A lesbian women’s guide to sexual health, from dental dams to latex gloves
“Um, I feel like I’m wearing a nappy," declared one of my ex-girlfriends in the heat of the moment. Not quite what I wanted to hear. We were following safe sex advice for lesbian women and trying to use what's known as a 'dental dam'.
For the uninitiated, a dental dam is basically like a condom for oral sex. Essentially, it's a latex sheet you lay over your partner’s genitals before going down on them.
Using dams and latex gloves (for intimate acts) is the ‘go to’ safe sex advice for lesbians. But, in reality, I don’t know anyone who uses them.
A lesbian sex survey back in 2015 by Autostraddle (‘a digital publication for LGBTQIA+ humans') showed that nearly 60% of respondents reported never using protection, around 20% rarely did and only 6.7% used protection every time they have sex.
Many queer women feel immune to STIs, but the reality is we're not.
Psychologist Dr. Lori Beth Bisbey, a sex and intimacy coach specialising in relationship and gender diversity, says it's “absolutely necessary” for queer women to take their sexual health seriously.
“Vaginas are more susceptible to sexually transmitted infections [STIs] than penises are," she explains. "Lots of STIs are 'sleepers' – i.e. they may have no obvious symptoms but can cause lots of problems later.”
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Lucy Rowett, who describes herself as a sexologist and 'intimacy coach for women and vulva-owners', feels it’s easy to forget STIs are transmittable because “sexual health for queer women is rarely talked about in standard sex education classes. It can seem like you don't need to take precautions, but you do.”
Also, it doesn't help that most sexual health clinics focus on heterosexuals and gay men. Queer women like me are an underserved demographic.
Lack of understanding
The advice we’re given can feel generic, like it’s coming through a heteronormative lens with a lack of understanding of queer sex.
A common complaint is we’re told to use dental dams and gloves for oral sex and fingering but heterosexual couples usually aren’t.
Relationship therapist Yana Tallon-Hicks thinks gloves and dams aren’t discussed as safe sex strategies among cisgender heterosexual couples because oral sex and digital penetration are deemed “foreplay” and “not the main event” in the hetero world.
“Condoms and birth control are top of the tree because of the increased risk of STI transmissions via penis and vagina/anus penetration and pregnancy,” says Tallon-Hicks.
Perhaps this point and what sexologist Rowett describes as a “societal script” where only “penis in vagina” sex is considered “real sex”, adds to the general ignorance and stigma around queer sexual health?
Rowett cites “the sad statistics that heterosexual women are far less likely to receive oral sex during casual sex than heterosexual men” and the “lack of focus on female sexual pleasure” as to why gloves and dams aren’t widely used in the straight community.
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Passion-killing protection
However, Bisbey believes dental dams and condoms for oral sex are standard advice for heterosexual couples and stresses, “barriers are best practice when engaging in any kind of sex where there is a fluid exchange.”
Oral sex is the most obvious example, but she points out that fluids can also enter the body during fingering, via a graze or a cut.
But these barriers turn sapphic fun into an unsexy faff surely? Bisbey sets me straight: “That’s the complaint of every heterosexual man too!”
She’s right. When I slept with guys who didn’t want to use protection, my response was, “If it’s not on, it’s not on!” And yet, as queer women, we seem more inclined to play Russian roulette with our sexual health as if the rules don’t apply.
The risks
So, what are the risks to women who sleep with women?
“Many of the same STIs as straight people and queer men,” says Bisbey, including herpes, genital warts gonorrhoea, HIV and hepatitis C. The risk of transmitting some STIs is lower than straight sex and gay male men, she says, but points out that there’s a “suggestion of a higher rate of hepatitis C and bacterial vaginosis among queer women."
Rowett reminds me we don’t need to be having any form of penetration to be at risk from herpes, genital warts and syphilis. These are spread through contact alone. She advocates taking precautions with any partner "where you don’t know each other’s STI statuses."
This is particularly vital if you share sex toys, or give or receive oral sex. Remember Chlamydia, gonorrhoea and HIV are spread through exchanging bodily fluids.
When it comes to HIV, the resource Aidsmap.com says: “Female-to-female transmission [of HIV] is extremely rare, with only a handful of reported cases.”
It suggests HIV-positive queer women may have contracted the virus through sleeping with men or injecting drugs. However, it does add that “transmission is possible through sharing of sex toys and exposure to blood during sex.”
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Raising the issue
So, how do you bring up STIs and screenings with a new partner?
Rowett recommends a “non-sexual setting, like over a meal or a glass or wine”. Basically, when you’re not in bed. She suggests using “I” statements and talking about why this is important to you and how it makes you feel. Finding support from like-minded queer women, online or in person could help.
“That way you feel less alone and less like you’re the crazy one and, crucially, that your needs matter just as much as your partner’s,” she says. “Remember you deserve to feel safe and have your sexual and emotional needs met and your boundaries respected.”
Hicks says if you feel strongly about using barriers like the dental dam, but your partner is dismissive or rude, “then you’ve saved yourself the hassle of sleeping with someone who is sexually incompatible with you. If they can’t hear your safer-sex boundary it speaks volumes. Don’t have sex with them.”
I couldn’t have put it better.
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