{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:21:33Z","timestamp":1772778093010,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T00:00:00Z","timestamp":1430438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Lesbian and bisexual women (LBs) have unique health needs compared with heterosexual women (HW).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>This study aimed to associate the health status of LB, their health behavior, disclosure of sexual orientation (SO), and avoidance of health care with that of HW.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants in this cross-sectional study completed anonymous questionnaires, which were distributed in Internet sites and public venues in Israel, comparing health behaviors and outcomes between LB and HW.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Health outcomes included subjective health status, general practitioner or gynecologist visit in the last 6 months, and satisfaction from the Israeli healthcare system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 2012, 681 (34.4%) lesbians, 242 (13.5%) bisexual women, and 937 (52.1%) HW completed the questionnaire. In comparison with HW, LBs were more commonly single, used drugs\/alcohol, smoked, experienced eating disorders, and reported an earlier sexual debut. In comparison with all women, lesbians performed less physical activities and were more satisfied with their body weight, whereas bisexuals had riskier sexual behavior and reported more verbal\/physical abuse. LB reported more emergency room visits, more visits to psychiatrists, yet underwent Pap smears less frequently compared with HW. In a multivariate analysis, lesbians had fewer gynecologists' visits and were less satisfied with the healthcare system than HW, whereas bisexuals visited their general practitioner or gynecologist less frequently and were less satisfied with the primary healthcare system. Lesbians were more likely to disclose their SO with their doctors than bisexuals and were satisfied with the disclosure. Nondisclosure of SO was correlated with poor subjective health status. The interaction between being bisexual and nondisclosure of SO was strong.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>LB utilized health care less frequently than HW, resulting in unmet medical needs. SO disclosure was associated with better healthcare utilization and health outcomes, especially among bisexuals. Providers should be trained about LB's unique health needs and improve their communication skills to encourage SO disclosure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1111\/jsm.12850","type":"journal-article","created":{"date-parts":[[2015,3,9]],"date-time":"2015-03-09T08:39:43Z","timestamp":1425890383000},"page":"1249-1256","source":"Crossref","is-referenced-by-count":20,"title":["Health Status, Behavior, and Care of Lesbian and Bisexual Women in Israel"],"prefix":"10.1093","volume":"12","author":[{"given":"Zohar","family":"Mor","sequence":"first","affiliation":[{"name":"Ramla Department of Health , Ramla, \u00a0 Israel"},{"name":"Ministry of Health , Ramla, \u00a0 Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.r.i.","family":"Eick","sequence":"additional","affiliation":[{"name":"Hoshen\u2014Education and Information Center of the LGBT (Lesbian, Gay, Bisexual, and Transgender) Community , Tel Aviv, \u00a0 Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.a.l.","family":"Wagner Kolasko","sequence":"additional","affiliation":[{"name":"Department of Family Medicine , Tel Aviv, \u00a0 Israel"},{"name":"Gan Meir Clinic , Tel Aviv, \u00a0 Israel"},{"name":"Clalit Health Services , Tel Aviv, \u00a0 Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irit","family":"Zviely-Efrat","sequence":"additional","affiliation":[{"name":"Hoshen\u2014Education and Information Center of the LGBT (Lesbian, Gay, Bisexual, and Transgender) Community , Tel Aviv, \u00a0 Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey","family":"Makadon","sequence":"additional","affiliation":[{"name":"The Fenway Institute , Boston, MA , USA"},{"name":"Fenway Health , Boston, MA , USA"},{"name":"Harvard Medical School , Boston, MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadav","family":"Davidovitch","sequence":"additional","affiliation":[{"name":"Department of Health Policy , Beer Sheva, \u00a0 Israel"},{"name":"Ben Gurion University in the Negev , Beer Sheva, \u00a0 Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2015,5,1]]},"reference":[{"key":"2023012309084405600_bb0010","article-title":"LGBT percentage highest in D.C.","author":"Gallup","year":"2013"},{"key":"2023012309084405600_bb0015","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1001\/archfami.9.10.1043","article-title":"Health behaviors, health status, and access to and use of health care","volume":"9","author":"Diamant","year":"2000","journal-title":"Arch Fam Med"},{"key":"2023012309084405600_bb0020","article-title":"The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding","year":"2011"},{"key":"2023012309084405600_bb0025","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3109\/02813430903226548","article-title":"Lesbian women's experiences with health care: A qualitative study","volume":"27","author":"Bjorkman","year":"2009","journal-title":"Scand J Prim Health Care"},{"key":"2023012309084405600_bb0030","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1007\/s11524-006-9096-8","article-title":"Health care access and utilization among women who have sex with women: Sexual behavior and identity","volume":"83","author":"Kerker","year":"2006","journal-title":"J Urban Heath"},{"key":"2023012309084405600_bb0035","first-page":"279","article-title":"Primary care for lesbians and bisexual women","volume":"74","author":"Mravcak","year":"2006","journal-title":"Am Fam Physician"},{"key":"2023012309084405600_bb0040","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1146\/annurev.publhealth.012809.103636","article-title":"The health and health care of lesbian, gay and bisexual adolescents","volume":"31","author":"Coker","year":"2010","journal-title":"Annu Rev Public Health"},{"key":"2023012309084405600_bb0045","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S0738-3991(02)00189-1","article-title":"The same but different: Clinician-patients communication with gay and lesbian patients","volume":"51","author":"Bonvicini","year":"2003","journal-title":"Patient Educ Couns"},{"key":"2023012309084405600_bb0050","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1300\/J082v51n01_01","article-title":"Current issues in lesbian, gay, bisexual and transgender health","volume":"51","author":"Harcourt","year":"2006","journal-title":"J Homosex"},{"key":"2023012309084405600_bb0055","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(11)60482-0","article-title":"Health of lesbian, gay, bisexual, and transgender populations [Editorial]","volume":"377","year":"2011","journal-title":"Lancet"},{"key":"2023012309084405600_bb0060","first-page":"15","article-title":"Lesbians in Israel: A legal perspective","author":"Hadar","year":"2005","journal-title":"Sappho in the Holy land: Lesbians' existence and dilemmas in contemporary Israel"},{"key":"2023012309084405600_bb0065","first-page":"117","article-title":"The presentation of self of young Israeli lesbians: A discourse on split identity","author":"Luzzatto","year":"2005","journal-title":"Sappho in the Holy land: Lesbians' existence and dilemmas in contemporary Israel"},{"key":"2023012309084405600_bb0070","article-title":"Estudio national de comportamiento sexual","author":"Ministerio de Salud, Gobierno de Chile","year":"2000","journal-title":"Primeros analisis"},{"key":"2023012309084405600_bb0075","article-title":"Comportamento sexual da popula\u00e7\u00e3o brasileira e percep\u00e7\u00f5es do HIV\/AIDS","author":"Minist\u00e9rio da Sa\u00fade","year":"2000"},{"key":"2023012309084405600_bb0080","first-page":"1","article-title":"Sexual orientation and health among U.S. adults: National Health Interview Survey, 2013","volume":"15","author":"Ward","year":"2014","journal-title":"Natl Health Stat Report"},{"key":"2023012309084405600_bb0085","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1186\/1471-2458-9-317","article-title":"Alcohol, tobacco and illicit drug use amongst same-sex attracted women: Results from the Western Australian Lesbian and Bisexual Women's Health and Well-Being Survey","volume":"9","author":"Hyde","year":"2009","journal-title":"BMC Public Health"},{"key":"2023012309084405600_bb0090","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1080\/10826080500411080","article-title":"Assessing gay and bisexual men's outcome expectancies for sexual risk under the influence of alcohol and drugs","volume":"41","author":"Bimbi","year":"2006","journal-title":"Subst Use Misuse"},{"key":"2023012309084405600_bb0095","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1300\/J041v18n02_03","article-title":"Lesbian survivors of intimate partner violence: Provider perspectives on barriers to accessing services","volume":"18","author":"Simpson","year":"2007","journal-title":"J Gay Lesbian Soc Serv"},{"key":"2023012309084405600_bb0100","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1080\/10826080802215130","article-title":"Elevated substance use among lesbian and bisexual women: Possible explanations and intervention implications for an urgent public health concern","volume":"43","author":"Rosario","year":"2008","journal-title":"Subst Use Misuse"},{"key":"2023012309084405600_bb0105","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.2105\/AJPH.2007.117770","article-title":"Risk for assault in abusive female same-sex relationships","volume":"98","author":"Glass","year":"2008","journal-title":"Am J Public Health"},{"key":"2023012309084405600_bb0110","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1177\/1524838010390707","article-title":"The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: A systematic review","volume":"12","author":"Rothman","year":"2011","journal-title":"Trauma Violence Abuse"},{"key":"2023012309084405600_bb0115","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1037\/0022-006X.71.1.53","article-title":"Prevalence of mental disorders, psychological distress and mental health services use among lesbian, gay and bisexual adults in the United States","volume":"71","author":"Cochran","year":"2003","journal-title":"J Consult Clin Psychol"},{"key":"2023012309084405600_bb0120","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1037\/0033-2909.129.5.674","article-title":"Prejudice, social distress, and mental health in lesbian, gay and bisexual populations: Conceptual issues and research evidence","volume":"129","author":"Meyer","year":"2003","journal-title":"Pschol Bull"},{"key":"2023012309084405600_bb0125","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1080\/073993302753429059","article-title":"Health care services for lesbians and bisexuals women: Some Canadian data","volume":"23","author":"Mathieson","year":"2002","journal-title":"Health Care Women Int"},{"key":"2023012309084405600_bb0130","article-title":"Fenway guide to lesbian, gay, bisexual and transgender health","author":"Makadon","year":"2007"},{"key":"2023012309084405600_bb0135","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.2105\/AJPH.92.7.1131","article-title":"Prediction f depressive distress in a community sample of women: The role of sexual orientation","volume":"92","author":"Matthews","year":"2002","journal-title":"Am J Public Health"},{"key":"2023012309084405600_bb0140","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/her\/15.1.97","article-title":"Internalized homophobia and health issues affecting lesbians and gay men","volume":"15","author":"Williamson","year":"2000","journal-title":"Health Educ Res"},{"key":"2023012309084405600_bb0145","doi-asserted-by":"crossref","first-page":"S84","DOI":"10.1093\/cid\/cir697","article-title":"Sexually transmitted infections among women who have se with women","volume":"53","author":"Gorgos","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2023012309084405600_bb0150","first-page":"53","article-title":"Health care use among gay, lesbian and bisexual Canadians","volume":"19","author":"Tjepkema","year":"2008","journal-title":"Health Rep"},{"key":"2023012309084405600_bb0155","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1093\/fampra\/cml030","article-title":"Regular health care use by lesbians: A path analysis of predicative factors","volume":"23","author":"Steele","year":"2006","journal-title":"Fam Pract"},{"key":"2023012309084405600_bb0160","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1080\/028134302321004845","article-title":"GPs and lesbian women in the consultation: Issues of awareness and knowledge","volume":"20","author":"Westerstahl","year":"2002","journal-title":"Scan J Prim Health Care"},{"key":"2023012309084405600_bb0165","doi-asserted-by":"crossref","first-page":"947","DOI":"10.2105\/AJPH.91.6.947","article-title":"Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women","volume":"91","author":"Marrazzo","year":"2001","journal-title":"Am J Public Health"},{"key":"2023012309084405600_bb0170","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.2105\/AJPH.2006.088419","article-title":"Overweight and obesity in sexual-minority women: Evidence from population-based data","volume":"97","author":"Boehmer","year":"2007","journal-title":"Am J Public Health"},{"key":"2023012309084405600_bb0175","article-title":"Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding","year":"2011"},{"key":"2023012309084405600_bb0180","doi-asserted-by":"crossref","first-page":"2048","DOI":"10.2105\/AJPH.2006.087254","article-title":"Physical health complaints among lesbians, gay men, and bisexual and homosexually experienced heterosexual individuals: Results from the California Quality of Life Survey","volume":"97","author":"Cochran","year":"2007","journal-title":"Am J Public Health"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609515310183?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609515310183?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/12\/5\/1249\/48586527\/jsm_12_5_1249.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/12\/5\/1249\/48586527\/jsm_12_5_1249.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T09:33:49Z","timestamp":1674466429000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/12\/5\/1249\/6980187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,1]]},"references-count":35,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2015,5,1]]},"published-print":{"date-parts":[[2015,5,1]]}},"URL":"https:\/\/doi.org\/10.1111\/jsm.12850","relation":{},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,5]]},"published":{"date-parts":[[2015,5,1]]}}}