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 out there that women who only have sex with women don’t get sexually transmitted infections (STIs). Unfortunately, this just isn’t true. Some STIs can be transmitted through skin to skin contact, and there are still often bodily fluids involved in sex between two vagina-havers. 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. Here’s what you need to know about STI risk and how to have safer sex.

Different sex acts carry different risks.

Unprotected oral sex (cunnilingus, eating out, assuming that there are vaginal fluids involved) puts you at risk for chlamydia, gonorrhea, herpes, HPV, syphilis, and hepatitis B, A and C. There is also a small chance of transmitting HIV, but this is quite rare, and would require the person giving oral sex to 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.

Manual sex (fingering) has a fairly low STI risk, but you can still potentially get chlamydia, syphilis, herpes, HPV or genital warts.

Sharing sex toys has a low STI risk. If you don’t wash toys in between uses, or use barriers like condoms, you or your partner could potentially get BV, a UTI, or chlamydia.

Using a strap-on could pass on herpes or HPV, since there is some direct genital touching going on.

Tribbing (or rubbing your genitals together without clothes) puts you and your partner at risk of chlamydia, gonorrhea, herpes, pelvic inflammatory disease, public lice, trichomoniasis, and HPV. There is also a low risk for HIV. HIV can be transmitted if fluids are involved, or one or both of you has cuts (which you could get from shaving, or just friction).

Analingus (rimming) is anytime a mouth comes into contact with an anus. Herpes, syphilis, hepatitis A, and intestinal parasites can all be transmitted.

How to Protect Yourself

Regular STI testing: Everyone who is sexually active should get regularly tested for STIs. Talk to your partner about when they were last tested, and what for. Talk to your doctor about how often you should get tested.

Dental dams: A dental dam is a thin piece of latex that you put over a partner’s genital area for oral sex or analingus. 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 safe 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.

Condoms: Using condoms on sex toys can prevent the spread of STIs. Change condoms every time you use the toy on a new partner or a new genital area (such as on the vulva or vagina, and then the anus). If you don’t have condoms on hand, you can wash sex toys with hot water and soap.

Latex gloves: You can help prevent the spread of STIs by using latex gloves with lube during manual sex (fingering). 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 manual sex can also help prevent the spread of STIs.

With tribbing, there is unfortunately not a great way to protect yourself. Your best bet is to get tested regularly for STIs, and talk to your partner about their testing history.

Other things to keep in mind

STI risk is higher when you or one of your partners is on their period. This is because the cervix is slightly more open (meaning infections are more likely to get in) and because blood can contain STIs. If you or your partner is on their period, be extra sure to use protection.

The risk of spreading STIs is also higher if there’s a lot of friction. This is because friction can create 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 (which we talk more about here). It’s also a good idea to keep your fingernails short if you’re performing manual sex. This way, they’re less likely to cut your partner.

If you have any more questions about your sexual health and are 10-22 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, and provide completely free, confidential STI testing and treatment and other health services.