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Biases and Gaps

In the medical literature, there is a lack of relevant research regarding LGBT health issues and most articles in professional journals regarding the health care of lesbians are not based on research data[1] [2]. Until recently, there was no federal funding available in the United States for research that asked questions and attempted to make analyses based on sexual orientation[1]. The absence of comprehensive epidemiological data on lesbian health issues has led to misunderstanding, mistreatment and misinformation[3].

The one exception is in HIV and homosexual men[4]. Between 1974 and 1992 The National Insititues of Health in the United States sponsored research on non-HIV related projects dealing with homosexuality at an average of $532 000 per year. HIV related projects funded between 1982 and 1992 averaged approximately $20 million per year[5].This research focus on HIV/AIDS and gay men is reflected in the content of medical textbooks[5].

Inconsistencies in the definition of sexual orientation and incongruity between behaviour and sexual identity make it difficult to conduct research on the LGBT population and methodological problems arise when trying to select an appropriate control or comparison group[6].

Western society is still heterosexist at best and homophobic at worst, forcing many in the LGBT community to remain secretive about their sexual orientation in order to maintain personal safety[1]. The distinction between people who are "in" versus those who are "out" makes selection bias a starting point for any study. A population that is not "out" is difficult to study[2]. At the same time, many of the studies that have been done, have used convenience sampling in order to access a hidden population, which results in generally homogeneous study groups[7].


1. Peterkin A, Risdon C. Caring for Lesbian and Gay People: A Clinical Guide. 2003. University of Toronto Press Incorporated. Toronto, Ontario.

2. Roberts SJ. Lesbian health research: a review and recommendations for future research. Health Care for Women International. 2001;22:537-552.

3. Rosenfeld, JA, Ed. Handbook of Women's Health. New York, NY. Cambridge University Press; 2001.

4. Lee R. Health care problems of lesbian, gay, bisexual, and transgender patients. Western Journal of Medicine. 2000;172:403-408.

5. Kaiser Permanente National Diversity Council. A Provider's Handbook on Culturally Competent Care: Lesbian, Gay, Bisexual and Transgendered Population. Oakland, CA. Kaiser Permanente; 2000.

6. Solarz, AL Ed. Lesbian Health: Current Assessment and Directions for the Future. Washington DC. National Academy Press; 1999.

7. White JC, Dull VT. Room for Improvement: Communication between Lesbians and Primary Care Providers. In Ponticelli CM, Ed. Gateways to Improving Lesbian Health and Health Care: Opening Doors. 1998. The Haworth Press, Inc. Binghamton, NY. pp. 95-110.

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