Highlights

Lesbian Health Matters June 14, 2003
OPENING AND WELCOME BY DR. PATRICIA ROBERTSON California Endowment supported our 2003 conference “Lesbian Health Matters” Here are some issues LHRC is dedicated to help address: How to communicate lesbian health concerns? What is the current status of Lesbian Health? Why there is a need for Lesbian Health Research? What makes Lesbian Health different from women’s heath in general?
SUSAN LEAL, SF MAYORAL CANDIDATE 1st Latina Lesbian as supervisor. She is San Francisco’s City Treasurer who balanced the budget and put investments through a progressive filter. Susan Leal’s statements: States that people committed to our community will make inroads to quality lesbian health care. She presented a certificate of commendation from San Francisco City Treasury to Dr. Patty Robertson.
DR. SUZANNE DIBBLE: History of LHRC 2000- first grant from Pride Law Firm 2002 —Web site starts: www.lesbianhealthinfo.org Summer 2002- created 5 summer internships/fellowships LHRC e-newsletter ONGOING—researcher breakfasts, grant planning, community support
DR. KATE O’HANLON There is societal harm from discrimination. Negative healthcare experiences reflect societal experience of LGBT people. Being “out” can alienate patients from routine & symptomatic care. Marriage is an issue of equal access to civil contract law. In many US schools there is no teaching in LGBT issues. REPARATIVE THERAPY (the process of making LGBT people heterosexual and follow societal gender norms) is not the answer. It is not effective, not ethical & is harmful. Per National Survey of Midlife Development, LGBT people are 2.2 times more likely to: Experience stress sensitive health problems 42% have stress due to discrimination Health disparity is created by discrimination Lesbians have a much poorer perceptions of medical system than straight people. There is socialization of heterosexuals against gays, also socialization of gays against themselves. Grant Review Committees - grants thrown out if they have the word “gay/lesbian” because they are considered to be discriminatory to heterosexuals.
PANEL DISCUSSION – LESBIAN HEALTH THROUGH THE AGES Ages 0 to ten: Dr. Tamar Gershon She believes that ages 0-10 is the most critical decade in lesbian development for mental & physical health. She suggest we: Be aware of and sensitive to kids Think of what is it like for young girls to be aware of gender issues. Three books that deal with lesbians and gender identity (Tomboys & Sissies (1999); Call Me Lesbian (1992); and Tipping the Velvet (1998)) DSM- diagnosis of gender identity may be removed. 1st wave of feminism---promoted discussion + definition of “tomboyism.” Cross sex behavior in boys is more negatively viewed than in girls Ideas for therapies à better than reparative therapy is to help children lessen depression & anxiety Ages 11-20: Caitlin Ryan Her current study is on Lesbian Youth Development & Health issues (Cognitive and emotional development, social skills, relationships, autonomy/intimacy, consolidate identity, what is multiple identity, sexual identity, & stigma related issues) Average Age event occurs First awareness of same sex attraction First same sex experience When self identify as lesbian or gay Young women: Are separating & evolving earlier Are negotiating puberty in the age of HIV/AIDS Have no role models, cannot project into the future Are challenging passive, reactive roles of older gays, coming out at a younger age Are coming out in contexts that don’t help them Research on Lesbian youth Neglect areas—only 12 articles in 30 years A few qualitative studies Youth risk behavior study Anecdotal info is limited Family Acceptance project Funded by Cal. Endowment Study of LGBT youth—including family, ethnicity & sexual orientation Initial observation Age average 17—sexually active Many are politically active but harassed for it Gay Straight alliance- only place for gay kids at schools Literature focuses on problems, not strengths Ages 20-29: Helen Smith & Leah Crask Problems in Research: Studies of lesbians in early twenties often lumped with lesbian youth or older lesbians. Little research is specifically geared toward women in their twenties (20-29). Characteristics of 20-Something Sexuality and outreach ideas were discussed. The following topics were reviewed: Partner Abuse, Sex & STDs, Drug & Alcohol Use, Body Image, Healthcare & Employment. Partner Abuse: Lesbians have the least reported cases of domestic violence. However this does not mean partner abuse among LBT people is uncommon, or not worthy of research. Support groups are still needed for lesbians specifically. Substance Abuse: Studies have found that alcohol use among lesbians is associated with reported feelings of: Low self-esteem, Anger, Frustration, Isolation, Problems concerning sexuality, and Patronizing of a lesbian or gay bar in social interaction. STDs/STIs: Risk factors associated with STI rates among lesbian women: Alcohol & Drugs, Sex with men, unprotected sex with men & women, Personal sense of invulnerability or low self esteem. Some lesbians believe they can not get STDs via sex with other lesbians, others believe that if they are at risk their sexual partner will disclose any potential harm of STIs before they have sex. In addition, some lesbians feel they have the same risk of getting STDs as anyone else. Body Image: Many women stated that coming out had greatly improved their body-image and self-esteem yet many of these women showed high rates of eating disorders, weight concerns and low body esteem. Though some women no longer felt confined by heterosexist beauty standards they did feel restricted by a new lesbian standard of beauty and attractiveness, which included physical strength and a particular dress code. Describe a shift from needing to look “feminine” enough to looking “dykey” enough. Employment opportunities & health care: Ford (1997) found that in a population of lesbians aged 20-29 more people experienced employment discrimination based on gender rather than sexual orientation. Lesbian and bisexual women were less likely to have health insurance, more likely to have been uninsured in the preceding year and more likely to have difficulty obtaining needed medical care. Some similar health concerns as heterosexual women, differences include: external and internal homophobia, lesbian culture (sexual practice, drugs & alcohol, body image, partner abuse, etc.), the need for different prevention programs focused on LBT issues, and less social support from family, friends, providers, & certain institutions. Age 31- 40 Sherron Mills Sherron Mills spoke about lesbians who choose to become pregnant via alternative insemination. Internet makes much of this possible. One can learn about the insemination process and select donors online. Sperm banks are easy to find online. After 35, women are less fertile. Some reports state women become less fertile starting at the age of 27. It can take several cycles to become pregnant. She advises to take vitamins 3 months before getting pregnant to increase chances for pregnancy. Women/lesbians should be educated to be aware that fertility declines early (encourage women to prepare and plan if they want to have children, before it is too late.) In US lesbians don’t get enough help getting pregnant—hard to find clinicians that will work with lesbians. Many clinics will refuse to help a lesbians become pregnant. Ages 41-49 Rani Eversly The problems in research in LBT women ages 41-49 are: Absence of population based data No studies connecting sexual orientation to disease outcome She believes the following are needs that should be addressed when doing research and addressing concerns of LBT women ages 41-49: Mental health issues that lesbians experience, substance abuse, anxiety, depression Physical changes- weight gain, lesser physical stamina, changes in sexuality Social losses—less age appropriate social network Increase in family responsibilities Stability & retirement become issues Role of stress Social, psychological impact Chronic stress + daily hassles Stressful life events Traumatic stress What is role of discrimination in stress How does social isolation affect this What are compounding effects Age 51 to 60 Sue Dibble- Lesbians and Cancer Risks When you start getting older if you haven’t gotten cancer, you will notice that people around you will start getting it. Cancer is a disease of aging. Cardiovascular disease starts in 40’s, but manifests later Ovarian Cancer Risks- Genetics Fertility drugs Using talcum??? No births Breast cancer risks: Drinking, being “chunky”, not giving birth to kids, HRT, exposure to radiation, being less than 12 with first period, starting menopause over 55, and having the breast cancer gene. **Age 61 to 70—Marcy Adelman—a psychologist and senior housing activist Keep doing research to and get political support. Anecdotal stories don’t work. She is on board of open house. They are planning mixed income housing for LGBT seniors. It will be a senior village in San Francisco, CA. It will be a multicultural hub. The preferred site is Hayes Valley. There will 225 units, 25 dementia units, and a wellness center. Final survey results of 300 LGBT adults, ages ranging from 18 to 92. 50-50 and 60 + are two oldest groups There is vulnerability in these groups: financial resources & health Often they have no kids to become caregivers They also have higher incidence of chronic difficulties 70 PLUS Joyce Pierson at NCLR She has been working in Aging programs since the 70’s She brings academic & grassroots perspectives together Access to legal tools that make a difference She has helped develop legal services & workshops Legal services, eldercare, and healthcare are civil rights Joyce’s opinions There is a lot of fluidity in life stages. We are pioneers to make lesbian life more meaningful Old women are the makers of civilization Older lesbians often have decades of shame & stigma they are dealing with Aging is very individual American Society on Aging—helps lesbians & Gays—40 workshops for G/L issues & training GENERAL SESSION PLENARY BRENDA CRAWFORD Came out in New York, before Stonewall & women’s movement, at 16 years old she was encouraged by African-American lesbian & gay male friends to look at herself Most people she came out with are dead of alcoholism, high blood pressure, etc. Then she writes proposals to get funding to create programs she wants to design methodologies that do not exploit her research subjects. Emotional/sensitivity is required. We must know how to ask questions. She wants to eliminate health disparities of black lesbians. She said we need to learn how to have discussions about: racism, ableism, sexism, and classism in lesbian community. Learn to talk about differences in an empowering way. We have more to learn by working together look to for similarities, and respect differences. PANEL DISCUSSION—Sexual Health in 2003 Moderated by- Trinity Ordona, PhD Reviewed the historical development of identity politics. Pacific Islanders were the last to be colonized. Asia has different forms of social discriminations. Marny Hall - (Why Limit me to Ecstasy?) She spoke on the midlife sexual concerns of lesbians in long-term relationships. Standard fusion model sex is redundant so why bother to have it Learn to talk about differences in an empowering way. We have more to learn by working together look to for similarities, and respect differences. Sex is a big fable. Its rigid truths are actually malleable. 2 master narratives about sex: First, hyper romantic-- hot, sexy passion is our certification Second, the evil twin—lesbian bed death The above 2 eliminate the middle ground Venerate your early sexual experiences, then so for sustainable sex practices Lesbians often prescribe “bed death” to medical reasons—not enough testosterone, or too much Prozac… The pharmaceutical companies need a follow up to Viagra. If the reason for “bed death” is community + social + cultural diversity there is no pill. Her advice to those in long-term relationships where sex has decreased: “Believe in occasional rapture but practice sustainable sex.” Jessica Meyer (Pregnancy, Gender Identity and Invisibility: Young Queer Women) Her focus was on young, queer women’s health, and looks at: Where are they at Where we are in history Sexual health needs of young queer women Queer women are different now than 10 years ago They may have been kicked out of their home When youth first come out, they are very passionate. Her exercise- 3 facets of one person 1. Identity (public face, what they say) 2. Orientation (inner thoughts & feelings) 3. Behavior (what is done with the body) Tina, first example 1. straight, except when she goes to her queer youth group 2. fantasizes, attracted to girls 3. when I go out with my friends, I end up with a guy a. I have a girlfriend no one knows about Joey, next example 1. identify as a boy with people I trust, but at school I am a girl 2. I always felt like a boy at every age since I was little 3. I always wear men’s clothes 4. If you feel you are a boy it is hard to get the female parts of your body to the doctor 5. Young people’s identities don’t line up, but often, neither do adults Amy Andre (Sexual Health Needs of Bisexual Women) Unique needs of Bi-women: mental health, pregnancy, and STD prevention What it means to be Bi varies from woman to woman It could be a political identity It could be feelings, inner emotions, attractions It does not have to be behavior Don’t assume any behavior is bad. Some feel that bisexual women are dirty and carry STDs into the lesbian community. This is prejudice—sexual orientation does not transmit disease, unsafe sex does. Information from health care providers needs to be broad & non-judgmental Ask about, honor & validate every woman’s orientation label People choose orientation labels for a lot of reasons, but in the end people are attracted to people Dr. Trinity Ordona** (Healing from Sexual Violence) Sexual Violence is seriously under-reported. Rule of thumb: 2 out of 3 females have been subjected to or witnessed sexual/gender violence. Multiple marginalization factors facilitate violence and further complicate the effects of sexual violence in our lives: Race/Ethnicity, Social Class, Gender and Sex, Sexual Orientation, and Gender Identity. Effects of Sexual Violence on Self Diminished mental health, low self-esteem - Depression, anxiety, fear, self-hatred Risky health behaviors - Smoking, unprotected sex, not seeking help Addictive behaviors - Food, alcohol, drugs; gambling Self-harming behaviors - Cutting, physical pain as an intense sensation to combat numbness Effects of Sexual Violence on Self and Relationships with Others Sexual dysfunction (disinterest in sex, lack of arousal, orgasm) Fear of intimacy, commitment Inability to experience or sustain healthy intimacy and partnership Reproduction of cycle of violence in intimate partner relationships What can I do if I have experienced sexual violence? Remove yourself from the scene Seek professional help (medical and psychological assistance) Seek social support (family, friends, support groups) If that is not enough, what next? Self-Healing Practice “Each patient carries her/his own doctor inside of her/him. They come to us [physicians] not knowing this truth. We are at our best when we give the doctor who resides within each patient a chance to go to work.” Albert Schweitzer, M.D. To Norman Cousins, Ph.D. The Body Never Forgets. Our bodies remember/store experiences just as our minds do. In a way, our experiences are also stored in our skin, and touches can trigger positive and negative memories. When our bodies “remember” these clues, we react. It may be a smile, or it may be fear. Vibrational Medicine can be used to help release the trapped energy: Homeopathy Chinese acupuncture Chakra (energy center) therapy Energy psychology, applied kinesiology Meditation practice Affirmations and prayer Body work Complementary Therapies Again, the question is . . . How to tap my (unconscious) healer? Start Your Own Self-Healing Practice