All women have certain risks that specifically affect their wellbeing, but certain issues are particularly a cause for concern among women who have sex with women. This is not just a case of sexual health risks – although that plays a part in your wellness – but lesbian and bisexual women face an increased risk of physical and mental health problems too.
1. Sexually transmitted infections (STIs): Some STIs can spread between women, particularly through oral sex, sexual behaviour involving digital-vaginal or digital-anal contact, and shared penetrative sex toys. Through these means, you’re at an increased risk of human papillomavirus (HPV), bacterial vaginosis, trichomonas and HIV, so it’s important to do everything you can to protect yourself from these STIs. Make sure you get tested regularly, and that whomever you have sex with has also been tested. During oral sex, use a split-open condom, dental dam (a small piece of latex) or plastic wrap. Finally, don’t share sex toys, protect them with a condom and make sure you clean them before and after every use.
2. Depression: Lesbians and bisexual women might be at higher risk of depression and anxiety, especially young people who identify themselves as lesbian, gay, bisexual or transgender. This could be due to a number of factors, including social alienation, discrimination, rejection by loved ones, abuse and violence. The fear of these negative reactions causes some women to try and hide their orientation or to forgo social support, but this makes depression all the more likely for these women. Depression, when left untreated, can add to your risk of unsafe sexual behaviour, as well as a downward spiral of emotional, behavioural, health, legal and financial problems. Therefore, it’s vital that you confide in a trusted loved one, and seek help from a doctor or mental health provider.
3. Substance abuse: There are unique risk factors involved in lesbians and bisexual women experiencing substance abuse. You might rely on drugs or alcohol due to the stress of passing as a heterosexual or coming out, sexism, discrimination, relying on bars or clubs for socialising and peer support and the trauma of bullying, violence, abuse or self-abuse. Contact your local lesbian, gay, bisexual and transgender health, mental health or community centres for substance abuse treatment or get a referral from organisations like the Gay and Lesbian Medical Association.
4. Domestic violence: As domestic violence is traditionally depicted as a man abusing a woman, women in a relationship with other women don’t think it can happen to them. However, domestic violence can affect anyone in an intimate relationship, so you need to watch out for the warning signs. If your partner threatens to tell others about your sexual orientation or gender identity, tells you that authorities won’t help a homosexual, bisexual or transgendered person, tells you that leaving the relationship means you’re admitting that homosexual relationships are deviant or tells you that domestic violence can’t occur in homosexual relationships or that women can’t be violent, this indicates abuse and you should tell someone – be it a friend, loved one, health care provider or other close contact. You might also consider calling a domestic violence hotline and creating a plan to leave your abuser.
5. Routine healthcare: Many women who have sex with women find it difficult to discuss their needs and concerns with a doctor, or to find a doctor knowledgeable about lesbian health issues. However, you need to choose a doctor who encourages you to discuss sexual issues in an easy environment, so make sure you identify yourself as lesbian or bisexual when picking your GP, and ask about routine screenings recommended for women in your age group.
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