10 harms of homosexual marriage
By Peter Sprigg
Some advocates of same-sex "marriage" scoff at the idea that it could harm anyone. Here are ten ways in which society could be harmed by legalizing same-sex "marriage." Most of these effects would become evident only in the long run, but several would occur immediately.
Immediate Effects
- Taxpayers, consumers, and businesses would be forced to subsidize homosexual relationships.
One of the key arguments often heard in support of homosexual civil marriage revolves around all the government "benefits" that homosexuals claim they are denied. Many of these "benefits" involve one thing-taxpayer money that homosexuals are eager to get their hands on. For example, one of the goals of homosexual activists is to take part in the biggest government entitlement program of all-Social Security. Homosexuals want their partners to be eligible for Social Security survivors' benefits when one partner dies.
The fact that Social Security survivor's benefits were intended to help stay-at-home mothers who did not have retirement benefits from a former employer has not kept homosexuals from demanding the benefit.[i] Homosexual activists are also demanding that children raised by a homosexual couple be eligible for benefits when one of the partners dies-even if the deceased partner was not the child's biological or adoptive parent.
As another example, homosexuals who are employed by the government want to be able to name their homosexual partners as dependents in order to get the taxpayers to pay for health insurance for them. Never mind that most homosexual couples include two wage-earners, each of whom can obtain their own insurance. Never mind that "dependents" were, when the tax code was developed, assumed to be children and stay-at-home mothers. And never mind that homosexuals have higher rates of physical disease, mental illness, and substance abuse,[ii]leading to more medical claims and higher insurance premiums. No, all of these logical considerations must give way in the face of the demand for taxpayer subsidies of homosexual relationships.
But these costs would be imposed not only upon governments, but upon businesses and private organizations as well. Some organizations already offer "domestic partner" benefits to same-sex couples as a matter of choice. Social conservatives have discouraged such policies, but we have not attempted to forbid them by law.
Imagine, though, what the impact on employee benefit programs would be if homosexual marriage is legalized nationwide. Right now, marriage still provides a clear, bright line, both legally and socially, to distinguish those who receive dependent benefits and those who don't. But if homosexual couples are granted the full legal status of civil marriage, then employers who do not want to grant benefits to homosexual partners-whether out of principle, or simply because of a prudent economic judgment-would undoubtedly be coerced by court orders to do so.
Schools would teach that homosexual relationships are identical to heterosexual ones.
The advocates of same-sex “marriage” argue that it will have little impact on anyone other than the couples who “marry.” However, even the brief experience in Massachusetts, where same-sex “marriage” was imposed by the state’s Supreme Judicial Court and began on May 17, 2004, has demonstrated that the impact of such a social revolution will extend much further—including into the public schools. In September 2004, National Public Radio reported, “Already, some gay and lesbian advocates are working on a new gay-friendly curriculum for kindergarten and up.” They also featured an interview with Deb Allen, a lesbian who teaches eighth-grade sex education in Brookline, Mass. Allen now feels “emboldened” in teaching a “gay-friendly” curriculum, declaring, “If somebody wants to challenge me, I’ll say, ‘Give me a break. It’s legal now.’” Her lessons include descriptions of homosexual sex given “thoroughly and explicitly with a chart.” Allen reports she will ask her students, “Can a woman and a woman have vaginal intercourse, and they will all say no. And I’ll say, ‘Hold it. Of course, they can. They can use a sex toy. They could use’—and we talk—and we discuss that. So the answer there is yes.”3
The parents of a kindergarten student in Lexington, Massachusetts were upset when their son’s school sent home a book featuring same-sex couples with the child in a “Diversity Bag.” David Parker, the child’s father, met with his son’s principal to insist that the school notify him and allow his child to opt out of discussions of homosexuality in the classroom. State law specifically guarantees parents the right to opt their child out of any curriculum involving “human sexuality issues.”4 Nevertheless, the principal refused, and because Parker was unwilling to leave without such assurances, he was arrested for trespassing and spent a night in jail—“stripped of my shoes, my belt, my wedding ring, and my parental rights,” as he later put it.5 Lexington school superintendent Paul Ash evaded the state law by insisting that books about homosexual couples dealt with “family experiences” and “diversity,” not “human sexuality.”6 Six months later, the criminal charges against Parker were dropped—but Ash continued to bar Parker from all school property,7 meaning that he is “banned from voting, teacher-parent conferences, and school committee meetings.”8
Freedom of conscience and religious liberty would be threatened.
Another important and immediate result of same-sex “marriage” would be serious damage to religious liberty.
Religious liberty means much more than liturgical rituals. It applies not only to formal houses of worship, but to para-church ministries, religious educational and social service organizations, and individual believers trying to live their lives in accordance with their faith not only at church, but at home, in their neighborhoods, and in the workplace. These, more than your pastor or parish priest, are the entities whose religious liberty is most threatened by same-sex “marriage.”
Some of these threats to religious liberty can arise from “nondiscrimination” laws based on sexual orientation, even without same-sex “marriage.” But when homosexual “marriage” becomes legal, then laws which once applied to homosexuals only as individuals then apply to homosexual couples as well. So, for example, when Catholic Charities in Boston insisted that they would stay true to principle and refuse to place children for adoption with same-sex couples, they were told by the state that they could no longer do adoptions at all.9
In other cases, a variety of benefits or opportunities that the state makes available to religious nonprofits could be withheld based on the organization’s refusal to treat same-sex couples and “marriages” the same as opposite-sex marriages. Organizations might be denied government grants or aid otherwise available to faith-based groups; they might be denied access to public facilities for events; and they might even have their tax-exempt status removed.10 That is what happened to the Ocean Grove Camp Meeting Association in New Jersey when they refused to rent facilities for a lesbian “civil union” ceremony.11
Religious educational institutions are particularly at risk, because in some cases they may allow students who are not believers to attend and even have staff who are not adherents of their religion, but still desire to maintain certain religiously-informed norms and standards of behavior. Yet a Lutheran school in California has been sued for expelling two girls who were in a lesbian relationship.12 Yeshiva University, a Jewish school in New York City, was forced to allow same-sex “domestic partners” in married-student housing.13 Religious clubs on secular campuses may be denied recognition if they oppose homosexual conduct—this happened to the Christian Legal Society at the University of California’s Hastings School of Law.14
curProfessionals
would face lawsuits or even a denial of licensing if they refuse to treat homosexual relationships the same as heterosexual ones. A California fertility doctor was sued for declining to artificially inseminate a lesbian woman.15 And the online dating service eHarmony succumbed to the pressure of a lawsuit and agreed to provide services for same-sex couples as well.16
Individual believers who disapprove of homosexual relationships may be the most vulnerable of all, facing a choice at work between forfeiting their freedom of speech and being fired.17
Religious liberty is one of the deepest American values. We must not sacrifice it on the altar of political correctness that homosexual “marriage” would create.
Even where legal recognition and marital rights and benefits are available to same-sex couples (whether through same-sex civil “marriages,” “civil unions,” or “domestic partnerships”), relatively few same-sex couples even bother to seek such recognition or claim such benefits.
The most simple way to document this is by comparing the number of same-sex couples who have sought such legal recognition in a given state18 with the number of “same-sex unmarried-partner households” in the most recent U.S. Census.19
When a relatively small percentage of same-sex couples—even among those already living together as partners—even bother to seek legal recognition of their relationships, while an overwhelming majority of heterosexual couples who live together are legally married, it suggests that homosexuals are far more likely than heterosexuals to reject the institution of marriage or its legal equivalent.
In California, same-sex “marriage” was only legal for a few months, from the time that the California Supreme Court ruled in May of 2008 until the voters adopted Proposition 8 in November of the same year. Press reports have indicated that about 18,000 same-sex couples got “married” in California20—less than 20% of the total identified by the Census.21 By contrast, 91% of opposite-sex couples who lived together in California were married.22 In other words, only 9% of heterosexual couples in California have rejected the institution of marriage, while over 80% of the homosexual couples rejected “marriage” when it was offered to them in 2008.
In Massachusetts, the number of same-sex “marriages between 2004 and the end of 200623 represented only 52% of the number of same-sex cohabiting couples in the state identified by the 2000 census.24 By contrast, 91% of opposite-sex couples who lived together were married.25 In other words, 48% of same-sex couples rejected “marriage”, a rate more than five times higher than the 9% of opposite-sex couples who did so.
In the Netherlands, the first country in the world to legalize same-sex civil “marriage”, the figures are even more dramatic. A 2005 report indicated that only 12% of same-sex cohabiting couples in that country have married, with another 10% in what are called “registered partnerships.” 26 By contrast, 82% of heterosexual couples in the Netherlands (as of 2004) were married.27 This means that 78% of the same-sex couples in the Netherlands have seen no necessity for legal recognition of their relationships at all, while only 18% of opposite-sex couples have similarly rejected marriage.
These figures show that a large percentage, and possibly even an outright majority, of homosexuals—even those already living with a partner—neither need nor desire to participate in the institution of marriage. Legalizing same-sex “marriage” would be very effective in sending a message of endorsement of homosexual behavior. But the indifference of most homosexuals to “marriage” would send a message to society that marriage does not matter—that it is no longer the normative setting for sexual relations and child-rearing, but is instead nothing more than one relationship option among many, made available as a government entitlement program to those who seek taxpayer-funded benefits.
Couples who could marry, but choose instead to cohabit without the benefit of marriage, harm the institution of marriage by setting an example for other couples, making non-marital cohabitation seem more acceptable as well. If same-sex “marriage” were legalized, the evidence suggests that the percentage of homosexual couples who would choose cohabitation over “marriage” would be much rent percentage of heterosexual couples who choose cohabitation over marriage. It is likely that the poor example set by homosexual couples would, over time, lead to lower marriage rates among heterosexuals as well.28
Fewer people would remain
monogamous and sexually faithful.
One value that remains remarkably strong, even among people who have multiple sexual partners before marriage, is the belief that marriage itself is a sexually exclusive relationship. Among married heterosexuals, having sexual relations with anyone other than one’s spouse is still considered a grave breach of trust and a violation of the marriage covenant by the vast majority of people.
Yet the same cannot be said of homosexuals—particularly of homosexual men. Numerous studies of homosexual relationships, including “partnered” relationships, covering a span of decades, have shown that sex with multiple partners is tolerated and often expected, even when one has a “long-term” partner. Perhaps the most startling of these studies was published in the journal AIDS. In the context of studying HIV risk behavior among young homosexual men in the Netherlands (coincidentally, the first country in the world to legalize homosexual civil “marriage”), the researchers found that homosexual men who were in partnered relationships had an average of eight sexual partners per year outside of the primary relationship.29 (It must be conceded that having such a partnership did have some “taming” effect upon such men—those without a “permanent” partner had an average of 22 sexual partners per year). This is an astonishing contrast to the typical behavior of married heterosexuals, among whom 75% of the men and 85% of the women report never having had extra-marital sex even once during the entire duration of their marriage.30
Again, the “conservative” argument for homosexual “marriage” suggests that granting the rights of civil “marriage” to homosexuals would “tame” such promiscuous behavior. (To be fair, it must be pointed out that the data in the Dutch study mentioned above were collected before the legalization of homosexual “marriage” in that country, albeit after most of the rights of marriage had been granted through civil unions). However, the implausibility of this claim is illustrated not only by the experience of the Netherlands and other northern European countries that recognize homosexual partnerships, but also by the open declarations of many homosexuals themselves.31
Rather than marriage changing the behavior of homosexuals to match the relative sexual fidelity of heterosexuals, it seems likely that the opposite would occur. If homosexual relationships, promiscuity and all, are held up to society as being a fully equal part of the social ideal that is called “marriage,” then the value of sexual fidelity as an expected standard of behavior for married people will further erode—even among heterosexuals.
Fewer people would remain married for a lifetime.
Lawrence Kurdek, a homosexual psychologist from Ohio’s Wright State University,32 who has done extensive research on the nature of homosexual relationships, has correctly stated, “Perhaps the most important ‘bottom-line’ question about gay and lesbian couples is whether their relationships last.”33 After extensive research, he determined that “it is safe to conclude that gay and lesbian couples dissolve their relationships more frequently than heterosexual couples, especially heterosexual couples with children.”34
Once again, abundant research has borne out this point. Older studies came to similar conclusions. In one study of 156 male couples, for instance, only seven had been together for longer than five years (and none of those seven had remained sexually faithful to each other).35
International findings are similar. The Dutch study mentioned earlier, which highlighted so dramatically the promiscuous nature of male homosexual relationships, also showed their transience. It found that the average male homosexual partnership lasted only 1.5 years.36 In contrast, more than 50 percent of heterosexual marriages last fifteen years or longer.37
Some may argue that granting homosexual relationships legal recognition as “marriages” would make them as stable as heterosexual marriages. However, a study of “married” same-sex couples in Massachusetts found that after only a year or less of “marriage,” more than a third (35%) of the male couples and nearly half (46%) of the female couples had already “seriously discussed” ending their relationship.38 And a study of same-sex divorce among homosexual couples in “registered partnerships” in Sweden found that “the divorce risk in partnerships of men appears 50 percent higher than the corresponding risk in heterosexual marriages, and that the divorce risk in partnerships of women is about the double of that of men”—thus making lesbian “divorces” almost three times as likely as heterosexual ones.39
How would this affect heterosexual couples? If the unstable nature of homosexual partnerships becomes part of the ideal of marriage that is being held up to society, it will inevitably affect the future behavior of everyone in society—heterosexuals included. Therefore, we can predict the following:
If homosexual “marriage” is legalized, the percentage of homosexual couples that remain together for a lifetime will always be lower than the percentage of heterosexual couples that do so; but the percentage of heterosexual couples demonstrating lifelong commitment will also decline, to the harm of society as a whole.
Fewer children would be raised by a married mother and father.
The greatest tragedy resulting from the legalization of homosexual “marriage” would not be its effect on adults, but its effect on children. For the first time in history, society would be placing its highest stamp of official government approval on the deliberate creation of permanently motherless or fatherless households for children.
There simply cannot be any serious debate, based on the mass of scholarly literature available to us, about the ideal family form for children. It consists of a mother and father who are committed to one another in marriage. Children raised by their married mother and father experience lower rates of many social pathologies, including:
• premarital childbearing;40• illicit drug use;41 • arrest;42 • health, emotional, or behavioral problems;43•poverty;44 • or school failure or expulsion.45
These benefits are then passed on to future generations as well, because children raised by their married mother and father are themselves less likely to cohabit or to divorce as adults.46
In a perfect world, every child would have that kind of household provided by his or her own loving and capable biological parents (and every husband and wife who wanted children would be able to conceive them together). Of course, we do not live in a perfect world.
But the parent who says, “I’m gay,” is telling his or her child that he or she has no intention of providing a parent of both sexes for that child. And a homosexual who “marries” someone of the same sex is declaring that this deprivation is to be permanent—and with the blessing of the state.
Homosexual activists argue that research on homosexual parenting does not show differences among the children raised by homosexuals and those raised by heterosexuals. Even leading professional organizations such as the American Academy of Pediatrics, under the influence of homosexual activists, have issued policy statements making such claims. 47
A close examination of the actual research, however, shows that such claims are unsupportable. The truth is that most research on “homosexual parents” thus far has been marred by serious methodological problems.48 However, even pro-homosexual sociologists Judith Stacey and Timothy Biblarz report that the actual data from key studies show the “no differences” claim to be false.
Surveying the research (primarily regarding lesbians) in an American Sociological Review article in 2001, they found that:
• Children of lesbians are less likely to conform to traditional gender norms.
• Children of lesbians are more likely to engage in homosexual behavior.
• Daughters of lesbians are “more sexually adventurous and less chaste.”
• Lesbian “co-parent relationships” are more likely to break up than heterosexual marriages. A 1996 study by an Australian sociologist compared children raised by heterosexual married couples, heterosexual cohabiting couples, and homosexual cohabiting couples. It found that the children of heterosexual married couples did the best, and children of homosexual couples the worst, in nine of the thirteen academic and social categories measured.50
As scholar Stanley Kurtz says,
If, as in Norway, gay “marriage” were imposed here by a socially liberal cultural elite, it would likely speed us on the way toward the classic Nordic pattern of less frequent marriage, more frequent out-of-wedlock birth, and skyrocketing family dissolution. In the American context, this would be a disaster.51
More children would grow up fatherless.
This harm is closely related to the previous one, but worth noting separately. As more children grow up without a married mother and father, they will be deprived of the tangible and intangible benefits and security that come from that family structure. However, most of those who live with only one biological parent will live with their mothers. In the general population, 79% of single-parent households are headed by the mother, compared to only 10% which are headed by the father.52 Among homosexual couples, as identified in the 2000 census, 34% of lesbian couples have children living at home, while only 22% of male couples were raising children.53 The encouragement of homosexual relationships that is intrinsic in the legalization of same-sex “marriage” would thus result in an increase in the number of children who suffer a specific set of negative consequences that are clearly associated with fatherlessness.
Homosexual activists say that having both a mother and a father simply does not matter—it is having two loving parents that counts. But social science research simply does not support this claim. Dr. Kyle Pruett of Yale Medical School, for example, has demonstrated in his book Fatherneed that fathers contribute to parenting in ways that mothers do not. Pruett declares, “From deep within their biological and psychological being, children need to connect to fathers . . . to live life whole.”54
Children—both sons and daughters—suffer without a father in their lives. The body of evidence supporting this conclusion is both large and growing.55 For example, research has shown that “youth incarceration risks in a national male cohort were elevated for adolescents in father-absent households,” even after controlling for other factors.56 Among daughters, “father absence was strongly associated with elevated risk for early sexual activity and adolescent pregnancy.”57 Author David Blankenhorn puts these risks more succinctly: “One primary result of growing fatherlessness is more boys with guns. Another is more girls with babies.”58 Even researchers who are supportive of homosexual parenting have had to admit that “children raised in fatherless families from infancy,” while closer to their mothers, “perceived themselves to be less cognitively and physically competent than their peers from father-present families.”59
Some lesbian couples are deliberately creating new children in order to raise them fatherless from birth. It is quite striking to read, for example, the model “Donor Agreement” for sperm donors offered on the Human Rights Campaign website, and to see the lengths to which they will go to legally insure that the actual biological father plays no role in the life of a lesbian mother’s child.60 Yet a recent study of children conceived through sperm donation found, “Donor offspring are significantly more likely than those raised by their biological parents to struggle with serious, negative outcomes such as delinquency, substance abuse, and depression, even when controlling for socio-economic and other factors.” 61 Remarkably, 38% of donor offspring born to lesbian couples in the study agreed that “it is wrong deliberately to conceive a fatherless child.”62
Birth rates would fall.
One of the most fundamental tasks of any society is to reproduce itself. That is why virtually every human society up until the present day has given a privileged social status to male-female sexual relationships—the only type capable of resulting in natural procreation. This privileged social status is what we call “marriage.”
Extending the benefits and status of “marriage” to couples who are intrinsically incapable of natural procreation (i.e., two men or two women) would dramat8 ically change the social meaning of the institution. It would become impossible to argue that “marriage” is about encouraging the formation of life-long, potentially procreative (i.e., opposite-sex) relationships. The likely long-term result would be that fewer such relationships would be formed, fewer such couples would choose to procreate, and fewer babies would be born.
There is already evidence of at least a correlation between low birth rates and the legalization of same-sex “marriage.” At this writing, five U.S. states grant marriage licenses to same-sex couples. As of 2007, the last year for which complete data are available, four of those five states ranked within the bottom eight out of all fifty states in both birth rate (measured in relation to the total population) and fertility rate (measured in relation to the population of women of childbearing age).63
Even granting marriage-related benefits to same-sex couples is associated with low birth and fertility rates. There are sixteen states which offer at least some recognition or benefits to same-sex relationships.64 Twelve of these sixteen states rank in the bottom twenty states in birth rate, while eleven of them rank in the bottom seventeen in fertility rate. Vermont, the first state in the U. S. to offer 100% of the rights and benefits of marriage to same-sex couples through passage of its “civil unions” law in 200065, ranks dead last in both birth rate and fertility rate.66
Similar data are available on the international level. Currently there are ten countries which permit same-sex “marriage.”67 Six of these ten fall well within the bottom quarter in both birth rates and fertility rates among 223 countries and territories. All ten fall below the total world fertility rate, while only South Africa has a birth rate that is higher (barely) than the world rate.68
It could be argued that the widespread availability and use of artificial birth control, together with other social trends, has already weakened the perceived link between marriage and procreation and led to a decline in birth rates. These changes may have helped clear a path for same-sex “marriage,” rather than the reverse.69 Nevertheless, legalization of same-sex “marriage” would reinforce a declining emphasis on procreation as a key purpose of marriage—resulting in lower birth rates than if it had not been legalized.
Of course, there are some who are still locked in the alarmism of the 1960’s over warnings of over-population.70 However, in recent years it has become clear, particularly in the developed world, that declining birth rates now pose a much greater threat. Declining birth rates lead to an aging population, and demographers have warned of the consequences,
. . . from the potentially devastating effects on an unprepared welfare state to shortages of blood for transfusions. Pension provisions will be stretched to the limit. The traditional model of the working young paying for the retired old will not work if the latter group is twice the size of the former. . . . In addition, . . . healthcare costs will rise.71
The contribution of same-sex “marriage” to declining birth rates would clearly lead to significant harm for society.
Demands for legalization of
polygamy would grow.
If the natural sexual complementarity of male and female and the theoretical procreative capacity of an opposite-sex union are to be discarded as principles central to the definition of marriage, then what is left? According to the arguments of the homosexual “marriage” advocates, only love and companionship are truly necessary elements of marriage.
But if that is the case, then why should other relationships that provide love, companionship, and a lifelong commitment not also be recognized as “marriages”—including relationships between adults and children, or between blood relatives, or between three or more adults? And if it violates the equal protection of the laws to deny homosexuals their first choice of marital partner, why would it not do the same to deny pedophiles, polygamists, or the incestuous the right to marry the person (or persons) of their choice?
Of these, the road to polygamy seems the best-paved—and it is the most difficult for homosexual “marriage” advocates to deny. If, as they claim, it is arbitrary and unjust to limit the gender of one’s marital partner, it is hard to explain why it would not be equally arbitrary and unjust to limit the number of marital partners.
There are also two other reasons why same-sex “marriage” advocates have trouble refuting warnings of a slippery slope toward polygamy. The first is that there is far more precedent cross-culturally for polygamy as an accepted marital structure than there is for homosexual “marriage.” The second is that there is a genuine movement for polygamy or “polyamory” in some circles.
The San Francisco Chronicle’s religion writer did a feature on the “polyamory” movement in 2004. It even quoted Jasmine Walston, the president of “Unitarian Universalists for Polyamory Awareness,” as saying, “We’re where the gay rights movement was 30 years ago.” The story also quoted Barb Greve, a program associate with the Association of Unitarian Universalists’ Office of Bisexual, Gay, Lesbian and Transgender Concerns in Boston. Greve, helpfully described as “a transgender person who likes to be called ‘he,’” said, “There are people who want to be in committed relationships—whether it’s heterosexual marriage, same-sex “marriage” or polyamory—and that should be acknowledged religiously and legally.”72
The “gay” oriented newspaper the Washington Blade has also featured this topic in a full-page article under the headline “Polygamy advocates buoyed by gay court wins.” It quotes Art Spitzer of the American Civil Liberties Union acknowledging, “Yes, I think [the Supreme Court decision in Lawrence v. Texas] would give a lawyer a foothold to argue such a case. The general framework of that case, that states can’t make it a crime to engage in private consensual intimate relationships, is a strong argument.”73
This argument is already being pressed in the courts. Two convicted bigamists in Utah, Tom Green and Rodney Holm, have appealed to have their convictions overturned—citing the Supreme Court’s decision in the Lawrence case as precedent.74 And another attorney has filed suit challenging the refusal of the Salt Lake County clerk to grant a marriage license for G. Lee Cook to take a second wife.75
Make no mistake about it—if same-sex “marriage” is not stopped now, we will have the exact same debate about “plural” marriages only one generation from now.
[i] One of the architects of Social Security, Abraham Epstein, said, "[T]he American standard assumes a normal family of man, wife, and two or three children, with the father fully able to provide for them out of his own income." Abraham Epstein, Insecurity: A Challenge to America(New York: Harrison Smith and Robert Haas, 1933), 101-102; cited in Allan Carlson, The "American Way": Family and Community in the Shaping of the American Identity (Wilmington, DE: ISI Books, 2003), 69. See generally Carlson's entire chapter on "'Sanctifying the Traditional Family': The New Deal and National Solidarity," 55-77.
[ii] See Victor M. B. Silenzio, "Top 10 Things Gay Men Should Discuss with their Healthcare Provider" (San Francisco: Gay & Lesbian Medical Association); accessed April 1, 2010; online at:http://www.glma.org/_data/n_0001/resources/live/Top%20Ten%20Gay%20Men.pdf; and Katherine A. O'Hanlan, " Top 10 Things Lesbians Should Discuss with their Healthcare Provider" (San Francisco: Gay & Lesbian Medical Association); accessed April 1, 2010; online at:http://www.glma.org/_data/n_0001/resources/live/Top%20Ten%20Lesbians.pdf
