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Second, we wanted to examine whether there would be any differences on these indices among SMW who identify as lesbian (herein referred to as “lesbian SMW”) and other queer-identified women (including those who identify as bisexual, pansexual, queer, etc. First, we wanted to investigate whether there would be differences between heterosexually identified women (herein referred to as HW) and SMW in terms of the degree to which they receive regular health care, are recommended and/or receive similar preventive screenings, and how satisfied they are with their HCPs. To that end, we had three primary objectives for this study. Similarly, Meckler, Elliott, Kanouse, Beals, and Schuster (2006) found that bisexual youth were less likely to disclose to HCPs than gay- or lesbian-identified youth.Īlthough researchers have begun to examine the nature of health care experiences among SMW and some have explored differential treatment and perceptions of stigma within SMW populations, we could find no contemporary research that examined whether health care experiences and actual health care receipt differed by sexual orientation status. Others have found that queer women whose self-reported orientation was more heterosexual than exclusively homosexual, were less likely to disclose their sexual orientation to HCPs than lesbian-identified women ( Polek, Hardie, & Crowley, 2008). For instance, Hiestand, Horne, and Levitt (2007) examined the health care experiences of lesbian and bisexual women who identified as being either more “butch” or “femme.” Indeed, they found that butch women had fewer regular gynecologic examinations and reported poorer treatment in health care settings, despite being more likely to be “out” with HCPs than femme women. Some have argued that there are differential degrees of stigma associated with various sexual minority and gender identity groups ( Finlon, 2002 Gay and Lesbian Medical Association and LGBT Health Experts, 2001). Moreover, SMW’s engagement in care and perceptions of health care quality are predicated on the perception of provider prejudice ( Bergeron & Senn, 2003 Dehart, 2008 Mathieson, Bailey, & Gurevish, 2002 Stevens, 1995).
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However, discriminatory practices within the health care context, patient perceptions of provider prejudice (e.g., heterosexism), and even internalized homophobia (i.e., the devaluing of self, conscious or not, based on one’s sexual orientation) likely serve as barriers to regular health care receipt and reinforce negative attitudes toward the health care system ( Hutchinson, Thompson, & Cederbaum, 2006 Stevens, 1995 Williamson, 2000). Health care providers (HCPs) have a unique opportunity to effect change among these patient populations.
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For example, sexual minority women (SMW) may be at elevated risk for overweight and cardiovascular disease and may be more likely to engage in deleterious behaviors, such as smoking and heavy drinking, that contribute to morbidity ( Cochran, 2001 Drabble & Trocki, 2005 Gruskin & Gorden, 2006). Women in the sexual minority, including women who identify as lesbian, bisexual, or who have another “queer” status (e.g., those who identify as pansexual, same-gender-loving, etc.) have been found to have poorer health outcomes than their heterosexual counterparts.