Lesbians’ health: myths and realities

The right to health is specifically on those related to Feel free to share and recognised in numerous lesbians’ health. disseminate the information, international and regional we count on you to demystify treaties as a fundamental part Three double-sided sheets those myths! of human rights. Many countries focusing on the “myths and around the world have included realities” surrounding lesbians’ ILGA is grateful for the financial the right to health in their health have been produced. support of the Belgian Foundation constitution. This means that The themes tackled are Breast against Cancer for the English governments must create the and Cervical Cancers, HIV and version and for the contribution of conditions so that every citizen Sexually Transmitted Infections, ILGA’s Women’s Secretariat, Minority can enjoy the best state of and Well-Being. The illustrations Women in Action. health possible. reflect the content of the texts. Those sheets can also be used The initial project in French and in Health is not immune to some individually and are available in Dutch was financially supported by the myths; and when the health French, Dutch and English. Belgian Foundation against Cancer. It of lesbians* is concerned, we was coordinated by ILGA with the help are confronted with many The information contained in of the following Belgian associations: Support ILGA’s work, stereotypes linked to sexual the sheets aim to: Maison arc-en-ciel, Plan F, Tels Quels, make a donation: orientation and gender • Improve the health of Merhaba, Fédération des Centres de www.ilga.org that can have adverse lesbians Planning Familial, Fédération laïque consequences on the health • Demystify myths and des Planning Familiaux, Wish, Cavaria, of lesbians. Unfortunately, due stereotypes on certain aspects Casa Rosa. to the lack of information and of lesbian’s health public awareness campaigns, • Enable lesbians to be more Patricia Curzi some false beliefs and autonomous and assertive about Project coordinator prejudices are driven by lesbians their health, and in their contact ILGA themselves, as well as by health with health professionals. care professionals. * By “lesbian”, we mean any woman who is attracted to other women and who identifies International Lesbian, Gay, Bisexual, A quiz on myths related to as lesbian, bisexual, butch, fem, androgyn, Trans and Intersex Association Though some misconceptions lesbians’ health will enable you dyke, queer, or who does not feel represented 17 rue de la Charité - 1210 Brussels - Belgium and stereotypes also apply to play with your friends and by any of these categories. We decided to use the term “lesbian” because it is the most [email protected] to women’s health and to test your knowledge. The quiz widespread, even if some individuals do not homosexuality in general, we can also be used for raising identify as such. www.ilga.org have decided here to focus awareness in trainings and www.cancer.be workshops.

September 2011

http://minoritywomeninaction.co.ke/ Lesbians’ health: myths and realities Copyright free, thank you for mentioning ILGA and for illustrations/graphic design auroredidit Quizz 1 • True that the risk of breast cancer for 5 • False Contribute to demystify some myths, Lesbians have a tendency to lesbians would be overall higher Lesbians have styles and consult their gynecologists less than the average of heterosexual identities that are as diverse as play with us! often than heterosexual women, women. heterosexual individuals. The as gynecological visits are For more information, see the masculine and feminine models associated with contraception sheet on Breast and Cervical that society proposes do not 1 • Lesbians need regular gynecological checkups and pregnancy. This medical Cancers. accord with the diversity of human beings, whatever their True False test allows the detection of STIs and certain cancers like breast 3 • False sexual orientation may be. The risk of transmission of HIV For more information, 2 • Lesbians are at higher risk of breast cancer than heterosexual cancer and cervical cancer. between women is weak - but see the sheet on Well-Being women That is why gynecological tests are essential for all women, of not inexistent. Several cases True False all ages, whatever their sexual of sexual transmission of HIV 6 • False orientation. between women have been A relationship between women 3 • Sexual relations between women do not present any risk For more information, identified (even though research can sometimes be considered of transmitting HIV see the sheet on Breast and on this specific issue is rare). by society as being less serious Cervical Cancers Some sexual practices between and not lasting. Love does not True False women expose them to a risk of know sexual orientation. When 2 • Probably true… HIV contamination. one loves, the feelings have the 4 • Lesbians are immune from sexually transmitted infections (STIs) In addition to the risk factors For more information, same intensity whether one is see the sheet on HIV and STIs homosexual or heterosexual. True False common to all women, the overconsumption of alcohol Being accepted as a couple, especially by friends and family, 5 • Lesbians who dress in a feminine way aren’t “real” lesbians and consumption of tobacco in 4 • False relation to heterosexual women Lesbians have a sexuality contributes to self-esteem. True False and the fact of not having that is as varied as the one of For more information, children expose certain lesbians heterosexual people. They can see sheet on Well-Being 6 • A loving relationship between women is less serious to a higher risk of breast cancer. have sexual behaviors at risk of than a heterosexual one Even if scientific studies are too STIs with women or men. The scarce to be definitive, it is likely risk of transmission of STIs is, True False therefore, real. Design/illustration: For more information, Aurore de Boncourt see the sheet on HIV and STIs Coordination / Writing: Patricia Curzi

The quiz was inspired by the Swiss Translation /proofreading from French: organization Santé plurielle. Andrew T. Damron and Tom Hoemig www.sante-plurielle.ch Breast Cancers & Cervical Cancers

/ Taking hormones for several after menstruation. HPV infection is very contagious diagnosis of cervical cancer. years starting at menopause / If you notice a change or anomaly and is transmitted by sexual contact • Lesbians do not need to have regular gynecological exams Over-consuming alcohol or tobacco in your breast since the previous with or without penetration. Most Screening by Pap Smear • Cervical cancer concerns only heterosexual women, particularly / Being overweight / Having a month, consult a doctor right infections pass without being seen Cervical cancer is one type of in developing countries sedentary lifestyle. away - even if you recently had a and heal spontaneously without any rare cancer that can be detected myths screening. lasting effects. However, in certain and treated early. It is, therefore, Symptoms cases, the infection can become important that all women have Any type of change you notice in Screening chronic and leave pre-cancerous regular gynecological screenings. • Gynecological exams are important for detecting sexually your breast, like: Mammogram and Ultrasound lesions around the cervix that can Every woman is advised to take transmitted infections (STIs) and some types of cancer. These exams Appearance of dimpling of the These exams detect early cancers develop into cancer. her first pap smear within a year of are indispensable for all women, no matter their sexual orientation. surface of the breast / Liquid before they are visible or palpable. her first sexual activity, or starting However, lesbians tend to take these exams more rarely than discharge by the nipple / Different The earlier the cancer is detected, Symptoms at 18 or 25 years of age (age heterosexual women. realities texture or coloration of the skin or the better the chance of recovery In the early stage, there are no recommendation differs according • Cervical cancer is one of the most frequent types of cancer found areola / Eczema around the areola and of avoiding disfiguring surgeries. visible symptoms. Later, one may to the country). This exam allows in women throughout the world. Any woman having had same-sex or the nipple / Inverted nipple / The two exams can compliment each observe some blood loss between identification of precancerous lesions relationships or heterosexual relationships can be a carrier of HPV (the Presence of a growth in the breast or other. In some countries, screenings menstrual cycles, after menopause and, if necessary, treatment. Human Papilloma Virus). HPV infection is considered to be the most armpits / Change in the sensibility, are free for women from 50 to or after sexual activity. White, prevalent STI on the planet. Some variations of the virus can play a total change in the appearance of 69 years of age. painless discharges are sometimes Vaccination Against HPV significant role in the appearance of cervical cancer. the breast or in its size. linked to the cancer as well. Since 2008, two vaccines have BUT none of these anomalies by protected against the several kinds themselves automatically mean Cervical Cancers Prevention of HPV that are responsible for that they relate to cancer. At an Screening (pap smears) and 70% of cervical cancer. In some early stage, symptoms appear less vaccination against HPV (advised countries the vaccination is free for Breast Cancers often, which is why screenings are In certain developing countries, for women before their first sexual adolescents and young women. so important. cervical cancers are the main relation) are important ways of Breast Cancer also touches breast cancer. reason for death by cancer among prevention, as well as a proper, However, the vaccination doesn’t women who love women. • Certain studies show that lesbians Prevention women. This is namely due to healthy lifestyle. Not smoking, or replace regular pap smear overuse alcohol and tobacco. Lifestyle specific sociological and medical quitting to smoke, is beneficial screenings! In this case, some particular risk No lifestyle guarantees avoiding conditions. for health in general, but also factors apply. Risk Factors cancer 100%. However, it’s important contributes to a smaller chance of • For fear of homophobic Being a woman / Age, especially to minimize all the risks: avoid Risk Factors reactions, or because they don’t from the age of 50 / Having had being overweight, regularly engage The principal factors are chronic use contraception as often as one or more cases of breast cancer in physical activity, limit your infections by certain kinds of HPV others, lesbians rarely consult in your family / Having certain consumption of alcohol, don’t smoke, (Human Papilloma Virus), and, to a Some helpful websites gynecologists. They are screened non-cancerous abnormalities in eat balanced and varied meals. lesser extent, smoking. Between 85% less often than other women - when your breast / Not having children and 90% of cervical cancers develop The Lesbian and Gay Foundation - www.lgf.org.uk such screening would allow early or having your first child after the Self-examination following a chronic infection by HPV. The Mautner Project - www.mautnerproject.org detection of breast cancer. age of 30 / Menstruating before Each month, you should attentively Any woman who has had same-sex LGBT Health Channel - http://lgbthealth.healthcommunities.com/ BreastCancer.org - www.breastcancer.org • On average, lesbians have children the age of 12 / Going through late self-examine your breasts starting or heterosexual relations can come less often, which raises the risk of menopause after the age of 52 at 25 years of age, ideally one week into contact with an HPV virus. An Copyright free, thank you for mentioning ILGA and for illustrations/graphic design auroredidit Breast Cancers & Cervical Cancers

Vaccination highly reduces the risk of cervical cancer The risk of breast cancer increases with age

HPV infection is transmitted by non protected same-sex or heterosexual relations

Self-checking one’s breasts is an important exercise for screening cancer

Regular gynecological exams help to detect and treat breast and cervical cancers. Speak with your doctor about it STIs & HIV STIs HIV • Two women cannot share a true sexual experience. blood. For vaginal and anal Sexually Transmitted Infections Human Immunodeficiency Virus • There is no risk of transmission of HIV between women. • through mother’s milk. penetration Be familiar with your body HIV is a virus that is responsible Use a condom and a water-based

myths • A lesbian would never have sexual relations with men. It is important to be familiar with for the Acquired Immunodeficiency Certain sexual practices between lubrication for each new vaginal or your body, especially being aware Syndrome (AIDS). women have some risks: anal penetration, whatever is being of any changes, to be familiar with HIV can cause serious problems inserted (fingers, sex toys). Do not • The existence of female sexuality is a “recent discovery” that your genitals and to know what is and can ultimately lead to the Heightened risks of contamination share sex toys and change your dates back to the end of the 1960s, when the fight for women’s normal (vaginal discharges, even death of infected individuals. by STIs and HIV: condom with each penetration. rights was taking place. If lesbians also benefited from the sexual lighter at certain periods of your Adequately treated, people battling • Cunnilingus (mouth-vagina) during Do not use the same sex toy for a liberation, the belief that two women cannot share a true sexual cycle) or abnormal (appearance of HIV can find some immunity that menstrual periods and anilingus vaginal penetration if it was already realities experience is, on the other hand, still widespread. And those who different discharges, of smell or enables them to avoid contracting (mouth-anus) used for an anal penetration, or say “no sex” imply “no transmissible infections”… abnormal color, pimples, wounds…). opportunistic infections. Despite • Rubbing vagina against vagina change condoms between the two Be attentive to all changes, some undeniable medical advances Exchange of sex toys penetrations. • The risk of HIV transmission between women is weak - but truly • still exists. Several cases have been identified since the beginning symptoms can be a sign of an STI. over the past several years, we • Vaginal or anal penetration of the epidemic, but one can suppose that the HIV rates for lesbians still cannot cure AIDS. HIV-positive (fingers, sex toys, fisting) With just the least doubt, consult a is under estimated considering the little research that exists on Different STIs individuals continue to be subject • Sadomasochist practices that doctor in order to get tested: the subject. There are various kinds of STIs that to discrimination based on the fears require contact with blood and/or • at least 3 weeks after being at risk pass through sexual fluids or through that they may inspire (AIDS Phobia). mucus of contracting an STI • There is not only one lesbian sexuality, rather many sexualities. blood (through either a wound or at least 3 months after being at Some women do not define themselves by a particular category; • they have relations fluidly with men and women. Furthermore, in a during a period). If two women do HIV is not transmitted: Weaker risks of contamination risk of contracting HIV lot of countries, women, either heterosexual or not, are obligated not use protection during sex, they • through a handshake of HIV, but major risks of STIs: to marry and to have children in order to survive! can thus transmit HIV or other STIs • through sweat or tears cunnilingus and anilingus outside Post-Exposure Treatment (ex.: Chlamydia, HPV, Syphilis). • by bug bites the menstrual period There is an emergency treatment As a result of these myths, some lesbians erroneously believe by toilet seats that reduces the risk of HIV that they cannot contract STIs or HIV. These erroneous beliefs are • Symptoms of STIs while swimming in public pools No risk of transmission of HIV: contamination, called the post- shared by a part of the medical world. • The following symptoms are often • while sharing food masturbating and kissing. exposure treatment, to be taken associated with STIs: • by using laundry, towels or the However, there are some STIs that within 72 hours at the latest after Burning, itching, or warts around telephone of somebody infected. can transmit through a kiss (for the risk of infection. the vulva or the anus / Vaginal example, Hepatitis B). discharges that are heavier HIV and STIs are transmitted: Some helpful websites than normal, with color or bad • through sexual relations: through How to protect yourself? smell / Pains or vaginal burning blood (including menstrual blood), For cunnilingus and Center for Young Women’s Health - sensation during or after sex / vaginal discharges, sperm, or through anilingus www.youngwomenshealth.org Burning sensation while urinating / a wound on the skin or even by mucus In order to avoid contact between Acon - www.acon.org.au Abnormal pains along the bottom of (from the mouth, vagina, or rectum) your mouth and the vaginal or Women’s Health - www.womenshealth.gov your stomach, bleeding outside the through the usage of drugs: sharing anal mucus of your partner, use a World Health Organization - www.who.int/hiv • time of your period, cysts - notably a syringe or straw (snorting) for drug dental dam or a latex square (see around the groin - and fever. purposes that contain contaminated illustration). Copyright free, thank you for mentioning ILGA and for illustrations/graphic design auroredidit

STIs & HIV

You should consult a doctor with some symptoms

Sexual practices between women also expose them to the risk of HIV and STIs

It is important to know your body, and to be aware of all changes Certain STIs like Hepatitis B can be transmitted through kissing

HIV can transmit itself Create a dental dam or a latex square from drug use or through by using a condom sharing a used syringe or straw Taking care of yourself is pleasant, substances, which can carry a risk of listen when you need it. Everyone must decide for herself Well-Being and it is good for your morale. sexual practices with a risk of STIs. if, when, and with whom to come So why deny it to yourself ? Knowing yourself well and being You can also call on groups out. Above all, one shouldn’t feel aware of the risks of dependence on or health professionals for obligated to do it just “like the • Lesbians are isolated, unstable, depressive and unhappy On average seven out of ten cancers drugs helps put matters into your psychological help or for therapy. others”. • Real lesbians are butch, masculine, ugly and neglected are linked to our lifestyles. A healthy own hands in all circumstances. lifestyle can help to reduce the risks Asking for help isn’t a sign of If you make the choice to come out, Homosexuality is a Western concept myths • of cancer and other illnesses. weakness, rather it is proof that here are several points to keep in Depression you’re taking the proper steps to mind: Some advice for keeping yourself take charge of your life as an adult. • Choose the person to whom you healthy: avoid becoming overweight, Lesbians are at a higher risk of want to come out to first do not expose yourself too much to depression than straight women, Depression is a sickness, Choose the moment when you feel • Sexual orientation in and of itself does not affect whether you are • happy or not. On the other hand, lesbophobia sometimes ruptures the sun, limit the amount of alcohol because they are subjected to homosexuality is not. comfortable to talk about it happiness with family and friends; and family, social, or even cultural that you consume, don’t smoke, eat discrimination linked to their sexual • Respect the time it takes for pressure has an impact on the well-being of lesbians. Being happy healthy and well-balanced meals, orientation (lesbophobia). It is important to avoid the people with whom you talk to accept realities with yourself starts by accepting your sexual orientation and by don’t use legal or illegal drugs, and consumption of prescription drugs the news evolving into a loving environment. Many lesbians are happy, thriving, participate in physical exercise on a Lesbophobia describes the without the advice of your doctor: • Keep in mind a place where you and joyous. Visit them often! regular basis. rejection, fear, hatred, violence it can be dangerous to self-prescribe can go if it does not go well, or think and discrimination towards with anti-depressants or with anti- about people close to you who can • There is not just one type of “lesbian woman” or “heterosexual woman”. Society often dictates a masculine model and a feminine homosexual women. Lesbophobia anxiety medicine. support you. model to which one must conform so that she is not excluded. consists of a double discrimination Whether somebody is homosexual or not, the simple fact of not Addictions where lesbians are the victims as And with medical conforming to the expected model can be a possible source of homosexuals (homophobia) and as Coming out professionals? rejection. In lesbian circles, particularly in women (sexism). Each person must decide to what big cities, the opportunity to meet To no longer live one’s homosexuality extent she feels comfortable in • Homosexuality is not confined to one society or another. Some is generally linked to parties, Some lesbians do not accept their in secret, to be oneself and to talking about her sexual orientation. ethnic groups in Benin, Kenya, Sudan and South Africa, for example, nightclubs and cafés, all where the sexuality as an integral and essential bloom requires to live openly with Sexual orientation is not the direct have been practicing forms of marriage between women well before consumption of alcohol, tobacco, part of their identity (internalized some close friends, which could be cause of cancer or another sickness, the arrival of the white colonialists. In China, female homosexuality and drugs, legal or illegal, is more lesbophobia). This is even more achieved through the coming out but it can have an indirect influence. was completely accepted under the Ts’ing dynasty (1644-1911). Despite readily accessible. Some lesbians difficult to accept if they are rejected process. This does not necessarily Whatever the decision you make, it that fact, in some societies and communities homosexuality can be develop their social lives exclusively by their family or their social circle. signify that you have to say is important to feel confident with denied, stigmatized or criminalized with a prison sentence or even the death penalty. in these environments, whereas For many lesbians who come from everything, to everybody, at every your doctor. If this is not the case, others prefer to spend time with a ethnic minorities, the cultural aspect moment and in every circumstance you should address your concerns to more limited circle of friends. plays an important role. They can be of life. somebody else. confronted with a difficult choice The over-consumption of alcohol, between living their homosexuality or “Health is a state of complete or even moderate consumption a total or partial breakup with their physical, mental and social well-being of tobacco or drug usage will family and certain individuals who are Some helpful websites and not merely the absence of deteriorate your health and will close to them. have an impact on your physical and Lesbian Health Center - www.lesbianhealthinfo.org disease or infirmity.” mental well-being. There are difficult moments in Lesbian and Gay Foundation: The fight against homophobia - www.who.int the life of everyone. It is essential www.lgf.org.uk The perception of risks diminishes to know how to surround yourself Avert - www.avert.org under the influence of certain with loving, positive people who will Copyright free, thank you for mentioning ILGA and for illustrations/graphic design auroredidit

Well-Being

It is essential to be surrounded by loving, positive people who can listen when you need it.

Depression is a disease, The over-consumption not homosexuality of alcohol, or even moderate consumption of tobacco or drugs can deteriorate one’s health

Eat balanced meals

Taking part in regular physical activity