There is a huge gap of accessible information on queer sexual health. And it’s not just annoying and demeaning, it’s dangerous. Even many doctors aren’t informed on the ways in which queer and trans people have sex—making them unable to provide us with valid information on how we can practice safer sex. This often leaves LGBTQ people anxious and fearful to even go to the doctors with sexual health questions—let alone for regular checkups.
I’ve heard horror stories from so many queer friends about experiences that left them feeling like they never wanted to visit the doctor’s office again. I myself have had awful experiences of being slut-shamed or asked inappropriate questions about my sex life.
When OBGYNs ask questions like “Do you sleep with men or women?” I respond with “How do you define man and woman?” Because I think what they are trying to get at is what is genitalia the people I’m sleeping with have. But that question is problematic on so many levels: 1. It’s biphobic, as if you can only sleep with one gender. 2. It’s not inclusive of people who don’t identify as either a man or a woman. 3. It connotes gender with genitalia. 4. It ignores people who may be bisexual and polyamorous (dating more than one person).
While it is on the onus of doctors to do better for LGBTQ patients—unfortunately, we often have to learn how to advocate for ourselves. And empower each other with the knowledge about sexual health that just isn’t as accessible in this cis-heteronormative world.
Knowledge is power and when we know the questions to ask and we have access to the resources we need, then we are able to be in control of our own sexual health. To learn more about what exactly queer women should know about their sexual health, GO spoke with Aimee Uchytil, a Family Nurse Practitioner at Callen-Lorde Health Center.
1. Don’t let fear stop you from prioritizing your sexual health.
“One of the main barriers that queer women face are assumptions and invisibility in the medical word,” Uchytil tells GO. “For heterosexual women, there’s no real barrier in being honest about who you’re having sex with. This is a big deterrent for queer women to even go to the doctor at all. They’re afraid the doctor will judge them or not understand their concerns.”
The most important thing to remember is that you are your biggest advocate when it comes to your sexual health. No one else can take care of your body’s needs better than you! Listen to what your body is telling you and speak up for yourself. I know that can be easier said than done, trust me. It’s taken practice for me to be able to tell the doctor that yes, I want my blood tested for herpes because sometimes symptoms don’t show up right away and my anxious brain needs to 100% certain of my sexual health status.
The best thing you can do is be honest with your healthcare provider. And if they’re homophobic, then leave. And find someone who can give you the care you deserve.
In many cities, you can actually report doctors for being homophobic now. They probably won’t get fired, but they will be required to attend cultural competency classes—which might just give them the change of heart they need!
2. Yes, queer women can get STIs.
This is one of the biggest assumptions about people with vaginas who have sex with people who have vaginas: That we simply aren’t at risk of contracting STIs. I’m really not sure where this misconception comes from. Because it’s absolutely, 100% incorrect.
“STDs can be shared from skin to skin contact, fluid exchange and even sharing sex toys. A lot of providers don’t talk about it and if the patient doesn’t request additional testing, you probably aren’t getting tested for all STDs,” Uchytil says. “There are risks with giving and receiving oral sex and rimming. There’s a potential of parasite transition when it comes to anal play.”
A lot of people with vaginas don’t know that a pap smear doesn’t cover it all! Pap smears test for HPV or cervical cancer. You can request that your OBGYN also collect fluid samples to test for Gonorrhea or Chlamydia. They can also run a urine test for those but a blood test is needed to screen for HIV, Hepatitis B, Herpes or Syphilis. Uchytil explained to me that you can also transmit STIs in the back of your throat when giving oral sex, so requesting a swab of the back of your throat is also an important option to keep in mind!
“The best way to get rid of this stigma is to treat all patients the same,” Uchytil tells GO. “Give the same services to anyone who is sexually active. Instead of basing it off of who they’re having sex with. Patients can request testing as well. You can request whatever you need from your healthcare provider. Just ask!”
Practicing safer sex for queer women can mean anything from using dental dams or finger cots to covering your dildos with condoms. And getting tested regularly.
3. Sex toy care is so important.
Though people of all sexualities can and do use sex toys—it definitely can be a big part of how queer women have sex. And sometimes healthcare providers don’t even think to mention that toy care is then a major aspect of our sexual health.
“I always try to discuss toy care in my practice,” Uchytil explains. “You can boil glass and silicon-based toys. It’s also a good idea to put condoms over them. Just remember that anytime there is a fluid exchange, there’s risk. Sex is messy and that’s okay. Continue to get tested and practice safer sex methods.”
4. You may be educating your provider—instead of the other way around.
“Sometimes you may be educating your provider,” Uchytil explains. “It’s like dating to find a good match for you with a doctor. You can hope that they’ll want to learn with you and respect your needs—but if they don’t, find someone else. It’s unfortunate that in rural areas queer women may have to do more work. The awareness just isn’t there in some places.”
Queer women face different issues when it comes to sexual health. We have sex differently than straight women, so of course, our issues would not be exactly the same. And a lot of what we’re dealing with is societal barriers and access to resources. This may mean you’ll be going to the doctors and asking them to do follow-up research for you. Or make a special request that they order free dental dams for the office, instead of just providing condoms. Your sexual health needs matter. Make sure your doctor knows that and takes your concerns seriously.
“There are definitely different sexual health issues that may come up for women who have sex with women, then for straight women. Two people with vulvas can pass Bacterial Vaginosis (BV) back and forth to one another. While this isn’t a lifelong STD, it’s frustrating and comes with itching or off-smelling discharge,” Uchytil tells GO. “It might be alarming but it’s treatable.”
5. Prepare ahead of time to help with nerves.
“There’s a certain amount of anxiety that comes with any visit. But acknowledging that this is a difficult process for you is the first step. Remember that you are your biggest advocate. You may be met with resistance from your provider, but most providers want to respect what matters to the patient,” Uchytil assures us. “When you’re stressed or anxious about a visit—write down your questions in advance so you can refer back to them. Practice in the mirror before you go! Sometimes you might not have the language to explain what type of sex you’re having. Express it in a way that you’re comfortable with!”
Is that bump from razor burn or is it herpes? Is this a yeast infection of BV? Should I be douching before sex (Quick answer, the answer is always NO.)? How do I talk about having an STI with my partner?
These are all normal questions to have. Once we can get past the fears of talking about sex with our doctors, there are possibilities for more nuanced conversations about sexual pleasure.
“Just because uncomfortable things might come up, doesn’t mean you have to stop having sex. These are normal things anyone can experience,” Uchytil says. “It’s important to not freak out and then we can have an open discussion about it. Once we get past talking about the symptoms, we can have a more complex conversation about sexual pleasure instead of just focusing on fear.”