Gynecological and childbearing needs of lesbians

This descriptive study explored how self-identification as lesbian ("coming out") affected gynecological and childbearing needs and experiences. Twenty interviews were conducted using a researcher-designed interview schedule. The majority of lesbians disclosed their sexual/affectional identity to providers ostensibly to negate heterosexual assumptions. Fear and the unpleasantness of coming out influenced the majority to postpone gynecological care or to seek lesbian-sensitive providers. Half of the participants had gone to ob/gyn appointments accompanied by the partner. Traditional health history questions about marital status, sexual activity, and birth control elicited inaccurate information from participants. Participants believed important qualities in providers to be: sensitivity, knowledge about lesbian sexuality, and female gender. Providers need to learn clues of lesbian identification or coming out; they should also strive to use inclusive gender words and remove heterosexual assumptions. Seventy percent of participants desired children; alternative insemination was an accepted method of conception to most. Midwives can play a special role with lesbians desiring pregnancy and children.