In the past two decades alone, numerous lesbian icons have been lost to cancer, including poet Audre Lorde in 1992, lawyer Paula Ettelbrick in 2011, and in July, astronaut Sally Ride. But it’s not just the high-profile people at risk. A link between lesbians and cancer, particularly breast cancer, is more than speculation, say experts. While no cancer registries collect data about sexual orientation, and existing studies have been too small to be considered conclusive, experts believe that lesbians have an increased risk of developing breast cancer, based on a cluster of risk factors that are more common among lesbians.
“There is nothing specific about the lesbian lifestyle which would cause and increase their breast cancer risk,” says Susan Love, MD, the lesbian founder of the Dr. Susan Love Research Foundation “However, many of the classic risk factors for breast cancer are more common in lesbians.”
Those risk factors include smoking, drinking alcohol, obesity, and infrequent pregnancy. While these habits aren’t unique to lesbians, they’re much more common among gay and bisexual women. Liz Margolies, executive director of the National LGBT Cancer Network, says cancer disproportionately affects lesbians, but not because their bodies are any different from those of heterosexual women. “The increased risks we have are a result of behaviors, many of which result from the stigma of being gender and sexual minorities,” she says.
Social factors, they agree, are also worth noting. Lesbians are less likely to have health insurance, less likely to get screened for fear of culturally incompetent health care providers, and butch women may have an especially difficult time paying attention to their breasts. “Until we can bring our whole selves into treatment, we either lie about who we are, or we leave [the doctor’s office] and don’t come back,” Margolies says.
Not getting regular breast cancer screening increases the risk of having a cancer diagnosed later, says Love, when it is harder to treat. Higher instances of risk factors plus lower screening rates must equal higher cancer rates, Margolies says, but there’s no data to prove it, making it harder to fund projects examining cancer in lesbians. There is hope, however: After pressure from advocates, the 2013 National Health Interview Survey will include questions about sexual orientation. The questions are designed to establish a precedent for health care facilities to more carefully collect information about LGBT patients.
For Margolies, who is preparing to observe National Breast Cancer Awareness Month in October, the fight has just begun. She tells every queer woman she meets, “If you love her, get her screened.”