Intended for healthcare professionals


Health needs of women who have sex with women

BMJ 2003; 327 doi: (Published 23 October 2003) Cite this as: BMJ 2003;327:939
  1. Clare Hughes, final year medical student (,
  2. Amy Evans, specialist registrar, genitourinary medicine (
  1. Guy's, King's, and St Thomas's School of Medicine
  2. Leeds General Infirmary, Great George Street, Leeds LS1 3EX

    Healthcare workers need to be aware of their specific needs

    The term “women who have sex with women” describes sexual behaviour while lesbian is a term that describes sexual identity. However, sexual identity does not necessarily predict sexual behaviour–most lesbians have a history of sexual intercourse with men.1 Women who have sex with women form a small but important group and have specific health needs. A lack of awareness among healthcare professionals about these needs may lead to ill informed advice and missed opportunities for the prevention of illness.

    An unfortunate perception exists among healthcare providers and women who have sex with women that they do not need regular cervical smears. High risk types of genital human papillomavirus are associated with developing high grade cervical intraepithelial neoplasia, and sexual intercourse with men is a powerful risk factor for cervical cancer. However, it is important to counter the erroneous assumption that women who have sex with women are not at risk of catching human papillomavirus. Around one in five women who have never had heterosexual intercourse have human papillomavirus.2

    Cytological abnormality in women who have sex with women varies in prevalence between studies but ranges from inflammation to severe dyskaryosis.1 w1 …

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