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Since the study focused on sexual preference, transgender individuals were not included, since being transgendered was considered a gender identity. Fear of stigmatization prevents many people from identifying themselves as lesbian, gay, bisexual, or transgender. Therefore, they may be at greater risk for depression, suicide, substance abuse, and antigay violence, although this has not been studied. Perceptions of cervical cancer and pap smear screening behavior by women's sexual orientation.
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