The Skinny on STI risk between women
STI risk charts are so so heteronormative! So I’ve summarized the information from the few resources I’ve found so you don’t have two weed through pages of info that focusses on straight, gay and bi sex, and doesn’t center lesbians.
In General – Safe Sex Between Women
Good news, in general the risk of the activities women do most often together is pretty low. Transmission via fluids involving the mouth is also pretty low risk (unless there are cuts or sores) because the mouth has evolved to deal with bacteria and such in food.
Plastic wrap and dental dams
If a woman is on her period, or there is broken skin on any of the places that will touch or be touched, you might want to use some non-microwaveable plastic wrap as a barrier. The microwaveable kind has little invisible holes in it, which doesn’t work for this purpose. Plastic wrap is larger and easier to hold on to than dental dams, a lot cheaper, thinner and generally tastes a lot better. Dental dams have a nasty latex taste and are so tiny there’s not much to hold on to, expecially when they get wet. Plastic wrap is also easier to explain to your mother if she finds it in your bedroom. This? Oh I was wrapping a sandwich…
Gloves
Tight fitting latex gloves are used by a lot of women, to protect your lady from roughness or nail edges, if you aren’t able to wash your hands, or again if you have broken skin on your hands.
General risk and safer sex info for sex between women
Lesbians are at slightly higher risk for bacterial vaginosis, but for everything else we are the same risk for things that are transmitted by kissing and touch, and a lot lower risk in general. Keep in mind that anything (toys, body parts) that gets coated with fluids from one woman should get thoroughly washed or covered in latex before going into another woman, and anything going in the back door should be thoroughly washed or covered in a latex condom or glove before going anywhere else. When having sex involving a penis, it should be covered with a condom if it is going into someone’s body. If you have both been tested, are negative for everything and are having sex only with one another (as long as everyone is honest about this) then your risk from everything is low (even without barriers) except Bacterial Vaginosis.
This is a really good summary of the basics from the British National Health Service (who knew?) on sex between women. Most of the information below can be verified there.
Trans women
When it comes to STI risks, what is in your pants does factor into how transmission occurs, and much more is known about sex between humans when one or both have a penis, than if both of you have a vulva. If you are a woman with penis or sleeping with one, your STI risks for various activities are going to be similar to other combinations of humans with your particular body parts. Here is a good source of information on those combinations. If you or your lover have had gender confirming bottom surgery, here is a resource that has some information on STI screening and risks.
Types of activities and how to have safer sex
Oral sex
Low risk in general. Avoid if one of you has cuts or sores on the mouth or lips, or use some plastic wrap or a dental dam.
Hands and sex toys
Clean thoroughly or put a condom or glove on it between women or body openings. If you are putting your whole hand (or most of it) into someone, there is a greater risk of small tears which increases risk of transmission, so a glove and a lot of lube is recommended. The risk for the woman giving is usually low or neglible. The women on the receiving end is higher risk.
Types of STI’s women tend to get from other women
Most of the STI’s women get from other women are the ones that can be transmitted by kissing, touching or fluid to skin contact.
- Bacterial Vaginosis – Is not necessarily a STI, but women who have sex with women get it more frequently. This might be because hands are not always freshly washed or gloved. Treatable with antibiotics.
- Chlamydia and Gonorrhoea- Can be spread if fluids from a vagina with an infection get on the vulva, mouth or anus of the other woman, or from a non-clean or unwrapped sex toy. More info Both are usually tested for using a urine sample. Gonorreah may need to be tested for with a swab depending on the part of the body you have it in. If you have a neovagina its better to request being tested with a swab as well . Gonorrhoea is treatable with antibiotics. Get tested for this one regularly if you are sexually active.
- HPV – You can avoid getting this by getting vaccinated against it. HPC can give you cervical cancer, and is the reason we have PAP tests. It can go away on it’s own, but cervical cancer is bad, so get your vaccine or regular PAP tests. You can get it from kissing or basically any kind of sex, so there really isn’t a good way to avoid getting it other than a vaccine. Generally doctors recommend getting the HPV vaccine (for all genders) in childhood to guarantee getting it before becoming exposed and exposure to this one is so common, but you can get the vaccine as an adult.
- HSV (Herpes Simplex) – Also not necesarily a STI. You can get this from kissing or any kind of sex. If you have ever had a cold sore, you have HSV. Basically anywhere the sore touches down can infect the other person. HSV is most easily transmitted when a sore is active, but can be transmitted when you don’t have a sore, which is why so many people have it, mostly in mild forms or even without symptoms. There are antiviral drugs you can take to manage it and prevent transmitting it to others if you do get it, but it’s not currently curable. Check out this link for more info from the CDC
- Syphilis – spread by close skin contact, so basically anything can transmit it when a person is infectious. Because of this is it hard to prevent other than by regular testing. Syphilis is treatable but noticeable symptoms may be mild. It’s a good idea to test for this one regularly if you are sexually active as if it is left untreated it can cause serious nerve and organ damage. They test your blood for antibodies to it. More info here
Diseases lesbians aren’t very likely to get
HIV – This disease spreads through fluids, mostly blood or semen. Saliva isn’t good at transmitting HIV, vaginal juices neither, so if your sex doesn’t involve semen or blood to blood contact, your risk here is extremely low. There have been been only 6 reported cases worldwide of sexual transmission between cis women. Here’s an example, showing how they thought it was transmitted. There was a study of lesbian couples where one had HIV and the other did not, and during the six months they were studied, no one got HIV from their partner, even though they had unprotected sex the whole time. The risk isn’t zero, but it’s really really low. If there is potential for blood to blood contact, such as a cut on your hand or mouth coming into contact with her menstrual blood, then you might want to use gloves or wrap to be completely sure.