 | Do
lesbians really need Pap tests?
Many
lesbians and health professionals believe that lesbians don't need
Pap tests; that being a lesbian is protection against problems like
cervical cancer and sexually transmitted diseases (STD's). It isn't.
Research
into cervical cancer among lesbians is scarce, but there is evidence
to suggest that abnormal cervical cells are found at a later stage
among lesbians. Reasons for this include:
- a
widespread belief that lesbians don't need Pap tests;
- the
difficulty some lesbians have in finding suitable doctors or
nurses;
- physical
and emotional anxiety about the process of having a Pap test.
For example; in Australia 1 in 4 women (including lesbians)
have experienced some form of sexual abuse.
This
brochure aims to answer some of the more common questions and concerns
lesbians may have about Pap tests.
Lesbians
need Pap tests too!
This
message is not always understood. Below are a range of views that
you may have heard expressed at one time or another.
| Belief: |
Lesbians
are not at risk of cervical cancer because they don't have
sex with men. |
| Fact: |
Most
lesbians have had sex with men at some time in their lives.
Some lesbians currently have sex with men or have partners
who are bisexual. This means that it is possible they have
become infected with the human papilloma virus (HPV), linked
to the development of cervical cancer. Smoking may also increase
your risk of cancer of the cervix. |
| Belief: |
If
a woman has never had sex, she is not at risk of developing
cervical cancer. |
| Fact: |
Often
when people refer to sex, they are speaking of heterosexual
sex. But sex is far more diverse than that. If you have ever
had any form of sex, there is still a possibility, although
rare that cervical cancer may develop. Smoking may also increase
your risk of cancer of the cervix. |
| Belief: |
Human
papilloma virus infection is less common in lesbians. |
| Fact: |
There
is no evidence to suggest that HPV rates are lower in the
lesbian community. HPV is a common sexually transmitted disease.
HPV may cause an outbreak of visible warts, more often it
causes no signs at all. This is why it spreads so easily.
Up to 70 per cent of the population may have had wart virus
at some time with many people not being aware they have ever
had it. It is important to remember that most women with HPV
do not develop cervical abnormalities or cervical cancer. |
| Belief: |
A
Pap test is also an STD screening test. |
| Fact: |
A
Pap test may detect HPV on the cervix, but it is not a screening
test for either STDs or related conditions. If you have any
concerns, check with your doctor, health practitioner or sexual
health clinic. |
 |
What
causes cervical cancer? |
 |
At
present the exact cause of cervical cancer is unknown, although
there are some known risk factors. These include:
- Age: A woman's risk of developing cervical cancer increases
with age. Most women who develop the disease are over
40 years of age.
- Human
papilloma virus: Some strains of genital wart virus or humanpapillomavirus
are associated with the development of cervical cancer.
- Smoking: Smoking can increase the risk of cervical cancer by up
to four times that of non-smokers.
- Sexual
history: Research shows a link between sexual activity and
cervical cancer.
Each
year in Australia, about 1,000 women develop cervical cancer
and about 340 women die of it. |
|
Can
cervical cancer be prevented? |
|
Cancer
of the cervix is one of the most preventable of all cancers.
Pap tests pick up early warning signs that can be treated
before cancer develops. Regular Pap tests can reduce a woman's
risk of developing cervical cancer by up to 90 per cent. By
having a Pap test every two years, you're giving yourself
a chance for anything unusual to be found and treated if necessary. |
|
What
is involved in having a Pap test? |
|
The
test checks for changes in the cells of the cervix, located
at the top of the vagina. It is a simple test that takes a
few minutes and is completely safe. It is done by placing
a speculum in the vagina. This holds the vaginal walls apart
so the cervix can be seen. A small spatula or brush is then
used to wipe some cells from the cervix. The cells are placed
onto a glass slide and sent to a laboratory to be tested.
Having
a Pap test can feel uncomfortable, however, most women do
not experience pain. If it is painful, tell your doctor or
nurse - there are strategies they can try to reduce your pain
or discomfort. |
|
Where
can you go for a Pap test? |
|
All
of the following options are available. Choose the person
and place where you would feel most comfortable.
You
can make an appointment with:
- your
doctor
- FPA
Health clinic
- women's
health nurse at your local community health centre
- women's
health centre
- sexual
health clinic
- Aboriginal
Medical Service
|
|
What
will it cost? |
|
A
Medicare rebate is available, but the cost of your Pap test
may vary depending on where you have it done. Ask your doctor
or nurse what it will cost. |
|
What
about the results? |
|
When
you have your Pap test, ask your doctor or nurse how you will
find out the result. Most Pap tests are entirely normal and
most women should expect a normal result.
In
a small percentage of Pap tests, abnormal changes are found
which may require further tests. In most cases, these changes
can be treated and are not cancer.
For
more information on abnormal Pap tests, talk with your practitioner
or contact the NSW Cervical Screening Program on toll-free
131 556 for a brochure. |
Remembering
to have a Pap test
The
NSW Pap Test Register is a confidential record of all Pap tests
of women in NSW. It will help you by:
- sending
you a letter if you are overdue for your next test;
- working
with your doctor or nurse to make sure you have follow-up care
if needed;
- keeping
a history of your results.
The
next time you have a Pap test your information will automatically
be sent to the Register unless you tell your doctor or nurse that
you don't want this to happen. Ask your doctor or nurse if you require
any further information about the Register.
Please
note that your sexuality is not recorded on the Register.
Having
a Pap test is not always easy for lesbians
Community
acceptance and recognition of lesbians and lesbian relationships
is not always apparent. In accessing health services there are a
number of problems that lesbians may face, such as:
Finding
a suitable doctor or nurse
 Find
a doctor or nurse who is knowledgeable and understanding of lesbian
health issues.
- Do
your own research
- Ask
friends for the name of a good doctor or nurse
- If
you would like to have a woman doctor ask about this when you
make an appointment
- If
you need support while having a Pap test, ask your partner or
a friend to come into the consultation room with you
Answering
sexual history questions
Often
a request for a Pap test begins with a doctor taking a sexual history.
You may be asked questions like "Are you sexually active?"
And "What form of contraception are you using?". This
frequent assumption that all women are heterosexual can be uncomfortable.
The choice to disclose this information is yours, don't feel that
you have to.
- If
you are not "out" to your doctor, think carefully
about how you will deal with these questions.
- Talk
to friends and draw from their experiences.
- Choose
a doctor or nurse who is sensitive to these issues and who uses
language that acknowledges all sexualities.
Protecting
confidentiality
Lesbians
are often concerned that their sexuality will not remain confidential
if disclosed to a doctor or nurse. This concern can be particularly
true for lesbians living in rural areas or lesbians with children.
- Ask
your doctor or nurse not to record your sexual orientation on
your medical history unless it has relevance to your health
concern.
- Doctors
and nurses are required by law to protect your confidentiality.
- You
have a right to take action if this confidentiality is breached.
Dealing
with bad experiences or discrimination
These
days health workers are better informed regarding lesbian health
issues and are being encouraged to take a more sensitive approach
to history taking and pelvic examinations. Occasionally you may
hear of bad experiences that women may have had when having Pap
tests.
Strategies:
If
this happens to you, remember that you can stop an examination at
any time or leave at any point during the consultation.
- If
you have had a bad experience and don't want to make a complaint,
talk it over with friends or with someone who can offer you
support.
- You
have the right to make a complaint if you are unhappy with a
service or felt that your treatment was unfair or discriminatory.
It's preferable to raise your complaint with the service provider
or organisation first - all health services have a complaints
procedure policy.
Remember: Have
a Pap test every two years.
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