GuideApril 17, 20269 min read2,240 words

Sexual Health for Lesbian and Bisexual Women: What Your Doctor Won't Tell You

By Dr. Meera Iyer

Gynecologist & Sexual Health Educator · MBBS, MS (OBG), Mumbai

3 women sitting on bench near the flowers — Photo by Priscilla Du Preez 🇨🇦 on Unsplash

Let's talk about something that barely exists in Indian healthcare conversations: sexual health for women who have sex with women (WSW). Whether you identify as lesbian, bisexual, pansexual, queer, or you're simply exploring -- this guide is for you.

Here's the uncomfortable truth. When it comes to sexual health resources in India, queer women are almost completely invisible. Most sex education assumes you're heterosexual. Most gynecologists ask "Are you married?" as their first question. And most STI awareness campaigns focus on men who have sex with men or heterosexual couples.

That leaves a massive gap. And that gap can cost you your health.

Why Queer Women's Sexual Health Gets Ignored

India has a serious blind spot when it comes to WLW sexual health. A 2023 scoping review published in PLOS Global Public Health found that only 4% of all LGBTQI+ health research in India focused on lesbian and bisexual women. Four percent. That's not a gap -- that's a chasm.

The reasons are layered:

Cultural invisibility. Indian society often doesn't acknowledge that women have sex with women at all. If you don't exist in the public imagination, you definitely don't exist in healthcare policy.
The "low risk" myth. There's a widespread -- and dangerous -- assumption that sex between women carries no STI risk. This is medically false.
Heteronormative healthcare. Most gynecologists are trained to ask about heterosexual activity. If you don't fit that framework, your specific health needs get overlooked.

As Dr. Pragya Lodha, a Mumbai-based clinical psychologist who works with LGBTQ+ individuals, has noted: "Queer women in India face a double stigma -- the stigma of being a sexual minority and the stigma of being a woman seeking sexual healthcare. This combination makes them one of the most underserved populations in our healthcare system."

Yes, Women Can Transmit STIs to Other Women

Let's clear this up immediately: STIs can and do pass between female sexual partners. The myth that "women can't give each other STIs" is one of the most dangerous misconceptions in sexual health.

Here's what the science says:

STIs That Can Be Transmitted Between Women

Human Papillomavirus (HPV)

HPV is one of the most easily transmitted STIs between women. It spreads through skin-to-skin contact, including vulva-to-vulva contact, sharing sex toys, and oral sex. Studies show that HPV prevalence among women who have sex exclusively with women ranges from 3% to 30%, depending on the study population (Oxford Academic, Clinical Infectious Diseases).

Bacterial Vaginosis (BV)

While technically not an STI, BV is significantly more common among women who have sex with women. Research shows that having a female sexual partner increases BV risk by 60% (StatPearls, NCBI). Gardnerella vaginalis -- the bacteria most commonly associated with BV -- can be transmitted through direct mucous membrane contact or shared sex toys.

Herpes (HSV-1 and HSV-2)

Both oral and genital herpes can be transmitted between women through oral sex, genital-to-genital contact, and shared sex toys.

Trichomoniasis

This parasitic infection can be transmitted between female partners, particularly through shared sex toys and direct genital contact.

Chlamydia and Gonorrhea

While less common in WLW relationships, these infections can be transmitted through shared sex toys, digital penetration, and oral sex, especially if one partner has a history of sexual contact with men.

HIV

Transmission between female partners is rare but not impossible, particularly during menstruation, if there are open sores, or through shared sex toys with blood or vaginal fluid present.

The Numbers You Need to Know

13% of women who have sex with women have never been tested for any STI (CDC data).
Bisexual women face higher rates of certain STIs than both heterosexual women and lesbian women, partly due to having partners of multiple genders and partly due to facing more barriers to healthcare.
Studies show WSW are less likely to receive routine Pap smears and cervical cancer screenings, despite being at risk for HPV.

Safer Sex for Women Who Have Sex with Women

"But we don't need protection -- we're both women." If you've ever thought this, you're not alone. But let's update that thinking with actual facts.

Barrier Methods

Dental Dams

A dental dam is a thin, flexible sheet of latex or polyurethane that you place over the vulva or anus during oral sex. It creates a barrier that reduces skin-to-skin and fluid contact.

Reality check: dental dams are extremely difficult to find in India. You can:

Cut a condom lengthwise to create a flat barrier (this works just as well)
Order dental dams online from international retailers
Use non-microwavable cling film as a last resort (though this is not medically validated for STI prevention)

Gloves

Latex or nitrile gloves during digital penetration (fingering) protect against transmission through small cuts or hangnails. They also make cleanup easier and can actually enhance sensation.

Condoms on Shared Toys

If you share sex toys, always use a fresh condom on the toy between partners. Wash toys thoroughly with soap and warm water after every use. Many STIs, including HPV and BV-associated bacteria, can survive on toy surfaces.

Hygiene Practices

Wash hands before and after sexual activity.
Trim nails to avoid small tears in vaginal or anal tissue that could increase infection risk.
Don't share towels immediately after sex if either partner has any visible sores or symptoms.
Urinate after sex to reduce UTI risk.

Screening and Testing: Your Checklist

Here's what many doctors won't tell you -- but should.

Every Queer Woman Needs:

Regular Pap smears/cervical screening -- HPV doesn't care about your orientation. If you have a cervix, you need screening. Current guidelines in India recommend starting at age 21 or within 3 years of becoming sexually active.

STI testing -- Ask your doctor to test for chlamydia, gonorrhea, syphilis, herpes, and HIV. Don't assume you're not at risk.

HPV vaccination -- If you haven't been vaccinated, it's not too late. The HPV vaccine is available in India and is recommended up to age 26 (and sometimes later). It protects against cervical cancer, genital warts, and several other cancers.

Hepatitis B vaccination -- Particularly important if you have multiple partners.

Regular BV check -- If you experience unusual discharge, odor, or itching, get tested. BV is very treatable but can cause complications if ignored.

Dr. Ranjana Kumari, a gynecologist at AIIMS, has observed: "Many women who have sex with women skip gynecological appointments altogether because they assume their risk is zero or because they've had negative experiences with judgmental providers. This leads to delayed diagnoses of conditions that are very treatable when caught early."

Finding Queer-Friendly Healthcare in India

This is one of the biggest practical challenges for queer women in India. Here's how to navigate it.

What to Look For

Doctors who don't assume heterosexuality. If the first question is "Are you married?" and the second is "What contraception does your husband use?" -- that's a red flag.
Providers who use inclusive intake forms. Some progressive clinics now ask about "sexual partners" rather than "husband/boyfriend."
Non-judgmental body language. You can often tell within the first few minutes whether a provider is going to be safe to open up to.

Resources in India

The Humsafar Trust (Mumbai) -- India's oldest LGBTQ+ organization, established in 1994. They provide health services and can refer you to queer-friendly healthcare providers. They run 4 clinics and were one of the petitioners in the landmark Section 377 Supreme Court case in 2018.
Swabhava Trust (Bangalore) -- Provides LGBTQ+ support services including healthcare referrals.
iCall (Mumbai) -- Free psychosocial helpline run by TISS that is trained to support LGBTQ+ individuals.
Queer-friendly doctor directories -- Search online communities and LGBTQ+ groups on social media for crowd-sourced lists of inclusive doctors in your city.

How to Talk to Your Doctor

You don't owe your doctor your full life story. But being honest about your sexual partners helps them give you better care.

Try these approaches:

"I have female sexual partners and I'd like to discuss relevant screening."
"I'm sexually active with women. Can we discuss STI testing?"
"I'd like a Pap smear. I want to make sure we cover all relevant risks for my situation."

If a doctor responds with judgment, confusion, or dismissal -- leave. You deserve better. And better providers exist.

Mental Health and Sexual Wellbeing

Sexual health isn't just physical. For queer women in India, the mental health dimension is significant.

A 2023 review found that LGBTQI+ individuals in India experience high levels of mental health burden linked to stigma, discrimination, and violence victimization (PLOS Global Public Health). For queer women specifically, internalized shame about their sexuality can affect:

Sexual confidence. Feeling ashamed of your desires can make it hard to communicate with partners or enjoy intimacy fully.
Healthcare avoidance. Fear of judgment keeps many queer women away from doctors entirely.
Relationship stress. Navigating a relationship that isn't socially recognized adds unique pressures.

Seeking support from LGBTQ+-affirming therapists or community groups can make a real difference. You don't have to navigate this alone.

Common Questions About Queer Women's Health

Can I get pregnant from sex with a woman?

If both partners are cisgender women, pregnancy from sexual activity between you is not possible. However, if either partner is transgender or if donor sperm is involved, pregnancy is possible. Use appropriate contraception based on your specific situation.

Do I still need to see a gynecologist if I only have female partners?

Absolutely yes. You still need cervical screenings, breast exams, and general reproductive health checkups. Your gynecologist isn't just for pregnancy-related care.

Is BV contagious between female partners?

Research strongly suggests yes. BV-associated bacteria, particularly Gardnerella vaginalis, can be transmitted between female partners through direct contact and shared sex toys. If one partner has BV, both should be aware and consider treatment.

Where can I buy dental dams in India?

Dental dams are not widely available in Indian pharmacies. Your best options are online international retailers, cutting condoms lengthwise, or checking with LGBTQ+ health organizations that sometimes distribute them.

Should I disclose my orientation to my gynecologist?

Ideally, yes -- it helps your doctor provide appropriate care. But only if you feel safe doing so. If your current provider isn't supportive, look for queer-friendly alternatives through LGBTQ+ organizations or community recommendations.

FAQs

Q: Are lesbian women at lower risk for cervical cancer?

A: Not necessarily. HPV -- the virus that causes most cervical cancers -- can be transmitted between female partners. All women with a cervix should get regular screenings regardless of orientation. Studies show WSW are less likely to get screened, which actually puts them at higher risk of late detection.

Q: Can I use the same sex toys with my partner without cleaning them?

A: No. Always wash sex toys thoroughly between uses and between partners. Use a fresh condom on shared toys. STIs and bacteria like BV can be transmitted through shared toys.

Q: Is it normal to not know how to practice safer sex with women?

A: Completely normal. Sex education worldwide, and especially in India, almost never covers safer sex for WLW. The fact that you're reading this means you're already taking your health seriously.

Q: Do I need an HIV test if I only have sex with women?

A: While female-to-female HIV transmission is rare, it's not impossible. If you've had partners of any gender, shared needles, or are unsure of a partner's status, testing is a good idea. HIV testing is free and confidential at NACO's Integrated Counselling and Testing Centres across India.

Q: How do I find queer-affirming mental health support?

A: Organizations like iCall (Mumbai), The Humsafar Trust, and Swabhava Trust can connect you with LGBTQ+-trained therapists. Many therapists now offer online sessions, making access easier regardless of your city.

The Bottom Line

Your sexual health matters. Your orientation doesn't make you immune to health risks -- it just means you need information that's actually relevant to your life. And in India, that information has been nearly impossible to find. Until now.

If you take away three things from this guide:

STIs can be transmitted between female partners. Use barrier methods and get tested regularly.
You need cervical screenings regardless of your orientation. Don't skip your Pap smear.
Queer-friendly healthcare exists in India. It might take some searching, but you deserve a provider who sees you fully.

Samjho exists because everyone deserves access to accurate, shame-free sexual health information -- regardless of who they love. If this guide helped you, share it with someone who needs it.

This article is for educational purposes and is not a substitute for professional medical advice. For personalized guidance, consult a healthcare provider.

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