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regular gynecological care, including regular pap smears and breast exams (Matthews,
Brandenburgh, Johnson, & Hughes, 2004). Lesbians and bisexual women avoid regu-
lar visits to the gynecologist due to past negative experiences, placing them at higher
risk of late diagnosis of cervical, ovarian, and endometrial cancers. Fewer pregnancies
and decreased use of contraceptives also contribute to increased rates of ovarian and
endometrial cancer, and human papillomavirus (HPV) (which is associated with cervi-
cal cancer) can be transmitted by unclean sex toys (Baernstein et al., 2006).
According to the U.S. Department of Health and Human Services (USDHHS,
Office on Women ’ s Health, 2000), another reason lesbians are likely to receive inade-

quate treatment is that some health care providers falsely believe lesbians are immune
to certain reproductive cancers and therefore do not conduct the proper tests to screen
for cancer. Still, lesbian and bisexual women, like all women, need regular gynecolog-
ical care and breast and STD screenings.
Along with cancer risks, lesbians and bisexual women are also at risk for obesity
and heart disease. There is evidence that lesbians are more likely to be overweight than
their heterosexual counterparts, possibly because of cultural norms within the lesbian
community and because lesbians may relate differently to, not accept, or not internalize
mainstream notions of ideal beauty and thinness (Aaron et al., 2001). On average, lesbi-
ans have been found to have higher BMIs (body mass indexes), and higher BMIs have
been found to predict health status in regard to obesity (Baernstein et al., 2006).

HEALTH ISSUES OF GAY AND BISEXUAL MEN

Like other LGBT people, gay and bisexual men make up a diverse group of people
who identify as different races, ethnicities, nationalities, and religions and who repre-
sent multiple socioeconomic classes from various areas in the United States. These
identities directly affect the health issues facing gay and bisexual men. However, we
will focus on issues we see as the most common and relevant and as sometimes over-
looked in gay and bisexual men ’ s communities.
The use of club drugs, such as crystal methamphetamine (often referred to as
crystal meth ) and ecstasy appears to be increasing in gay and bisexual men’s commu-
nities (GLMA et al., 2001). Crystal methamphetamine can cause erratic, violent behav-
ior among its users. Effects also include suppression of appetite, interference with
sleeping behavior, mood swings, tremors, convulsions, and an irregular heart rate. The
long - term effects of the drug can include coma, stroke, and death (Partnership for a
Drug - Free America, 2006). Additionally, crystal methamphetamine, which is highly
addictive, can increase the risk of HIV transmission, as it lowers users ’ inhibitions,
which can result in unsafe sex practices (Reuters, 2004). Crystal methamphetamine is
especially popular in rural and economically depressed areas, as it is produced easily
and inexpensively (Reuters, 2004).
Eating disorders and negative body image also affect gay and bisexual men.
Research indicates that eating disorders occur more often among gay men than among

heterosexual men (Meyer, Blissett, & Oldfield, 2001). Eating disorders, such as

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