I am here. I am queer. And, my sexual activity matters!
Some lesbian women aren’t receiving Pap smears because their doctors have told them they don’t need them because lesbian sex “doesn’t count” as real sex. A 2011 study from the University of Salford found that 37 percent of the queer women surveyed were told by their doctors that they didn’t need a cervical screening test. According to researchers Jennifer Kates, Usha Ranji, Adara Beamesderfer, Alina Salganicoff, and Lindsey Dawson, queer women’s healthcare is also stigmatized within the medical community. Their 2018 study, “Health and Access to Care and Coverage for Lesbian, Gay, Bisexual, and Transgender (LGBT) Individuals in the U.S.,”published by the Henry J. Kaiser Family Foundation, notes that discrimination, violence, workplace inequality, and family rejection can create barriers to quality healthcare for LGBTQ populations, with some individuals reporting “outright denial of care” because of their sexual orientation or gender identity.
Part of the problem, one study indicated, is that many doctors assume their queer, bi, and lesbian patients are straight, or believe the “urban myth” that lesbian women don’t need to be tested for STIs or reproductive cancers because they don’t have heterosexual sex with cisgender men. These kinds of assumptions reinforce the misguided notion that queer women are militantly monogamous, and therefore don’t need to worry about STDs. The idea that queer sex between women isn’t “real” sex suggests that queer relationships are somehow less valuable or meaningful than heterosexual relationships—a belief that is both alienating and dangerous. Lesbian women are screened for HPV, STIs, and cervical cancer less frequently, and may not be offered the same amount of information about preventative measures like dental dams or the HPV vaccine as heterosexual patients, leading to a greater risk for cervical cancers and other reproductive health issues.
Young queer women are particularly vulnerable to contracting HPV and STIs, and according to one 2015 study, may be more likely to opt out of receiving the HPV vaccine without sufficient information from their healthcare providers. Fish’s research focused primarily on lesbian women, but bisexual women, trans women and men, and gender nonbinary individuals regularly report experiencing anxiety about disclosing their gender identity and sexual orientation. They have good reason to: Trans individuals surveyed in “Transgender Patient Perceptions of Stigma in Health Care Contexts,” a 2013 study published in the journal Medical Care, reported being denied healthcare, or experiencing “substandard care, forced care, [and] verbal abuse.”
The Trump administration’s plan to reinstate a Reagan-era domestic gag rule would make it illegal for healthcare providers receiving funding from Title X to refer patients to outside clinics or abortion providers. “Planned Parenthood serves 41 percent of the 4 million people who rely on the Title X program. If Planned Parenthood were pushed out of the program, the ability for those people to access free or low-cost birth control, cancer screenings, STD screenings, and other reproductive health care would be at risk,” Dean says. With growing numbers of young people identifying as queer, access to safe spaces and resources for appropriate and accurate sex education is more important than ever. Until the mainstream medical community learns to recognize queer women’s right to affordable, queer-inclusive care, Planned Parenthood will remain an essential, valuable resource.