Paula Martinac | September 17, 2003
Mainstream news programs and publications love to report on medical scares,
which make good copy. Because the stories are ubiquitous, the temptation for
some of us is to ignore them. But recently, a brief news item did catch my
attention: "Lesbians Face Higher Heart Disease Risk." The study it reported on
should give the lesbian community important food for thought, but I worry that
many of us will simply disregard it.
If some skeptical lesbians dismiss the report, I guess it's understandable.
We've gotten stern warnings about our health before that didn't amount to much.
In the late '90s, researchers claimed we were at much higher risk for breast
cancer than straight women, and our community shot into panic mode. Happily,
no lesbian breast cancer epidemic has yet materialized.
But the issues raised by that scare - about lesbians' propensity to smoke,
drink, and be overweight - continue to crop up. A recent San Francisco-based
study about lesbian health, whose results were just released, hypothesizes that
our body mass and waist measurements make us prime candidates for
cardiovascular disease. In addition, a few months ago the University of Pittsburgh's Center
for Research on Health and Sexual Orientation received funding from the
National Institutes of Health to do a groundbreaking four-year study on the various
risks of heart disease in lesbians.
A lot of us, I think, may end up ignoring such studies. First, for thin
lesbians, the San Francisco report's highlighting of body size as a risk factor for
heart disease may lead to the false assumption that a person has to be
overweight to have a heart attack. In fact, high cholesterol, high blood pressure,
and diabetes, which can lead to heart disease, can plague slim people, too.
Second, some lesbian feminists of size may assume that anyone who puts a
negative spin on weight must be buying into male ideas about how women ought to
look. Indeed, lesbians in general pride ourselves on being above the fray when
it comes to body image; straight women have to worry about things like weight
to please men, but not us. All sizes and shapes welcome! That's always been a
very positive aspect of the lesbian community, but it could have negative
health consequences, too. Besides that, it sometimes leads to an eerie silence in
our community about weight concerns.
For example, the last time I wrote a column on weight and health, I got
several sanctimonious e-mails from dykes of size who chastised me, a thin woman,
for daring to voice an opinion about obesity and problems like heart disease.
One reader offered her pity, surmising that I must have really deep-seated
body-image problems. And didn't I know that most medical research is controlled by
Well, sure. In fact, that's the third and most serious reason why lesbians
may fail to heed warnings about heart disease: because heart attacks have been
gendered "male" by doctors, who fuel women's cancer fears instead. Even the Gay
and Lesbian Medical Association's list of 10 health issues lesbians should
discuss with their doctors puts breast cancer first and heart disease last
(right after osteoporosis, which is a serious threat to women's health, but not a
killer). The fact is, though, that more women die of heart disease than of all
forms of cancer combined, including breast cancer.
Consider this personal anecdote: Since the age of 35 I've had more mammograms
than I can even remember, based on doctors' recommendations. But I've had to
specifically request cholesterol tests, whose purpose is to help identify
the potential risk for heart disease and stroke.
Much of the medical establishment's de-emphasis of heart disease in women and
overemphasis on cancer has its roots in sexism. Our society views breast
cancer as particularly frightening, since a woman's loss of a breast to mastectomy
is perceived as a diminishing of her femininity and attractiveness. But heart
disease is "masculine" because it may be triggered by the stress of work or
of worries about supporting a family. The assumption has been that woman don't
have the same pressing concerns as men, even though we have jobs, too, and
often take care of homes, children, or aging parents on top of that. Because of
this gross misreading of heart disease, most women never learn until it's too
late that our symptoms - nausea, fainting, shortness of breath - are very
different from those that men experience.
When it comes to heart disease, then, lesbians have good reasons to keep a
close watch on the study findings and ask a lot of questions of our health-care
professionals. Among our concerns should be: How do weight and behavior affect
our risk for heart disease? Can a thin nonsmoker be at risk? And how can we
protect ourselves against this silent killer of women?
is a Lambda Literary Award-winning author of seven books and editor in chief of Q Syndicate.