Lesbian Health

Tip Sheet for Health Care Providers

By reading the Caring for Lesbian Health booklet and distributing the health promotion postcards, you have already taken important steps towards helping improve care for your lesbian and bisexual women patients.

Here are some other steps you can take:

• Avoid making assumptions about gender or sexual identity or about sexual/health behaviours. Let the patient tell you about herself and her issues.
• Ask questions about sexual behaviour, not sexual identity. Instead of asking "Are you sexually active?" try "Are you currently sexually active? If so, are you active with men, women or both?" Instead of "What form of birth control do you use?" try "Do you need to use birth control?" This opens the door for all patients to talk about their sexual histories and behaviours.
• Ask non-judgmental, open-ended questions to solicit information about psycho-social stressors and supports. This demonstrates a sensitive and holistic approach to health.
• Be aware that in many provinces, same-sex partners are not considered next-of-kin. Ask every patient to define in writing whom they want involved in their care if necessary. For example, leave a blank line on your patient information form for patients to identify an emergency contact or to identify a partner if they wish. Encourage lesbian patients with female partners to put their wishes in writing, especially on these two issues: (1) name the partner as the one who can make decisions if the patient becomes mentally incompetent; (2) specify that the partner has full visitation rights in hospitals and care facilities.
• Be aware that lesbians who have lost a lifelong partner or who are living with a partner with a debilitating disease experience pain and problems as would any heterosexual widow or spouse.
• Be aware that families in the lesbian community are often differently constituted than those in traditional, heterosexual society. For example, to many lesbians, friends are family. For lesbian patients in hospital or care facilities, it may be especially important to keep visitor guidelines as flexible as possible.
• Respect the importance of lesbian music and books to some lesbians. Ask lesbians who are ill or dying what their friends can bring that will make the surroundings more familiar and help ease the process.
• Screen for, address and treat patient concerns linked to mental health and substance use. Recognize the impact that societal oppression has on these health issues. Screen for, address and treat concerns related to abuse and violence, whether domestic, sexual or bias-related.
• Make referrals with sensitivity. If your patient has trusted you and come out as a lesbian, keep this in mind when referring to other practitioners. Try to refer to providers who are sensitive to issues of diversity.
• Find out whether a group in your area (e.g., lesbian/gay group, anti-discrimination course or union organization) offers homophobia education workshops or workshops about providing sensitive care to lesbians, gays and bisexuals, then attend it. If no such workshops exist, ask a lesbian/gay group to offer one to you and your colleagues. (For ideas, see the Resource/Referral list at the back of the Caring for Lesbian Health booklet.)
• If you do not have easy access to a group that can offer homophobia education workshops, order the Mautner Project's Tools for Caring about Lesbian Health Kit (1998), which includes an 18-minute training video and a discussion guide for health care providers, as well as other information. Then organize an education/discussion evening for yourself and your colleagues. For ordering information, contact:

Mary Helen Mautner Project for Lesbians with Cancer
1707 L Street, Ste 230
Washington, DC 20036
(202) 332-5536
Email: Mautner@mautnerproject.org