If you're a queer woman, finding accurate sexual health information can be tricky.
You might have had a negative experience asking a GP, or simply not been given the right information at school.
These are both issues Dr Ruth McNair, a GP and LGBTQIA+ health researcher, and Lee Wang, from the LGBTQ Women's Health Program at ACON, have seen first-hand in their work.
We asked them to break down some common questions from women who have sex with women.
And a heads up: Safe sex for you is going to depend on the kind of sex you're having, and who with — so if you're trans (more tips below!) or bisexual, you might have different considerations.
Do queer women have lower rates of STI transmission?
Short answer: No.
"There's just a prevailing myth that women who have sex with women can't get STIs, which is just false. That's just not true," Ms Wang says.
Dr McNair says studies have found homosexual women have about the same rates of STIs as heterosexual women.
However, she adds that "bi women have a higher rate than both of those groups".
As a queer woman, what STIs should I ask my GP to test for?
Dr McNair says the most common STIs among women who have sex with women are:
- Herpes simplex
- Human papillomavirus (HPV)
General STI checks would usually check for chlamydia and gonorrhoea, which Dr McNair says are less likely, but still possible, in queer women. These tend to be tested with a urine sample.
Other common infections that can be related to sexual activity include:
"You'd definitely want to get a high vaginal swab, because that would pick up candida and BV when other tests wouldn't."
She adds that cervical screening (pap smears) are important too, and that the queer community tends to be under-screened.
Dr McNair says you may also need to consider additional tests such as an anal swab.
Ms Wang says that your STI risk is going to be dependent on "who you are, what kind of sex you're having, and what protection you're using".
"You need to just be frank with your GP and describe the types of sex you're having in detail to make sure you get the best advice."
Dr McNair agrees that providing enough information is "really important", to determine whether tests for blood-borne viruses (like HIV, hepatitis B or C) are necessary, as these are generally less common in women who have sex with women.
How effective is a dental dam in preventing STI spread?
A dental dam is a thin rectangular sheet of latex that is stretched across the genitals, acting as a barrier during oral sex.
For women having sex with women, Dr McNair says dental dams are "not that useful, pretty difficult to get, and quite expensive".
"All they would prevent is the transmission of herpes during oral sex."
She says that it's important to regularly check your vulva for bumps or lesions, which could indicate herpes. If you do have a lesion around your genitals or mouth, she says you should use a dam, or avoid having oral sex at that time.
How to safely use sex toys in the bedroom
If you're using sex toys, condoms are your best bet, and should be used with water-based lube rather than silicone lube (as silicone lubricant can damage toys and condoms).
Alternatively, Dr McNair says you can wash your toys with warm water and soap between every usage.
Safe sex and hygiene are important even if you and your partner are monogamous, as Dr McNair says, "a lot of women carry bacterial vaginosis or candida".
And these aren't just from sex — they can be caused by smoking, antibiotics, or any number of factors.
"For you, bacterial vaginosis or candida might not be problematic at all, but if you spread that to your partner, they might then get symptoms like nasty discharge or urine pain."
Keep things safe and clean
Whatever kind of sex you're having, including penetration, Dr McNair says it's important to make sure your hands are clean and washed.
In addition, she suggests keeping your nails are nice and short, taking off any jewellery, and using lube where needed.
"Lube is really important to reduce damage, so that you're not creating any little nicks or cuts that could cause problems."
Extra tips for the trans community
If you're a trans or non-binary person with a vagina, most of the above tips will apply to you too.
If you're a trans woman or non-binary person with a penis, whether these tips are applicable will depend on what kind of sex you're having.
If you're using your penis for sex, Dr McNair says the safest practice is to use a condom. This also applies to oral sex, as "there is still a risk of giving someone gonorrhoea or chlamydia in their throat — which often has no symptoms — or picking it up".
Dr McNair says you may also need to think about contraception.
"For trans women [or non-binary people] who are on estrogen, most of them would find they don't have any sperm, because their testosterone is really low," she says.
"But some trans women do have active sperm, might be fertile, and needing contraception."
Dr McNair says trans men and non-binary people will usually find taking testosterone stops them ovulating — you can usually tell if you've stopped getting periods.
However, if you've "been a bit late to take your T shot, or forgot to put your gel on for a couple of days, you may be at risk of pregnancy if you have penetrative sex with someone with sperm".
Ms Wang adds that if you're a partner of a trans or non-binary person, it's important to be "open, active and honest" in your communication.
"You want to be communicating really openly about where and how they want to be touched, because you don't want to be causing any dysphoria in the bedroom."
This is general information only. For personal advice, you should see a qualified medical practitioner.
Editor's note: This story has been updated to differentiate between common STIs and infections that can be related to sexual activity. An incorrect reference to AIDS has been removed for accuracy.
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