Index
A
Access to health care, 6
defined, 37
financial barriers, 5, 10, 37, 41-42, 157
focus of women's health services and, 45-46
literature on, 186-189
personal/cultural barriers, 5, 10-11, 37, 42-46, 157-158
research recommendations, 10-11, 87, 157-158
structural barriers, 10, 37, 40-41, 157
Adolescents. See Children and adolescents
Adoption by same-sex parents, 37, 53
Adult lesbians, developmental issues, 52-54
Affective disorders, 68-69
African Americans
cultural values, 24
depressive distress in, 61
HIV seroprevalence, 76
Lesbian studies, 108-109
Age
and awareness of sexual identity, 50-51
and cancer risk, 56
and coming out, 48-49
and dimensions of same-sex sexuality, 28
and drinking behaviors, 80
Alcohol use, 56, 58, 64, 65, 68, 79-81, 102-103, 120
American Academy of Pediatrics, 44 n.4
American Community Survey, 160
American Medical Association, 44 n.4
American Psychiatric Association, 36, 44 n.4
American Psychological Association, 44 n.4
Division 44, 137
American Sociological Association, 138
Antigay hate crimes, 36, 38, 42
Artificial insemination, 54, 76
Asian American lesbians and gay men, 24
B
Bacterial vaginosis, 73, 102-103
Bisexual women, 4, 22-23, 27, 31, 32
HIV seroprevalence, 76
reproductive health studies, 106-107
Body mass index (BMI), 57, 64, 67, 68
Breast cancer, 21, 46, 64, 65, 67, 141, 142
Bureau of Labor Statistics National Longitudinal Surveys, 128
C
See also specific forms of cancer
literature on, 177
prevention studies, 112-113
research recommendations, 86
risk factors, 55, 56, 64-67, 86
Cardiovascular disease, 42, 46, 62, 68, 86, 112-113
Centers for Disease Control and Prevention, 1, 14, 18, 140
lesbian research and programs, 142, 162-163
Office of Women's Health, 19
Cervical cancer, 66-67, 70, 73, 142
Chicago Women's Health Study, 102
Childhood sexual abuse, 58-59, 70, 77, 81
Children and adolescents
coming-out process, 51-52
development of sexual identity, 50-51
heterosexual activity, 78
literature on, 170-173
raised in lesbian households, 53-54
sexuality studies, 149
Civil rights protection, 39
Clearinghouses on lesbian health, 163
Colon and rectal cancer, 64, 67
Coming out
age and, 48-49
coping mechanisms, 51
cultural contexts of, 24, 49-50, 55
to health care providers, 6, 40, 44-45
lesbian academics, 138
Committee on Lesbian Health Research Priorities, 17, 18
Conferences on Health Survey Methods, 162
Confidentiality, 9, 13, 113, 128-129, 150 n.12, 152-153, 161, 162
Contextual barriers to research, 135-136
career ramifications, 8, 136-138
funding to study lesbian health, 8, 9, 97, 137, 139-140, 153
mentors for lesbian researchers, 8, 138-139, 164
publishing and disseminating findings, 14-15, 140-144, 153, 161
strategies for overcoming, 14-15, 144, 163-164
training and education of researchers, 14-15, 163-164, 203-204
Coronary Artery Risk Development in Young Adults, 62 n.10
Cultural competency of health care providers, 5, 41, 42-44, 157
D
Definition of lesbian, 21-23
methodological issues, 3, 6-7, 10, 23, 97-98, 99, 100-101, 102-114, 156-157
racial/ethnic minority perspectives, 3-4, 23-25
Department of Health and Human Services, 149
Secretary's Task Force on Youth Suicide, 52
Depressive illness, 60, 61, 68-69, 80
Developmental challenges of lesbians, 5, 46, 48
children and adolescents, 7-8, 50-52
coming out, 6, 48-50, 51-52, 157
research recommendations, 85
Disclosure of sexual orientation.
See also Coming out
audio computer-assisted self-interview, 8, 115-117
to researchers, 23, 31 n.9, 97, 99 n.1, 114-115, 118-119, 120, 128 -129
Discrimination. See Prejudice and discrimination
Domestic partner benefits, 5, 37, 41
Duke University, 141
E
East Asian cultural values, 24, 25
Eating disorders, 42
Education, and dimensions of same-sex sexuality, 28
ENCOR Eplus programs, 142
Endometrial cancer, 67
Ethical issues, 150
confidentiality, 9, 113, 152-153
risks to research participants, 9, 151
Ethnographic research, 114
F
Federal Bureau of Investigation, 36
Foster parents, same-sex, 37, 53
G
Gay and Lesbian Medical Association, 19, 139, 143 n.6
Gay Urban Men Survey, 117, 122-123
General Social Survey, 26 n.4
Genital warts, 78
Geographic distribution
of dimensions of same-sex sexuality, 29
of lesbians, 119
Georgetown University, 141
Gynecological care, 21, 42, 66-67, 112-113
H
Health, definition, 17 n.1
Health care providers
cultural competency, 5, 41, 42-44, 157-158, 163-164
dissemination of lesbian health information to, 14-15, 163
recognition of partners, 41
sexual history taking, 43-44, 45
Health insurance coverage, 41-42
Health-seeking behaviors, 43, 112-113
Herpes, 78
Heterosexual activity, 52, 56, 66, 78
HIV/AIDS, 3, 21, 54, 61, 71, 74, 75-79, 82, 86, 102-107, 148, 189-192
HIV Epidemiology Research Study, 142
Homophobic attitudes, 5, 44, 151, 174-176
Homosexuality, APA classification, 36
Hormone replacement therapy, 68
Human papillomavirus infection, 56, 66, 73, 78
I
Identity. See Sexual identity
Illicit drug use, 76, 79, 81-84, 104-105, 177-180
Inter-University Consortium for Political and Social Research, 27 n.6
Institutional review boards, 12-13, 153, 161
J
Jews, dimensions of same-sex sexuality, 28
L
Latino cultural values, 24-25
Legal status of gay men and lesbians, 36-37, 38-39, 41, 152
Lesbian AIDS Project, New York City, 142
Lesbian Health Fund, 139
Literature on lesbian issues, 18, 140
adolescents, 170-173
aging, 173-174
attitudes and homophobia, 174-176
cancer, 177
drug abuse, 177-180
ethnic, racial, and cultural minority groups, 180-182
family, 182-184
general, 165-170
health, 185-186
health care services, 186-189
HIV/AIDS, 189-192
mental health, 192-197
methodology of studies, 198-199
relationships, 199-200
reproductive health, 200-201
sexual behavior, 201
sexually transmitted diseases, 201-202
suicide, 202-203
training and education, 203-204
violence, 204-206
work, 206
Lyon-Martin Center, San Francisco, 142
M
Maine, 37
Marital status, and dimensions of same-sex sexuality, 28
Measures of sexual orientation, 7, 11-12, 22, 26-27 n.5, 30-32, 97 -98, 99, 101-114, 158-159
Menstrual synchrony in couples, 112-113
Mental health of lesbians, 54, 68-70
research recommendations, 10, 85-86
studies, 102-103, 108-109, 192-197
Methodological issues in research, 136.
See also Sampling strategies
adding sexual orientation questions to existing studies, 12-13, 119 , 126-129, 159-160
cross comparison of findings, 97-98, 101
defining the population, 6-7, 10, 23, 97-98, 99, 100-101, 156-157
disclosure of sexual orientation, 7, 97, 99 n.1, 114-117, 118-119, 122, 128-129
generalizability of conclusions, 7, 23, 33, 55, 70, 98, 118
literature on, 198-199
measures of sexual orientation, 7, 11, 97-98, 99, 101-114, 158-159
research recommendations, 9, 101, 114, 129-130, 156-157, 158-159
sample representativeness, 75, 80, 98, 118, 120
Miami University, 141
Michigan Lesbian Health Survey, 36, 41, 42, 43, 45, 74, 106-107
Minnesota, 52
Morality issue, 150
Multicultural Men's Health Study, 123
N
National Association of Social Workers, 44 n.4
National Black Lesbian Study, 108-109
National Cancer Institute, 65, 141
National Center for Injury Prevention and Control, 142
National Comorbidity Survey, 68, 69
National Gay and Lesbian Health Association, 43 n.3
National Health and Nutrition Examination Survey, 119, 128, 160
National Health and Social Life Survey (NHSLS), 26 n.4, 27, 30 n.7, 57, 72 n.18, 74, 83, 84, 108-109
National Health Interview Survey, 119, 128
National Household Survey on Drug Abuse, 55, 79, 82, 160
National Human Subjects Protections Education Workshop Program, 162 -163
National Institute of Allergy and Infectious Diseases, 140
National Institute of Child Health and Development, 149
National Institute of Mental Health, 140
National Institute on Drug Abuse, 140
National Institutes of Health, 12-13, 160
conference support, 14, 162-163
Office of Protection from Research Risks, 163
Office of Research on Women's Health, 1, 17-18, 19, 140, 144
Revitalization Act, 149
National Lesbian and Bisexual Women's Health Survey, 78
National Lesbian Health Care Survey (NLHCS), 36, 41-42, 45, 57, 58 , 63, 66, 69, 81-82, 108-109
National Opinion Research Center, 83 n.23, 148-149
National Research Council
Committee on AIDS Research and Behavioral and Social Sciences, 99 n.1, 150 n.12
Committee on Evaluating Genetic Diversity, 150 n.12
National Survey of Adolescent Males, 116
O
Office of Management and Budget, 149
Oral contraceptive use, 56, 57-58, 64, 67, 68
Osteoporosis, 112-113
Overweight and obesity, 56, 57, 62, 64, 65, 68, 102-103
P
Partners, lesbian.
See also Domestic partner benefits
alcohol use, 81
legal recognition of, 41
relationships, 199-200
Pregnancy history, 56, 57, 64, 65
Prejudice and discrimination
and coming out, 49
laws against, 37
lesbian researchers, 136
research used for, 151
studies of, 106-107
Prevalence of being lesbian, 23, 26, 28-29, 57
Preventive health care, 45-46, 104-105, 112-113
Professional associations, provider, 44
Prostitution, 78
Protective factors for health, 6, 10, 13-14, 63, 68, 85, 156
Protestants, 28
Providers. See Health care providers
Public liaison group, 18
R
Racial discrimination/racism, 61-62
Racial/ethnic minorities
cancer risk, 64
and dimensions of same-sex sexuality, 3-4, 29
perspectives of sexual orientation, 23-25
research needs, 13, 117-118, 146, 156, 157, 160-161
studies of lesbians of, 13, 54-55, 70, 106-109, 129, 180-182
Religion.
See also specific religions
and dimensions of same-sex sexuality, 28-29
influences on attitudes, 24, 25
Reproductive health, literature on, 200-201
Research on lesbian health
adolescents, 153
barriers, see Contextual barriers to research
community-researcher collaboration, 8, 145-148
ethical issues, 150-153
funding, 7, 11-12, 141, 144, 148-150, 158
longitudinal, 99
methodologies, see Methodological issues in research
needs and recommendations, 10-11, 50, 81, 84-87, 99, 156-164
racial and ethnic minorities, 54-55
uses, concerns about, 151, 162
Risk factors for lesbian health
beliefs and misconceptions, 2, 21, 63, 65, 72-73, 76-77
communication with providers and, 43
literature, 185-186
research recommendations, 9, 10, 13-14, 85, 155, 156, 161-162
S
Sampling strategies, 117-118.
See also Methodological issues in research
combining strategies, 126, 158-159
disproportionate stratification, 122-123
location (convenience), 80, 81, 98, 120, 125-126
multiple frames, 123-124
multiplicity or network, 124
nonprobability, 7, 80, 119-120, 125-126, 139
one-stage screening, 121-122
probability, 7, 13-14, 27, 33, 68, 81, 82, 98, 116, 117, 118-119, 121-124, 158-159, 161-162
selection bias, 119, 121-122, 126
snowball, 125
two-stage screening, 122
Sensitization, 48
Sexual behavior.
See also Sexual practices
and cervical cancer, 66
and definition of lesbian, 22, 26, 102, 104, 106, 108, 110, 112
funding of research on, 8-9, 148-149
history taking by providers, 43-44, 45
and illicit drug use, 83-84
literature on, 201
longitudinal studies, 7-8, 110-111
measures of, 30-31
and sexual identity, 32
Sexual desire/attraction, measures of, 30 n.7, 32, 103, 113
Sexual identity
adolescents, 110-111
and alcohol use, 102-103
appeal and sexual behavior by, 32
bisexual, 22
confusion, 77
definitional issues, 22, 26, 102, 104, 106, 108, 110, 112
and discrimination, 106-107
and gynecological care, 112-113
and HIV risk behavior, 104-107, 110-111
measures of, 27 n.7, 31 n.9, 102, 104, 106, 108, 110, 112
and mental health, 102-103, 108-111
racial, ethnic, and cultural perspectives, 3-4, 23-25, 106-109
and reproductive system problems, 106-107
and sexual practices, 102-113
and weight/dieting, 102-103
Sexual orientation
age of awareness of, 50-51
children raised in lesbian households, 53
determinants of, 51
dimensions of, 3-4, 5, 25-33, 101, 102-114
Kinsey scale, 112-113
measures of, 7, 11-12, 22, 26-27 n.5, 30-32, 99, 102-114, 158-159
racial/ethnic minority perspectives, 23-25
and smoking, 55-57
underreporting, 33 n.10
Sexual practices
assumptions about, 70-71
and discrimination, 106-107
disease prevention studies, 112-113
and gynecological care, 112-113
and HIV/AIDS, 77-78, 102-107, 110-111
and menstrual synchrony in couples, 112-113
and mental health, 102-103
and reproductive health, 106-107
Sexually transmitted diseases (STDs), 54, 66, 67-75, 78, 86, 102-105, 110-111, 149, 201-202
Smoking, 42, 55-57, 64, 67, 68, 81
Social networks and support systems, 63, 77, 125
Socioeconomic status, 13, 62, 70, 156, 160-161
Stanford University, 141
Stigmatization, 5.
See also Prejudice and discrimination
of conducting research, 136, 137
of lesbian academics, 137-138
research data used for, 152
and stress, 21
Stress, 3, 21, 59-62, 63, 65, 68, 81
Substance abuse, 54, 77, 79, 86-87.
See also Alcohol use;
Illicit drug use
Suicide, 51-52, 69-70, 110-111, 202-203
Survey of Family Growth, 117
T
U
University of North Carolina, 149
University of Washington, 78
University of Wisconsin, 141
U.S. Census of Population and Housing, 128
Uterine cancer, 64
V
Violence against gay men and lesbians, 36, 42, 49, 59, 61, 70, 204 -206
W
Whitman Walker Clinic, Washington, D.C., 142
Women's Health Initiative, 55, 57, 112-113, 114, 127, 128, 139
Work, literature on, 206
Workshop
written testimony, sources, 19, 223-226
Y
Yale University, 142
Young Women's Christian Association, 142
Youth Risk Behavior Study, 160