I’m a lesbian. What are the ACTUAL chances of me getting an STD? Does anyone really use dental dams?
Great question! Taking care of your sexual health is super important no matter who you’re attracted to. There’s a myth that lesbians don’t get sexually transmitted infections (STIs), but that’s just that– a myth. Lesbians can get STIs.
Some STIs can be transmitted through skin to skin contact, and there are still often bodily fluids involved in sex between two people who have vaginas. The risk of STIs is generally lower with sex between two people with vaginas, but there’s still a risk.
The only way to be 100% safe is to not have partnered sex. If/when you decide you want to have sex, it’s important to understand how to effectively reduce your risk.
Different sex acts carry different risks. Below, we talk through what you should know about different sex acts, and how to make them safer.
First though, let’s talk about STI testing.
Everyone who is sexually active should get regularly tested for STIs. It’s a normal part of taking care of your health, just like getting your blood pressure checked. Talk to your partner about when they were last tested, and what for. Ask your health care provider about how often you should get tested.
Oral sex (cunnilingus, eating out)
Unprotected oral sex puts you at risk for chlamydia, gonorrhea, herpes, HPV, syphilis, and hepatitis B, A, and C. In very rare circumstances, it is possible to transmit HIV. However, this would require that the person giving oral sex have cuts or open sores in or around their mouth. The chances of transmission are higher if the giver has gum disease, or the receiver is on their period.
To make oral sex safer, use a dental dam. A dental dam is a thin piece of latex that you put over a partner’s genital area for oral sex or analingus (rimming). This creates a physical barrier to avoid the transmission of STIs, much like a condom. You can even make a dental dam from a condom. Just cut off the tip and then cut the condom lengthwise! You can put a little lube on the vulva side of the dental dam to make it more pleasurable for the receiver.
It’s true, unfortunately, that not many couples use dental dams.
One Australian study found that less than 10% of women who had oral sex with women had used one in the last 6 months, and only 2.1% used them “often.” However, dental dams are still a great way to practice safer oral sex! You can get them at drug stores, online, and at many community health clinics, including here at the Mount Sinai Adolescent Health Center.
Manual sex (fingering)
Unprotected manual sex has a fairly low STI risk, but you can still potentially get chlamydia, syphilis, herpes, HPV or genital warts.
To make manual sex safer, use latex gloves and lube. Just change the gloves before touching your own genitals or another genital area (like the vulva or vagina and then the anus). Washing your hands for a full 20 seconds before and after manual sex can also help prevent the spread of STIs.
Keeping your fingernails short can help prevent cuts during manual sex. Cuts not only hurt (ow!) but can be entry points for infections.
You can also use latex finger cots (or finger condoms). These are pretty much what they sound like—a latex sheath that goes over your finger. Since they don’t cover your whole hand, they’re not quite as effective as a latex glove. However, they’re still way better than nothing. They’re also a great option if you have a cut on your finger.
Sharing sex toys like vibrators or dildos has a low STI risk. If you don’t take precautions though, you or your partner could potentially get BV, a UTI, or chlamydia. To avoid spreading an infection, wash your sex toy thoroughly with soap and warm water between uses and sex acts. Or, use a condom on the toy for easier clean up! Again, just change condoms between sex acts.
If you use a sex toy or strap-on for anal sex, be extra sure to use lube. Unlike the vagina, the anus does not make natural lubrication. Anal sex without lube can be painful and increases STI risk.
Strap-ons carry a similar risk to sharing sex toys. However, since there is some direct genital touching going on, you or your partner could also pass on herpes or HPV. Using a condom on a strap on and/or thoroughly washing it between uses definitely makes this sex act safer. But there’s not as much you can do for direct genital touching. Your best bet is to get tested regularly for STIs, and talk to your partner about their testing history.
Tribbing (rubbing your genitals together without clothes)
Tribbing puts you and your partner at risk of chlamydia, gonorrhea, herpes, pelvic inflammatory disease, pubic lice, trichomoniasis, and HPV. There is also a low risk for HIV if fluids are involved, or one or both of you has cuts (which you could get from shaving, or just friction). Like with strap-ons, there’s not a great barrier method to make tribbing safer. Get tested regularly for STIs, and talk to your partner about their testing history.
Analingus (rimming, anytime a mouth comes into contact with an anus)
Unprotected analingus can spread herpes, syphilis, hepatitis A, and intestinal parasites. Use a dental dam over the anus to make this safer. Just be sure to throw it out and use a new one between sex acts (for example, if you do analingus and then cunilingus).
Other things to keep in mind
STI risk is higher when you or one of your partners is on their period. The cervix is slightly more open during your period, which means infections are more likely to get in. Plus, blood can contain STIs. If you or your partner is on their period, be extra sure to use protection.
Friction can also increase STI risk. Friction sometimes makes tiny, microscopic cuts in the skin or inside the vagina or anus. These cuts are entry points for infections. Blood that can come out of these cuts can also transmit infections. To avoid friction, go slow and use lube.
If you have any more questions about your sexual health and are 10-26 years old in NYC, you can come to the Mount Sinai Adolescent Health Center. Our adolescent medicine specialists can answer any other questions you have. We provide completely confidential STI testing and treatment and other health services, all at no cost to you.
A version of this post was originally published in September, 2017.