Research on Bisexual and Lesbian Women Comes Out of the Closet

In the 1990s, nonheterosexual women, particularly teenagers, didn’t show up much in the family planning literature. Or not explicitly, at any rate. But in 1999, Family Planning Perspectives, as the journal was then known, ran an article in which Elizabeth Saewyc and colleagues studied teenage women’s histories of intercourse, abuse and pregnancy according to their sexual orientation. The study was based on analyses of data from a 1987 survey of Minnesota public high school students, which explored teens’ health and asked them to categorize themselves as “100% heterosexual,” “mostly heterosexual,” “bisexual,” “mostly homosexual,” “100% homosexual” or “not sure.” Earlier work on nonheterosexual women’s reproductive health needs had relied largely on convenience or clinic-based samples of women who were publicly out, so it likely suffered from a certain amount of selection bias; the approach of a statewide survey therefore represented a large step forward. In the Minnesota sample, Saewyc and colleagues found, teens who categorized themselves as bisexual or homosexual (whether mostly or exclusively) were about as likely as those describing themselves as heterosexual (again, mostly or exclusively) to have had intercourse with a male, and were more likely to have experienced pregnancy or physical or sexual abuse. The investigators’ conclusion, fairly novel at the time: Family planning service providers “should not assume that their pregnant adolescent clients are heterosexual or that adolescents who identify themselves as lesbian or bisexual do not require family planning counseling.”

Nearly 20 years later, as gender identity is continually redefined and increasingly recognized as a fluid concept, it doesn’t hurt to keep reminding ourselves that meeting the sexual and reproductive health needs of all people requires the provision of sensitive, individualized, unbiased care.

Cover illustrations of Margaret Sanger © Matthew and Eve Levine