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Greater economic and social freedom allowed them gradually to be able to determine how they could form relationships and families.
With second wave feminism and 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.
However, Ellis 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.
The development of medical knowledge was a significant factor in further connotations of the term lesbian.
In the middle of the 19th century, medical writers attempted to establish ways to identify male homosexuality, which was considered a significant social problem in most Western societies.
Women in many cultures throughout history have had sexual relations with other women, but they rarely were designated as part of a group of people based on who they had physical relations with.
As women have generally been political minorities in Western cultures, the added medical designation of homosexuality has been cause for the development of a subcultural identity.
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.
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; sexual identity is not necessarily the same as one's sexual orientation or sexual behavior, due to various reasons, such as the fear of identifying their sexual orientation in a homophobic setting.
Portrayals of lesbians in the media suggest that society at large has been simultaneously intrigued and threatened by women who challenge feminine gender roles, and fascinated and appalled with women who are romantically involved with other women.
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.
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