Barriers	Interventions
Lack of awareness of community resources2,5	Become familiar with community resources for referral, such as legal assistance including family law and pregnancy/parenting resources.
Lack of awareness of WSW health disparities5,8 and lack of focus on issues of particular significance in the WSW population5	Facilitate training for all staff (including physician assistants, nurses, and others) to become knowledgeable about health care issues that disproportionately affect WSW, including obesity, tobacco use, STIs, substance use, and psychological issues.
	Inquire about substance use, including tobacco and alcohol.
	Screen for depression and other psychological issues and their effect on safer sex practices.9
	Assess risks of human immunodeficiency virus infection and other STIs, including multiple sex partners and lack of barrier protection.
	Assess risks of obesity and cardiovascular disease.
	Test and treat as appropriate.
	Refer to community resources as appropriate.
Lack of focus on routine health care5	Provide WSW with the same comprehensive health care as for all patients, in addition to targeted care for issues common among WSW.
	Screen for breast and cervical cancer according to the U.S. Preventive Services Task Force guidelines.10,11
	Screen for intimate partner violence according to the U.S. Preventive Services Task Force guidelines.12
Lack of welcoming environment as perceived by WSW patients2,5,8	Ensure that office publications, websites, and social media include photos of female same-sex couples and overtly welcoming symbols such as rainbow flags and pink triangles.
	Revise intake forms to include WSW-friendly terms such as partnered in addition to married and single.
	Facilitate training for front office staff in orientation sessions and diversity workshops to use gender-neutral, WSW-friendly terminology and to remove assumptions of heterosexuality.
	Address confidentiality concerns with WSW patients. Discuss what will be entered in the health record and who will have access to it.