Lesbian women are less likely than heterosexual women to have ever used any contraceptive method, according to “Contraceptive use by women across different sexual orientation groups,” by Brittany Charlton of Boston Children’s Hospital and colleagues. By contrast, study authors found that other sexual minority groups—including bisexual women, mostly heterosexual women and heterosexual women who have had same-sex partners—were more likely to use long-acting reversible contraceptives (LARCs) than heterosexual women. It is critical to document disparities by sexual orientation group since sexual minorities are more likely than heterosexuals to have sexually transmitted infections (STIs) and unintended pregnancies.

“Women of all sexual orientations deserve access to a full range of reproductive health care, including contraception information and services, because they stand to benefit, regardless of their risk for pregnancy,” says Guttmacher researcher and coauthor Rachel Jones

Research examining contraceptive use across sexual orientation groups has been sparse due to limited data. Despite this, it is imperative that the health needs of sexual minorities are not ignored and that patients of all sexual orientations, as well as gender identities, have access to contraceptive counseling. This new study is the first with robust sexual orientation data (there were 118,462 participants), allowing for in-depth analysis of contraceptive use by sexual orientation across all methods. The large analytic sample utilized data from two longitudinal cohorts, the Nurses’ Health Study 2 and 3, which provided detailed information on sexual orientation and contraceptive use.

While contraceptive care should not be dependent on health care such as Pap tests, patients often enter the U.S. health care system because they need contraceptive counseling. Nearly 90% of study participants used a contraceptive method that brought them into the health care system, such as the pill. However, lesbians were less likely than heterosexual women to use such methods, meaning lesbians miss opportunities for health care, including STIs screenings and Pap tests.  

“Providers must ensure patients who want to use contraceptives, regardless of sexual orientation, have access,” says lead author Brittany Charlton. “Additionally, patients who are not regularly seeing a provider for contraceptive care need to be brought into the health care system.” 

Contraceptive Use by Women across Different Sexual Orientation Groups,” by Brittany Charlton et al., is currently available online and will appear in a forthcoming issue of Contraception.