Everything you need to know about vulva-to-vulva sex.
If you’re a lesbian, bisexual, pansexual or queer woman, or someone who has a vagina and sleeps with vagina-having people, it’s likely you haven’t had the sexual health education you need. School sex ed is so heteronormative that many of us never heard so much of a mention of vulva-to-vulva sex. It’s no wonder many queer folk don’t realise STIs can be transmitted through fingering, oral sex and sharing sex toys.
This gap in our knowledge is nothing to be ashamed of. Safe sex for LGBTQ+ women, non-binary, trans and intersex people is just rarely (if ever) efficiently covered in school.
So here’s your essential safe sex guide, courtesy of Linnéa Haviland from sexual health service SH:24.
Stigma exists and it might affect you
A recent study found LGBTQ+ women face barriers when accessing sexual health care, the main reason being ignorance and prejudice among health care staff. I have certainly been questioned a few times about why I’m going for a smear test, simply because I’ve said I have a girlfriend. With information about safe sex being extremely penis-centred, it can be really hard to know the facts and stand your ground in the face of individual and institutionalised queerphobia.
Know how STIs are actually spread…
Contrary to popular belief, there doesn’t have to be a penis involved for STIs to spread. STIs can be passed on through genital skin-on-skin contact, through bodily fluids on hands and fingers, oral sex and sharing sex toys. STIs “like the specific environment of the genitals, so can spread from one vulva to another when they are in close contact or if fluids come in contact via sex toys or fingers,” says SH:24 sexual health nurse Charlotte.
Chlamydia, syphilis, gonorrhoea, HPV, genital warts and genital herpes can all be spread this way. These STIs can also spread via oral sex. Throat swabs for STIs aren’t routinely offered to women, but if you are worried you can request one. STIs won’t survive outside their cosy environments for long though, so you can’t get them from sharing towel, toilet seats, or by using a sex toy someone else used a week ago.
…and know how to protect yourself
You’ve probably heard of a dental dam for oral sex, but if you’re anything like me before I started working for a sexual health service, you’ve probably never actually seen one. Originally used for dentistry, they are quite expensive and hard to get hold of, so unless your local sexual health clinic has them I would recommend a DIY version: the cut up condom!
Unroll the condom, cut the tip off, then cut it lengthwise to unroll it into a rectangle. Use the lubricated side against the vulva, or if flavoured, the flavoured side against your mouth (note: flavours can irritate the vulva!) When sharing sex toys, use a condom on the sex toy, and change this every time you switch user.
For fingering and fisting, you can use latex gloves for extra protection (add some lube though – they’re dry!) If you’re rubbing genitals or scissoring, you can try to keep a dental dam in between, but it can be really hard to keep it in place… the best way to stay protected is to test regularly for STIs (we recommend yearly or when changing partners – whichever comes first!)
Go for your smear test
There is a prevalent heteronormative notion that you don’t need to get a smear test unless you’ve had/are having S.E.X (meaning penetrative sex with a penis.) This isn’t true! HPV, the virus which can cause cervical cancer, can be transmitted via oral sex, sharing sex toys and genital contact. HPV is very common, and most people will have it at some point in their life, but clear it without symptoms. Because it’s so common it’s important to always go for your smear test!
Know about HIV
HIV is is slightly different from other STIs, because it has to get into your bloodstream. “There is a high quantity of white blood cells both in the rectum and on the cervix, so if the virus gets there, it is very close to where it needs to be. Tearing adds another way for the virus to come in contact with your blood stream during sex,” says Charlotte. HIV can only survive outside the body for a few seconds, so transmission via non-penetrative sex or sharing sex toys is thought to be extremely low.
However the actually transmission rates of HIV during sex between two vagina-having people is unknown, since this has not been recorded or studied on any larger scale. There has been one documented case of HIV transmission between two women – but more cases might be masked by assumptions that the virus was contracted in a different way (such as heterosexual/penis-vagina sex or needle sharing). There is a lot of stigma attached to HIV, so it’s important to remember that if you have HIV and are on the right medication, you can keep the viral load undetectable, which means you can’t pass it on!
Learn the risk factors
When making a decision about whether to have protected or unprotected sex with someone, it’s a good idea to be informed about the risk factors involved in different types of sex. British Association for Sexual Health and HIV (BAASH) guidelines says non-penetrative contact carries the lowest risk, but no sexual contact is without risk.
For penetrative sex (like fingering, using sex toys and fisting) the risk of transmission is related to the degree of trauma – i.e if there is friction or aberration (tiny cuts). Risk is also related to if you or your partner(s) are likely to have an STI – so be in the know and test, test, test! There is an assumption in the medical field that vulva-to-vulva sex carries hardly any risk of STI transmission, but different reports suggest this generalisation may not be correct.
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