Here's a handy guide to safe girl-on-girl sex! Medical staff was consulted for this article, but it is not a substitute for medical advice/attention.
Before writing the following piece, I read Natalie's Why Are Gay Ladies So Afraid of the Gyno? Everyone seemed to have a lot of questions about sexual health and I was hoping I could help answer some of them! Unfortunately, I also noticed some antagonism towards doctors in general, which seemed to be fueled by the negative experiences a lot of you have had. Believe me, I get it - I've been there.
But, speaking from the perspective of someone who's inside the system, choosing not going to the doctor is not the answer! While medicine is a patriarchal and hierarchical institution, there are plenty of us who are working to change that.
I personally conduct a lot of LGBT health education and there's a real push to ensure that the next generation of medical professionals is one that'll recognize that not all women are heterosexual baby-makers (nothing wrong with those!). Change takes time, sure, but your health shouldn't suffer because of a doctor who isn't as enlightened as you'd hope.
Girl You Need To Get Yourself Checked Out
It can be pretty difficult to discuss queer women's health issues 'cause there just hasn't been much research done on the rates of sexually transmitted infections (STIs) and HIV in women who like to ride the hobby horse with other women.
I've learned just from talking to my friends and other sapphically-inclined ladies that most of y'all are not having safe sex! We don't worry about unplanned pregnancy and most lesbians seem to think that we don't have to worry about contracting STIs from our partners either.
Howevs, statistics show that at least 75% of women who identify as lesbians have had sexual intercourse with men and approximately two-thirds of the time, those women were engaging in unprotected sex 1.
This means that if you or your partner have Had the Sex with a dude, and hasn't been tested, your risk for STIs and HIV is comparable to that of a heterosexual woman!
So hayyy you should get tested. As Natalie discussed in her articles, queers (like other marginalized groups of women) tend to frequent the gyno less often for a lot of reasons.
But don't let negative experiences with narrow-minded providers stop you from taking responsibility for your sexual health and for your partner's sexual health. If you don't have insurance, most free clinics do STI testing at very little cost, or for free. Do it!
STIs: Getting Them & Getting Rid of Them
This is by no means a comprehensive list of the STIs out there, but I want to hit on some of the more common infections and the ones that stick with you once you get infected.
Human Papilloma virus is probably the most common STI in the USA, with some statistics estimating that up to 75% of sexually active adults in the US demonstrate a history of the infection 2. HPV is transmitted by skin-to-skin contact. This means that even if you only have sex with women, you're still at risk for infection. This virus is sneaky too, because it can lay latent in your body, so without being tested, you may never know you have it. If you have had sex with a man in the past, you are at increased risk for contracting (and transmitting!) HPV. This is important, because a history of HPV infection is the single most significant risk factor for developing cervical cancer.
Some strains of HPV cause genital warts and two strains in particular have been identified to cause over 75% of cervical cancer. Butttt some strains aren't cancerous. In fact, some even clear up on their own!
But how do you know which strain you have? Get a pap smear! Cervical cancer takes years and years to develop, so going to the gyno and having them take a look-see gives you a darn good chance of never having the disease progress any further.
Also, if you're under the age of 26, you may want to think about getting Gardasil, the HPV vaccine, which covers two strains of HPV that are responsible for 75% of cervical cancer and another two strains that cause up to 90% of genital warts AND is covered by many insurance companies now. But it's worth noting that being vaccinated is a personal decision and should be an informed one, so read up -- there's been a lot of controversy around Gardasil. Perhaps you have feelings?
GONORRHEA & CHLAMYDIA
Two fairly common STIs and another reason to get tested. Gonorrhea and chlamydia can be transmitted through sharing toys, bodily fluids, and genital contact. These infections can be silent, or can present with symptoms like burning when you pee, discharge and stomach pain. Luckily, both are easily treated with a quick dose of antibiotics. Without treatment, however, gonorrhea and chlamydia can progress to pelvic inflammatory disease, which can cause infertility, ectopic pregnancy, and serious infections, among other things.
Bacterial vaginosis is another easily treatable sexually transmitted infection. Interestingly enough, queer women seem to be at increased risk for transmitting and acquiring the infection. This one can also be silent, or may announce itself with white-ish discharge and a fishy smell, but is usually not itchy or painful. We're not exactly sure how it's transmitted, but the likely routes are through sex toys, oral and oral-anal sex 5. One important note about this infection: usually when one partner has it, the other partner is often infected too. If you happen to find yourself with this infection, bring your partner with you to the doctor, and have her get tested as well.
Special Comment: THIS PORTION OF THE ARTICLE WAS NOT WRITTEN BY A MEDICAL PROFESSIONAL. It contains discussion of home remedies and opinions about personal care. It is not intended to be medical advice and does not claim to be.
HEY BITCHES! The doctor is out for a bit and you're gonna have to listen to me, your anonymous expert on yeast infections and how to get rid of them. This is important 'cause lesbians give each other YIs all the damn time.
It's a touchy subject with women's health experts: most docs refuse to prescribe Diflucan (the YI pill) unless you come in for an appointment, even if they've successfully diagnosed you in the past. COME ON NOW. (See: Tales of my Vagina, Or Why Women's Health is Totally F*cking Unfair) Butttt... apparently someone just invented a Vagisil Screening Kit, so perhaps our luck is changing?
Personally, I found my chronic yeast infections cleared up when I gave up men and the pill, except for this one time my lady-lover and I gave each other yeast infections which is sort of a long story. Also, she had a boyfriend. You know how it is.
Anyhow, plenty of gay ladies get YIs for a number of reasons, like taking antibiotics or chilling out in your Dinah Shore bikini for a bit too long, and 75% of all ladies will get at least one in their lifetime. I've never experienced the discharge most women do, but the itchiness and redness can be bad enough in & of itself, espesh 'cause it's taboo so you can't whine about it like you can when you've got a migraine or something.
Diflucan, a prescription-only pill, takes a few days to work, but it's worth it 'cause there's no mess. Howevs, as aforementioned, you'll often need a doctor's appointment which's a pain in the ass then as well as being a pain in the vadge.
Some friends tell me their YIs go away on their own. Lucky bastards. There was one proposed DIY remedy that sounded particularly bogus to me, and trust me it shocked my socks off when it turned out to be the only thing that works: BORIC ACID.
You get "0" empty vegetable capsules at your local health food store, pick up a tub of boric acid (in powder form) just about anywhere, and try not to freak out that it's often advertised as a roach-killer. Fill a capsule or two with the powder and pop those babies inside you every night 'til the infection goes away. It can also be used preventatively if you feel a YI coming on, that's the best part!
You should definitely check out this website, it's a great resource because as the author points out, "to my mind, the conventional treatment of vaginal yeast infections is a nutshell of what's wrong with the way our society deals with wimmin's health issues."
Okay, back to the doctor now...
These Things Never Leave
So, we saved the best and by best I mean worst infections for last! Herpes! And HIV! 'Cause see once you get HIV or Herpes, you've got it for life.
Herpes can be transmitted through oral or genital sex. There is treatment for herpes, which will cause you to have fewer outbreaks, but won't cure you. The tricky thing about herpes is, even if you do not have an active sore, you can still transmit the infection to your partner. However, there are ways to predict when you are infectious, so talk to your doctor.
HIV can be transmitted through blood, genital secretions and breast milk, but not saliva. There aren't a lot of statistics out there on risks of HIV transmission in queer women. Overall, the general consensus seems to be that transmission is possible 3. However, as I've stressed before, if you are a woman who has unprotected sex with men on a regular or occasional basis, then your risk for HIV infection is comparable to that of a heterosexual woman, and if you are not tested, your partner's risk of infection is also increased.
Safe Sex: Not Just For Straight People
Sex is sexy! Talking about safe sex, on the other hand, can be a bit of a drag. Get over it! Knowledge is sexy and I'm about to make you smokin' hot.
Dental dams are one barrier method that can help prevent the transmission of STIs.
Brief interlude between our Editor-in-Chief Riese & Executive Editor Laneia, which took place as we were tag-team editing this article -
Riese: can we just be straight about dental dams
like do people really use them
Laneia: i don't know?
like, i want to use one now
b/c i honestly want to know what the fuck's up
Riese: i have some
given to me by planned parenthood
Laneia: there's a mention of dental dams in some erotica i read two weeks ago,
she needed it for anal
oral anal on the butch top
you still with me?
Riese: oral anal to a butch top
not gonna lie
i am not going to be giving oral anal to anyone
probs never in my life
which is fine, i'm not judging
Laneia: but if you DID, you'd use a dental dam
Riese: oh yeah
Laneia: then you could lick from ass to vadge w/out worrying about spreading anything
Riese: or i could just not do it
Laneia: mhm or that
i don't know if i'd necessarily want to either, but i'm not ruling anything out
especially if there's saran wrap involved
AND YOU CAN QUOTE ME ON THAT
Riese: i'll do anything that involves saran wrap
make love to AIDS
swaddle marijuana for cross-country air travel
Riese: do you ever see porn with people using dental dams in it
Laneia: no, but i haven't watched a lot of porn
Riese: me neither
Laneia: i bet if you emailed someone who does, they could tell you. you could email sugarbutch.
Riese: but i don't know if i want to be like, hey whats up, ever used a dental dam
Laneia: noooo you'd be asking if they've ever watched PORN in which a dental dam was used
Now back to the article...
However, if dental dams aren't your bag, there are still plenty of things that you can do to insure a safe and sexy time is had by all. Most are pretty much common sense.
1. Wash your hands before getting down and dirty.
2. Don't share sex toys and if you do, use a condom, or properly clean them with soap and water before switching to a new user 4.
3. And finally, one of the best things that you and your partner can do to protect yourselves and one another, is to communicate! Talk about your sexual history, whether you've had sex with men in the past, if you've been tested before and if you haven't been tested, (once more, with feeling! ... ) get tested!
I hope that this overview was informative and answered questions that some of you might have had. I would love to hear any comments, questions or other topics you'd like to hear about!
1. Diamant AL et al., Lesbians' sexual history with men: implications for taking a sexual history, Archives of Internal Medicine, 1999, 159(22):2730-2736.
2. Marazzo, JM. Genital human papillomavirus infectioin in women who have sex with women: a concern for patients and providers. AIDS Patient Care STDS 2000; 14: 447.
5. Carol, NM. Gynecologic and obstetric care for lesbians. Uptodate. January 2010