Women who have sex with women (WSW) are women who engage in sexual activities with other women, whether they identify themselves as lesbian, bisexual, or heterosexual, or dispense with sexual identification altogether. The term WSW is often used in medical literature to describe such women as a group for clinical study, without needing to consider sexual self-identity.
In terms of medical issues with regard to lesbian sexual practices, the sexual identification of women who consult a medical professional is usually not sought nor volunteered, due to the misconceptions and assumptions about sexuality and the hesitancy of some women in disclosing their accurate sexual histories even to a physician. Lack of differentiation between lesbians and heterosexual women in medical studies that concentrate on health issues for women skews results for lesbians and non-lesbian women. Many women who do not participate in heterosexual activity do not go to see a physician because they do not require birth control, which is the initiating factor for most women to seek consultation with a gynecologist when they become sexually active. As a result, these women are not screened regularly with pap smears because they have a lower perceived risk of acquiring a sexually transmitted infection or types of cancer. Lesbians are less likely than their heterosexual and bisexual counterparts to get screened for cervical cancer, with some being refused screenings by medical professionals.
The lower rate of lesbians tested by regular pap smears makes it more difficult to detect cervical cancer at early stages in lesbians. The risk factors for developing ovarian cancer rates are higher in lesbians than in heterosexual women, perhaps because many lesbians lack protective factors of pregnancy, abortion, contraceptives, breastfeeding, and miscarriages.
A factor which leads to lesbians neglecting to seek medical screening in the United States is a lack of health insurance offered by employers for same-sex domestic partners.
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