Health Considerations for Women Who Have Sex With Women: A Complete Guide

Every woman deserves access to comprehensive healthcare information tailored to her unique needs. For women who have sex with women (WSW), including lesbians, bisexual women, and others, understanding specific health considerations is an important part of maintaining overall wellness. While sexual orientation is just one aspect of health, being informed about potential risks and preventive measures can help you make empowered decisions about your healthcare.

This guide provides evidence-based information on health topics particularly relevant to women who have sex with women, from sexual health to mental wellness, helping you navigate your healthcare journey with confidence.

Understanding Your Sexual Health Needs

A common misconception is that women who have sex with women face minimal sexual health risks. However, sexually transmitted infections (STIs) can and do transmit between female partners through various forms of intimate contact.

STIs that can be transmitted between women include:

• Human papillomavirus (HPV), which can lead to cervical cancer and other cancers
• Herpes simplex virus (HSV)
• Bacterial vaginosis
• Trichomoniasis
• Chlamydia
• Gonorrhea
• HIV (though risk is generally lower than other transmission routes)

Reducing STI Risk Through Safer Sex Practices

Protecting your sexual health involves several practical strategies:

Regular testing: Both you and your partner should get tested for STIs regularly, especially when beginning a new relationship. Many infections have no symptoms, so testing is the only way to know your status with certainty.

Barrier methods: Use dental dams during oral-vulval or oral-anal contact. These thin latex or polyurethane barriers prevent the exchange of bodily fluids. You can purchase dental dams or create one by cutting open a condom or using plastic wrap as an alternative.

Sex toy safety: Clean all sex toys thoroughly with hot water and soap between uses and between partners. Alternatively, cover toys with a fresh condom for each use or each partner.

Hand hygiene: Wash hands before sexual activity. Consider using latex or nitrile gloves for digital penetration, particularly if you have cuts or hangnails.

Communication: Have open conversations with partners about sexual history, testing, and safer sex practices before becoming intimate.

Mental Health and Emotional Wellbeing

Research indicates that women who have sex with women may experience higher rates of mental health challenges, including depression, anxiety, and stress. These disparities often stem from external factors rather than sexual orientation itself.

Contributing Factors to Mental Health Challenges

Several societal factors can impact mental wellness:

• Discrimination or prejudice in various settings
• Family rejection or strained relationships with loved ones
• Internalized stigma or shame
• Limited social support networks
• Experience of harassment or hate-motivated incidents
• Stress from concealing sexual orientation in unsupportive environments

Prioritizing Your Mental Wellness

Taking care of your mental health is as important as physical health:

Seek supportive therapy: Look for mental health professionals who are affirming and experienced in LGBTQ+ issues. Organizations like the Association of LGBTQ+ Psychiatrists maintain directories of providers.

Build community connections: Connect with LGBTQ+ community centers, social groups, or online communities that provide peer support and understanding.

Address crisis situations: If you’re experiencing thoughts of self-harm, contact the 988 Suicide and Crisis Lifeline by calling or texting 988. The Trevor Project also provides crisis support specifically for LGBTQ+ individuals.

Practice self-care: Maintain healthy sleep habits, regular physical activity, and stress-management techniques that work for you.

Substance Use and Addiction Awareness

Studies have shown that women who have sex with women may face elevated risks for substance use disorders, including alcohol misuse, tobacco use, and illicit drug use. These patterns may relate to coping with minority stress, discrimination, or social factors.

Recognizing Problematic Use

Consider whether substance use:

• Interferes with daily responsibilities or relationships
• Occurs in response to stress or negative emotions
• Feels difficult to control or cut back on
• Leads to risky behaviors or dangerous situations

Getting Support

If you’re concerned about substance use, reaching out for help is a sign of strength:

Talk with your healthcare provider about treatment options and resources. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a national helpline at 1-800-662-4357 that provides free, confidential support 24/7.

Some LGBTQ+ community centers offer specialized substance use support groups where you can connect with others who share similar experiences.

Recognizing and Addressing Intimate Partner Violence

Intimate partner violence affects people across all sexual orientations and gender identities. Research suggests that women who have sex with women experience domestic violence at rates comparable to or higher than the general population, yet they may face unique barriers to seeking help.

Understanding the Dynamics

Intimate partner violence can include:

• Physical abuse or threats of violence
• Emotional manipulation or verbal abuse
• Sexual coercion or assault
• Financial control
• Isolation from friends and family
• Threats to “out” your sexual orientation to others

Unique Barriers for WSW

Additional challenges that may prevent seeking help include:

• Fear that law enforcement or service providers won’t take same-sex violence seriously
• Concerns about discrimination or homophobia from helping professionals
• Limited awareness that domestic violence resources serve LGBTQ+ individuals
• Threats from an abusive partner to expose your sexual orientation
• Small, tight-knit LGBTQ+ communities where privacy feels impossible

Finding Help and Support

If you’re experiencing intimate partner violence, know that you deserve support and safety:

The National Domestic Violence Hotline (1-800-799-7233) provides confidential support 24/7 and can connect you with local resources. They serve people of all sexual orientations and gender identities.

Many cities have LGBTQ+-specific domestic violence resources. Search for LGBTQ+ anti-violence projects in your area for culturally competent support.

Consider developing a safety plan with the help of an advocate, including secure places to go, trusted contacts, and important documents to have readily accessible.

Preventive Healthcare and Screenings

Regular preventive care forms the foundation of long-term health, yet some women who have sex with women may avoid healthcare due to concerns about discrimination or assumptions from providers.

Essential Screenings and Preventive Care

Cervical cancer screening: All women with a cervix, regardless of sexual orientation, need regular Pap tests and HPV testing according to current guidelines. Sexual contact with women does not eliminate cervical cancer risk.

Breast health: Follow recommended mammography guidelines based on your age and risk factors. Discuss your family history with your provider to determine if earlier or more frequent screening is appropriate.

STI screening: Discuss appropriate testing based on your sexual practices and number of partners. Don’t assume providers will automatically offer comprehensive STI screening.

Blood pressure and cholesterol: Regular monitoring helps detect cardiovascular risk factors early.

Bone density: Screening may be recommended based on age and risk factors.

Mental health screening: Ask your provider about depression and anxiety screening, especially if you’re experiencing symptoms.

Vaccination Considerations

Ensure you’re up to date on recommended vaccines:

• HPV vaccine: Recommended for individuals up to age 26, and may be beneficial for some people ages 27-45 after discussion with a healthcare provider
• Hepatitis A and B vaccines: Important protection against liver infections that can transmit through sexual contact
• Standard vaccines: Stay current with tetanus, flu, COVID-19, and other recommended immunizations

Finding Affirming Healthcare

Quality healthcare requires open, honest communication between you and your provider. However, some women who have sex with women have experienced discrimination, assumptions, or discomfort in healthcare settings.

What to Look for in a Healthcare Provider

An affirming provider will:

• Use inclusive language and not make assumptions about your sexual practices
• Ask appropriate questions about sexual history and behaviors
• Respond professionally and non-judgmentally when you discuss your sexual orientation
• Demonstrate knowledge about health issues relevant to WSW
• Maintain patient confidentiality
• Display visible signs of LGBTQ+ inclusion, such as non-discrimination statements or pride symbols

Communicating Effectively with Your Provider

To get the best care:

Be specific about your sexual practices: Rather than relying on labels, describe your actual sexual behaviors. This helps your provider understand which screenings and preventive measures are most relevant.

Ask questions: If you don’t understand why a particular test or screening is recommended, ask for clarification.

Advocate for yourself: If a provider dismisses your concerns or makes you uncomfortable, you have the right to seek care elsewhere.

Provide relevant history: Share information about past STIs, mental health concerns, substance use, or other factors that affect your health.

Finding LGBTQ+-Affirming Providers

Resources for locating inclusive healthcare include:

• GLMA (Health Professionals Advancing LGBTQ Equality) provider directory
• Local LGBTQ+ community centers, which often maintain healthcare referral lists
• Online directories specifically for LGBTQ+-friendly providers
• Recommendations from trusted friends or community members

Reproductive Health Considerations

Women who have sex with women have diverse reproductive goals and needs. Don’t let assumptions prevent you from accessing the care you need.

Contraception

If you’re in sexual relationships that could result in pregnancy, discuss contraceptive options with your provider. Even if you primarily have sex with women, bisexual women or those who occasionally have sex with men need contraception if they wish to prevent pregnancy.

Fertility and Family Planning

If you’re considering becoming pregnant, discuss options such as:

• Donor insemination (home-based or clinic-based)
• In vitro fertilization (IVF)
• Fertility evaluations to assess reproductive health
• Legal considerations for non-biological parents

Finding a fertility clinic or reproductive endocrinologist experienced in working with same-sex couples can make the process smoother and more affirming.

Body Image and Weight Management

Research on body image among women who have sex with women shows mixed findings, but some studies suggest unique patterns related to body satisfaction, weight concerns, and eating behaviors within lesbian and bisexual communities.

Maintaining Healthy Habits

Focus on health rather than appearance:

• Engage in physical activity you enjoy rather than exercise solely for weight loss
• Eat a balanced, nutritious diet that supports your overall health
• Seek support if you’re experiencing disordered eating patterns or body dysmorphia
• Challenge societal beauty standards that don’t serve your wellbeing

Aging and Long-Term Health

As you age, health priorities may shift. Women who have sex with women should be aware of considerations related to aging:

Menopause and Hormone Changes

Discuss menopause symptoms and management options with your provider. Your sexual orientation doesn’t change your experience of menopause, though communication with a same-sex partner about changes may differ from heterosexual relationships.

Chronic Disease Prevention

Focus on preventing or managing conditions like:

• Cardiovascular disease
• Type 2 diabetes
• Osteoporosis
• Certain cancers

Risk factors for these conditions relate more to lifestyle, genetics, and age than sexual orientation, but access to preventive care is essential.

Planning for the Future

Consider legal protections for you and your partner:

• Healthcare proxies and advance directives
• Power of attorney documents
• Wills and estate planning
• Understanding your partner’s rights in healthcare decisions

Building a Support System

Strong social connections contribute significantly to both mental and physical health. Cultivating supportive relationships can buffer against stress and discrimination.

Types of Support to Seek

• LGBTQ+ community connections: Community centers, social groups, sports leagues, or interest-based organizations
• Affirming family and friends: Nurture relationships with people who accept and celebrate you fully
• Professional support: Therapists, support groups, or coaches who understand your experiences
• Online communities: Virtual spaces can provide connection, especially in areas with limited local LGBTQ+ resources

Advocating for Yourself in Healthcare Settings

You have the right to respectful, competent healthcare. If you encounter discrimination or inadequate care:

• Request to see a different provider within the practice
• File a complaint with the practice manager or patient advocate
• Report discrimination to appropriate authorities, such as state medical boards or civil rights offices
• Share your experience with LGBTQ+ health advocacy organizations
• Leave reviews to help other LGBTQ+ individuals make informed choices about providers

Taking Charge of Your Health

Your sexual orientation is just one aspect of who you are, but being informed about health considerations specific to women who have sex with women empowers you to make the best decisions for your wellbeing. Key takeaways include:

• Practice safer sex and get regular STI testing
• Prioritize mental health and seek support when needed
• Find affirming healthcare providers who make you comfortable being honest
• Stay current with recommended screenings and preventive care
• Address substance use concerns proactively
• Recognize signs of intimate partner violence and know resources are available
• Build strong social support networks
• Advocate for yourself in healthcare settings

Remember that quality healthcare should be accessible to everyone regardless of sexual orientation. Don’t let fear of discrimination prevent you from getting the care you need and deserve. By staying informed, communicating openly with affirming providers, and taking proactive steps to protect your health, you can thrive and live your healthiest life.

If you’re unsure where to start, consider scheduling a comprehensive wellness visit with an LGBTQ+-affirming provider. This appointment can establish baseline health markers, address any concerns, and create a preventive care plan tailored to your individual needs. Your health matters, and taking steps to care for yourself is an important form of self-advocacy and self-respect.

Sources:

• Centers for Disease Control and Prevention – LGBT Health
• American College of Obstetricians and Gynecologists – Health Care for Lesbian and Bisexual Women
• Office on Women’s Health – Sexual Health
• World Health Organization – Sexual Health
• American Psychological Association – LGBT Resources