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Les lesbiennes en consultation gynécologique : enquête qualitative en Suisse romande
Abstract
On estime qu’au moins 1% des femmes s’identifient comme lesbiennes et qu’entre 3 et 6% ont eu une partenaire féminine, ce qui, au niveau suisse représenterait au moins 30'000 lesbiennes et entre 100'000 et 200'000 femmes ayant du sexe avec des femmes (FSF). De nombreuses recherches montrent que les lesbiennes recourent moins régulièrement au contrôle gynécologique que les autres femmes et qu’une partie d’entre elles rapportent des expériences de lesbophobie lors des consultations. Ceci peut entraîner un sous-dépistage, des traitements tardifs et des complications, notamment en ce qui concerne le cancer du col de l’utérus et les infections sexuellement transmissibles (IST). L’objectif principal de cette recherche était, à l’aide de groupes focus menés avec des lesbiennes et d’entretiens auprès de gynécologues, d’identifier ce qui pourrait encourager les femmes homosexuelles à effectuer des contrôles gynécologiques réguliers et à améliorer leur expérience de consultation. Il en ressort que les lesbiennes ne perçoivent pas toujours l’utilité des contrôles gynécologiques perçus comme fortement liés aux rapports hétérosexuels et qu’elles ont souvent l’impression que les gynécologues sont mal informés sur la thématique de l’homosexualité féminine et notamment sur les risques d’IST entre femmes. Le manque de signes explicites d’ouverture à l’homosexualité féminine est également jugé problématique. Les gynécologues rencontrées ont confirmé que l’orientation sexuelle faisait très rarement partie de l’anamnèse et qu’il serait nécessaire d’inclure le thème de l’homosexualité féminine dans la formation des gynécologues, les guidelines et les congrès de gynécologie.
... Eine qualitative Studie mit lesbischen Frauen in der Westschweiz zeigte, dass gynäkologische (Vorsorge-)Untersuchungen von diesen nicht notwen digerweise als nützlich eingestuft werden, da solche Untersuchungen stark mit heterosexueller sexueller Aktivität in Verbindung gebracht würden. Die lesbischen Frauen äußerten zudem, dass Gynäkolog*innen nicht gut über weibliche Homosexualität und im Speziellen über Risiken der Über tragung sexueller Infektionen zwischen Frauen Bescheid wüssten (Berrut, 2016). Dass der Zugang zur medizinischen Versorgung für Frauen, die Sex mit Frauen haben (FSF), nicht ungehindert gegeben ist, zeigen auch Resul 2.1 2.1.1 2. Forschungsstand: Ergebnisse des Literaturreviews tate einer aktuellen quantitativen Westschweizer Umfrage. ...
... Dies un terstreichen auch die Befunde einer qualitativen Studie aus der Romandie, wonach Gynäkolog*innen die sexuelle Orientierung ihrer Patient*innen in Konsultationen nur selten Beachtung schenken würden. Es sei daher wichtig, das Thema weibliche Homosexualität in gynäkologische Weiter bildungen zu integrieren (Berrut, 2016). Entsprechend dieser Forderungen wurde an der Universität Lausanne eine Studie mit Medizinstudent*innen durchgeführt (Wahlen, Bize, Wang, Merglen & Ambresin, 2020). ...
This Swiss study identifies areas where LGBTQ+ people have unequal health opportunities compared to the general population, including mental and sexual health, discrimination and violence, barriers to healthcare and substance use. Using data from the Swiss Health Survey (2012, 2017) and a large-scale national survey of LGBTQ+ people conducted in 2021, the authors identify differences in health status as well as behaviour which promotes and is detrimental to health. The study also includes a review of the current research literature on this topic and concludes with recommendations on how to strengthen the health of LGBTQ+ people.
... La constitution de « listes » de médecins (d'avocats, de notaires…) friendly n'est pas une pratique propre aux communautés trans, mais une pratique commune à différentes « minorités » (lesbiennes, gays, personnes racisées, etc.) qui souhaitent éviter les préjugés et les discriminations. Comme le mettent en exergue les résultats d'une étude consacrée à la prise en charge de patientes lesbiennes par des gynécologues de Suisse romande(Berrut, 2016), une expérience de coming out négative en contexte médical peut avoir des conséquences néfastes sur la santé de femmes qui ne sont alors plus disposées à consulter des médecins. Le site internet Barbieturix, consacré à la culture lesbienne et féminine, publie un article regroupant des témoignages d'« aventures en terres gynécologiques » 5 qui s'avère éclairant sur les situations d'homophobie rencontrées par de jeunes filles.Le salon « médecins friendly », tout comme les photographies montrant les résultats d'une opération, correspondent à ce que Nathalie appelle les « bonnes adresses » (voir supra). ...
... LGBT en général et des femmes lesbiennes, bisexuelles et transgenres en particulier. Des ajustements mineurs dans les compétences de consultation des médecins pourraient grandement aider les patient·e·s non hétérosexuel·le·s qui souhaitent parler de leur sexualité à le faire [26][27][28][29][30][31][32]. ...
Introduction:
Sexual and reproductive health (SRH) of lesbians and other women who have sex with women (WSW) remains largely unexplored in Switzerland. A cross-sectional web- and pa-per-based survey was conducted in 2012.
Purpose of research:
The aim of this study was to gain more knowledge on the SRH of the WSW in French-speaking Switzerland in order to inform preventive activities and promote more adequate SRH services for these women.
Results:
Sexual practices between women are very diverse, some of them potentially risky in terms of transmitting various STIs, but 71% of WSW never practice safer sex or other risk reduction strategies for HIV and other STIs with their female partners. Only 69% have had a gynecological check-up in the last 3 years. 16% had one or more children. 29% reported having experienced violence in a lesbian relationship.
Conclusions:
Specific information on SRH should be developed to match the specificities and needs of WSW and more research is needed on their SRH, their risk regarding breast cancer and ways to improve the cultural sensitivity and knowledge of gynecologists and other health care providers towards their lesbian, bisexual and other WSW patients.
Heteronormativity is the presumption of heterosexuality as the default sexual orientation and can result in discrimination against the lesbian, gay, and bisexual (LGB) population. This study serves as one of the first experimental studies to examine heteronormative perceptions in communication and their effects on practitioner-patient relationships. LGB participants were randomly assigned to read either heteronormative or non-heteronormative vignettes of a doctor-patient interaction. They then indicated how much health-relevant information they would disclose to the doctor in the vignette and their level of trust in the doctor. In the heteronormative condition, participants were less likely to disclose health-relevant information to the doctor in the vignette and were less trustful of the doctor as compared to those in the non-heteronormative condition. These results have important health implications, as lack of disclosure and trust may prevent people from getting needed care and prevent doctors from giving the best health advice possible. The results of this study provide further evidence that there is a need for more education for all health care professionals to feel comfortable while respectfully communicating with and treating patients who do not identify as heterosexual in order to ensure the best health care experience.
We demonstrate that widely used measures of antigay sentiment and the size of the lesbian, gay, bisexual, and transgender (LGBT) population are misestimated, likely substantially. In a series of online experiments using a large and diverse but nonrepresentative sample, we compare estimates from the standard methodology of asking sensitive questions to measures from a “veiled” methodology that precludes inference about an individual but provides population estimates. The veiled method increased self-reports of antigay sentiment, particularly in the workplace: respondents were 67% more likely to disapprove of an openly gay manager when asked with a veil, and 71% more likely to say it should be legal to discriminate in hiring on the basis of sexual orientation. The veiled methodology also produces larger estimates of the fraction of the population that identifies as LGBT or has had a sexual experience with a member of the same sex. Self-reports of nonheterosexual identity rose by 65%, and same-sex sexual experiences by 59%. We conduct a “placebo test” and show that for nonsensitive placebo items, the veiled methodology produces effects that are small in magnitude and not significantly different from zero in seven out of eight items. Taken together, the results suggest antigay discrimination might be a more significant issue than formerly considered, as the nonheterosexual population and antigay workplace-related sentiment are both larger than previously measured.
Data, as supplemental material, are available at http://dx.doi.org/10.1287/mnsc.2016.2503 .
This paper was accepted by Uri Gneezy, behavioral economics.
des progrès importants ont été accomplis en matière de soins de santé des femmes au cours de la dernière décennie. Pourtant, il continue d’y avoir une pénurie de publications et de recherches sur la santé des femmes lesbiennes. Les patientes lesbiennes constituent souvent un groupe invisible parmi les patients d’un médecin. Si on ne connaît pas, ou si on prend pour acquis, les pratiques sexuelles d’un individu, il se peut que le traitement médical en soit compromis. L’attitude des médecins affecte les soins qu’ils prodiquent à leurs patients, particulièrement lorsqu’ils sont homophobes ou hétérosexistes. Une meilleure éducation en matiàre de sexualité et une meilleure sensibilisation permettront aux prestateurs de soins de relever les antécédents des patients d’une manière impartiale. Pour que les médecins soient en mesure de procurer des soins adéquats aux lesbiennes, ils doivent connaître et comprendre leur orientation sexuelle et leurs habitudes de vie. Si l#x2019;éducation constitue le premier pas vers une amélioration des soins fournis aux patientes lesbiennes, l#x2019;acquisition d’attitudes plus éclairées en matière de sexualité chez les prestateurs de soins en représente l#x2019;étape finale.
This paper examines the shifting nature of contemporary epidemiological classifications in the HIV/ AIDS epidemic. It first looks at assumptions that guide a discourse of vulnerability and circulate around risk categories. It then examines the underlying emphasis in public health on the popular frame of "vulnerable women" who acquire HIV through heterosexual transmission. Drawing on work on gender, sexuality, and intersectionality, the paper asks why a discourse of vulnerability is infused into discussions of heterosexually-active women's HIV risks but not those pertaining to heterosexually-active men's. The paper then moves to current surveillance categories that are hierarchically and differentially applied to women's and men's risks in the HIV epidemic. Here, the focus is on the way in which contemporary classifications allow for the emergence of the vulnerable heterosexually-active woman while simultaneously constituting lack of fathomability concerning bisexual and lesbian transmission risk. Lastly, theories of intersectionality, are used to examine current research on woman-to-woman transmission, and to suggest future more productive options.
Introduction:
A growing body of evidence reveals higher rates of tobacco use among sexual minority populations relative to non-minority ("straight") populations. This study seeks to more fully characterize this disparity by examining tobacco use by distinct sexual identities and gender to better understand patterns of: (1) cigarette smoking and smoking history; and (2) use of other tobacco products including cigars, pipes, hookah, e-cigarettes, and smokeless tobacco.
Methods:
Data from the 2012-2013 National Adult Tobacco Survey, a random-digit dialed landline and cellular telephone survey of U.S. adults aged ≥18 years, were analyzed in 2014. A sexual minority category was created by combining gay, lesbian, and bisexual responses, along with those who selected an option for other non-heterosexual identities.
Results:
Smoking prevalence was higher among sexual minority adults (27.4%) than straight adults (17.3%). Cigarette smoking was particularly high among bisexual women (36.0%). Sexual minority women started smoking and transitioned to daily smoking earlier than their straight peers. Use of other tobacco products was higher among sexual minority women: prevalence of e-cigarette (12.4%), hookah (10.3%), and cigar use (7.2%) was more than triple that of their straight female peers (3.4%, 2.5%, and 1.3%, respectively). Likewise, prevalence of sexual minority men's e-cigarette (7.9%) and hookah (12.8%) use exceeded that of straight men (4.7% and 4.5%, respectively).
Conclusions:
Tobacco use is significantly higher among sexual minority than straight adults, particularly among sexual minority women. These findings underscore the importance of tobacco control efforts designed to reach sexual minorities and highlight the heterogeneity of tobacco use within this population.
To provide deeper insights into the experiences of lesbian women in accessing cervical cancer screening and to inform strategies to increase the uptake of these services for this group of women.
Lesbian women continue to face significant health disparities and are at increased risk for specific medical conditions. With cervical cancer being largely a preventable disease, early detection through the Papanicolaou test is crucial, as it enables treatment to commence early and limit the progression of the disease. Although the rates of cervical abnormalities among lesbian women are similar to that of the general population, lesbian women are less likely to have regular cervical screening. The reasons for this are largely unknown and there is a paucity of research that explores cervical cancer screening in lesbian women.
Qualitative descriptive design.
Participants (n = 9) were recruited via media release and those living in New South Wales who self-identified as lesbian, meeting the inclusion criteria were recruited for the study. Semi-structured, face to face and telephone interviews were used to obtain narrative data from lesbian women on their experiences of cervical screening.
Three main themes emerged from the data: 'Lack of opportunistic screening'; 'Fear of penetration' and 'Encountering heterosexism and discrimination'.
This current study builds on existing knowledge and further, has identified issues that have not been previously raised in the literature. New findings from this study highlight participants' fear of penetration, and stigma associated with accessing information, as substantial barriers to cervical screening.
This study's findings can guide future research and highlight possibilities for specific strategies to reduce health disparities among lesbian women.
© 2015 John Wiley & Sons Ltd.