Deciding whether or not to get a pap smear or when to start having an annual
mammogram is confusing enough for many women who are faced with conflicting
research and recommendations. Making these decisions can be even more daunting
for a lesbian, bisexual or transgender woman. Right now, little is known or
information isn’t readily available about the health of lesbian, bisexual and
transgender women and their health care experiences primarily because of a lack
of research This lack of research could be impacting the quality of health care
services these women receive, according to UCSF researchers.
To fill this void, UC San Francisco’s Institute for Health & Aging and School
of Nursing has created the Center for Lesbian Health Research. One of the
center’s objectives is to identify the health research needs of lesbians,
bisexual and transgender women, and to determine how they are any different
from those of heterosexual women. Another objective is to coordinate and
compile research that is already available into one location and provide
findings on line for individuals, researchers and health care providers, UCSF
The main thrust of the UCSF center is to initiate and support research projects
that can be used to educate both providers and lesbians, bisexuals and
transgender women on their unique health issues and to provide culturally
appropriate care and outreach, said Suzanne Dibble, RN, DNSC, adjunct professor
in the Institute for Health & Aging and co-interim director for the Center for
Lesbian Health Research. The center also will work to debunk misconceptions
about lesbian, bisexual and transgender women’s health held by both doctors and
these individuals, Dibble said.
Pat Fox, PhD and Wendy Max, PhD, co-directors of the UCSF Institute for Health
& Aging, noted that the Center adds another dimension to the Institute’s goals
of serving women across the lifespan and provides the science for public policy
decisions and public education necessary to improve health and aging.
Researchers already know from the Institute’s projects on breast cancer that
minority communities and their providers face many cultural and social barriers
that need to be overcome with education and appropriate outreach, they said.
Lesbians, bisexual and transgender women health research is an extension of
that research, they added.
One way to gather more information about lesbian health is to include the
question of sexual orientation into data collection forms for health studies,
much in the same way as race is factored in, Dibble said. “Nobody is asking the
question of sexual orientation,” she said. “so we can’t do the descriptive
studies that need to be done.”
The center also wants to help make sure lesbians, bisexuals, and transgender
women get the health services they need, Dibble said. “These women are less
likely to get pap smears,” she said. “Some physicians say you don’t need to
have a Pap smear unless you are with a man. We know that’s not true.” Dibble
also said that lesbians, bisexual and especially those women who live as men,
often do not get regular breast exams.
“We are trying to look at more than what is, but what is going on behind it and
what we can we do to change it,” Dibble said. “Simply put, these communities,
as with other minorities and/or cultures, have both individual and provider
bias in the delivery of health care and the design of appropriate
Patricia Robertson, MD, is co-interim director of the center and associate
professor in the Department of Obstetrics, Gynecology and Reproductive
Sciences. Robertson is co-founder of Lyon-Martin Women’s Health Services
established in 1978 to provide medical care to low-income lesbians and other
women in the Bay Area.
The center’s faculty are working on several different studies that address
issues related to lesbian health including breast cancer risk factors in
lesbians compared to heterosexual women, types of health care providers sought
by lesbians compared to heterosexual women, and HIV transmission between women.
Another study follows the children of lesbian couples from infancy to grade
school to see how well they do in school and how socially adjusted they are,
compared to children of single mothers and of male/female couples.
The Center for Lesbian Health Research was formed in September 1999 after the
Institute of Medicine produced a report titled Lesbian Health Research
Priorities. Among its’ conclusions: additional data is required to determine if
lesbians may be at higher risk for certain health problems; there are
significant barriers to conducting research on lesbian health-including lack of
funding-which have limited the development of more sophisticated studies; and
research on lesbian health will help advance scientific knowledge that is also
of benefit to other population groups. “That legitimized the decision that this
was the time and place for a center and that it would be appropriate,” Dibble
The center is one of the first of its kind, Dibble said. Currently, the goals
for the immediate future are to create a web page with frequently asked
questions for clinicians and current research abstracts, co-sponsor with the
City of San Francisco, the Lesbian, Bisexual and Transgender Health Research
Forum, and increase core support funding. The center is recruiting lesbians who
want to participate in different research projects and UCSF researchers to join
For more information on the center, call Sue Dibble, Co-Director, 476-5685.