Lesbian

The word lesbian is the demonym of the Greek island of Lesbos, home to the 6th-century BCE poet Sappho.^[3] Little of Sappho's poetry survives, but her remaining poetry discusses women's daily lives, their relationships and rituals, and Sappho's love for women.^{[6]: 47–49}

Before the mid-19th century,^[7] the word lesbian referred to any derivative or aspect of Lesbos, including a type of wine.^[a] A shift of the word to describe erotic relationships between women had been documented in 1870.^[9]

In 1875, critic George Saintsbury referred to Baudelaire's poem "Delphine and Hippolyte" (a poem about love between two women and without reference to Lesbos) as "Lesbian".^[10] In 1890, the term lesbian was used in the National Medical Dictionary as an adjective to describe tribadism (as "lesbian love").^[11]

The terms lesbian, invert and homosexual were interchangeable with sapphist and sapphism around the turn of the 20th century.^[9] The use of lesbian in medical literature became prominent; by 1925, the word was recorded as a noun to mean the female equivalent of a sodomite.^[9][12]

Prenatal androgen exposure correlates with same-sex sexual behavior in women.^[18] Biological correlates known to be affected by prenatal hormone exposure -- such as the human cochlear amplifier auditory system,^[19] and finger length ratios^[20] -- have been shown to vary by sexual orientation in women. The finding that lesbians' digit ratios differ from those of heterosexual women has been replicated in cross-cultural studies.^[20]

Genetics also play a role; around 20% of the variance of sexual orientation in women is controlled by genetics.^[21]

When a woman realizes she is a lesbian, it may cause an "existential crisis". When a woman was raised in an environment with negative stereotypes of lesbians, she may need to work through these stereotypes and prejudices to come to terms with her orientation.^[22]: 93

Lesbians in modern times share an identity that parallels those built on ethnicity, including the concept of group heritage and group pride.^[23]

Compared to gay men, lesbians more often developed their sexual self-concepts either alone or in intimate relationships, instead of in communities, and disclosed them less often.^[22]: 153

Some women experience a consistently lesbian orientation. Other women experience varying degrees of fluidity in their orientation.^[24]

Lesbians who have never had sex with men may be referred to as "gold star lesbians." Lesbians who have previously had sex with men before coming out may face ridicule from other lesbians or identity challenges with regard to defining what it means to be a lesbian.^[25]

Some researchers observe that behavior and identity sometimes do not match: self-identified straight women may have sex with women, or self-identified lesbians may have sex with men.^{[5]: 22 [26]}

Several sexology studies have found that the sexual behavior and attractions of exclusively-lesbian women are significantly more likely to be aligned with their sexual identity than they are in exclusively-heterosexual women. These included studies of reported attraction throughout the fertility cycle (in which the higher-fertility phase intensified lesbian attractions for exclusively-lesbian women), of direct measures of arousal towards different imagery, etc.^[27]

Some arguments are about the concept of lesbian bed death. In a 1983 survey, sexologists Philip Blumstein and Pepper Schwartz asked couples "About how often during the last year have you and your partner had sex relations?" and found that long-term lesbian couples named lower numbers than heterosexual or homosexual male couples.^[28] This conclusion became known as "lesbian bed death".^[29]

Some arguments attested that the study was flawed and misrepresented accurate sexual contact between women. Other critiques suggest that the language "sex relations" could easily be misinterpreted to mean "heterosexual intercourse." Other critiques suggest that sexual contact between women has increased since 1983.^[30]

Researchers report that lesbian and heterosexual women are just as likely to view achieving orgasm as important,^[31] and that the two groups report statistically equivalent rates of overall sexual and romantic satisfaction.^[32][33] The research suggests that lesbian women tend to achieve said satisfaction through higher quality rather than more frequent sex, and that they engage in different romantic and sexual scripts than heterosexual women.^[33][31]

There has been extensive debate as to what qualifies a historic relationship as 'lesbian'. In 1989, an academic cohort named the Lesbian History Group wrote:

Because of society's reluctance to admit that lesbians exist, a high degree of certainty is expected before historians or biographers are allowed to use the label. Evidence that would suffice in any other situation is inadequate here... A woman who never married, who lived with another woman, whose friends were mostly women, or who moved in known lesbian or mixed gay circles, may well have been a lesbian. ... But this sort of evidence is not 'proof'. What our critics want is incontrovertible evidence of sexual activity between women. This is almost impossible to find.^[34]: 184

Female sexuality is often not adequately represented in texts and documents. Until very recently, much of what has been documented about women's sexuality has been written by men, in the context of male understanding, and relevant to women's associations to men—as their wives, daughters, or mothers, for example.^[35]

The lives of ancient Greek women were in general little-documented.^[35] In a notable exception, in the 500s BC, Sappho of Lesbos wrote extensive poetry regarding her love for other women, fragments of which survive.^[36]

Some male-written works reference lesbianism. One example, from the 300s BC, is the tale of the four-legged humans told by Aristophanes in Plato's Symposium^[37][b]. Another example, from the 100s CE, is the Dialogues of the Courtesans, where a female character talks about being seduced by two lesbian characters.^[38]

In visual culture, historian Nancy Rabinowitz notes that some ancient Greek red vase images portray women in affectionate or erotic scenes.^{[39]: 27–28 [35]}

In first century sources, accounts of lesbian characters include the story of Iphis and Ianthe, related in the Metamorphoses;^{[40]: 79-86} a story, related by the fabulist Phaedrus, about Prometheus exchanging the genitals of different men and women;^[41] and a satirical figure of a masculine woman who has sex with women, named Philaenis, related in the epigrams of Martial.^{[42][40]: 98-99}

In the ruins of Pompeii, a Roman town destroyed in 79 CE, archaeologists discovered a love poem graffitied onto a wall.^[40] The poem is written with feminine declensions for both speaker and addressee, and identified archivally as Corpus Inscriptionum Latinarum 4.5296.^[43]

A love spell from 3rd or 4th century CE Roman Egypt was written to enchant a woman named Gorgonia to fall in love with a woman named Sophia.^{[40]: 89–92}

The earliest law against female homosexuality appeared in France in 1270.^[34]: 191

In Spain, Italy, and the Holy Roman Empire, sodomy between women was included in acts considered unnatural and punishable by burning to death, although few instances are recorded of this taking place.^[6]: 130 The earliest such execution occurred in Speier, Germany, in 1477. Forty days' penance was demanded of nuns who "rode" each other or were discovered to have touched each other's breasts. An Italian nun named Sister Benedetta Carlini was documented to have seduced many of her sisters when possessed by a Divine spirit named "Splenditello"; to end her relationships with other women, she was placed in solitary confinement for the last 40 years of her life.^[34]: 190

In England, female homoeroticism was so common in literature and theater that historians suggest it was fashionable for a period during the Renaissance.^[44]: 1 Englishwoman Mary Frith has been described as lesbian in academic study.^[45]

Ideas about women's sexuality were linked to contemporary understanding of female physiology. The vagina was considered an inward version of the penis; in lesbians, nature was thought to be trying to right itself by prolapsing the vagina to form a penis.^[44]: 12 The idea of hermaphroditism became synonymous with female same-sex desire. A longer, engorged clitoris was thought to be used by women to penetrate other women. Penetration was the focus of concern in all sexual acts, and a woman who was thought to have uncontrollable desires because of her engorged clitoris was called a "tribade" (literally, one who rubs).^{[44]: 14–16} For a while, masturbation and lesbian sex carried the same meaning.^[6]: 129

Tribades were simultaneously considered members of the lower class trying to ruin virtuous women, and representatives of an aristocracy corrupt with debauchery. Satirical writers began to suggest that political rivals (or more often, their wives) engaged in tribadism in order to harm their reputations. Queen Anne was rumored to have a passionate relationship with her close advisor Sarah Churchill, Duchess of Marlborough. When Churchill was ousted as the queen's favorite, she purportedly spread allegations of the queen having affairs with her bedchamberwomen.^[6]: 137 Marie Antoinette was also the subject of such speculation for some months between 1795 and 1796.^{[44]: 17–18}

Hermaphroditism appeared in medical literature enough to be considered common knowledge, although cases were rare.

Homoerotic elements in literature were pervasive, specifically the masquerade of one gender for another to fool an unsuspecting woman into being seduced. Such plot devices were used in Shakespeare's Twelfth Night (1601), The Faerie Queene by Edmund Spenser in 1590, and James Shirley's The Bird in a Cage (1633).^{[44]: 1–11, 22–24}

Cases during the Renaissance of women taking on male personae and going undetected for years or decades have been described as transvestism by homosexual women.^[46][47] If discovered, punishments ranged from death, to time in the pillory, to being ordered never to dress as a man again.

Some historians view cases of cross-dressing women to be manifestations of women seizing power they would naturally be unable to enjoy in feminine attire, or their way of making sense out of their desire for women. Lillian Faderman argues that Western society was threatened by women who rejected their feminine roles.^{[48]: 51–54}

Henry Fielding wrote a pamphlet titled The Female Husband in 1746, based on the life of Mary Hamilton, who was arrested after marrying a woman while masquerading as a man, and was sentenced to public whipping and six months in jail.^{[48]: 51–54}

Similar examples were procured of Catharine Linck in Prussia in 1717, executed in 1721.^{[48]: 51–54}

Swiss Anne Grandjean married and relocated with her wife to Lyons, but was exposed by a woman with whom she had had a previous affair and sentenced to time in the stocks and prison.^{[48]: 51–54}

In the 1600s, Queen Christina of Sweden had a tendency to dress as a man, abdicated the throne in 1654 to avoid marriage, and was known to pursue romantic relationships with women.^{[49]: 54–55}

Catharine Linck and other women who were accused of using dildos, such as two nuns in 16th century Spain executed for using "material instruments", were punished more severely than those who did not.^{[34]: 191 [48]: 51–54}

Two marriages between women were recorded in Cheshire, England, in 1707 (between Hannah Wright and Anne Gaskill) and 1708 (between Ane Norton and Alice Pickford) with no comment about both parties being female.^{[44]: 30 [6]: 136}

During the 17th through 19th centuries in the West, a woman expressing passionate love for another woman was fashionable, accepted, and encouraged.^[6]: 136 These relationships were termed romantic friendships, Boston marriages, or "sentimental friends".^[50] These relationships were documented by large volumes of letters written between women. Any sexual components of the relationships were not publicly discussed. Romantic friendships were promoted as alternatives to and practice for a woman's marriage to a man.^{[49]: 74–77 [c]}

Around the turn of the 20th century, the development of higher education provided opportunities for women. In all-female surroundings, a culture of romantic pursuit was fostered in women's colleges. Older students mentored younger ones, called on them socially, took them to all-women dances, and sent them flowers, cards, and poems that declared their undying love for each other.^{[49]: 297–313} These were called "smashes" or "spoons", and they were written about quite frankly in stories for girls aspiring to attend college in publications such as Ladies Home Journal, a children's magazine titled St. Nicholas, and a collection called Smith College Stories, without negative views.^[51]: 255 Enduring loyalty, devotion, and love were major components to these stories, and sexual acts beyond kissing were consistently undescribed.^{[49]: 297–313}

Faderman calls this period "the last breath of innocence" before 1920 when characterizations of female affection were connected to sexuality, marking lesbians as a unique and often unflatteringly portrayed group.^{[49]: 297–313} Specifically, Faderman connects the growth of women's independence and their beginning to reject strictly prescribed roles in the Victorian era to the scientific designation of lesbianism as a type of aberrant sexual behavior.^{[48]: 45–49}

In 1709, English aristocrat Lady Mary Wortley Montagu, wrote to Anne Wortley: "Nobody was so entirely, so faithfully yours ... I put in your lovers, for I don't allow it possible for a man to be so sincere as I am."^[49]: 119

In the 1700s, English poet Anna Seward had a devoted friendship with Honora Sneyd. Sneyd was the subject of many of Seward's poems. When Sneyd married despite Seward's protest, Seward's poems became angry, and she continued to write about Sneyd long after her death.^{[49]: 132–136}

Also in the 1700s, Deborah Sampson fought in the American Revolution under the name Robert Shurtlieff, and pursued relationships with women.^[52]

Also in the 1700s, English writer and philosopher Mary Wollstonecraft was attached to a woman named Fanny Blood. Writing to another woman, Wollstonecraft declared, "The roses will bloom when there's peace in the breast, and the prospect of living with my Fanny gladdens my heart:—You know not how I love her."^{[49]: 139 [d]}

The Irish Eleanor Butler and Sarah Ponsonby were nicknamed the Ladies of Llangollen. Butler and Ponsonby eloped in 1778, to the relief of Ponsonby's family (concerned about their reputation had she run away with a man)^[49]: 75 to live together in Wales for 51 years and be thought of as eccentrics.^{[6]: 227–229} Their story was considered "the epitome of virtuous romantic friendship" and inspired poetry by Anna Seward and Henry Wadsworth Longfellow.^{[44]: 45–46}

In the 1800s, English Diarist Anne Lister, captivated by Butler and Ponsonby, recorded her affairs with women between 1817 and 1840. Some of it was written in code, detailing her sexual relationships with Marianna Belcombe and Maria Barlow.^[53]: 390

In the 1800s, Edward De Lacy Evans was born female in Ireland, but took a male name during the voyage to Australia and lived as a man for 23 years in Victoria, marrying three times.^[6]: 224

American poet Emily Dickinson (1830-1886) wrote over 300 letters and poems to Susan Gilbert, who later became her sister-in-law, and later engaged in another romantic correspondence with Kate Scott Anthon.^{[51]: 145–148}

American freeborn Black women Addie Brown and Rebecca Primus left evidence of their passion in letters: "No kisses is like youres".^[6]: 234 They wrote openly about their sexual affection for one another, and despite their working-class economic status their writings survived, both of which are unusual for the time.

In 1870, American Alice Baldy wrote to Josie Varner, "Do you know that if you touch me, or speak to me there is not a nerve of fibre in my body that does not respond with a thrill of delight?"^[6]: 232

In the early 1900s, the unmarried professor Jeannette Augustus Marks at Mount Holyoke College, who lived with the college president, Mary Woolley, for 36 years. Even while unmarried and living with a woman, Marks discouraged young women from "abnormal" friendships and insisted happiness could only be attained with a man.^{[6]: 239 [e]}

In 1909, Percy Redwood created a scandal in New Zealand when she was found to be Amy Bock, who had married a woman from Port Molyneaux; newspapers argued whether it was a sign of insanity or an inherent character flaw.^[54]

In research on "inversion" by German sexologist Magnus Hirschfeld, researchers categorized what was normal sexual behavior for men and women, and therefore to what extent men and women varied from the "perfect male sexual type" and the "perfect female sexual type".^[6]: 168 Sexologists Richard von Krafft-Ebing from Germany and Britain's Havelock Ellis wrote some of the earliest and more enduring categorizations of female same-sex attraction, approaching it as a form of insanity.^[49]: 241 Krafft-Ebing and Ellis debated whether lesbianism was a lifelong condition or whether women's feelings would change after they had experienced marriage and a "practical life".^[49]: 242

Ellis eventually conceded that there were "true inverts" who would spend their lives pursuing erotic relationships with women. These were members of the "third sex" who rejected the roles of women to be subservient, feminine, and domestic.^[49]: 240 Invert described the opposite gender roles, and also the related attraction to women instead of men; since women in the Victorian period were considered unable to initiate sexual encounters, women who did so with other women were thought of as possessing masculine sexual desires.^[44]: 77

The work of Krafft-Ebing and Ellis was widely read and helped to create public consciousness of female homosexuality.^[f] In the absence of any other material to describe their emotions, homosexuals accepted the designation of different or perverted, and used their outlaw status to form social circles in Paris and Berlin. Lesbian began to describe elements of a subculture.^{[6]: 178–179}

From the 1890s to the 1930s, American heiress Natalie Clifford Barney held a weekly salon in Paris to which major artistic celebrities were invited and where lesbian topics were the focus. Combining Greek influences with contemporary French eroticism, she attempted to create an updated and idealized version of Lesbos in her salon.^[56]: 234 Her contemporaries included artist Romaine Brooks, who painted others in her circle; writers Colette, Djuna Barnes, social host Gertrude Stein, and novelist Radclyffe Hall.^{[citation needed]}

Berlin had a vibrant homosexual culture in the 1920s, and about 50 clubs catered to lesbians. Die Freundin (The Girlfriend) magazine, published between 1924 and 1933, targeted lesbians. Garçonne (aka Frauenliebe (Woman Love)) was aimed at lesbians and male transvestites.^{[6]: 241–244} These publications were controlled by men as owners, publishers, and writers. Around 1926, Selli Engler founded Die BIF – Blätter Idealer Frauenfreundschaften (The BIF – Papers on Ideal Women Friendships), the first lesbian publication owned, published and written by women. In 1928, the lesbian bar and nightclub guide Berlins lesbische Frauen (The Lesbians of Berlin) by Ruth Margarite Röllig^[57] further popularized the German capital as a center of lesbian activity. Clubs varied between large establishments that became tourist attractions, to small neighborhood cafes where local women went to meet other women. The cabaret song "Das lila Lied" ("The Lavender Song") became an anthem to the lesbians of Berlin. Although it was sometimes tolerated, homosexuality was illegal in Germany and law enforcement used permitted gatherings as an opportunity to register the names of homosexuals for future reference.^[58] Magnus Hirschfeld's Scientific-Humanitarian Committee, which promoted tolerance for homosexuals in Germany, welcomed lesbian participation, and a surge of lesbian-themed writing and political activism in the German feminist movement became evident.^{[56]: 230–231}

In 1928, Radclyffe Hall published the novel The Well of Loneliness. The novel's plot centers around Stephen Gordon, a woman described as an invert. The novel included a foreword by Havelock Ellis and was intended to be a call for tolerance for inverts by publicizing their disadvantages and accidents of being born inverted.^[49]: 320 The novel's trial for obscenity was described as "the crystallizing moment in the construction of a visible modern English lesbian subculture" by professor Laura Doan.^[59]

Newspaper stories frankly divulged that the book's content includes "sexual relations between Lesbian women", and photographs of Hall often accompanied details about lesbians in most major print outlets within a span of six months.^[59] Hall reflected the appearance of a "mannish" woman in the 1920s: short cropped hair, tailored suits (often with pants), and monocle that became widely recognized as a "uniform". When British women supported the war effort during the First World War, they became familiar with masculine clothing, and were considered patriotic for wearing uniforms and pants. Postwar masculinization of women's clothing became associated primarily with lesbianism.^[59]

In the United States, the 1920s was a decade of social experimentation, particularly with sex. This was heavily influenced by the writings of Sigmund Freud, who theorized that sexual desire would be sated unconsciously, despite an individual's wish to ignore it.^{[48]: 63–67} Freud said that while most people have phases of homosexual attraction or experimentation, he attributed exclusive same-sex attraction to stunted development resulting from trauma or parental conflicts.^{[56]: 242 [g]} Freud's theories were much more pervasive in the U.S. than in Europe. With the well-publicized notion that sexual acts were a part of lesbianism and their relationships, sexual experimentation was widespread. Large cities that provided a nightlife were immensely popular, and women began to seek out sexual adventure. Bisexuality became chic, particularly in America's first gay neighborhoods.^{[48]: 63–67}

No location saw more visitors for its possibilities of homosexual nightlife than Harlem, the predominantly African American section of New York City. White "slummers" enjoyed jazz, nightclubs, and anything else they wished. Blues singers Ma Rainey, Bessie Smith, Ethel Waters, and Gladys Bentley sang about affairs with women to visitors such as Tallulah Bankhead, Beatrice Lillie, and the soon-to-be-named Joan Crawford.^{[48]: 71 [61]} Homosexuals began to draw comparisons between their newly recognized minority status and that of African Americans.^[48]: 68 Among African American residents of Harlem, lesbian relationships were common and tolerated, though not overtly embraced. Some women staged lavish wedding ceremonies, even filing licenses using masculine names with New York City.^[48]: 73 Most homosexual women were married to men and participated in affairs with women regularly.^[61]

Across town, Greenwich Village also saw a growing homosexual community; both Harlem and Greenwich Village provided furnished rooms for single men and women, which was a major factor in their development as centers for homosexual communities.^[34]: 181 The tenor was different in Greenwich Village than Harlem. Bohemians—intellectuals who rejected Victorian ideals—gathered in the Village. Homosexuals were predominantly male, although figures such as poet Edna St. Vincent Millay and social host Mabel Dodge were known for their affairs with women and promotion of tolerance of homosexuality.^{[49]: 82–83} Women in the U.S. who could not visit Harlem or live in Greenwich Village for the first time were able to visit saloons in the 1920s without being considered prostitutes. The existence of a public space for women to socialize in bars that were known to cater to lesbians "became the single most important public manifestation of the subculture for many decades", according to historian Lillian Faderman.^{[48]: 79–80}

The primary component necessary to encourage lesbians to be public and seek other women was economic independence, which virtually disappeared in the 1930s with the Great Depression. Independent women in the 1930s were generally seen as holding jobs that men should have. Most lesbians in the U.S. found it necessary to marry to a "front" such as a gay man where both could pursue homosexual relationships with public discretion, or to a man who expected a traditional wife.^{[48]: 94–96}

The hostile social attitude made very small and close-knit communities in large cities that centered around bars. Women in other locales typically remained isolated. Speaking of homosexuality in any context was socially forbidden, and women rarely discussed lesbianism even amongst themselves; they referred to openly gay people as "in the Life".^{[48]: 105–112 [h]}

Homosexual subculture disappeared in Germany with the rise of the Nazis in 1933.^{[6]: 191–193}

American First Lady from 1933 to 1945, Eleanor Roosevelt, exchanged rings with and wrote letters to journalist Lorena Hickok, expressing her love and desire to kiss Hickock; her writings were in the style of romantic friendship. The view that Roosevelt's relationship with Hickok may have been sexual, therefore deserving of the lesbian label, created controversy among Roosevelt's biographers.^{[49]: 297–313}

The onset of World War II caused a massive upheaval in people's lives as military mobilization engaged millions of men. Women were also accepted into the military in the U.S. Women's Army Corps (WACs) and U.S. Navy's Women Accepted for Volunteer Emergency Service (WAVES). Unlike processes to screen out male homosexuals, which had been in place since the creation of the American military, there were no methods to identify or screen for lesbians; they were put into place gradually during World War II. Despite common attitudes regarding women's traditional roles in the 1930s, independent and masculine women were directly recruited by the military in the 1940s, and frailty discouraged.^{[63]: 28–33}

Some women arrived at the recruiting station in a man's suit, denied ever being in love with another woman, and were easily inducted.^{[63]: 28–33} Sexual activity was forbidden and blue discharge was almost certain if one identified oneself as a lesbian. As women found each other, they formed into tight groups on base, socialized at service clubs, and began to use code words. Historian Allan Bérubé documented that homosexuals in the armed forces either consciously or subconsciously refused to identify themselves as homosexual or lesbian, and also never spoke about others' orientation.^[63]: 104

The most masculine women were not necessarily common, though they were visible, so they tended to attract women interested in finding other lesbians. Women had to broach the subject about their interest in other women carefully, sometimes taking days to develop a common understanding without asking or stating anything outright.^[63]: 100

Women who did not enter the military were aggressively called upon to take industrial jobs left by men, in order to continue national productivity. The increased mobility, sophistication, and independence of many women during and after the war made it possible for women to live without husbands, something that would not have been feasible under different economic and social circumstances, further shaping lesbian networks and environments.^{[48]: 129–130}

In Germany, there was no explicit law against lesbianism. During the Holocaust, Jewish and Roma lesbians were imprisoned and killed as Jews or Roma, and politically dissident lesbians were persecuted as political dissidents.^[64] Prior to 1939, Aryan lesbians were imprisoned as 'asocials', which was "a broad category applied to all people who evaded Nazi rule."^[65] Asocials were identified with an inverted black triangle.^[64] In the 1990s in the U.S., some lesbians used the black triangle symbol as an identifier, and the pink triangle was also used for the combined lesbian-gay movement.^[65]

Following World War II, a nationwide movement pressed to return to pre-war society as quickly as possible in the U.S.^[66] When combined with the increasing national paranoia about communism and psychoanalytic theory that had become pervasive in medical knowledge, homosexuality became an undesired characteristic of employees working for the U.S. government in 1950. Homosexuals were thought to be vulnerable targets to blackmail, and the government purged its employment ranks of open homosexuals, beginning a widespread effort to gather intelligence about employees' private lives.^[56]: 277 State and local governments followed suit, arresting people for congregating in bars and parks, and enacting laws against cross-dressing for men and women.^[66]

The U.S. military and government conducted many interrogations, asking if women had ever had sexual relations with another woman and essentially equating even a one-time experience to a criminal identity, thereby severely delineating heterosexuals from homosexuals.^{[48]: 150–155} In 1952, homosexuality was listed as a pathological emotional disturbance in the American Psychiatric Association's Diagnostic and Statistical Manual.^[56]: 247 The view that homosexuality was a curable sickness was widely believed in the medical community, general population, and among many lesbians themselves.^[67]

Attitudes and practices to ferret out homosexuals in public service positions extended to Australia^[68] and Canada.^[69] A section to create an offence of "gross indecency" between females was added to a bill in the United Kingdom House of Commons and passed there in 1921, but was rejected in the House of Lords, apparently because they were concerned any attention paid to sexual misconduct would also promote it.^{[44]: 109–114}

Very little information was available about homosexuality beyond medical and psychiatric texts. Community meeting places consisted of bars that were commonly raided by police once a month on average, with those arrested exposed in newspapers. In response, eight women in San Francisco met in their living rooms in 1955 to socialize and have a safe place to dance. When they decided to make it a regular meeting, they became the first organization for lesbians in the U.S., titled the Daughters of Bilitis (DOB). The DOB began publishing a magazine titled The Ladder in 1956. Inside the front cover of every issue was their mission statement, the first of which stated was "Education of the variant". It was intended to provide women with knowledge about homosexuality—specifically relating to women and famous lesbians in history. By 1956, the term "lesbian" had such a negative meaning that the DOB refused to use it as a descriptor, choosing "variant" instead.^[70]

The DOB spread to Chicago, New York, and Los Angeles, and The Ladder was mailed to hundreds—eventually thousands—of DOB members discussing the nature of homosexuality, sometimes challenging the idea that it was a sickness, with readers offering their own reasons why they were lesbians and suggesting ways to cope with the condition or society's response to it.^[67] British lesbians followed with the publication of Arena Three beginning in 1964, with a similar mission.^{[44]: 153–158}

As a reflection of categories of sexuality so sharply defined by the government and society at large, early lesbian subculture developed rigid gender roles between women, particularly among the working class in the United States and Canada. For working class lesbians who wanted to live as homosexuals, "A functioning couple ... meant dichotomous individuals, if not male and female, then butch and femme", and the only models they had to go by were "those of the traditional female-male [roles]".^{[48]: 167–168} Although many municipalities enacted laws against cross-dressing, some women would socialize in bars as butches: dressed in men's clothing and mirroring traditional masculine behavior. Others wore traditionally feminine clothing and assumed the role of femmes. Butch and femme modes of socialization were so integral within lesbian bars that women who refused to choose between the two would be ignored, or at least unable to date anyone, and butch women becoming romantically involved with other butch women or femmes with other femmes was unacceptable.^{[48]: 167–168}

Butch women were not a novelty in the 1950s; even in Harlem and Greenwich Village in the 1920s some women assumed these personae. In the 1950s and 1960s, the roles were pervasive and not limited to North America: from 1940 to 1970, butch/femme bar culture flourished in Britain, though there were fewer class distinctions.^{[44]: 141–143} They further identified members of a group that had been marginalized; women who had been rejected by most of society had an inside view of an exclusive group of people that took a high amount of knowledge to function in.^{[48]: 170–174} Butch and femme were considered coarse by American lesbians of higher social standing during this period.^{[48]: 175–178}

Regardless of the lack of information about homosexuality in scholarly texts, another forum for learning about lesbianism was growing. A paperback book titled Women's Barracks describing a woman's experiences in the Free French Forces was published in 1950. It told of a lesbian relationship the author had witnessed. After 4.5 million copies were sold, it was consequently named in the House Select Committee on Current Pornographic Materials in 1952.^[71] Its publisher, Gold Medal Books, followed with the novel Spring Fire in 1952, which sold 1.5 million copies. Gold Medal Books was overwhelmed with mail from women writing about the subject matter, and followed with more books, creating the genre of lesbian pulp fiction.^[71]

Between 1955 and 1969, over 2,000 books were published using lesbianism as a topic, and they were sold in corner drugstores, train stations, bus stops, and newsstands all over the U.S. and Canada. Literary scholar, Yvonne Keller created several subclasses for lesbian pulp fiction, to help highlight the differences between the types of pulp fiction being released.^[72] Virile adventures were written by authors using male pseudonyms, and almost all were marketed to heterosexual men. During this time, another subclass emerged called "Pro-Lesbian". The emergence of pro-lesbian fiction began with authors seeing the voyeuristic and homophobic nature of virile adventures. With only a handful of lesbian pulp fiction authors were women writing for lesbians, including Ann Bannon, Valerie Taylor, Paula Christian, and Vin Packer/Ann Aldrich. These authors deliberately defied the standard of virile adventures by focusing on the relationship between the pair, instead of writing sexually explicit material like virile adventures.^[72]

The differences between virile adventures and pro-lesbian covers and titles were distinct enough that Bannon, who also purchased lesbian pulp fiction, later stated that women identified the material iconically by the cover art.^[73] Pro-lesbian covers were innocuous and hinted at their lesbian themes, and virile adventures ranged from having one woman partially undressed to sexually explicit covers, to demonstrate the invariably salacious material inside.^[72] In addition to this, coded words and images were used on the covers. Instead of "lesbian", terms such as "strange", "twilight", "queer", and "third sex", were used in the titles, and cover art was invariably salacious.^[74] Many of the books used cultural references: naming places, terms, describing modes of dress and other codes to isolated women. As a result, pulp fiction helped to proliferate a lesbian identity simultaneously to lesbians and heterosexual readers.^[75]

The social rigidity of the 1950s and early 1960s encountered a backlash as social movements to improve the standing of African Americans, the poor, women, and gays all became prominent. The gay rights movement and the feminist movement connected after a violent confrontation occurred in New York City in the 1969 Stonewall riots.^{[6]: 212–216}

From the late 1950s to the 1970s, the sexual revolution took place, and many women took advantage of their new social freedom to try new experiences. Women who previously identified as heterosexual tried sex with women, though many maintained their heterosexual identity.^[48]: 203

From the 1960s to the 1980s, the movement of second-wave feminism developed. Lesbianism as a political identity grew to describe a social philosophy among women, often overshadowing sexual desire as a defining trait. Different groups and authors defined "lesbian" as "the rage of all women condensed to the point of explosion".^[22]: 70, "a woman-identified woman who does not fuck men. It does not mean compulsory sexual activity with women."^[44]: 177, or "a woman whose primary erotic, psychological, emotional and social interest is in a member of her own sex[...].".^[76]: 7 Women who subscribed to this philosophy dubbed themselves lesbian-feminists. In the ideal society, named Lesbian Nation, "woman" and "lesbian" were interchangeable.^{[48]: 218–219}

Separatist feminists expressed their disdain with an inherently sexist and patriarchal society, and concluded the most effective way to overcome sexism and attain the equality of women would be to deny men any power or pleasure from women. Many believers strove to separate themselves physically and economically from traditional male-centered culture.^{[48]: 218–219} As equality was a priority for lesbian-feminists, disparity of roles between men and women or butch and femme were viewed as patriarchal. Lesbian-feminists also eschewed the perceived chauvinism of gay men; many lesbian-feminists refused to work with men, or take up their causes.^{[48]: 210–211}

Although lesbian-feminism was a significant shift, not all lesbians agreed with it. Lesbian-feminism was a youth-oriented movement: its members were primarily college educated, with experience in New Left and radical causes, but they had not seen any success in persuading radical organizations to take up women's issues.^[22]: 11 Many older lesbians who had acknowledged their sexuality in more conservative times felt maintaining their ways of coping in a homophobic world was more appropriate.^[77] Lesbians who believed they were born homosexual, and used the descriptor "lesbian" to define sexual attraction, often considered the separatist opinions of lesbian-feminists to be detrimental to the cause of gay rights.^{[48]: 217–218}

In 1970, the Daughters of Bilitis folded over which direction to focus on: feminism or gay rights issues.^[78]

From 1974 to 1993, the organization Salsa Soul Sisters, today known as the African Ancestral Lesbians United for Societal Change, was a lesbian womanist organization operating in New York City.^[79]: 55

In October 1980, the First Black Lesbian Conference was held, an outgrowth from the First National Third World Lesbian and Gay Conference.^[80][81]

In the 1980s, a significant movement rejected the desexualization of lesbianism by cultural feminists, causing a heated controversy called the feminist sex wars.^{[48]: 246–252} Butch and femme roles returned, although not as strictly followed as they were in the 1950s. They became a mode of chosen sexual self-expression for some women in the 1990s. Once again, women felt safer claiming to be more sexually adventurous, and sexual flexibility became more accepted.^[82]

In 1997, Marxist political activist Angela Davis came out a lesbian in an interview with Out magazine.^[83]

"Lesbians of color" is an umbrella term for Black, Latina, Asian, Arab, Native American, and other non-white lesbians. Lesbians of color have often been a marginalized group,^[84] and experienced racism in addition to homophobia and misogyny.^{[85][page needed]}

Some scholars have noted that in the past the predominant lesbian community was largely composed of white women and influenced by American culture, leading some lesbians of color to experience difficulties integrating into the community at large. Many lesbians of color have stated that they were often systematically excluded from lesbian spaces based on the fact that they are women of color.^[86] Additionally, lesbians of color face unique sets of challenges within their respective racial communities. Many feel abandoned, as communities of color often view homosexual identity as a "white" lifestyle and see the acceptance of homosexuality as a setback in achieving equality.^{[85][page needed]}

Lesbians of color, especially those of immigrant populations, often hold the sentiment that their sexual orientation identity adversely affects assimilation into the dominant culture. Historically, women of color were often excluded or culturally marginalized from participating in white-dominated lesbian and gay movements. The early lesbian feminist movement was criticized for excluding race and class issues from their spaces and for a lack of focus on issues that did not benefit white women.^[84] Audre Lorde, Barbara Smith, and Cherrie Moraga are cited as major theorists within the various lesbians of color movements for their insistence on inclusion and equality, from both racial communities and white lesbian communities.^[84]

The many intersections surrounding lesbians of color can often contribute to an increased need for mental health resources. Lesbians of color are more likely to experience a number of psychological issues due to the various experiences of sexism, racism, and homophobia.^[87] Mental health providers often use heteronormative standards to gauge the health of lesbian relationships, and the relationships of lesbian women of color are often subjects of judgment because they are seen as the most deviant.^[87]

Within racial communities, the decision to come out can be costly, as the threat of loss of support from family, friends, and the community at large is probable. Lesbians of color are often exposed to a range of adverse consequences, including microaggression, discrimination, menace, and violence.^[86]

Arabic-language historical records have used various terms to describe sexual practices between women.^[88] A common one is "sahq", which refers to rubbing. Lesbian practices and identities are largely absent from the historical record. The common term to describe lesbianism in Arabic today is essentially the same term used to describe men, and thus the distinction between male and female homosexuality is to a certain extent linguistically obscured in contemporary queer discourse.^[88] Overall, the study of contemporary lesbian experience in the region is complicated by power dynamics in the postcolonial context, shaped even by what some scholars refer to as "homonationalism", the use of politicized understanding of sexual categories to advance specific national interests on the domestic and international stage.^[89]

Women in the Middle East have been historically segregated from men. In the 7th and 8th centuries, some extraordinary women dressed in male attire when gender roles were less strict. The Caliphal court in Baghdad featured women who dressed as men, including false facial hair, but they competed with other women for the attentions of men.^[90][88]

In the ninth century, the Muslim philosopher al-Kindi, who was born and educated in modern-day Iraq, explicitly discusses lesbianism: "Lesbianism is due to a vapor which, condensed, generates in the labia heat and an itch which only dissolve and become cold through friction and orgasm. When friction and orgasm take place, the heat turns into coldness because the liquid that a woman ejaculates in lesbian intercourse is cold whereas..."^[91]

In the tenth century, the erotic writings Jawami ` al-ladhdha (Encyclopedia of Pleasure), by Abul Hasan Ali ibn Nasr al-Katib, was written also in modern-day Iraq. It describes a committed relationship between a Christian woman and an Arab woman in pre-Islamic Iraq, and the mourning process one went through when the other died.^[91]

According to the 12th-century writings of Sharif al-Idrisi, highly intelligent women were more likely to be lesbians; their intellectual prowess put them on a more even par with men.^[90]

While male-written accounts of lesbianism in the Middle East exist, a 1978 treatise about repression in Iran asserted that women were completely silenced: "In the whole of Iranian history, [no woman] has been allowed to speak out for such tendencies ... To attest to lesbian desires would be an unforgivable crime."^[90] Although the authors of the treatise argued this did not mean women could not engage in lesbian relationships, a lesbian anthropologist in 1991 visited Yemen and reported that women in the town she visited were unable to comprehend her romantic relationship to another woman. Women in Pakistan are expected to marry men; those who do not are ostracized. Women may have intimate relations with other women as long as their wifely duties are met, their private matters are kept quiet, and the woman with whom they are involved is somehow related by family or logical interest to her lover.^[90]

Individuals identifying with or otherwise engaging in lesbian practices in the region can face family violence and societal persecution, including "honor killings". The justifications provided by murderers relate to a person's perceived sexual immorality, loss of virginity (outside of acceptable frames of marriage), and target female victims primarily.^[92]

Lesbians also face government persecution in the Middle East. In Yemen, homosexuality is criminalized, and women can face lashings, up to three years in prison or the death penalty for consensual lesbian sex.^[93][94] In 2017, the Egyptian government arrested and tortured out lesbian and activist Sarah Hegazi after she flew a rainbow flag at a concert.^[95]

Both male and female homosexuality were known in Aztec culture. Although both were generally disapproved of, there is no evidence that homosexuality was actively suppressed until after the Spanish Conquest.^[96] Female homosexuality is described in the Florentine Codex, a 16th-century study of the Aztec world written by the Spanish Franciscan friar Bernardino de Sahagún. It describes Aztec lesbians as masculine in appearance and behavior and never wishing to be married.^[96] The book Monarquía indiana by Fray Juan de Torquemada, published in 1615, briefly mentions the persecution of Aztec lesbians: "The woman, who with another woman had carnal pleasures, for which they were called Patlache, which means: female incubus, they both died for it."^[96][i]

In Latin America, lesbian subcultures increased as several countries transitioned to or reformed democratic governments. However, social harassment has been common even in places where homosexuality is legal. Laws against child corruption, morality, or "the good ways" (faltas a la moral o las buenas costumbres) have been used to persecute homosexuals.^[97] Lesbian groups and advocacy have faced repression in many countries where dictators have seized power, including Argentina.^[97]

Argentinian lesbian group Nuestro Mundo (NM) was created in 1969.^[97]

Mexican lesbian group Lesbos was founded in 1977. In 1997, 13 lesbian organizations were active in Mexico City.^[97]

In Chile, the dictatorship of Augusto Pinochet forbade the creation of lesbian groups until 1984. The first lesbian group Ayuquelén ("joy of being" in Mapuche) was first founded in 1984, prompted by the very public homophobic murder of a woman. Ayuquelén worked to remove the sodomy laws then in place in Chile.^[97]

In Nicaragua in 1986, the Sandinista National Liberation Front expelled gay men and lesbians from its midst. State persecution prevented the formation of associations until AIDS became a concern, when educational efforts forced sexual minorities to band together. The first lesbian organization was Nosotras, founded in 1989. An effort to promote visibility from 1991 to 1992 provoked the government to declare homosexuality illegal in 1994, effectively ending the movement until 2004, when Grupo Safo – Grupo de Mujeres Lesbianas de Nicaragua was created, four years before homosexuality became legal again.^[97]

Some Indigenous peoples of the Americas conceptualize a third gender for women who dress as, and fulfill the roles usually filled by, men in their cultures.^[98][99] In other cases they may see gender as a spectrum, and use different terms for feminine women and masculine women.^[100] These identities are rooted in the context of the ceremonial and cultural lives of the particular Indigenous cultures, and "simply being gay and Indian does not make someone a Two-Spirit."^[101] These ceremonial and social roles, which are conferred and confirmed by the person's elders, "do not make sense" when defined by non-Native concepts of sexual orientation and gender identity.^[99] Rather, they must be understood in an Indigenous context, as traditional spiritual and social roles held by the person in their Indigenous community.^{[101][99][102]}

Founded in 2004 in Namibia, the Coalition of African Lesbians is a pan-Africanist, radical feminist network of fourteen nonprofits across ten African countries, working to eradicate stigma, legal discrimination, and violence against lesbians.^[103]

Cross-gender roles and marriage between women has also been recorded in over 30 traditional African societies.^[6]: 262 Women may marry other women, raise their children, and be generally thought of as men in societies in Nigeria, Cameroon, and Kenya. The Hausa people of Sudan have a term equivalent to lesbian, kifi, that may also be applied to males to mean "neither party insists on a particular sexual role".^[6]: 259

Near the Congo River, a female who participates in strong emotional or sexual relationships with another female among the Nkundo people is known as yaikya bonsángo (a woman who presses against another woman). Lesbian relationships are also known in matrilineal societies in Ghana among the Akan people. In Lesotho, females engage in what is commonly considered sexual behavior to the Western world: they kiss, sleep together, rub genitals, participate in cunnilingus, and maintain their relationships with other females vigilantly. Since the people of Lesotho believe sex requires a penis, they do not consider their behavior sexual, nor label themselves lesbians.^{[6]: 237–238}

In Tanzania, lesbians are known as or called "Msagaji" (singular), "Wasagaji" (plural), which in Swahili means grinder or grinding because of the perceived nature of lesbian sex that would involve the mutual rubbing of vulvas.^[104]

Corrective rape is reported to be on the rise in South Africa.^[105] The crime is sometimes supervised by members of the woman's family or local community,^[106] and is a major contributor to HIV infection in South African lesbians.^[105] "Corrective rape" is not recognized by the South African legal system as a hate crime despite the fact that the South African Constitution states that no person shall be discriminated against based on their social status and identity, including sexual orientation.^{[107][108][109]} Legally, South Africa protects gay rights extensively, but the government has not taken proactive action to prevent corrective rape, and women do not have much faith in the police and their investigations.^[110][111] Local South African organizations including nonprofit "Luleki Sizwe" and The Triangle Project, between 500 (per Triangle Project) and 3600 (Luleki Sizwe) South Africans suffer from corrective rape every year,^[112][110] the vast majority of lesbians live in fear of corrective rape, and victims are less likely to report the crime because of their society's homophobia.^[110]

China before westernization was another society that segregated men from women. Historical Chinese culture has not recognized a concept of sexual orientation, or a framework to divide people based on their same-sex or opposite-sex attractions.^[113]: 29 Although there was a significant culture surrounding homosexual men, there was none for women. Outside their duties to bear sons to their husbands, women were perceived as having no sexuality at all.^[6]: 311

This did not mean that women could not pursue sexual relationships with other women, but that such associations could not impose upon women's relationships to men. Rare references to lesbianism were written by Ying Shao, who identified same-sex relationships between women in imperial courts who behaved as husband and wife as dui shi (paired eating). "Golden Orchid Associations" in Southern China existed into the 20th century and promoted formal marriages between women, who were then allowed to adopt children.^[34]: 187 Westernization brought new ideas that all sexual behavior not resulting in reproduction was aberrant.^{[113]: 30–31}

The liberty of being employed in silk factories starting in 1865 allowed some women to style themselves tzu-shu nii (never to marry) and live in communes with other women. Other Chinese called them sou-hei (self-combers) for adopting hairstyles of married women. These communes passed because of the Great Depression and were subsequently discouraged by the communist government for being a relic of feudal China.^[34]: 195 In contemporary Chinese society, tongzhi (same goal or spirit) is the term used to refer to homosexuals; most Chinese are reluctant to divide this classification further to identify lesbians.^[113]: 28

In Japan, the term rezubian, a Japanese pronunciation of "lesbian", was used during the 1920s. Westernization brought more independence for women and allowed some Japanese women to wear pants.^[6]: 246 The cognate tomboy is used in the Philippines, and particularly in Manila, to denote women who are more masculine.^[113]: 122 Virtuous women in Korea prioritize motherhood, chastity, and virginity; outside this scope, very few women are free to express themselves through sexuality, although there is a growing organization for lesbians named Kkirikkiri.^[113]: 75 The term pondan is used in Malaysia to refer to gay men, but since there is no historical context to reference lesbians, the term is used for female homosexuals as well.^[113]: 145 As in many Asian countries, open homosexuality is discouraged in many social levels, so many Malaysians lead double lives.^{[113]: 148–150}

In India, a 14th-century Indian text mentioning a lesbian couple who had a child as a result of their lovemaking is an exception to the general silence about female homosexuality. According to Ruth Vanita, this invisibility disappeared with the release of a film titled Fire in 1996, prompting some theaters in India to be attacked by religious extremists. Terms used to label homosexuals are often rejected by Indian activists for being the result of imperialist influence, but most discourse on homosexuality centers on men. Women's rights groups in India continue to debate the legitimacy of including lesbian issues in their platforms, as lesbians and material focusing on female homosexuality are frequently suppressed.^[114]

The most extensive early study of female homosexuality was provided by the Institute for Sex Research, who published an in-depth report of the sexual experiences of American women in 1953. More than 8,000 women were interviewed by Alfred Kinsey and the staff of the Institute for Sex Research for Kinsey Reports. The reports' methodology was criticized during and after its publication.^{[115][116][117]} However, the reports were unexpectedly popular. They reported that 28% of women had been aroused by another female, and 19% had a sexual contact with another female.^{[118]: 453 [j]}, and that around nine percent of the women had orgasmed.^{[118]: 453–454} The report's dispassionate discussion of homosexuality as a form of human sexual behavior was revolutionary. Up to this study, only physicians and psychiatrists studied sexual behavior, and almost always the results were interpreted with a moral view.^[117]

In 1976, sexologist Shere Hite published a report on the sexual encounters of 3,019 women who had responded to questionnaires, under the title The Hite Report. Hite's questions differed from Kinsey's, focusing more on how women identified, or what they preferred rather than experience. Respondents to Hite's questions indicated that 8% preferred sex with women and 9% answered that they identified as bisexual or had sexual experiences with men and women, though they refused to indicate preference.^[119]

Hite's conclusions are more based on respondents' comments than quantifiable data. She found it "striking" that many women who had no lesbian experiences indicated they were interested in sex with women, particularly because the question was not asked.^[119] Hite found the two most significant differences between respondents' experience with men and women were the focus on clitoral stimulation, and more emotional involvement and orgasmic responses.^[119]

Lesbians in the U.S. are estimated to be about 2.6% of the population, according to a National Opinion Research Center survey of sexually active adults who had had same-sex experiences within the past year, completed in 2000.^[120] A survey of same-sex couples in the United States showed that between 2000 and 2005, the number of people claiming to be in same-sex relationships increased by 30%—five times the rate of population growth in the U.S. The study attributed the jump to people being more comfortable self-identifying as homosexual to the federal government.^[k]

The government of the United Kingdom does not ask citizens to define their sexuality. A survey by the UK Office for National Statistics (ONS) in 2010 found that 1.5% of Britons identified themselves as gay or bisexual, and the ONS suggests that this is in line with other surveys showing the number between 0.3% and 3%.^[122][123] Estimates of lesbians are sometimes not differentiated in studies of same-sex households, such as those performed by the U.S. census, and estimates of total gay, lesbian, or bisexual population by the UK government. Polls in Australia recorded a range of self-identified lesbian or bisexual women from 1.3% to 2.2% of the total population.^[124]

Medical research and care sometimes use the term women who have sex with women (WSW) instead of lesbian.^[125]

In a 2006 American survey of 2,345 lesbian and bisexual women, only 9.3% had ever been asked their sexual orientation by a physician. A third of the women had received a negative reaction from a medical professional after identifying themselves as lesbian or bisexual.^[126]

When women do seek medical attention, medical professionals often fail to take a complete medical history. A patient's complete history helps medical professionals identify higher risk areas. In a 1995 U.S. survey of 6,935 self-identified lesbians, 77% had had one or more lifetime male sexual partners, and 6% had that contact within the previous year.^[127][l]

The risk factors for developing ovarian cancer rates are higher in lesbians than heterosexual women, perhaps because many lesbians lack the protective factors of pregnancy, abortion, contraceptives, breast feeding, and miscarriages.^[128]

Many lesbians neglect to see a physician because they do not participate in heterosexual activity and require no birth control, which is the initiating factor for most women to seek consultation with a gynecologist when they become sexually active.^[129]: 359 As a result, many lesbians are not screened for cancer regularly with Pap smears.^[130]

Factors that add to risk of heart disease include obesity and smoking, both of which are more prevalent among lesbians. Studies show that lesbians are generally less concerned about weight issues than heterosexual women; and lesbians consider women with higher body masses to be more attractive than heterosexual women do. Research is needed to determine specific causes of obesity and smoking in lesbians.^[130][126]

Lesbians are more likely to exercise regularly than heterosexual women. Lesbians, unlike heterosexual women, do not generally exercise for aesthetic reasons.^[131]

Some sexually transmitted infections (STIs) are communicable between women, including human papillomavirus (HPV), trichomoniasis, syphilis, and herpes simplex virus (HSV). Transmission of specific STIs among women who have sex with women depends on the sexual practices women engage in. Any object that comes in contact with cervical secretions, vaginal mucosa, or menstrual blood, including fingers or penetrative objects may transmit STIs.^[132] Orogenital contact may indicate a higher risk of acquiring HSV,^[133] even among women who have had no sex with men.^[125]

Bacterial vaginosis (BV) occurs more often in lesbians, but it is unclear if BV is transmitted by sexual contact; it occurs in celibate as well as sexually active women. BV often occurs in both partners in a lesbian relationship;^[134] a recent study of women with BV found that 81% had partners with BV.^[125]

Lesbians do not frequently transmit human immunodeficiency virus (HIV), although transmission is possible through vaginal and cervical secretions. The highest rate of transmission of HIV to lesbians is from intravenous drug use or sex with women who have sexual intercourse with bisexual men.^[129][135]

Much literature on mental health and lesbians centered on their depression, substance abuse, and suicide. Although these issues exist among lesbians, discussion about their causes shifted after homosexuality was removed from the Diagnostic and Statistical Manual in 1973. Instead, social ostracism, legal discrimination, internalization of negative stereotypes, and limited support structures indicate factors homosexuals face in Western societies that often adversely affect their mental health.^[136]

Lesbian women report feeling significantly different and isolated during adolescence.^{[136][22]: 153} These emotions have been cited as appearing on average at 15 years old in lesbians and 18 years old in bisexual women.^[137]

More than half the respondents to a 1994 survey of health issues in lesbians reported they had suicidal thoughts, and 18% had attempted suicide.^{[5]: 70 [needs update]} American studies in the 2010s and 2020s have found that LGBT people experience higher rates of mental distress, and that this relationship is mediated by experiences of rejection and adverse childhood experiences.^[138]

Depression is reported among lesbians at a rate similar to heterosexual women.^[5]: 69 Depression is a more significant problem among women who feel they must hide their sexual orientation from friends and family, or experience compounded ethnic or religious discrimination, or endure relationship difficulties with no support system.^{[22]: 157–158}

Generalized anxiety disorder is more likely to appear among lesbian and bisexual women than heterosexual women.^[136][m]

Studies have shown that heterosexual men and lesbians have different standards for what they consider attractive in women. Lesbians who view themselves with male standards of female beauty may experience lower self-esteem, eating disorders, and higher incidence of depression.^[131]

A population-based study completed by the National Alcohol Research Center found that women who identify as lesbian or bisexual are less likely to abstain from alcohol. Lesbians and bisexual women have a higher likelihood of reporting problems with alcohol, as well as not being satisfied with treatment for substance abuse programs.^{[140][non-primary source needed]} Many lesbian communities are centered in bars, and drinking is an activity that correlates to community participation for lesbians and bisexual women.^[5]: 81

Lesbians portrayed in literature, film, and television often shape contemporary thought about women's sexuality. The majority of media about lesbians is produced by men;^{[22]: 389–390} women's publishing companies did not develop until the 1970s, films about lesbians made by women did not appear until the 1980s, and television shows portraying lesbians written by women only began to be created in the 21st century. As a result, homosexuality—particularly dealing with women—has been excluded because of symbolic annihilation. When depictions of lesbians began to surface, they were often one-dimensional, simplified stereotypes.^{[22]: 389–390}

Ancient lesbian writers include Sappho.^[n] Ancient stories interpreted as examples of lesbianism include the Book of Ruth,^{[51]: 22–23 [53]: 108} Camilla and Diana, Artemis and Callisto, and Iphis and Ianthe.^{[51]: 24–27}

Greek stories of the heavens often included a female figure whose virtue and virginity were unspoiled, who pursued more masculine interests, and who was followed by a dedicated group of maidens.^{[citation needed]}

For ten centuries after the fall of the Roman Empire, lesbianism disappeared from literature.^[53]: 11 Foster points to the particularly strict view that Eve—representative of all women—caused the downfall of mankind; original sin among women was a particular concern, especially because women were perceived as creating life.^{[51]: 30–31} During this time, women were largely illiterate and not encouraged to engage in intellectual pursuit, and men shaped ideas about sexuality.^[53]: 6

In the 15th and 16th centuries, French and English depictions of relationships between women, writers' attitudes spanned from amused tolerance to arousal, whereupon a male character would participate to complete the act. Physical relationships between women were often encouraged; men felt no threat as they viewed sexual acts between women to be accepted when men were not available, and not comparable to fulfillment that could be achieved by sexual acts between men and women.^{[49]: 26–28} At worst, if a woman became enamored of another woman, she became a tragic figure. Physical and therefore emotional satisfaction was considered impossible without a natural phallus. Male intervention into relationships between women was necessary only when women acted as men and demanded the same social privileges.^[49]: 29

In the 17th and 18th centuries, writings mentioning lesbianism included the Lives of Gallant Ladies by Brantôme in 1665, John Cleland's 1749 erotica Memoirs of a Woman of Pleasure, and L'Espion Anglais by various authors in 1778.^{[citation needed]}

Lesbianism became almost exclusive to French literature in the 19th century, based on male fantasy and the desire to shock bourgeois moral values.^{[49]: 264, 268} Honoré de Balzac, in The Girl with the Golden Eyes (1835), employed lesbianism in his story about three people living amongst the moral degeneration of Paris, and again in Cousin Bette and Séraphîta. His work influenced novelist Théophile Gautier's Mademoiselle de Maupin, which provided the first description of a physical type that became associated with lesbians: tall, wide-shouldered, slim-hipped, and athletically inclined.^{[51]: 51–65} Charles Baudelaire repeatedly used lesbianism as a theme in his poems "Lesbos", "Femmes damnées 1" ("Damned Women"), and "Femmes damnées 2".^[53]: 435

Reflecting French society, as well as employing stock character associations, many of the lesbian characters in 19th-century French literature were prostitutes or courtesans: personifications of vice who died early, violent deaths in moral endings.^{[49]: 281–283} Samuel Taylor Coleridge's 1816 poem "Christabel" and the novella Carmilla (1872) by Sheridan Le Fanu both present lesbianism associated with vampirism.^{[49]: 277, 288–289} Portrayals of female homosexuality not only formed European consciousness about lesbianism, but Krafft-Ebing cited the characters in Gustave Flaubert's Salammbô (1862) and Ernest Feydeau's La comtesse de Chalis (1867) as examples of lesbians because both novels feature female protagonists who do not adhere to social norms and express "contrary sexual feeling", although neither participated in same-sex desire or sexual behavior.^[51]: 72 Havelock Ellis used literary examples from Balzac and several French poets and writers to develop his framework to identify sexual inversion in women.^[49]: 254

Gradually, women began to author their own thoughts and literary works about lesbian relationships. Until the publication of The Well of Loneliness, most major works involving lesbianism were penned by men. Foster suggests that women would have encountered suspicion about their own lives had they used same-sex love as a topic, and that some writers including Louise Labé, Charlotte Charke, and Margaret Fuller either changed the pronouns in their literary works to male, or made them ambiguous.^{[51]: 116–127} Author George Sand was portrayed as a character in several works in the 19th century; writer Mario Praz credited the popularity of lesbianism as a theme to Sand's appearance in Paris society in the 1830s.^{[49]: 263 [o]}

In the 20th century, Katherine Mansfield, Amy Lowell, Gertrude Stein, H.D., Vita Sackville-West, Virginia Woolf, and Gale Wilhelm wrote popular works that had same-sex relationships as themes. Some women, such as Marguerite Yourcenar and Mary Renault, wrote or translated works of fiction that focused on homosexual men, like some of the writings of Carson McCullers. All three were involved in same-sex relationships, but their primary friendships were with gay men.^[34]: 182 Foster further asserts 1928 was a "peak year" for lesbian-themed literature; in addition to The Well of Loneliness, three other novels with lesbian themes were published in England: Elizabeth Bowen's The Hotel, Woolf's Orlando, and Compton Mackenzie's satirical novel Extraordinary Women.^[141] Unlike The Well of Loneliness, none of these novels were banned.^{[51]: 281–287 [p]}

As the paperback book came into fashion, lesbian themes were relegated to pulp fiction. Many of the pulp novels typically presented very unhappy women, or relationships that ended tragically. Marijane Meaker later wrote that she was told to make the relationship end badly in Spring Fire because the publishers were concerned about the books being confiscated by the U.S. Postal Service.^[144] Patricia Highsmith, writing as Claire Morgan, wrote The Price of Salt in 1951 and refused to follow this directive, but instead used a pseudonym.^{[53]: 1024–1025}

Following the Stonewall riots, lesbian themes in literature became much more diverse and complex, and shifted the focus of lesbianism from erotica for heterosexual men to works written by and for lesbians. Feminist magazines such as The Furies, and Sinister Wisdom replaced The Ladder.^{[citation needed]}

Well-known fiction writers who used lesbian characters and plots included Rita Mae Brown's Rubyfruit Jungle (1973) and the works of Dorothy Allison.^{[22]: 377-379} Audre Lorde became a well-known poet and essayist, and Cherríe Moraga wrote and edited extensive nonfiction.^[22]: 379

Lesbianism, or the suggestion of it, began early in filmmaking. The same constructs of how lesbians were portrayed—or for what reasons—as what had appeared in literature were placed on women in the films. Women challenging their feminine roles was a device more easily accepted than men challenging masculine ones. Actresses appeared as men in male roles because of plot devices as early as 1914 in A Florida Enchantment featuring Edith Storey. In Morocco (1930) Marlene Dietrich kisses another woman on the lips, and Katharine Hepburn plays a man in Christopher Strong in 1933 and again in Sylvia Scarlett (1936). Hollywood films followed the same trend set by audiences who flocked to Harlem to see edgy shows that suggested bisexuality.^{[145]: 27–28}

Overt female homosexuality was introduced in 1929's Pandora's Box between Louise Brooks and Alice Roberts. After the Hays Code in 1930, most references to homosexuality in films were censored under the umbrella term "sex perversion". German films depicted homosexuality and were distributed throughout Europe, but 1931's Mädchen in Uniform was not distributed in the U.S. because of the depiction of an adolescent's love for a female teacher in boarding school.^[146]: 58

Because of the Hays Code, lesbianism after 1930 was absent from most films, even those adapted with overt lesbian characters or plot devices. Lillian Hellman's play The Children's Hour was converted into a heterosexual love triangle and retitled These Three. Biopic Queen Christina in 1933, starring Greta Garbo, veiled most of the speculation about Christina of Sweden's affairs with women.^[146]: 58 Homosexuality or lesbianism was never mentioned outright in the films while the Hays Code was enforced. The reason censors stated for removing a lesbian scene in 1954's The Pit of Loneliness was that it was, "Immoral, would tend to corrupt morals".^[146]: 102 The code was relaxed somewhat after 1961, and the next year William Wyler remade The Children's Hour with Audrey Hepburn and Shirley MacLaine. After MacLaine's character admits her love for Hepburn's, she hangs herself; this set a precedent for miserable endings in films addressing homosexuality.^[146]: 139

Gay characters also were often killed off at the end, such as the death of Sandy Dennis' character at the end of The Fox in 1968. If not victims, lesbians were depicted as villains or morally corrupt, such as portrayals of brothel madames by Barbara Stanwyck in Walk on the Wild Side from 1962 and Shelley Winters in The Balcony in 1963. Lesbians as predators were presented in Rebecca (1940), women's prison films like Caged (1950), or in the character Rosa Klebb in From Russia with Love (1963).^{[146]: 143–156} Lesbian vampire themes have reappeared in Dracula's Daughter (1936), Blood and Roses (1960), Vampyros Lesbos (1971), and The Hunger (1983).^[146]: 49 Basic Instinct (1992) featured a bisexual murderer played by Sharon Stone; it was one of several films that set off a storm of protests about the depiction of gay people as predators.^{[145]: 150–151}

The first film to address lesbianism with significant depth was The Killing of Sister George in 1968, which was filmed in The Gateways Club, a longstanding lesbian pub in London. It is the first to claim a film character who identifies as a lesbian, and film historian Vito Russo considers the film a complex treatment of a multifaceted character who is forced into silence about her openness by other lesbians.^{[146]: 170–173} Personal Best in 1982, and Lianna in 1983 treat the lesbian relationships more sympathetically and show lesbian sex scenes, though in neither film are the relationships happy ones. Personal Best was criticized for engaging in the clichéd plot device of one woman returning to a relationship with a man, implying that lesbianism is a phase, as well as treating the lesbian relationship with "undisguised voyeurism".^{[145]: 185–186} More ambiguous portrayals of lesbian characters were seen in Silkwood (1983), The Color Purple (1985), and Fried Green Tomatoes (1991), despite explicit lesbianism in the source material.^[147]

An era of independent filmmaking brought different stories, writers, and directors to films. Desert Hearts arrived in 1985, to be one of the most successful. Directed by lesbian Donna Deitch, it is loosely based on Jane Rule's novel Desert of the Heart. It received mixed critical commentary, but earned positive reviews from the gay press.^{[145]: 194–195} The late 1980s and early 1990s ushered in a series of films treating gay and lesbian issues seriously, made by gays and lesbians, nicknamed New Queer Cinema.^[145]: 237 Films using lesbians as a subject included Rose Troche's avant garde romantic comedy Go Fish (1994) and the first film about African American lesbians, Cheryl Dunye's The Watermelon Woman, in 1995.^{[145]: 241–242}

Realism in films depicting lesbians developed further to include romance stories such as The Incredibly True Adventure of Two Girls in Love and When Night Is Falling, both in 1995, Better Than Chocolate (1999), and the social satire But I'm a Cheerleader (also in 1999).^[145]: 270 A twist on the lesbian-as-predator theme was the added complexity of motivations of some lesbian characters in Peter Jackson's Heavenly Creatures (1994), the Oscar-winning biopic of Aileen Wuornos, Monster (2003), and the exploration of fluid sexuality and gender in Chasing Amy (1997), Kissing Jessica Stein (2001), and Boys Don't Cry (1999).^{[145]: 274–280} The film V for Vendetta shows a dictatorship in future Britain that forces lesbians, homosexuals, and other "unwanted" people in society to be systematically slaughtered in Nazi concentration camps. In the film, a lesbian actress named Valerie, who was killed in such a manner, serves as inspiration for the masked rebel V and his ally Evey Hammond, who set out to overthrow the dictatorship.^{[citation needed]}

The first stage production to feature a lesbian kiss and open depiction of two women in love is the 1907 Yiddish play God of Vengeance (Got fun nekome) by Sholem Asch. Rivkele, a young woman, and Manke, a prostitute in her father's brothel, fall in love. On March 6, 1923, during a performance of the play in a New York City theatre, producers and cast were informed that they had been indicted by a Grand Jury for violating the Penal Code that defined the presentation of "an obscene, indecent, immoral and impure theatrical production." They were arrested the following day when they appeared before a judge. Two months later, they were found guilty in a jury trial. The producers were fined $200 and the cast received suspended sentences. The play is considered by some to be "the greatest drama of the Yiddish theater".^[148][149] God of Vengeance was the inspiration for the 2015 play Indecent by Paula Vogel, which features lesbian characters Rifkele and Manke.^[150][151] Indecent was nominated for the 2017 Tony Award for Best Play and Drama Desk Award for Outstanding Play.^{[citation needed]}

Broadway musical The Prom featured lesbian characters Emma Nolan and Alyssa Greene. In 2019, the production was nominated for six Tony Awards, including Best Musical, and received the Drama Desk Award for Outstanding Musical. A performance from The Prom was included in the 2018 Macy's Thanksgiving Day Parade and made history by showing the first same-sex kiss in the parade's broadcast.^[152][153] Jagged Little Pill featured lesbian character Jo, who is dealing with her religious mother's disapproval.^[154]

Television began to address homosexuality much later than film. Local talk shows in the late 1950s first addressed homosexuality by inviting panels of experts (usually not gay themselves) to discuss the problems of gay men in society. Lesbianism was rarely included. The first time a lesbian was portrayed on network television was the NBC drama The Eleventh Hour in the early 1960s, in a teleplay about an actress who feels she is persecuted by her female director, and in distress, calls a psychiatrist who explains she is a latent lesbian who has deep-rooted guilt about her feelings for women. When she realizes this, she is able to pursue heterosexual relationships, which are portrayed as "healthy".^{[155]: 7–9}

Invisibility for lesbians continued in the 1970s when homosexuality became the subject of dramatic portrayals, first with medical dramas (The Bold Ones, Marcus Welby, M.D., Medical Center) featuring primarily male patients coming out to doctors, or staff members coming out to other staff members. These shows allowed homosexuality to be discussed clinically, with the main characters guiding troubled gay characters or correcting homophobic antagonists, while simultaneously comparing homosexuality to psychosis, criminal behavior, or drug use.^{[155]: 13–44}

Another stock plot device in the 1970s was the gay character in a police drama. They served as victims of blackmail or anti-gay violence, but more often as criminals. Beginning in the late 1960s with N.Y.P.D., Police Story, and Police Woman, the use of homosexuals in stories became much more prevalent, according to Vito Russo, as a response to their higher profiles in gay activism.^{[146]: 186–189} Lesbians were included as villains, motivated to murder by their desires, internalized homophobia, or fear of being exposed as homosexual. One episode of Police Woman earned protests by the National Gay Task Force before it aired for portraying a trio of murderous lesbians who killed retirement home patients for their money.^[155]: 68 NBC edited the episode because of the protests, but a sit-in was staged in the head of NBC's offices.^[155]: 69

In the middle of the 1970s, gay men and lesbians began to appear as police officers or detectives facing coming out issues. This did not extend to CBS' groundbreaking show Cagney & Lacey in 1982, starring two female police detectives. CBS production made conscious attempts to soften the characters so they would not appear to be lesbians.^{[155]: 75–76} In 1991, a bisexual lawyer portrayed by Amanda Donohoe on L.A. Law shared the first significant lesbian kiss^[q] on primetime television with Michele Greene, stirring a controversy despite being labeled "chaste" by The Hollywood Reporter.^[155]: 89

Though television did not begin to use recurring homosexual characters until the late 1980s, some early situation comedies used a stock character that author Stephen Tropiano calls "gay-straight": supporting characters who were quirky, did not comply with gender norms, or had ambiguous personal lives, that "for all purposes should be gay". These included Zelda from The Many Loves of Dobie Gillis, Miss Hathaway from The Beverly Hillbillies, and Jo from The Facts of Life.^{[155]: 185–186} In the mid-1980s through the 1990s, sitcoms frequently employed a "coming out" episode, where a friend of one of the stars admits she is a lesbian, forcing the cast to deal with the issue. Designing Women, The Golden Girls, and Friends used this device with women in particular.^{[155]: 202–204}

Recurring lesbian characters who came out were seen on Married... with Children, Mad About You, and Roseanne, in which a highly publicized episode had ABC executives afraid a televised kiss between Roseanne and Mariel Hemingway would destroy ratings and ruin advertising. The episode was instead the week's highest rated.^{[22]: 394, 399} By far the sitcom with the most significant impact to the image of lesbians was Ellen. Publicity surrounding Ellen's coming out episode in 1997 was enormous; Ellen DeGeneres appeared on the cover of Time magazine the week before the airing of "The Puppy Episode" with the headline "Yep, I'm Gay". Parties were held in many U.S. cities to watch the episode, and the opposition from conservative organizations was intense. WBMA-LP, the ABC affiliate in Birmingham, Alabama, even refused to air the first run of the episode, citing conservative values of the local viewing audience, which earned the station some infamy and ire in the LGBT community. Even still, "The Puppy Episode" won an Emmy for writing, but as the show began to deal with Ellen Morgan's sexuality each week, network executives grew uncomfortable with the direction the show took and canceled it.^{[155]: 245–249}

Dramas following L.A. Law began incorporating homosexual themes, particularly with continuing storylines on Relativity, Picket Fences, ER, and Star Trek: The Next Generation and Deep Space Nine, both of which tested the boundaries of sexuality and gender.^{[155]: 128–136} A show directed at adolescents that had a particularly strong cult following was Buffy the Vampire Slayer. In the fourth season of Buffy, Tara and Willow admit their love for each other without any special fanfare and the relationship is treated as are the other romantic relationships on the show.^{[155]: 183–184}

What followed was a series devoted solely to gay characters from network television. Showtime's American rendition of Queer as Folk ran for five years, from 2000 to 2005; two of the main characters were a lesbian couple. Showtime promoted the series as "No Limits", and Queer as Folk addressed homosexuality graphically. The aggressive advertising paid off as the show became the network's highest rated, doubling the numbers of other Showtime programs after the first season.^{[155]: 150–152} In 2004, Showtime introduced The L Word, a dramatic series devoted to a group of lesbian and bisexual women, running its final season in 2009.^{[citation needed]}

Lesbian visibility has improved since the early 1980s. This is in part due to public figures who have drawn speculation from the public and comment in the press about their sexuality and lesbianism in general. The primary figure earning this attention was Martina Navratilova, who served as tabloid fodder for years as she denied being lesbian, admitted to being bisexual, had very public relationships with Rita Mae Brown and Judy Nelson, and acquired as much press about her sexuality as she did her athletic achievements. Navratilova spurred what scholar Diane Hamer termed "constant preoccupation" in the press with determining the root of same-sex desire.^[158]

Other public figures acknowledged their homosexuality and bisexuality, notably musicians k.d. lang and Melissa Etheridge. Madonna pushed sexual boundaries in her performances. In 1993, heterosexual supermodel Cindy Crawford posed for the August cover of Vanity Fair in a provocative arrangement that showed Crawford pretending to shave lang's face, as lang lounged in a barber's chair wearing a pinstripe suit.^[159] The image "became an internationally recognized symbol of the phenomenon of lesbian chic", according to Hamer.^[158] The year 1994 marked a rise in lesbian visibility, particularly appealing to women with feminine appearances. Between 1992 and 1994, Mademoiselle, Vogue, Cosmopolitan, Glamour, Newsweek, and New York magazines featured stories about women who admitted sexual histories with other women.^[157]

One analyst reasoned the recurrence of lesbian chic was due to the often-used homoerotic subtexts of gay male subculture being considered off-limits because of AIDS in the late 1980s and 1990s, joined with the distant memory of lesbians as they appeared in the 1970s: unattractive and militant. In short, lesbians became more attractive to general audiences when they ceased having political convictions.^[158] All the attention on feminine and glamorous women created what culture analyst Rodger Streitmatter characterizes as an unrealistic image of lesbians packaged by heterosexual men; the trend influenced an increase in the inclusion of lesbian material in pornography aimed at men.^[157]

A resurgence of lesbian visibility was noted in 2009 when sexually fluid female celebrities, such as Cynthia Nixon and Lindsay Lohan, commented openly about their relationships with women, and reality television addressed same-sex relationships. Psychiatrists and feminist philosophers wrote that the rise in women acknowledging same-sex relationships was due to growing social acceptance, but also conceded that "only a certain kind of lesbian—slim and elegant or butch in just the right androgynous way—is acceptable to mainstream culture."^[160]

Before the 1970s, the idea that same-sex adults formed long-term committed relationships was unknown to many people. In the 1990s in the U.S., the majority of lesbians (between 60% and 80%) reported being in a long-term relationship.^[22]: 117 Sociologists credit the high number of paired women to women's higher propensity to commit to relationships. Unlike heterosexual relationships that tend to divide work based on sex roles, lesbian relationships divide chores evenly between both members. Studies have also reported that emotional bonds are closer in lesbian and gay relationships than heterosexual ones.^{[22]: 118–119}

Family issues were significant concerns for lesbians when gay activism became more vocal in the 1960s and 1970s. Custody issues in particular were of interest since often courts would not award custody to mothers who were openly homosexual, even though the general procedure acknowledged children were awarded to the biological mother.^{[22]: 125–126 [44]: 182}

Several studies performed as a result of custody disputes compared outcomes for children of single lesbian mothers and single nonlesbian mothers. They found that children's mental health, happiness, overall adjustment, sexual orientation, and sex roles, were similar between both groups.^{[22]: 125–126}

As of 2025, same-sex marriage is legal in thirty-eight countries, and eight countries offer civil unions. Thirty-five countries have created laws specifically prohibiting same-sex marriage.^{[citation needed]}

The ability to adopt domestically or internationally children or provide a home as a foster parent is also a political and family priority for many lesbians, as is improving access to artificial insemination.^{[22]: 128–129}