Lesbians, Bisexual Women, Queer Women and Other Women Who Have Sex with Women - NYC Health

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Lesbians, Bisexual Women, Queer Women and Other Women Who Have Sex with Women

Women who have sex with women (WSW) may experience poorer health outcomes than heterosexual women due to discrimination, stigma, homophobia and transphobia. WSW includes lesbians, bisexual women, queer women and transgender women.

These experiences may result in:

Lower rates of Pap test and mammogram use

Higher rates of heart disease

Higher risk for mental health conditions

Higher rates of alcohol, tobacco and other substance use

Higher risk of getting HIV and other sexually transmitted infections

Find Affirming Health Care

You have the right to honest and judgement-free health care. This means your health care provider affirms who you are and does not make assumptions about your sexual orientation, gender identity or gender expression.

For help finding LGBTQ-knowledgeable providers, visit the NYC Health Map.

Learn about your rights with the LGBTQ Health Care Bill of Rights. If you experience discrimination in a health care setting, call 311 or 718-722-3131 to file a complaint with the NYC Commission on Human Rights.

Sexual Health and Safer Sex Practices

Sexual health and pleasure involve open communication with your partner(s). That includes talking about all aspects of your physical and emotional health.

To stay sexually healthy:

See your primary care provider at least once a year. If you have a cervix, visit your health care provider at least once a year.

Have open and honest conversations with your provider about your sex life, including the gender(s) of your sex partner(s) and the kinds and quality of your sexual experiences.

Watch: Bare it All

Get tested regularly for sexually transmitted infections (STIs), including HIV. Your partner(s) should get regularly tested too. Do not wait until you experience symptoms to get tested. Many people with STIs do not feel sick or experience any symptoms.

Some STIs can be passed between people with vaginas. Such infections include bacterial vaginosis, human papillomavirus (HPV), herpes and trichomoniasis.

Check yourself for signs and symptoms of other health conditions. You know your body best. If you are worried about something, see a health care provider instead of trying to self-diagnose online.

Visit a Sexual Health Clinic or your primary care provider for testing and screenings. Care is available regardless of your immigration status or ability to pay.

Make sure your provider tests every part of your body that you use for sex.

Stay up to date on your vaccinations. In addition to standard vaccinations, everyone 26 years and younger should receive an HPV vaccine if they did not get all recommended doses. Some adults ages 27 through 45 who did not get all recommended doses when they were younger might decide to get the HPV vaccine based on discussion with their clinician. Ask your doctor if vaccines for hepatitis A, hepatitis B and meningococcal disease are right for you.

If you are a transgender woman, there are local tips and resources available for you.

Take Pride, Take Care: Tips for Transgender Women’s Health

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Safer Sex Practices

Stay safe while you have sex by following the below tips.

Talk about sexual consent.

Use latex barriers, such as dental dams, gloves and finger cots, to prevent transmission of STIs, other bacteria and fungi. Decide with your partner(s) which options work best for you.

Use condoms on penetrative sex toys and penises as often as possible during genital and anal sex.

Use lubrication when having genital and anal sex to prevent discomfort and injury. Silicone- and water-based lubes are safe to use with latex condoms. Oil-based lube, such as Vaseline®, can break down condoms and stop them from working.

Use birth control to prevent unintended pregnancy.

Use a tampon or menstrual cup while having sex during your or your partner’s period to lower the risk of transmitting HIV, hepatitis B and hepatitis C.

Limit alcohol and drug use before sex to reduce your chances of getting HIV or other STIs.

Do not vaginal douche or clean the inside of your vagina with water or other fluids. Some people douche before or after sex. Vaginal douching can increase your chance of getting infections and pelvic inflammatory disease.

Fingering

To reduce the chance of injury and infection when fingering:

Wash your hands before and after play.

Use different fingers or hands for different partners and locations on the body.

Keep your fingernails short.

Remove jewelry.

Use latex gloves or finger cots. Use lube with latex gloves and finger cots to increase comfort and avoid injury, such as cuts from fingernails.

Oral Sex

To reduce the chance of transmitting STIs, use dental dams as often as possible during oral sex.

Oral and genital herpes can be transmitted during oral sex. Try to avoid oral sex if there are cuts or sores on your or your partner’s mouth or genitals.

Toys

When you find a toy that is right for you, follow the manufacture’s instructions for storage, use and cleaning. You can avoid injuries by checking for any damage before and after use.

You can also use condoms on toys. Be sure to change condoms when changing partners or locations on the body.

Physical Health

Fitness

Studies have found WSW are at higher risk for being overweight or obese. This can lead to discrimination, sizeism and social stigma in everyday life and medical treatment. You have the right to be treated by doctors and medical professionals who will not mistreat or misdiagnose you based on your weight.

WSW are also more likely to smoke and have heart disease.

Learn what you can do to avoid the health risks linked to obesity and heart disease through physical activity and nutrition.

Cancer

Routine cancer screening is the best way to prevent cancer. Talk to your health care provider about which screening tests are right for your body.

Schedule a pap test if you have a cervix. Pap tests, or pap smears, can detect cervical cancer. If you are between the ages of 21 and 65, get a pap test every three years.

Schedule a pelvic exam if you have a cervix, uterus or vagina and notice anything different from normal. This could include pain, vaginal discomfort or abnormal discharge or periods. Pelvic exams can help diagnose cancers such as ovarian, uterine, vaginal and vulvar cancer.

Schedule a prostate exam with your provider if you are a transgender woman with a prostate, especially if you are 50 years or older.

Pregnancy and Growing Your Family

If you are thinking about growing your family, you have several options, including adoption, pregnancy and surrogacy.

If you are considering having a baby, talk to your health care provider about your fertility options. This might include having a doula — a trained professional who can provide educational, emotional and physical support before, during and after childbirth.

There are a variety of ways you can have a baby or become pregnant, including:

Intrauterine Insemination: Also called artificial insemination, this option involves putting sperm directly into the uterus.

In Vitro Fertilization: This complex process involves taking eggs from the body, fertilizing them with sperm to grow an embryo and placing the embryo back in the uterus.

Reciprocal IVF: In this process, eggs are taken from one partner and fertilized with sperm to grown an embryo. The embryo is then placed in the uterus of another partner.

Fertility Preservation: You can remove and freeze eggs, sperm or embryos for future use. This option allows you to plan for a future family and can be helpful for transgender people to consider before medically transitioning.

Mental Health

WSW may face issues that impact their mental health, such as stigma, prejudice and discrimination. As a result, WSW are more likely than heterosexual women to have anxiety, depression and other mental health conditions. This is especially true for younger people and bisexual and transgender WSW.

If you or someone you know could benefit from counseling or other mental health services, contact 988 for free confidential support.

A traumatic incident can include verbal harassment, physical violence or sexual assault. If you or someone you know has experienced trauma and are looking for help, speak with a health care provider or contact 988 or local authorities.

Alcohol, Tobacco and other Drugs

Stigma, isolation and stress can lead to the use and misuse of tobacco, alcohol and other drugs. Substance misuse can have both immediate and long-term health effects.

If you are a smoker, quitting smoking is the single most important thing you can do for your health. If you are ready to quit, check out our resources to help you drop the habit.

Binge drinking and excessive drinking can lead to immediate and long-term health risks. Learn more about how to manage your alcohol consumption and find help if you are concerned about your drinking.

If you are concerned about your drug use, learn more about New York City’s drug and alcohol use services, including syringe access and disposal and opioid overdose prevention.

Violence

WSW can face abuse from anyone of any gender. If you or someone you know has experienced or is experiencing intimate partner violence, help is available.

If you are in an emergency situation, call 911. For other situations, call 311 and ask to be connected to an NYC Family Justice Center near you. You can also call the City’s 24-hour Domestic Violence Hotline at 800-621-HOPE (800-621-4673), or visit NYC Hope to learn about immediate safety planning, shelter assistance and other resources.

WSW may need specific support for queer-, transgender- or gender-based violence. If you have experienced any kind of assault and need LGBTQ-specific resources, visit LGBTQ Anti-Violence Project or call their hotline at 212-714-1141.

More Information

LGBTQ Health

Transgender, Gender Non-Conforming, Non-Binary and Gender Expansive Health

Intersex Health