As you read this, you may be tending to a one- or two-day hangover, after the hideous booze-fest that is St Patrick’s Day in Ireland. Appropriately, then, read on to find out about some issues affecting lesbians and our health.
I spoke with GP Dr Mary Condren of the Temple Bar Medical Centre, Dublin, and with sociologist Dr Mel Duffy of DCU’s School of Nursing to find out their views about some aspects of health concerns and the health system which affect lesbians. I also discussed with Dr Duffy this weekend’s Self, Selves and Sexualities International Conference 2010 taking place in DCU.
Dr Mary Condren was involved in establishing the MSc in Women’s Health with the Royal College of Surgeons in Ireland (RCSI) and, although she is not currently a regular lecturer on the course, she does still provide seminars as part of the MSc on the subject of women who have sex with women.
Speaking to Dr Condren, she believes that disclosure of one’s sexuality shouldn’t necessarily be needed when speaking to your GP, but that it may well affect the kinds of questions a patient is asked. There are, of course, many myths that apply to lesbian health, including sexual health.
Lesbian sex is low- or no-risk? Not so. Dr Condren feels that there are always issues if someone is sexually active, including the risk of HPV, the human papilloma virus. There are myriad types of HPV, some of which can cause warts and some of which can cause cancers including cervical cancer, or cancers of the vulva, vagina or anus. “So, women who are lesbians should be having smear tests just as regularly” as their non-lesbian counterparts, Dr Condren advises.
Interestingly, experience seems to show that bacterial vaginosis (BV) is very common among women who have sex with women. This may be due to the use of dildos and toys. If BV has been diagnosed, it may be prudent for both partners to receive treatment. BV is not a sexually transmitted infection (STI), Dr Condren clarifies, “but is connected to disturbance of the bacterial environment within the vagina.”
Of course, since sex between women is not risk-free, safer sex practices are a must. STIs can be passed on by sharing toys – or fingers – and oral sex can also pass on infection. Think herpes (known in some quarters as a cold sore), gentital warts (yum!) and so on. Therefore using dental dams and gloves is hugely important.
She is also keen to emphasise that fertility is very much an important issue for lesbian woman, as much as for any woman, and it’s important to be able to discuss this with your GP.
What is more is that there is a theory in relation to a possible cause of ovarian cancer in some women. The theory stems from the correlation between the numbers of women who have never become pregnant and the numbers of women who present with ovarian cancer. The research on this subject is limited, but it is thought that if there is never an interruption of the monthly cycles, this may increase the risk of this cancer. Therefore this may also be especially important for lesbian women who may be less likely to become pregnant, or to have fewer pregnancies, than their straight sisters. It’s thought that a possible way to lower the risk is to take the contraceptive pill on a therapeutic basis (rather than necessarily for contraceptive reasons) for a period of time, such as 9 to 12 months.
When I spoke to Dr Mel Duffy at DCU, she clarified that her background is in sociology, rather than practicing as a nurse. She discussed with me some of the findings of her doctoral thesis, Voices from the Hinterland: Lesbian women’s experiences of Irish health care, the forthcoming international conference on Self, Selves and Sexualities which is jointly organised between the School of Applied Language and Intercultural Studies and the School of Nursing and the new Masters programme currently being developed on sexuality aiming for a start date in September in DCU.
I began by asking about the title of her thesis and lesbian visibility, both as patients and health care professionals. “The title actually comes out of the findings, to be honest, because one of the things is first of all, let’s go and try and find a few lesbians. And I think part of the problem is – what I found – there is a misconception out there that we are more visible. In a lot of ways we’re not.
“I put an ad in GCN, and I asked for those who’d experienced health care if I could talk to them. What I found, and which was found in other studies, was that while women wanted to talk, the problem was that they were afraid of being identified. So there’s still a fear factor out there, there’s still a stigma factor out there. And I think while we may be quite happy behind closed doors and in our own relationships behind closed doors, or in our venues that we meet up in, we’re still not very free publicly. And that’s where “Voices from the Hinterland” came from.
“When I talked to the women who responded about their health care, their health care was not divorced from their experiences of their day-to-day life. They brought whatever was going on in their day-to-day life into health care. So, you had women who spoke about that they were very careful – particularly those who were hospitalised – about if they have to share, if they have to use showers; about being uncomfortable being in dressing gowns in an all-women ward. It was very interesting. Things that may affect others who are non-lesbians, but they may not think about it in the same way as lesbians do. There were issues about how we interact together, and the fear of interacting because the fear is, “If they know I’m a lesbian, do they think I’m coming on to them?” Well, actually you’re ill, you’re in hospital because you’re ill, not because you’re a lesbian!
“One of the things that did come out in my research was that GPs are far more understanding, and are far more able to deal with diversity in their practices than hospitals are. Hospitals appear, from my research anyway, to have an inability to deal with difference. And there’s an inability to deal with women who present as different. And if lesbians are one minority of differences out there, then how are other women from minority groups being treated?
“The one other place that the ability to deal with diversity appears, is cancer care. I haven’t delved into this area, but maybe it’s because you’re dealing with life and death issues. So they really, maybe, “don’t really care” whether you’re a lesbian or not. They care about your cancer, where the site of your cancer is, and how can they treat that. How can they treat you as a human being. And what is so important and seems to be very much part of cancer care is taking the person as a whole person and whatever comes with that person – and that includes our relationships. Because our relationships enable us to get better.
“It goes back to the Women’s Health Policy of 1997-1999 which stated that all women were to be treated equally. And that women who were marginalised were not to be further marginalised. That’s one of the things it stated. What my thesis has shown is that that is not on the ground. The one place it is on the ground is in the local primary health care: your GPs’ surgeries; and in cancer care. There is an ability to deal with diversity there. After that, it disappears.”
Talking about the conference and the joint Faculty Masters programme which will be hosted by the School of Applied Language and Intercultural Studies and which Jean-Philippe Imbert (SALIS) and herself are currently working on, Dr Duffy emphasised that both will be all-encompassing and interdisciplinary: that is to say, that the aim is to avoid pigeon-holing lesbian/gay/bi/trans/straight sexualities, but to look at them all together under the heading of sexuality, and to examine them from all perspectives be that sexualities in literature, society, art, health, law, and so on.
The conference will be an attempt to collectively look at sexualities as lived experiences, both in life and academia. It will also be intercultural, with numerous speakers attending from every continent.
The concept of setting a Masters programme between the Faculty of Humanities and Social Sciences and the Faculty of Science & Health has been developed from the idea that that there is a need for such a programme and no programme exists in Ireland to study sexuality generally. Currently, studies in Ireland include gender or women’s studies, or queer studies, rather than sexuality per se. It is important to look at reports about sexuality in Ireland, including power structures in Irish life, and using peoples’ bodies for themselves. The conference may then enable people to become sexuality-literate.
Speakers at the conference include: Philip Esterhuizen, of the Hogeschool van Amsterdam, The Netherlands with a paper on “Self-disclosure or Not? That is the Question”; Paul Willis, of Swansea University, United Kingdom, “Homophobic Encounters of the Third Kind: Young Queer Workers Witnessing and Refuting Homophobia in Australian Workplaces”; Prof. Stef Adriaenssens, of HUB – University College Brussels, Belgium, “Ethical Consumption? Normative Consciousness by Prostitution Clients”; Baboucar Diouf, of Université Gaston Berger de Saint-Louis, Senegal, “Lifecycle and Sexuality in James Baldwin’s Go tell It on the Mountain and Shimmer Chinodya’s Harvest of Thorns”; Dr Ravinder Kumar, of Omar Al-Mukhtar University, Libya “Gender, Sex and Discrimination in The God of Small Things”; Prof. Cheryl Stobie, of University of KwaZulu-Natal, South Africa, ““He uses my body”: Lesbian Traditional Healers, Male Ancestors and Transgender in South Africa”; Nicole Rouhana, CNM, FNP-BC, of Stony Brook University, U.S.A., “Women’s Perspectives of Sexual Function after Menopause: A Grounded Theory Study”; Dr Ana Cruz Garcia, of N.U.I. Cork & Cork Institute of Technology, “Lesbian Bodies and Sexuality in Mexican Writing by Women Writers”; Beverley Nambozo Nsengiyunva, Beverley Nambozo Poetry Award, “Undo Me: Letting go of Hindrances of Sexual Freedom”; Dr Petar Penda, of University of Banja Luka, Bosnia Herzegovina, “Sexuality and Ethical Discourse in T. S. Eliot’s Poetry.”
The Self, Selves and Sexualities International Conference 2010 is a cross-faculty venture, in keeping with the academic ethos of Dublin City University. It is co-organised by Dr Mel Duffy, from the School of Nursing, and Jean-Philippe Imbert from the School of Applied Language and Intercultural Studies. The School of Nursing is part of the Faculty of Science and Health, and the School of Applied Language and Intercultural Studies belongs to the Faculty of Humanities and Social Sciences, at Dublin City University
Dr Mary Condren and her husband, Dr Leonard Condren, operate a medical partnership in general practice at the Temple Bar Medical Centre, Dublin. She graduated in medicine in UCD in 1980 and has spent all of her professional life practicing in her native city of Dublin. Dr Condren has extensive experience in the field of women’s health and was centrally involved in the establishment of a Master’s course in Women’s Health at The Royal College of Surgeon’s in Ireland.
Dr Mel Duffy is a lecturer in the School of Nursing at DCU. Her research interests include lesbian health and health care, sexuality, gender, marginalisation, health experiences, inequalities in health, the lived experience (phenomenology).