Primary care of the lesbian/gay/bisexual/transgendered woman patient

Lesbian patients comprise a special population which has unique health care needs. Providing those needs is hindered by a number of factors: (1) difficulty characterizing a population whose members may identify themselves, or be identified, as lesbian, gay, bisexual or transgendered; (2) barriers to care due to patient discomfort with the health care system, and the system's discomfort with the lesbian patient; and (3) scarcity of medical evidence regarding healthcare risks and behaviors of lesbian patients, due to the lack of controlled medical studies. The primary care physician addresses these needs by careful analysis of known risk factors, preliminary information about lesbian health, and the health risks and behaviors of the individual patient. Through the template provided in this article, decisions about appropriate healthcare maintenance can be made. Finally, we address emerging issues regarding lesbian conception and childbirth, and the needs of the transgendered patient.