The Mautner Project The National Lesbian Health Organization

REMOVING THE BARRIERS TO ACCESSING CARE FOR LESBIANS Removing the Barriers to Accessing Health Care for Lesbians is a special project aimed at building the skills of health care providers and promoting change in health care institutions through training and technical assistance. Objectives: Define the dimensions of culture and the principles of culturally competent medical care; Discuss the diversity of the population described as lesbian or women who partner with women; List individual, structural and institutional factors that affect access to health care and result in barriers to screening for breast and cervical cancer among lesbians; Describe ways in which a culturally competent approach can reduce or eliminate barriers to accessing health care and cancer screening; Demonstrate the application of principles of cultural competency to your medical practice; Implement a plan for applying the skills learned; and help you locate resources to facilitate ongoing education and skill building in providing optimal care to lesbians. The goal of the curriculum is to improve individual practitioners' skills and create systemic change so that lesbians feel truly comfortable in a hospital or other health care setting. We are working with sites around the nation to pilot-test this curriculum and provide technical assistance follow-up. Why Are Lesbians at Greater Risk of Cancer? Access - Lesbians access health care less frequently than heterosexual women. Childbearing - Lesbians are more likely to be childless or delay parenting until after 30. Screening - Lesbians are less likely to receive routine gynecological services such as birth control and prenatal care – and are therefore screened less often for breast and cervical cancer. Insurance - Lesbians are more affected by women’s lower earning power and do not benefit from spousal health insurance coverage. What Are the Barriers for Lesbians? Discrimination - Anticipated, perceived, or actual discrimination based by health care provider based on sexual identity and/or behavior. Misinformation - Or inaccurate assumptions about health risks of women who partner with women and the need for screening (both among women who partner with women and providers). Exclusion - Perceived or actual exclusion from health promotion campaigns. Fear - Disclosure of sexual orientation may lead to loss of custody, job, housing and social support; substandard or refusal of health care; military discharge. Past Experience - Previous negative encounters with the health care system including: derogatory comments, voyeurism, hostility toward patient or her partner, undue roughness in physical examinations, etc. Informed and open discussions regarding sexuality promote health, prevent disease and improve access to and the quality of health care. To deliver competent care to this special population, providers need knowledge of the special needs of lesbians in their care. Sufficient information on lesbian health care and how providers can communicate their expertise and acceptance to patients is not provided in medical school curricula or in the continuing education programs of health professions. With the increase in managed care, lesbians have fewer options regarding their choice of health care providers. This makes it imperative that all health professionals are able to provide competent care to all people. If you are interested in receiving further information about this training program, or would like to apply to become a Partner in Removing the Barriers to Accessing Care for Lesbians please contact: April Nelson, LGSW. National Training Coordinator / National Lesbian and Feminist Health Coalition Coordinator The Mautner Project 1707 L Street, Suite 230 Washington, DC 20036 (202) 332-5536 (phone) (202) 332-0662 (fax) E-mail anelson@mautnerproject.org Related Projects to Increase Breast and Cervical Cancer Screenings for Underserved Women American Social Health Association Association of Asian Pacific Community Health Organizations National Asian Women's Health Organization (NAWHO) National Association of Community Health Centers National Caucus and Center on Black Aged, Inc. National Center for Farmworker Health National Education Association (NEA) National Hispanic Council on Aging United States Conference of Mayors World Education Funded by the Centers For Disease Control and Prevention Top

Last updated: 02-17-2003