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Avoiding the doctor

Lesbians miss pap smears, bisexuals underserviced

Queers are struggling with routine healthcare and preventative medicine, says a report from Statistics Canada. Among other things the report found that lesbians are less likely than straight women to have a regular doctor and that bisexuals are more likely than straight or gay/lesbian respondents to have health issues they’re not getting adequate treatment for.

“The self-perceived general health of gay men and lesbians was similar to that of heterosexuals,” states the report, which draws on data from the 2003 and 2005 Canadian Community Health Survey (CCHS). “By contrast, bisexuals were more likely than heterosexuals to report fair or poor health.
“Gay men and bisexual women tended to report more chronic conditions than did the heterosexual population…. When respondents were asked if they had been diagnosed with a mood or anxiety disorder, all sexual minority groups reported levels above those for the heterosexual population.”

Anna Travers, director of Rainbow Health Ontario, a newly formed network seeking to improve healthcare for queers in the province, says she’s not surprised by the contents of the report.

“There have been a number of studies in different parts of Canada and other jurisdictions that show we as a population tend to avoid healthcare particularly when we feel that we may not be treated respectfully or that our needs may not be understood,” says Travers, “There’s a pattern in particular of avoiding preventative healthcare.”

The study found that fewer than two-thirds of lesbian women report having had a pap smear, which tests for early signs of cervical cancer, within the last three years — well below the number of straight women who had been tested in that time.

Travers says it’s difficult to gauge how big of a concern this is because it’s not known to what extent lesbians are at risk for cervical cancer compared to straight and bisexual women, but she adds that the Rainbow Health Ontario recommends that all women follow the Ontario Screening Guidelines. These call for a pap test once a year for any woman who is sexually active, regardless of what sort of sexual activity they engage in.

The study also raises a red flag about mental health issues among bisexual men and women. “Bisexual men were more than twice as likely as heterosexual men to perceive their mental health as fair or poor; for bisexual women, the proportion reporting fair or poor mental health was three times that of heterosexual women,” states the study.

Travers says this point is particularly important to highlight. “People in both the straight and queer communities sometimes think that bisexuals have it a bit easier,” she says. “These figures seem to show that people who self-identify as bisexual seem to have more health concerns and unmet needs than either lesbian or gay-identified people.”

The report, authored by Michael Tjepkema, suggests the situation may be worse than what was captured by the study because queers who are reluctant to come out to their doctors may also have declined to self-identify during the study.

“Respondents who disclosed their sexual identity to a CCHS interviewer,” Tjepkema writes in the report, “might be more open about their sexuality to others, and as a result, might be more inclined to use the healthcare system.”

Travers says education is key to addressing the issues raised in the report. “We need to ensure that healthcare providers are more aware of LGBT people in their practices and more conscious of their needs. LGBT people also need to have more information and more education about what some of their health issues are.”

The report focused on sexual identity; information on whether or not respondents were trans was not gathered in CCHS data.