Health needs of women who have sex with women

Editor—The health needs of lesbian women clearly deserve more attention. I strongly agree with Hughes and Evans's statements about the importance for healthcare providers to understand that lesbianism is within the normal range of sexual behaviour and to reduce perceived and actual prejudice in medical settings.¹

However, the editorial seems to neglect some essential methodological problems related to the epidemiology of lesbian health by listing conditions where lesbians are supposedly at special risk.

The Solarz report from the Institute of Medicine reviewed empirical research about physical and mental health in lesbian women.² The report concludes that they are vulnerable for the consequenses of specific psychosocial pressure related to marginalisation, and that the healthcare system does not provide sufficiently culture sensitive care for women who have sex with women. Apart from this, no conclusions can yet be drawn about the relative risk or prevalence of breast cancer and other disorders in lesbian women. So long as representative population based samples are not available, where people give an honest answer to the question of sexual orientation, quantitative comparisons between lesbian and heterosexual women cannot be accomplished or justified.²

I am surprised that the BMJ did not question the methodological assumptions underlying the epidemiological conclusions drawn from the studies referred to in this editorial. More research is needed within this field, rather than re-forwarding epidemiological myths about the health of lesbian women.