However, it is lower than the 17 percent for women in the general UK population who report never having had a cervical smear. What is surprising about these low figures is that the UK has national health service. Pap smears are free, and women receive a reminder letter every five years, with two or three follow-up letters if they don't come in for the pap smear. When Sue and Julie examined lesbians' written comments about cervical screening, they found that one reason for non-attendance was lack of time. They imagine the procedure will be painful, or embarrassing, or that they will encounter heterosexism.
Cervical cancer appears to be connected with sexual activity, particularly penetrative sex with men.
This is why lesbians have traditionally been viewed as at low risk for cervical cancer. Cervical cancer is not well understood, so women, including lesbians, may be at risk for other reasons unrelated to sexual activity. In the UK study, about 40 percent of lesbians felt they did not need a cervical screen because they had never had intercourse. Many lesbians wrote that they had specifically been told this by a doctor or nurse. But the pap smear is not a comfortable procedure for many women, and may be particularly painful, uncomfortable, unusual, or traumatizing for lesbians.