ABSTRACT
The investigation of diverse sexual orientations and associated health outcomes is emerging as an important research area (Institute of Medicine, 1999). Sexual orientation may influence health behaviors, risk for disease, and health outcomes in at least two important ways. First, lesbians may have differential risk of negative health outcomes for specific diseases because of a different prevalence of risk factors for those diseases due to lower rates of early detection. One hypothesis is that lesbians may be at increased risk for breast cancer based on a confluence of risk factors more prevalent in lesbians (Haynes, 1994; Denenberg, 1995; Brownworth, 1993; Gallagher, 1997; Brandt, 1993). These risk factors include higher reported rates of nulliparity (Gage, 1994; Bradford, Ryan, & Rothblum, 1994) and alcohol consumption (Skinner & Otis, 1992; Skinner, 1994; McKirnan & Peterson, 1989) compared with heterosexual women. Second, lesbians may perform health screening behaviors at different rates than heterosexual women. Lesbians reported that they were half as likely as heterosexual women to get mammograms and to perform regular breast self-examination (Trippet & Bain, 1992; Deevy, 1990; Polena, Gillispie, Lederman, &
KEYWORDS. Lesbian health, sexual orientation, health behaviors, mammography, Pap testing
O ’Hara, 1994), thereby losing the 25% survival benefit attributed to such screening. If lesbians have lower rates of early detection because of lower rates of performing screening behaviors, this could lead to higher mortality.
