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Lesbian and Bisexual Women

Narrative

Research suggests that lesbian and bisexual women are at increased risk for adverse health outcomes, including overweight and obesity, poor mental health, substance abuse, violence, and barriers to optimal health care resulting from social and economic inequities.1,2 Although frequently referred to as part of a larger group of sexual minorities, including gay men and transgender individuals, the health status and needs of lesbians and bisexual women are uniquely shaped by a range of factors including sexual identity and behavior, as well as traditional sociodemographic factors, like age, education, and race and ethnicity. The terms “lesbian” and “bisexual” are used to define women according to their sexual orientation which can reflect sexual identity, behavior, or attraction;3 however, for the purposes of the data presented on this page, both lesbian and bisexual refer to women’s self-reported identity.4

In 2006–2008, 1.1 percent or 590,000 women aged 18–44 years self-identified as homosexual, gay, or lesbian and 3.5 percent or 1.9 million self-identified as bisexual. The proportion of women who reported any same-sex sexual behavior, however, was substantially higher at 12.7 percent, while 16.7 percent of women in this age group reported some degree of same-sex attraction.

Among reproductive-aged women in 2006–2008, differences were observed for several health indicators by sexual identity. Bisexual women were less likely than heterosexual women to report having health insurance (72.4 versus 79.9 percent, respectively) and marginally less likely to report being in excellent or very good health (58.9 versus 68.1 percent, respectively); no significant difference was observed between lesbian and heterosexual women for either indicator. Conversely, while approximately 66 percent of heterosexual and bisexual women received a Pap smear in the past 12 months, only 38.3 percent of lesbians reported receiving this service. Both lesbian and bisexual woman, however, were about twice as likely as straight women to report smoking and binge drinking (defined as consuming 5 or more drinks within a couple of hours at least once a month during the past year). Nearly half of lesbian and bisexual women reported smoking, while 31.8 percent and 21.2 percent of lesbians and bisexuals, respectively, reported binge drinking.

A recent report from the Institute of Medicine concluded that to better understand and meet the unique needs of lesbian, gay, bisexual and transgender people, more data are needed in several priority areas: demographics, social influences, health care inequalities, and transgender-specific health needs.3 The U.S. Department of Health and Human Services is working to increase the number of federally-funded health and demographic surveys that collect and report sexual orientation and gender identity data.5

1 U.S. Department of Health and Human Services. Healthy People 2020: Lesbian, Gay, Bisexual and Transgender Health. Accessed 05/23/11.
2 Mayer KH, Bradford JB, Makadon HJ, Stall R, Goldhammer H, Landers S. Sexual and gender minority health: what we know and what needs to be done. Am J Public Health. 2008;98(6):989-995.
3 National Academy of Sciences, Institute of Medicine.External Web Site Policy The health of lesbian, gay, bisexual and transgender people: building a foundation for better understanding. Accessed 05/23/11.
4 Chandra A, Mosher WD, Copen C, Sionean C. Sexual behavior, sexual attraction, and sexual identity in the United States: Data from the 2006–2008 National Survey of Family Growth. National health statistics reports; no 36. Hyattsville, MD: National Center for Health Statistics. 2011. Accessed 05/25/11.
5 U.S. Department of Health and Human Services. Recommended Actions to Improve the Health and Well-Being of Lesbian, Gay, Bisexual, and Transgender Communities. Accessed 05/25/11.

Graph

Data

Selected Health Indicators Among Females Aged 18–44 Years, by Sexual Identity, 2006–2008
Health Indicator Percent of Women
Heterosexual or Straight Homosexual, Gay, or Lesbian Bisexual
*Smoked at least one cigarette per day on average in the past year.
**Defined as consuming 5 or more drinks within a couple of hours at least once a month on average in the past year.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. National Survey of Family Growth 2005-2008. Analysis conducted by the Maternal and Child Health Bureau.
Insured 79.9 78.0 72.4
Excellent/Very Good Health Status 68.1 62.0 58.9
Received Pap Smear in past 12 Months 66.2 38.3 66.7
Current Smoking* 23.7 44.8 55.9
Binge Drinking** 12.7 31.8 21.2

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