Same-sex attracted females lead very interesting, but different lives. Lesbians are a minority within the category of women and also a minority within the evolving and at times confusing LGBTQ+ population. This dual minority status creates unique experiences of minority stress that impact mental health and wellbeing (Meyer, 2003, 2015¹).

Research on women is limited and research on lesbians is almost non-existent. The Institute of Medicine has identified this research gap as a significant barrier to providing adequate healthcare for lesbian women (IOM, 2011²).

Our lives are just different from standard issue heterosexual women, who are also trying to make their way in a world designed for males. Therefore, therapy for lesbians will have to be different. Therapy approaches that understand these unique experiences lead to better therapeutic outcomes (Crisp & McCave, 2007³; Shelton & Delgado-Romero, 2011⁴).

Who are the Lesbians?

There are things that are just stereotypes, but it is true that a lot of us are resourceful, wear practical shoes and drive Subarus. We can also be wildly colorful and ultra feminine.

Protecting the vulnerable is on our minds and our to-do lists. Actively organizing and framing our lives for the welfare of animals, children and Mother Earth are common themes. We choose natural over artificial. Holding a strong sense of right and wrong propels us. Lesbians show a fierce dedication to the ones we love and the causes we support.

We know what it is like to feel misunderstood. People don’t quite know where to place us or what to do with us. There are lesbians who appear very like their heterosexual sisters, but plenty of us are gender non-conforming. Many of us spend way less time and resources on things. This makes us utterly useless to the consumer economy compared to other demographic groups. This non-conformity to traditional gender roles and consumer patterns reflects broader patterns of gender expression diversity within lesbian communities (Rothblum, 2009⁵) We are often outsiders from the mainstream. This makes us strong, free-spirited and formidable.

Pathological helpfulness and overactive idealism

There is an underside. It can make us insufferable, cautious or even humorless. Giving too much is a trap women fall into. When we give too much for too long we can end up feeling exhausted and like the weight of the world is on us. The result can be a stubborn, self-righteousness or bitterness. Lesbians are more likely to either be organic, gluten-free and sober or addicted to a myriad of things. Research shows lesbians have higher rates of substance use compared to heterosexual women, though patterns vary significantly across age and demographic groups (Hughes et al., 2006⁶). Additionally, lesbians face elevated rates of mental health challenges including depression and anxiety, often related to minority stress (King et al., 2008⁷). We are women so tend towards being people-pleasing caretakers who could use better boundaries.

When we seek therapy it is not because we are lesbians, but our experiences of life are different. There is an efficiency to seeing a lesbian therapist who is going to understand what you are going through based upon a lot of actual lived experience. More details at this link. https://wisewomantherapy.com/about-debdettman/

labrys art — Amazon axe of the Matriarchy. MWMF.

A Biological Female Body But Not a Heterosexual Life

Therapy for lesbians needs to consider that the female body is the deluxe model, but not used in the most common manner. We are capable of giving birth, but it will never happen accidentally. Our female bodies will be subject to the male gaze, which we do not seek or appreciate. Lesbians grow up with the shocks of female puberty and endure the female hormonal process. when the standards of the medical system assume women have sex with men and want to have babies, lesbians are left invisible. Healthcare providers often fail to ask about sexual orientation, leaving lesbian health concerns unaddressed (Boehmer & Case, 2004⁸). This invisibility contributes to documented health disparities, including delayed cancer screenings and inadequate reproductive health discussions (Makadon et al., 2015⁹).

Self-acceptance is often a goal in therapy. Body acceptance falls within that and is a challenge for most women in general. There is an additional layer of frustration for any women who know they are not having sex with men and not trying to get pregnant.

The menstrual process and all the female hormonal fluctuations impact all women. In these times the medical establishment treats us like customers and if we just want convenience and relief we could be lead to think there should just be a medical solution that allows us to sidestep all this. Lesbians report lower healthcare utilization rates partly due to perceived or actual discrimination in medical settings (Tjepkema, 2008¹⁰; Cochran & Mays, 2007¹¹).

The problem is that our bodies are designed with these processes that are not just so we can have babies. Every cell in our bodies is female no matter how non-conforming we are. The symphony of our hormones impacts our blood and bones and everything.

Lesbian Relationships are Different

Therapy for lesbians needs to consider the landscape or the dynamics of our relationships. We have challenges of an extremely small dating pool. Lesbian relationship dynamics are often quite different from the heterosexual world or even to rest of the ever-expanding rainbow or the LGBTQ+ community. Our relationships are intense and can sometimes evolve rather quickly. While relationship dynamics vary greatly, research shows that lesbian couples demonstrate high levels of relationship satisfaction and equity (Kurdek, 2004¹²).

Once we’ve found each other, navigating the depth of our togetherness is a lot. We are known to “meet, merge, marry.” There are debates about the existence and prevalence of LBD or whether we are really more likely than any other group to divorce if we marry. Long-term studies of same-sex couples in civil unions show relationship stability comparable to heterosexual marriages, though relationship processes may differ (Balsam et al., 2008¹³).

A Lesbian’s Place in Her Family of Origin

Despite many people becoming more accepting over time, our families are still complicated. Family acceptance significantly impacts mental health outcomes for lesbian individuals (Ryan et al., 2009¹⁴). Lesbians are still navigating families who wonder what went wrong or when will she snap out of it. Parental awareness and acceptance of lesbian identity varies widely, with many families requiring time to process disclosure (D’Augelli et al., 2005¹⁵; Savin-Williams & Dubé, 1998¹⁶).

In some families lesbians feel like they need to make up for being lesbian by having to be nicer or get in less trouble. There can be a pressure to excel to distract from being different. We have to be better just to be okay. This pressure to compensate for being different reflects the ongoing impact of minority stress on identity development and family relationships (Meyer, 2003¹⁷; Cass, 1979¹⁸; McCarn & Fassinger, 1996¹⁹) This is a lot when it is from within your family where you should ideally be able to be nurtured and safe.

Questions? debdettman@wisewomantherapy.com

Ready now? Book a free phone consultation.

Individual therapy: $200/session. I provide Super Bills for clients seeking reimbursement from their insurance companies. PPO plans often reimburse 60-80%. Limited availability for reduced fee for those with financial need.

References

1. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697.
2. IOM Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. National Academies Press.
3. Crisp, C., & McCave, E. L. (2007). Gay affirmative practice: A model for social work practice with gay, lesbian, and bisexual youth. Child and Adolescent Social Work Journal, 24(4), 403-421.
4. Shelton, K., & Delgado-Romero, E. A. (2011). Sexual orientation microaggressions: The experience of lesbian, gay, bisexual, and queer clients in psychotherapy. Journal of Counseling Psychology, 58(2), 210-221.
5. Rothblum, E. D. (2009). An overview of same-sex couples in relationships: A research area still at sea. In D. A. Hope (Ed.), Contemporary perspectives on lesbian, gay, and bisexual identities (pp. 113-139). Springer.
6. Hughes, T. L., Wilsnack, S. C., Szalacha, L. A., Johnson, T., Bostwick, W. B., Seymour, R., … & Kinnison, K. E. (2006). Age and racial/ethnic differences in drinking and drinking-related problems in a community sample of lesbians. Journal of Studies on Alcohol, 67(4), 579-590.
7. King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., & Nazareth, I. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8(1), 70.
8. Boehmer, U., & Case, P. (2004). Physicians don’t ask, sometimes patients tell: Disclosure of sexual orientation among women with breast carcinoma. Cancer, 101(8), 1882-1889.
Minority Stress Theory
9. Makadon, H. J., Mayer, K. H., Potter, J., & Goldhammer, H. (Eds.). (2015). The Fenway guide to lesbian, gay, bisexual, and transgender health (2nd ed.). American College of Physicians.
10. Tjepkema, M. (2008). Health care use among gay, lesbian and bisexual Canadians. Health Reports, 19(1), 53-64.
11. Cochran, S. D., & Mays, V. M. (2007). Physical health complaints among lesbians, gay men, and bisexual and homosexually experienced heterosexual individuals: Results from the California Quality of Life Survey. American Journal of Public Health, 97(11), 2048-2055.
12. Kurdek, L. A. (2004). Are gay and lesbian cohabiting couples really different from heterosexual married couples? Journal of Marriage and Family, 66(4), 880-900.
13. Balsam, K. F., Beauchaine, T. P., Rothblum, E. D., & Solomon, S. E. (2008). Three-year follow-up of same-sex couples who had civil unions in Vermont, same-sex couples not in civil unions, and heterosexual married couples. Developmental Psychology, 44(1), 102-116.
14. Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123(1), 346-352.
15. D’Augelli, A. R., Grossman, A. H., & Starks, M. T. (2005). Parents’ awareness of lesbian, gay, and bisexual youths’ sexual orientation. Journal of Marriage and Family, 67(2), 474-482.
16. Savin-Williams
17. Meyer, I. H. (2015). Resilience in the study of minority stress and health of sexual and gender minorities. Psychology of Sexual Orientation and Gender Diversity, 2(3), 209-213.
18. Cass, V. C. (1979). Homosexual identity formation: A theoretical model. Journal of Homosexuality, 4(3), 219-235.
19. McCarn, S. R., & Fassinger, R. E. (1996). Revisioning sexual minority identity formation: A new model of lesbian identity and its implications for counseling and research. The Counseling Psychologist, 24(3), 508-534.