV —specifically genital warts — squamous intraepithelial lesions , trichomoniasis , syphilis , and herpes simplex virus HSV. Transmission of specific sexually transmitted diseases among women who have sex with women depends on the sexual practices women engage in. 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.

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 these issues exist among lesbians, discussion about their causes shifted after homosexuality was removed from the Diagnostic and Statistical Manual in 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.

Women who identify as lesbian report feeling significantly different and isolated during adolescence. 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 disorders , and higher incidence of depression. 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. Lesbians portrayed in literature, film, and television often shape contemporary thought about women's sexuality. The majority of media about lesbians is produced by men; [] women's publishing companies did not develop until the s, films about lesbians made by women did not appear until the s, and television shows portraying lesbians written by women only began to be created in the 21st century.

As a result, homosexuality—particularly dealing with women—has been excluded because of symbolic annihilation. When depictions of lesbians began to surface, they were often one-dimensional, simplified stereotypes. In addition to Sappho's accomplishments, [note 15] literary historian Jeannette Howard Foster includes the Book of Ruth , [] and ancient mythological tradition as examples of lesbianism in classical literature.

Foster cites Camilla and Diana , Artemis and Callisto , and Iphis and Ianthe as examples of female mythological figures who showed remarkable devotion to each other, or defied gender expectations. En-hedu-ana , a priestess in Ancient Iraq who dedicated herself to the Sumerian goddess Inanna , has the distinction of signing the oldest-surviving signed poetry in history.

She characterized herself as Inanna's spouse. For ten centuries after the fall of the Roman Empire, lesbianism disappeared from literature. Physical relationships between women were often encouraged; men felt no threat as they viewed sexual acts between women to be accepted when men were not available, and not comparable to fulfillment that could be achieved by sexual acts between men and women. Physical and therefore emotional satisfaction was considered impossible without a natural phallus.

Male intervention into relationships between women was necessary only when women acted as men and demanded the same social privileges. Reflecting French society, as well as employing stock character associations, many of the lesbian characters in 19th-century French literature were prostitutes or courtesans: personifications of vice who died early, violent deaths in moral endings.

Gradually, women began to author their own thoughts and literary works about lesbian relationships. Some women, such as Marguerite Yourcenar and Mary Renault , wrote or translated works of fiction that focused on homosexual men, like some of the writings of Carson McCullers.

All three were involved in same-sex relationships, but their primary friendships were with gay men. As the paperback book came into fashion, lesbian themes were relegated to pulp fiction.

Many of the pulp novels typically presented very unhappy women, or relationships that ended tragically. Marijane Meaker later wrote that she was told to make the relationship end badly in Spring Fire because the publishers were concerned about the books being confiscated by the U.

Postal Service. Serious writers who used lesbian characters and plots included Rita Mae Brown 's Rubyfruit Jungle , which presents a feminist heroine who chooses to be a lesbian. Further changing values are evident in the writings of Dorothy Allison , who focuses on child sexual abuse and deliberately provocative lesbian sadomasochism themes. Lesbianism, or the suggestion of it, began early in filmmaking. The same constructs of how lesbians were portrayed—or for what reasons—as what had appeared in literature were placed on women in the films.

Actresses appeared as men in male roles because of plot devices as early as in A Florida Enchantment featuring Edith Storey. Hollywood films followed the same trend set by audiences who flocked to Harlem to see edgy shows that suggested bisexuality.

The reason censors stated for removing a lesbian scene in 's The Pit of Loneliness was that it was, "Immoral, would tend to corrupt morals". After MacLaine's character admits her love for Hepburn's, she hangs herself; this set a precedent for miserable endings in films addressing homosexuality. Gay characters also were often killed off at the end, such as the death of Sandy Dennis ' character at the end of The Fox in If not victims, lesbians were depicted as villains or morally corrupt, such as portrayals of brothel madames by Barbara Stanwyck in Walk on the Wild Side from and Shelley Winters in The Balcony in Lesbians as predators were presented in Rebecca , women's prison films like Caged , or in the character Rosa Klebb in From Russia with Love The first film to address lesbianism with significant depth was The Killing of Sister George in , which was filmed in The Gateways Club , a longstanding lesbian pub in London.

It is the first to claim a film character who identifies as a lesbian, and film historian Vito Russo considers the film a complex treatment of a multifaceted character who is forced into silence about her openness by other lesbians.

Personal Best was criticized for engaging in the cliched plot device of one woman returning to a relationship with a man, implying that lesbianism is a phase, as well as treating the lesbian relationship with "undisguised voyeurism". An era of independent filmmaking brought different stories, writers, and directors to films. It received mixed critical commentary, but earned positive reviews from the gay press.

In the film, a lesbian actress named Valerie, who was killed in such a manner, serves as inspiration for the masked rebel V and his ally Evey Hammond, who set out to overthrow the dictatorship. Television began to address homosexuality much later than film. Local talk shows in the late s first addressed homosexuality by inviting panels of experts usually not gay themselves to discuss the problems of gay men in society.

Lesbianism was rarely included. The first time a lesbian was portrayed on network television was the NBC drama The Eleventh Hour in the early s, in a teleplay about an actress who feels she is persecuted by her female director, and in distress, calls a psychiatrist who explains she is a latent lesbian who has deep-rooted guilt about her feelings for women.

When she realizes this, however, she is able to pursue heterosexual relationships, which are portrayed as "healthy". Invisibility for lesbians continued in the s when homosexuality became the subject of dramatic portrayals, first with medical dramas The Bold Ones , Marcus Welby, M. Another stock plot device in the s was the gay character in a police drama.

Beginning in the late s with N. One episode of Police Woman earned protests by the National Gay Task Force before it aired for portraying a trio of murderous lesbians who killed retirement home patients for their money. In the middle of the s, gay men and lesbians began to appear as police officers or detectives, facing coming out issues. CBS production made conscious attempts to soften the characters so they would not appear to be lesbians.

Law shared the first significant lesbian kiss [note 18] on primetime television with Michele Greene , stirring a controversy despite being labeled "chaste" by The Hollywood Reporter. Though television did not begin to use recurring homosexual characters until the late s, some early situation comedies used a stock character that author Stephen Tropiano calls "gay-straight": supporting characters who were quirky, did not comply with gender norms, or had ambiguous personal lives, that "for all purposes should be gay".

Recurring lesbian characters who came out were seen on Married The episode was instead the week's highest rated. Publicity surrounding Ellen's coming out episode in was enormous; Ellen DeGeneres appeared on the cover of Time magazine the week before the airing of " The Puppy Episode " with the headline "Yep, I'm Gay".

Parties were held in many U. Even still, "The Puppy Episode" won an Emmy for writing, but as the show began to deal with Ellen Morgan's sexuality each week, network executives grew uncomfortable with the direction the show took and canceled it. Dramas following L. Law began incorporating homosexual themes, particularly with continuing storylines on Relativity , Picket Fences , ER , and Star Trek: The Next Generation and Deep Space Nine , both of which tested the boundaries of sexuality and gender.

In the fourth season of Buffy , Tara and Willow admit their love for each other without any special fanfare and the relationship is treated as are the other romantic relationships on the show. What followed was a series devoted solely to gay characters from network television. Showtime 's American rendition of Queer as Folk ran for five years, from to ; two of the main characters were a lesbian couple.

Showtime promoted the series as "No Limits", and Queer as Folk addressed homosexuality graphically. The aggressive advertising paid off as the show became the network's highest rated, doubling the numbers of other Showtime programs after the first season. The invisibility of lesbians has gradually eroded since the early s. This is in part due to public figures who have caused speculation and comment in the press about their sexuality and lesbianism in general.

The primary figure earning this attention was Martina Navratilova , who served as tabloid fodder for years as she denied being lesbian, admitted to being bisexual, had very public relationships with Rita Mae Brown and Judy Nelson , and acquired as much press about her sexuality as she did her athletic achievements.

Navratilova spurred what scholar Diane Hamer termed "constant preoccupation" in the press with determining the root of same-sex desire. Other public figures acknowledged their homosexuality and bisexuality, notably musicians k.

In , lang and self-professed heterosexual supermodel Cindy Crawford posed for the August cover of Vanity Fair in a provocative arrangement that showed Crawford shaving lang's face, as lang lounged in a barber's chair wearing a pinstripe suit.

Between and , Mademoiselle , Vogue , Cosmopolitan , Glamour , Newsweek , and New York magazines featured stories about women who admitted sexual histories with other women. One analyst reasoned the recurrence of lesbian chic was due to the often-used homoerotic subtexts of gay male subculture being considered off limits because of AIDS in the late s and s, joined with the distant memory of lesbians as they appeared in the s: unattractive and militant.

A resurgence of lesbian visibility and sexual fluidity was noted in with celebrities such as Cynthia Nixon and Lindsay Lohan commenting openly on their relationships with women, and reality television addressing same-sex relationships. Psychiatrists and feminist philosophers write that the rise in women acknowledging same-sex relationships is due to growing social acceptance, but also concede that "only a certain kind of lesbian—slim and elegant or butch in just the right androgynous way—is acceptable to mainstream culture".

Although homosexuality among females has taken place in many cultures in history, a recent phenomenon is the development of family among same-sex partners.

Know important health issues for lesbians and women who have sex with women — from sexually transmitted infections to depression — and get tips for taking charge of your health. All women face certain health risks. However, sexual minority women, such as those who identify as lesbian or bisexual as well as women who have sex with women, have some specific health concerns. Although your individual risks are shaped by many factors beyond your sexual orientation and practices — including family history and age — it's important to understand common health issues for sexual minority women and steps you can take to stay healthy.

Sexual minority women are at higher risk of depression and anxiety. Contributing factors include social alienation, discrimination, rejection by loved ones, abuse and violence. If you think you might be depressed, talk to your doctor or seek help from a mental health provider. If you're reluctant to seek treatment, confide in a trusted friend or loved one.

Sharing your feelings might be the first step toward getting treatment. Certain sexually transmitted infections — such as human papillomavirus HPV , bacterial vaginosis and trichomoniasis — can spread between women. The best way to stay healthy is to practice safer sex. If you have a substance abuse concern, remember that help is available. Local lesbian, gay, bisexual and transgender health, mental health or community centers often provide substance abuse treatment. Organizations such as GLMA also might provide referrals.

Domestic violence can affect anyone in an intimate relationship. Staying in an abusive relationship might leave you depressed, anxious and hopeless. If you don't want to disclose your same-sex relationship or sexual identity, you might be less likely to seek help after an assault.

Still, the only way to break the cycle of domestic violence is to take action — the sooner the better. Some sexual minority women struggle to find a doctor knowledgeable about their specific health issues and with whom they feel comfortable discussing their needs and concerns.

The GLMA website is one place to find referrals for doctors. Look for a doctor who is curious, empathic and respectful of your specific needs. If you're not in a long-term, mutually monogamous relationship, schedule regular screenings for sexually transmitted infections. Share any other health concerns you might have with your doctor as well.

Early diagnosis and treatment help promote long-term health. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below.

A single copy of these materials may be reprinted for noncommercial personal use only. This site complies with the HONcode standard for trustworthy health information: verify here. This content does not have an English version. This content does not have an Arabic version.

Make an appointment. Visit now. Explore now. Choose a degree. Get updates. Give today. Healthy Lifestyle Adult health. Products and services. Free E-newsletter Subscribe to Housecall Our general interest e-newsletter keeps you up to date on a wide variety of health topics.

Sign up now. Health issues for lesbians and women who have sex with women Know important health issues for lesbians and women who have sex with women — from sexually transmitted infections to depression — and get tips for taking charge of your health. By Mayo Clinic Staff.

Show references Lesbian and bisexual health. Accessed Sept. Carroll NM. Medical care of sexual minority women. Knight DA, et al. Preventive health care for women who have sex with women.

American Family Physician. Sexually transmitted diseases treatment guidelines, Centers for Disease Control and Prevention. Intimate partner abuse and relationship violence. American Psychological Association. Faubion SS expert opinion. Mayo Clinic, Rochester, Minn. Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.

Reprint Permissions A single copy of these materials may be reprinted for noncommercial personal use only.

Lesbian sex and disease

Lesbian sex and disease