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Instead, lesbian relationships have often been regarded as harmless and incomparable to heterosexual ones, unless the participants attempted to assert privileges traditionally enjoyed by men.

As a result, little in history was documented to give an accurate description of how female homosexuality was expressed.

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Krafft-Ebing, who considered lesbianism (what he termed "Uranism") a neurological disease, and Ellis, who was influenced by Krafft-Ebing's writings, disagreed about whether sexual inversion was generally a lifelong condition.

Ellis believed that many women who professed love for other women changed their feelings about such relationships after they had experienced marriage and a "practical life".

In 1890, the term lesbian was used in a medical dictionary as an adjective to describe tribadism (as "lesbian love").

The terms lesbian, invert and homosexual were interchangeable with sapphist and sapphism around the turn of the 20th century.

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With second wave feminism and the growth of scholarship in women's history and sexuality in the 20th century, the definition of lesbian broadened, sparking a debate about sexual desire as the major component to define what a lesbian is.

Some women who engage in same-sex sexual activity may reject not only identifying as lesbians but as bisexual as well, while other women's self-identification as lesbian may not align with their sexual orientation or sexual behavior.

However, Ellis conceded that there were "true inverts" who would spend their lives pursuing erotic relationships with women.

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