Why women who have sex with women need to get tested for STIs

By Nina Pine

Unfortunately the magical unicorn of in-built immunity doesn’t exist

It’s a common misconception that women who have sex with women - lesbians, bisexual, fluid, or queer-identified women for example - don’t need to be tested for STIs (for the rest of this article I will refer to women who have sex with women as “queer women,” not to oversimplify or homogenise identity *you do you* but for readability). Unfortunately, the magical unicorn of in-built immunity doesn’t exist. Regardless of sexual orientation and/or gender identity, all people are susceptible to STI transmission if they have unprotected sex. Remember, unlike Donald Trump, STIs are non-discriminatory.

According to the NHS, the most prevalent STIs amongst lesbians include chlamydia, gonorrhoea, genital warts, genital herpes, and syphilis. One study in Seattle also found that lesbians had higher levels of bacterial vaginosis (BV). While BV is not an STI in and of itself, it may increase one’s chances of contracting an STI at a later point. At the same time, trans* women globally are a high risk group for HIV transmission. While it may not receive much media attention, it is still crucial to note that queer ladies, too, must be wary of STIs.

How are STIs transmitted during queer lady sex?

You're more connected than you think

You're more connected than you think

While data on the sexual health of queer women is (irresponsibly) limited, we do understand how STIs transmit in general. Think of “The Chart” of Shane’s sexual adventures in the L-Word (see left), but just add chlamydia to the mix (sorry not sorry!). Also keep in mind that some queer women sleep with cis-men or have done so in the past, which can also play a role in transmission.

For queer lady sex specifically, STIs can be transmitted through oral, vaginal, and anal sex when fingers, hands, or sex toys come into contact with infected cervicovaginal secretions or through direct mucosal contact. Common viral STIs such as HPV and herpes can be transferred through skin-to-skin or mucosal contact too. And while most folks may not want to actively think about infected mucous, your sexual health and happiness should be a priority.

Here are some NHS approved safe-sex tips to help mitigate the muscous malady:

  1. If you’re using toys, make sure you clean them effectively for each partner and between penetration of different body parts. For further information on keeping sex toys clean, check out Good Vibrations’ advice.
  2. Avoid oral sex if you or your partner have cuts or sores on the mouth or lips, or use a dental dam. It’s important to note that dental dams are not widely accessible, are not commonly used, and have the absolute worst name. And while a more user-friendly method needs to be designed, they can still reduce transmission.
  3. Wash your hands before and after sex. And in general, proper handwashing is good for your health!

Queer women of the world, get tested!

Queer women face numerous barriers to having protected sex, from a lack of access to culturally competent medical care to poorly-designed protection (looking at you, dental dams). But lack of information shouldn’t be an obstacle to self-care (hopefully, this blog can add to the ongoing dialogue?). So, the moral of the story: get tested no matter your gender identity, sexual orientation, or preferred sexual activities. You can find a local clinic or home testing service at sxt.org.uk

Nina Pine is a health promotion specialist and member of the #ContraceptivesUX project - chat to her on twitter.