By Meredith Goad
Staff Writer
©Copyright 1997 Guy Gannett Communications
This month, Maine researchers will begin studying the bone health of lesbian women and their biological, heterosexual sisters to see if lesbians are more likely to be at risk for developing osteoporosis.

It's the first study of its kind in the United States, according to researchers at the Maine Center for Osteoporosis Research and Education in Bangor. But it's one of several new research projects involving lesbians' health and their access to health care that will be conducted in Maine this summer.

Although medical and sociological research focusing on lesbians is not new, researchers are showing new interest in the topic, especially in Maine.

Just as women were once given short shrift in medical research, scientists are now beginning to ''pay attention to the fact that things might be different for gays and lesbians than they are for the heterosexual community,''' says Sandra Butler, an assistant professor of social work at the University of Maine. Butler is working on a study of lesbians' access to health care in rural Maine.

When it comes to health issues, there are no inherent biological differences between lesbians and other women, says Jill Carter, a nurse practitioner who recently completed a survey examining Cumberland County health care workers' attitudes toward lesbians.

''It's more of a lifestyle issue,'' Carter said. ''For example, some physicians and researchers believe lesbians may be at greater risk for breast, ovarian and endometrial cancer - not because they're lesbian, but because they're more likely to have not ever been pregnant.''

Women who don't give birth and breastfeed don't experience the burst of estrogen that comes with pregnancy. That surge of hormones, in addition to warding off cancer, may help protect against the bone loss that leads to osteoporosis.

Sociological studies also suggest that lesbians may have other risk factors that affect their bodies' rate of bone loss and make them more vulnerable to osteoporosis than other women.

Some studies have shown that lesbian women ''tend to have higher risks in terms of smoking and physical inactivity than do heterosexual women,'' said Dr. Clifford Rosen, director of the osteoporosis research center in Bangor.

Other studies also have shown that lesbians may drink more alcohol than heterosexual women. Alcohol and cigarette smoking can help deplete the body's stores of calcium.

''Some of those are smaller factors,'' said Christine Patton, who is managing the osteoporosis study. ''They can, together, make them more at risk.''

Of course, there are also many heterosexual women who smoke and drink and choose not to have children. This study will help determine if there really is a difference in risk for straight and gay women, and if so, lay the groundwork for prevention programs.

''We're looking at premenopausal women, so we hope to be able to influence eventual risk'' through education, Rosen said.

Rosen is working with Dr. Ann Babbitt, director of the Osteoporosis Healthcare Network in Portland, on the project, which is funded by an $8,000 grant from the Lesbian Health Fund in San Francisco.

The study is recruiting at least 50 lesbian women in Maine between the ages of 30 and 50, and their heterosexual sisters. Another 50 women will be recruited to serve as controls.

The women participating in the study will receive three questionnaires in the mail covering the issues of physical activity, health and reproductive factors, and dietary calcium intake. Only one face-to-face visit will be required, and a $20 stipend will be given to cover travel expenses to Bangor or Portland.

Anyone participating in the study who is found to be at great risk for osteoporosis will get follow-up tests and examinations from one of the two physicians.

Studies of lesbian health are not limited to lifestyle or medical issues. A big concern is access to health care. In study after study, lesbian women have said they sometimes avoid - and even fear - entering the health care system because of anxiety about how they will be received.

Suzanne Brunner has been awarded a $4,300 grant from the Maine Community Foundation to do a survey of health care providers in northern and eastern Maine this summer. Brunner is an assistant professor of nursing at the University of Maine who also serves as co-chair of the Lesbian Health Project at the Mabel Wadsworth Women's Health Center in Bangor.

Her survey will assess health care workers' knowledge of lesbian health and social issues, and their attitudes toward lesbians.

''The literature says over and over and over again that one of the primary concerns is that people can't find (physicians) that they feel comfortable disclosing their sexual orientation to,'' Brunner said.

Brunner hopes her survey will identify doctors and nurse practitioners who would be willing to accept referrals from a lesbian health clinic that she plans to open at Mabel Wadsworth in the fall.

She also wants to find health care providers who would be open to educational programs that show them how, for example, to be sensitive to sexual orientation when taking a patient's medical history.

''It's not only about the attitude,'' Brunner said, ''it's that the attitudes then interfere with the treatment.''

Brunner's survey is based on a similar project recently completed by Carter, the nurse practitioner who recently surveyed doctors and nurses in Cumberland County.

Doctors who automatically assume a woman is heterosexual make assumptions that can affect the quality and cost of lesbians' health care, Carter says.

''They assume you need birth control,'' Carter said. ''They assume you need a Pap smear every year.

''Lesbian women who are exclusively lesbian have much lower rates of sexually transmitted diseases,'' she continued. ''This becomes an issue in a place like the emergency department, where people go in with lower abdominal pain.''

In that situation, Carter says, lesbians sometimes are given inappropriate medical tests.

When women disclose their sexual orientations to their physicians, Carter adds, they get a range of responses. A few say they were given lectures about why homosexuality is wrong, or are referred inappropriately to a mental health care provider.

In Carter's survey of 120 primary-care providers in Cumberland County, she found that the nurses she surveyed were significantly more knowledgeable about lesbian health and social issues and had more positive attitudes toward lesbians than physicians.

Feeling comfortable with a health care provider is important for getting quality health care, Carter says. But it also goes beyond that.

When lesbians feel they can't disclose their sexual orientation to their doctor, ''it's like they're not really dealing with you as a whole person,'' she said.