Lesbian Safe Sex 101: The Doctor Is In (Also, the Cartoonist)

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.

Our very own Technostraddle editor Taylor has provided some cartoons for you to enhance your learning experience. For more of Taylor’s cartoons, you should check out DoodleShroom!+


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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!

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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.

HPV

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

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.

YEAST INFECTIONS/CANDIDIASIS

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.

The following things never helped: Monistat, AZO, Gyne-Lotrimin, tea tree oil, yogurt, cotton underpants, acidophilus, hydrogen peroxide douching, garlic, etc.

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

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
but
well, bacteria
i dunno
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
package food
eat ass
make love to AIDS
swaddle marijuana for cross-country air travel
Laneia: mte
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.
3. http://www.cdc.gov/hiv/topics/women/resources/factsheets/wsw.htm
4. http://www.nhs.uk/Livewell/LGBhealth/Pages/lesbianhealth.aspx
5. Carol, NM. Gynecologic and obstetric care for lesbians. Uptodate. January 2010


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This article is intended to educate, but is in no way a substitute for medical advice / attention and that the opinions expressed are those of the author and no the institution with which she’s associated.
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83 Comments

  1. Thumb up 0

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    I got the gardasil injections back when it was free in Australia, so I hope it doesn’t turn out to cause mutation or something. Or if it does, I hope it’s the fun kind of mutation that lets me fight crime.

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    I just wanted to chime in a shout-out for the Boric Acid remedy. Don’t be afraid ladies, because Boric acid is the best thing that ever happened to you if you suffer from chronic yeast infections. Like me! In fact, even though the doctors say it’s not really possible, or at least not common, I managed to have both BV and yeast at the same time. Boric acid deals with them both.

    You might think it sounds like it’ll burn you, but it totally doesn’t (in my experience). Just don’t eat the stuff. Fill up your capsules, tuck one or two inside, wear a panty liner cuz it’ll make you all watery for a while, and boom, you’re good to go.

    She didn’t mention it above, but it’s worth saying that if you suffer from chronic yeast infections, you probably need to take stock of your whole diet and lifestyle. They probably will keep coming back until you figure out what is amiss. Stop eating sugar, for a start, and then start doing some research.

    Three cheers for happy healthy lady parts!

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    …and she thought I was crazy when I told her to use a condom with the strap on.

    WHO’S THE CRAZY ONE NOW, HUH?

    If she hadn’t blocked me on every social networking site, I’d be linking her to this just to web-smack her.

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    I talked about dental dams once in a group of gay-dies I had just met at a bar. It was a weird situation. None of us knew anyone who used them. Then a girl asked me where to get some. I said I wasn’t sure, but maybe you could awkwardly ask your dentist? I mean, they probs order them by the case for actual dental work, they wouldn’t miss a few… ;)

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    Gardasil was free for every woman in australia, and was fine for me and all of the women i know. having free vacinations is one of the things i like about australian medicine

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    fact: i think the only people i’ve ever slept with who have even brought up dental dams were dudes. also i think you can make them by just cutting a regular condom open up the side, so there’s that if you’re really looking to get your hands/mouth on one.

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    I am so curious when it comes to dental dams. My next girlfriend will be the victim of this curiousity, I think. And I read about cutting condoms open, too.
    Cause here’s the deal: in Europe, condoms get tested (if they’ll hold, if something could possibly get through and so on…), but dental dams don’t!! they’re for fun, it seems, and if you buy one you can’t be sure it’s been tested by european standards. thumbs down and blääääääääh! (and yeah, this one even gets german vowels)

    and as someone who’s had herpes labialis for nearly her whole life: don’t get it. I mean, it’s too easy to pass it on and I can’t say I haven’t, and I even got it out of the stupidity of some family member who just HAD to kiss me (cheeks? mouth?) when I was about 8 or 9. thanks ya’ll. It doesn’t go away. I’m just pretty happy it’s not the genitalis kind, but it’s still annoying.

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    also, the doctor thing is crucial. demand a good one, especially as a gay lady. the first time I went to my doctor because of sexual health angst was a catastrophe. it’s a shared practice, so I got her (yes. HER.)as my doctor out of bad luck or something.
    I’d been freaking out because of unprotected sex and after hearing me out about being confused and not knowing what I should get tested for she looked at me and said: “Couldn’t you have googled that?” I tried to discuss the topic with her and her genius conclusion was that my problem was that I had had sex with a woman. she didn’t test me for anything at all and after that all that was left for me was calling her boss.

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      A DOCTOR told you to GOOGLE? Wow. Really, the mind, it boggles.

      I thought it was bad that I had to explain to my (lovely but ancient) Doctor what a lesbian was when I told him that I was definitely not pregnant despite non-condom use. But go google your problems? That takes the cake.

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    Ok ladies and gents here is the deal with dental dams from my perspective. I used them at the beginning with my last gf because I was tired of worrying about potentially getting something/ passing something on even though the risk is super low between women (we’d both been with men in the past). Having a dental dam over my lady garden when receving didn’t really feel much different for me honestly as long as there’s lube happening whether natural or from a bottle. Giving with a dental dam feels like licking a vagina with a layer of plastic over it and it takes some getting used to. I think it makes things less intimate at least in the beginning but then again there’s nothing particularly intimate or sexy about infecting anyone with anything and it’s obviously always important to keep your partner happy and safe. We stopped using them when we got tired of them and I wasn’t as anxious about stuff.

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    I have used a dental dam before which makes me feel like a mystical creature, like the lady licking unicorn of this comment thread.

    I didn’t use them regularly because I am uncoordinated and trying to maneuver latex while doing something else is not my strong suit.

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    Dental dams are so freaking expensive (in Cali they are $12 for a pack of three at Pleasure Chest!). I mean I could just save money and use wax paper taped to my girlfriend instead.

    But I do see why they are a taboo subject for most lesbos, one of the perks of being a woman loving woman is that you can’t get knocked up and let’s face it that is the only reason heteros use condoms, not because they are afraid of getting a STD.

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      i do like butch tops, but oral anal makes me think of that guy in my dorm freshman year who told me about how this girl “tossed his salad” and the way he described it scarred me for life.

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    well..i havent had my cervarix jab yet..planning to..
    and good thing, me and my partner have this good gyne who understand us..
    dental dams..ewww..haha sorry but thinking abt trying sucks:/
    uhmm..JUST BE HEALTHY AND CAUTIOUS..fun is good but need to think about our health also…
    VISIT YOUR GYNE ONCE IN A WHILE..no harm:)

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    While I found this article interested, my jaw dropped when I saw your info on yeast infections. A third year med student? My first-year nursing students could tell you why a doctor should never prescribe anything over the phone to a patient they haven’t seen for those particular symptoms, at that specific time. It has nothing to do with the patriarchy of the medical profession (though I’m not denying that exists) and everything to do with not over/mis-prescribing meds. I get bronchitis fairly frequently and need to go on antibiotics. About 75% of the time I think I have bronchitis, I’m right – and the doctor finds out by listening to my lungs and she gives me my antibiotics. 25% of the time I’m wrong, which the doctor finds out by listening to my lungs and she tells me I don’t need antibiotics and I should just take in fluids and rest and I will get better. She’s never been wrong – I’ve rested up and avoided the cost of prescriptions (as well as the harm they do to the normal microbiota in my body). But is her refusal to prescribe me azithromycin over-the-phone a sign of her being a bad/patriarchially-biased doctor?

    The answer is, of course, no. I REALLY hope you figure that out before you move from med student –> doctor, or, if you don’t, let me know so I can know never to go to you.

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      I realize that this response is about a year late, but as the original author of this article, I would like to point your attention to the fact that above the yeast infection it says “The Doctor is Out.” While I realize that this was not clearly portrayed, I did not write any of the information on yeast infections, nor did I agree with its inclusion in the article. I was not given final editorial control over this article and was actually quite upset to see its inclusion in the article, considering it contains information that is not medically accurate. Yeast infections are not by definition sexually transmitted infections. Furthermore, as you mentioned, I would never prescribe something to a patient or recommend that they take anything without having seen them first.

      I apologize for the fact that this was not clear and certainly agree with your assessment that a doctor should never prescribe a drug for a patient without having seen them.

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    Saran wrap used to be made of a unique plastic, polyvinylidene chloride (a.k.a. “saran”) that had a uniquely small pore size and was shown to be an effective viral barrier. That’s why it’s often mentioned in safe-sex advice.

    This is out-of-date information. The manufacturer changed the formulation in 2004 to get rid of the chlorine (a big manufacturing toxin, although not an issue in the finished product), so it’s no longer the same polymer, and doesn’t offer the same protection.

    So sorry; it was thinner, clingier, and much wider than dental dams, which made it very convenient. But the stuff sold these days as “saran wrap” is interchangeable with any other brand of plastic wrap.

    Kyle: plenty of us don’t have a doctor. It’s over the counter, overseas pharmacies, or nothing. Advice to speak to my doctor is as useful to me as advice to speak to my butler.

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    Aaaand I just discovered this article now, but it’s STILL RELEVANT!

    Boric acid is THE WAY TO GO! Fixin that PH, hell yes. If you have a gyno and you’re squeamish about making your own capsules, you can ask her to prescribe them and get a fancy drugstore to make em up for you all nice and medical-fancy! They can be expensive–$40 for 20 in NYC, watch out.

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    Oh man, yeast infections. DO NOT WANT.
    But thanks for this article! It’s well written, and as an artist I appreciated the cute illustrations. I think I’ll be showing my friends the STDs, they’re pretty on-the-spot.
    Personally, I don’t think I would risk anything without a dental dam. But thats as a previous germ-o-phobe.

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    Boric Acid powder is generally a benign (doesn’t hurt you) chemical that is used in ears and eyes (as a wash) to make where it is used a bad place for bacteria, yeasts, molds and fungi to live in. It increases the acidity a very little bit – just enough. It is way less acid than is vinegar and is less harsh.

    It is used as a roach killer to disrupt its digestion. You can dust it around where they go when you turn on the lights, and it is safe for humans (some restrictions with very young kids) and animals. Just don’t be stupid about it and snort it or eat a lot of it.

    Just be careful with it (as usual) around young children.

    More here http://en.wikipedia.org/wiki/Boric_acid

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    Sooo the info on HPV isn’t totally right. I have HPV and the standard clinical test does not give information about what strain you have. Also, the test is not given for the “wart” version; you’ll test positive only if you have an active, contagious “cancer” version.

    Also, HPV only lasts for about two years, especially for younger people. You should only be contagious for two years, and you will only test positive during that window.

    Please rethink this paragraph:
    “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.”

    It’s clear on second inspection that you mean, “Get a pap smear to see if you have cervical cancer, because you don’t want cervical cancer to progress.” However, it initially reads as if there is a cure to HPV, and you need to catch it early. There is no cure.

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    As someone with HSV-1 both oral and genital…it’s really hard not to get it since you can get it by kissing, and sometimes the lady you’re kissing doesn’t have a cold sore when you start kissing them, but then after you’ve been dating for six months they get one and they’re like “oh yeah btw I get cold sores” and then you realize you’ve been kissing/having unprotected oral sex with someone who has HSV-1 for six months. We tried using dental dams but couldn’t get them to work…and although we tried to be safe I ended up with both areas infected.
    HOWEVER
    I still have great sex. (Although the greatest sex was with the girl who gave me HSV-1 so I can’t even be too upset about it.) Herpes is permanent, but it’s not the end of the world. Since I’d guess that herpes is probably the most common std among women having sex with women, I was surprised to see just one paragraph on it here.
    The virus itself isn’t bad, the worst thing is the stigma. So a word of hope to anyone who has/gets hsv: it’ll all be fine. People will still want to have sex with you. Some people will still even want to have unprotected sex with you. Know the risks, talk to your doctor, and make sure your partner(s) is educated, and it’ll all be fine.

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