Sexual health for LGBTQ+ people

Having sex only with women doesn’t rule out sexually transmitted infections (STIs). If you have a cervix, it doesn’t remove the need for cervical screening either. Your care needs to fit your body and the sex you have.

For trans and non-binary people, CDC guidance also says care needs to take into account your body as it is now, the sex you have, and any hormone treatment or surgery. You can ask the clinician to use the words and pronouns you prefer while you talk about these things.

STI testing follows the contact involved

STIs can pass during sex between women, non-binary people and trans men. Some infections cause no symptoms, so you may need a test even if you feel well. Tell the clinician about the contact you’ve had and any symptoms, and ask which tests you need.

Depending on the tests, a clinic may use a urine sample, a blood sample or swabs. CDC guidance for trans people takes into account where contact happened, including oral, anal and vaginal contact. Saying more than just “sex” helps the clinician choose the right samples.

If you share sex toys, NHS Wales advises washing them between uses and using a new condom for each partner. Change the condom when moving between vaginal and anal use. Barriers for oral sex, such as dental dams (thin squares of latex), can help lower the risk of passing on infections. Ask a sexual health service which options suit the sex you have.

Cervical screening depends on having a cervix

Women who have sex with women can get HPV, the virus linked to cervical cancer. Trans men and non-binary people with a cervix also need screening under their local programme. Having had the HPV vaccine doesn’t remove the need for screening.

In England, you may not be invited automatically if your GP surgery has you registered as something other than female. Contact your GP surgery, sexual health service or gender clinic to ask about invites. If you don’t have a cervix but get an invite, ask the service to check its records.

If an examination feels hard, talk about it before the appointment. The NHS suggests asking about a smaller speculum, a different position or bringing someone for support. You can ask them to stop during cervical screening. You could tell the clinician: “Please explain each step before you do it, and use these words for my body.”

Testosterone is not a contraceptive method

You can’t rely on testosterone to prevent pregnancy. If you still have a womb and ovaries, you may still ovulate (release eggs) while taking testosterone. CDC recommends offering advice on contraception, and contraception itself, to people taking testosterone who could get pregnant and don’t want to.

If the sex you have could lead to pregnancy, ask a clinician about contraception that suits you. Mention your hormone treatment in that conversation. You can ask whether pregnancy is possible without making plans for a future pregnancy or changing your prescribed treatment yourself.

Asking for care that fits your needs

Anyone can go to an NHS sexual health clinic, including people with no symptoms. In the US, CDC asks providers to make people feel welcome and to give care that includes all genders. When you contact a service, you can ask about its experience with LGBTQ+ patients, options for examinations and the words staff will use.

Ask how your results will be sent and which contact details to use. NHS clinic guidance says staff will ask how you’d like to get your results. If privacy worries you, say so before you give a phone number or agree to a message.

Contact a sexual health clinic or A&E now (UK), an emergency department (US), or a local urgent medical service elsewhere if you think you may have been exposed to HIV in the last 72 hours. Ask straight away about post-exposure prophylaxis (PEP). Don’t wait for symptoms or a routine test.

Contact a GP or sexual health clinic in the UK, or your doctor or sexual health service in the US or elsewhere, if you have symptoms or are worried about an STI. You can also book for contraception advice while taking testosterone. You can start with what you need help with today.