Sexuality and ­Reproductive Health

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Sexuality is complicated and does not necessarily stay the same over time.
To be more specific, how women identify—in other words, heterosexual, lesbian, gay or bisexual, etc.—may not be the same as who women are attracted to (i.e. women may be attracted to women, men or both), and with whom women chose to be intimate (i.e. women, men or both).
All of these details are important for your doctor to know.
My research team at Children’s Hospital of Pittsburgh of UPMC surveyed almost 4,000 women ages 16-29 at reproductive health clinics in Western Pennsylvania. They found that women who had sex with men and women were more likely to have ever been pregnant and have had an unwanted pregnancy compared to women who had sex with men only. However, these women were less likely to be seeking care for birth control (note: we did not ask women with female partners only about their pregnancy history).
Why might this be the case?
It is possible that women in our study did not feel comfortable talking to their doctor about their sexual orientation or sexual history.
Also, our study found that women with both male and female sex partners were more likely to have experienced physical or sexual abuse and reproductive coercion at the hands of their partner.
This increases women’s risk for unintended pregnancy.
While it is not necessary to discuss birth control options for women who have sex with women only, I do encourage doctors to ask about patients’ history at each visit—including questions about the gender of patients’ sexual partners—to make sure they are providing health care that best fits patients’ needs.
E-mail Dr. McCauley with any questions at heather.mccauley@ chp.edu.

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