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Neither lesbian nor straight – reclaiming the middle ground

Neither lesbian nor straight – reclaiming the middle ground

Women who are neither heterosexual nor lesbian-identified have traditionally been ignored in research and healthcare practice. Yet, recent research evidence indicates that these women have significant health inequities in areas of mental health, substance use, physical health and sexual health. Reasons for these inequities are not clear, although hypotheses include greater marginalisation and social isolation, and an absence of a unifying activist voice. Emerging literature indicates that these women are a disparate group with few unifying features, and varied sexual attraction, behaviour and identity.

Mixed methods were used for this exploration of the middle ground of women’s sexual orientation. Secondary data analysis of surveys from the Australian Longitudinal Study of Women’s Health examined women who identify as lesbian, bisexual, mainly heterosexual and exclusively heterosexual. Measures of mental health, substance use, physical health, victimisation and health care usage were compared against sexual identity using logistic regression modelling. A qualitative study was also conducted using a critical hermeneutic approach, involving in-depth interviews with 33 same sex attracted women and 27 GPs, including 24 woman-GP pairs.

Women’s sexual identity experience plays a significant role in the risk and protective factors influencing their health. It also influences their interaction with the healthcare system and wider social networks. For example, the degree of importance women place on their sexual identity is central to whether they disclose this identity publicly, including within healthcare settings, and this, in turn, can influence the effectiveness of their healthcare experience.

Although substantial progress has been made in understanding health risks among bisexual and mainly heterosexual women, there are still many questions regarding who these women are and what underpins their health inequalities. Nevertheless, researchers, clinicians and policy makers need to consider the diversity within sexual minority populations and develop more targeted prevention and intervention strategies to reduce health disparities and engage these women more effectively.

Speakers: Ruth McNair
Areas of Interest / Categories: Australasian Sexual Health Conference 2011

Australasian Sexual Health Conference 2011

Current Medical Treatment of Premature Ejaculation

Over the past 20-30 years, the Premature Ejaculation (PE) treatment paradigm, previously limited to behavioural psychotherapy, has expanded to include drug treatment. Animal and human sexual psychopharmacological studies have demonstrated that serotonin and 5-HT receptors are involved in ejaculation and confirm a role for SSRIs in the treatment of PE. Multiple well-controlled evidence-based studies have demonstrated the efficacy and safety of SSRIs in delaying ejaculation, confirming their role as first-line agents for the medical treatment of lifelong and acquired PE. Daily dosing of SSRIs is associated with superior fold increases in IELT compared to on-demand SSRIs.

The importance of mobility in sustaining high STI prevalence in remote indigenous communities

Despite high rates of screening and treatment in many remote Indigenous communities in Australia, diagnosis rates for sexually transmitted infections (STI), chlamydia and gonorrhoea in particular, remain alarmingly high. One contributing factor may be the high rate of temporary mobility for residents of remote communities. We use mathematical modelling to explore the impact of mobility on STI transmission within remote communities.

Gay men prefer partner notification by short message service (SMS) rather than e-postcards: a web-based evaluation

In 2006 two new innovative features were added to the WhyTest website; the ‘Tell them’ service allowing visitors to forward anonymous e-postcard or short message services (SMS) to sexual partners who may have been exposed to an STI, and the ‘remind me’ service allowing visitors to register for a 3, 6 or 12 monthly SMS reminder for a sexual health check. We describe the usage of the new website functionality, and recognition of a health promotion campaign conducted in January-June 2007 to promote these new features.

Lighting the fire, not filling the pail - positioning sexuality in the Australian curriculum

This symposium presentation will discuss conceptual approaches to how processes underway to develop the Australian Curriculum might link to improved sexual health outcomes. It will also explore the assumptions underpinning the ‘partnership’ between health and education sectors to uncover both the opportunities and the pitfalls for those who want to promote young people’s learning. 

Oropharyngeal carcinoma related to human papillomavirus

Human papillomavirus (HPV) induced oropharyngeal squamous cell carcinoma is a unique subtype of oropharyngeal cancer. It has a significantly better prognosis than that caused by tobacco and/ or alcohol. The incidence of HPV related oropharyngeal cancer is raising in the western countries.

High chlamydia prevalence found among young Australian men and women - results from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt).

ACCEPt is a multi-state cluster randomised trial that aims to increase annual chlamydia testing in 16-29 year olds attending general practice. 54 postcodes (80% in rural areas) are being randomised to a multi-faceted intervention and GP clinics within each postcode enrolled. The primary outcome is change in chlamydia prevalence, and a prevalence study is being conducted at the beginning and end of the trial. We report on the findings of the baseline prevalence study.

Surgical Aspects of Transgender Medicine

Surgery for gender dysphoria was not routinely available prior to the 80’s, surgery and psychiatry having had an unhappy liaison. While gender dysphoria is DSM classified it’s not because it is deemed to be an illness, rather than to give guidelines as to establishing a diagnosis, and surgery is now deemed to be an appropriate activity.