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What if I have a vagina and have sex with other people with vaginas?
There is a wide variety of people that can fall under this category and grouping all of them together is often to the detriment of those most marginalized. However, when it comes to medical and sexual safety concerns that can accompany sex between two people with vaginas, some things are common across identities. One concern is lack of use of or knowledge about protection. The use of gloves for digital-vaginal stimulation, condoms for sex toys, or dental dams for oral sex is infrequent. It is especially important to discuss and proliferate the use of protection for any type of sexual activity between two people with vaginas, especially if you don’t know your partner’s sexual history. Additionally, as safety with sex toys is often overlooked in sex education, many people might not take the proper steps to sanitize and use protection with their toys. This includes washing toys (check with the manufacturer and cleanse toys properly based on their material) and using condoms or protective barriers during toy sex. All STIs mentioned in this toolkit can be passed from vagina to vagina via oral, digital, toy, or genital sex, despite prolific myths about the impossibility of STI transmission. Members of this population are at a higher risk for HPV transmission, and may be at a higher risk for HSV-1 transmission, although the risk for HSV-2 transmission is lower than in the general population (about 8% of those who identify as homosexual women have HSV-2 as compared to 24-36% of those who identify as heterosexual or bisexual women). Notably, bacterial vaginosis can be transmitted between two vaginal sex partners. Unfortunately, the lack of general research on and resources for any identities that include vagina-on-vagina intercourse is disappointing (hint hint, future healthcare researchers!).
What if I have a penis and have sex with other people with penises?
Like the last section, there are lots of people who fall under this category, and grouping them together is also fraught. But again, there are some medical and safety commonalities that are useful to explain here. This particular population can be more susceptible to certain types of STIs than others because sex between two people with penises more frequently includes anal intercourse. Anal sex can raise the risk of STI transmission, due to certain transmissive qualities of the rectal cavity. Higher levels of early-stage syphilis, gonorrhea, and chlamydia have also been documented for people with penises who have sex with other people with penises (usually specifically anal sex), as well as HPV-related health complications. This population also experiences higher rates of HIV and AIDS, with gay and bisexual men comprising over half of those in the U.S. living with HIV/AIDS, and this virus can in turn can increase susceptibility to other STIs. There is a lot of social stigma surrounding STIs, especially for gay and bisexual men and transgender women, which can create barriers towards safer sex practices, prevent adequate access to sexual health resources, or make asking for help difficult. If you practice anal sex, or if your sexual partners practice anal sex, it is especially important to get tested regularly and to use barrier protection, even during oral sex (this includes blowjobs and oral-anal contact). Talk to your healthcare provider about more ways to be safe under your specific circumstances, and make sure to alert your healthcare provider about your sexual practices to inform testing and vaccination decisions. PrEP and PEP are also tools that can reduce risk of an HIV-negative person contracting HIV. Learn more about PrEP here.