Beliefs and attitudes of middle aged lesbians about hysterectomy

E. Lees, A. Shelton, J. Groff

Objective: The aim of this study was to identify the beliefs and attitudes of lesbians aged 30-65 years regarding hysterectomy. Design: This qualitative study comprised 12 lesbians in three focus groups, utilizing a semistructured guided discussion technique based on qualitative application of Multiattribute Utility Theory. Participants were chosen to represent various stages of decision making, and women who had undergone a hysterectomy were excluded from the study. Setting: All sessions were conducted in a Houston health clinic serving the lesbian community. Measurements: Transcripts were analyzed using Nonnumerical Unstructured Data Indexing Searching and Theorizing (NUD*IST). Results: Major categories, comprising multiple themes, were perceived outcomes of hysterectomy, help-seeking, and experiences with the physician or with the medical establishment. The lesbians in the study revealed both positive and negative outcomes of hysterectomy on sexuality. Loss associated with hysterectomy was perceived as physical, emotional, and ontological. Partner support emerged as a salient outcome. There were varying attitudes toward the use of hormone replacement following hysterectomy. For the lesbians, being in charge of decisions concerning their bodies was crucial, and they would seek information from a number of sources, including two or more physicians, before making a decision regarding hysterectomy. Although the women reported negative experiences with physicians, these experiences were not related to the physician's gender or sexual orientation. Conclusion: While being sensitive to the needs of lesbian patients, physicians also must keep in mind that hysterectomy is an individual decision.