In terms of health care, this definition is inadequate. Sexual behavior and sexual orientation may not correlate and each may vary over time. Some women who have sex with other women choose not to identify themselves as lesbian. 3 Lesbian invisibility in the culture, in research, and in medicine makes providing appropriate health care to lesbians difficult. Many authors have suggested that lesbians do not receive adequate health care or screenings.
Most lesbians lack the benefit of spousal or domestic partner health coverage.
Heterosexual assumptions on the part of care givers and hesitancy to disclose sexual orientation directly affect lesbian health care. The literature is replete with reports of rejection and other inappropriate responses by health care providers after disclosure of sexual orientation by lesbians. Rather than face such negative responses, some lesbians avoid health visits. Birth control counseling, a part of gynecologic visits, was found to upset many lesbians because it could force disclosure of sexual identity. The infrequency of doctor visits by lesbians has also been linked to the mistaken belief that they are at low risk for gynecologic diseases.