'Lesbians Don't Need Birth Control'

Debunking the Myth and Assessing Contraceptive Health Problems

This feature was created by Eric, Caroline, and Russell

Lesbians have short hair. Lesbians hate men. And most of all, lesbians don’t have sex with men. These are only a few of the common myths and stereotypes circulating about young women who have sex with women. Such stereotypes also impede lesbians’ access to sexual health information. Pregnancy happens among lesbian teens. Contrary to popular belief, self-identifying as lesbian or gay does not mean that someone will never have sex with a member of the other sex.

People who are questioning their sexual orientation may experiment in an effort to determine their sexual identity. Sometimes, gay or lesbian people have heterosexual relationships to hide their sexual orientation or for other personal, cultural, or family reasons. Unprotected sex with a male puts a lesbian at risk of pregnancy. Unprotected sex with anyone of either sex puts lesbians at risk of sexually transmitted infections (STIs). Being lesbian is no protection against pregnancy or STIs. Unfortunately, health care professionals often assume, incorrectly, that lesbians do not need information about pregnancy prevention or STI testing and treatment. They also assume, also incorrectly, that heterosexual youth never have same-sex partners.

Lesbian teens are twice as likely as their heterosexual peers to experience unintended pregnancy. So, young lesbians are in the unusual position of often needing to educate their doctors about their reproductive health needs. Some things may help:

• Notice whether the clinic has a nondiscrimination policy posted in the waiting room or lobby and whether it included both sexual orientation and gender identity.
• Ask about the clinic’s policies on confidentiality and what steps staff takes to ensure that others don’t accidentally learn of your visit. [For example, is the clinic careful about phone calls, mailed reminders, and bills?] Parental notification for some medical procedures is a requirement in many states; but the clinic should let you know, in advance, about any procedure that requires parental notification or consent. Clinics receiving Title X family planning funding must, by law, ensure your confidentiality.
• Bring a written list of questions you need answered. During a visit, it can be difficult to remember your questions. But, if they are in writing, the questions are easy to remember. Be sure to write down the answers as well.
• Be honest about your sexual and medical history.
• Talk to the doctor or physician assistant right then on any stereotypes, judgmental statements, or misconceptions about teens or about lesbians that arise during your conversation. The doctor isn’t there to judge you. For good quality care, you need an informed, nonjudgmental health care provider. And the doctor needs to know about you in order to make good recommendations for your sexual and reproductive health.

Unfortunately, research shows that many health care providers do not have inclusive practices. So, contact health clinics directly and ask about their policies. Do they serve lesbian, bisexual, and questioning teens as carefully and respectfully as heterosexual teens? Are they aware that lesbian teens frequently experience unintended pregnancy?

What might an ideal clinic visit be like? Click here!

One investigation of women’s clinics, GLBT-focused clinics, and university clinics uncovered gaps in services regarding young women’s sexual health. In all three types of clinics, researchers found similar assumptions regarding lesbians’ need for reproductive health care. Women’s clinics rarely saw lesbians as being at risk for pregnancy—a view based solely on lesbians sexual identity. Likewise at GLBT-focused clinics and university clinics, staff was surprised to hear that lesbian teens frequently experienced unintended pregnancy. Clinics’ outreach services regarding EC (i.e., peer education, voicemail referral during non-operating hours, etc.) were consistently lacking or inadequate.

The researchers concluded that offering emergency contraception to teenage women, regardless of their sexual orientation, could be an important piece in helping them prevent unintended pregnancy.

Emergency contraception (EC) is a form of back-up birth control. EC is a time-sensitive method of preventing unintended pregnancy after unprotected sex. EC—often repackaged birth control pills or the specifically packages Plan B TM—is good for up to 120 hours (five days!) after unprotected sex. EC does not affect a fertilized egg or an established pregnancy. EC is not Mifeprix (the abortion pill). EC can prevent half of all the unintended pregnancies U.S. women experience each year. EC is a hugely important element for ensuring the reproductive and sexual health of lesbian teens!

So what does this mean for you? Getting quality medical service is chancy, unless you are willing to take control, ask questions, and insist on quality care. No one can gauge how a health care provider will react to an individual’s sexual identity or sexual experiences. But, lesbian youth can educate their providers and demand respectful, comprehensive care.

Health care providers often need to understand that sexual identity and sexual behaviors are two very separate things

• Lesbian and gay adolescents may not be sexually experienced.
• Lesbian and gay adolescents may have had heterosexual sex.
• Heterosexual adolescents may have had same-sex sexual experiences.
• Self-identity and behaviors are never the same thing.

It’s important to know yourself and your body. It’s important to establish a mutually respectful relationship with your practitioner, so that she/he is aware of your needs and the risks you face. You can then work together to meet those health care needs and to reduce those risks. You want a partnership with your health care provider, and both members of a partnership have to work at it to make the partnership effective.

Just remember …

• Ask about their policies!
• Take your written questions with you!
• If necessary, assert your right to be treated with dignity and to have your needs met!
• If your health care provider’s statements or questions betray ignorance or stereotyped thinking about teens or about lesbians, take this opportunity to educate him/her!

References

1. American College of Obstetricians and Gynecologists. Health Care for Adolescents. Washington, DC: ACOG, 2003.
2. Romer, Daniel, ed. Reducing Adolescent Risk. Thousand Oaks, CA: Sage Publications, 2003.
3. Ryan, Caitline and Donna Futterman. Lesbian and Gay Youth. New York: Columbia University Press, 1998.