As an LGBT person, it can be difficult to figure out what you need in terms of contraception. Also, the term birth control may be confusing: remember it’s not just about ‘controlling birth’ but also keeping you safe from STDs/STIs.
In some cases, asking a doctor can only add to the confusion since they might not be prepared to talk about the birth control needs of LGBT persons.
Your best bet is to figure out your needs for yourself by critically looking at who you have sex with and how. For example, a woman who identifies as lesbian but still occasionally has sex with male partners shouldn't just get information on how to be safe with female partners, but also on condoms to prevent STDs and methods to avoid unintended pregnancy. Be honest with yourself and know which sexual activity requires which form of protection. You can have your questions answered by checking out our safe sex section below, or by asking one of the moderators on our forum.
To avoid unintended pregnancy, you need to use birth control.
First, you have to figure out if there is a chance of pregnancy. In order to get pregnant, three things are needed: a functioning egg, sperm, and a uterus. If a chance exists that the egg and sperm come together and get cosy in the uterus, this could result in pregnancy.
For example, if you are a trans man who hasn't undergone gender affirmation surgery and you are still producing eggs, and you have intercourse with a cis-man, you could get pregnant. If you are a gay man who is having anal sex with another man, you don't need to worry about pregnancy.
If you don't want to get pregnant, the safest thing to do is to use a barrier method (male/female condom) in combination with a hormonal birth control method, such as an IUD or the pill. Condoms are great but with 'typical use', they are only 86 per cent effective.
In case you forget to use contraception, or if it fails, and you think you could be at risk of getting pregnant, you can use the e-pill, or a copper-T IUD as emergency contraception.
Sexually transmitted infections
More important than pregnancies for most LGBT people will be staying safe and avoiding getting STDs/STIs.
Every person who's sexually active is at risk of contracting these, regardless of your sexual orientation and gender identity. Your risk is decreased if you only have sex with one partner, if you are faithful to each other, and if you get tested regularly. The more partners you have, the higher your risk is going to be, especially when you are having casual sex and don’t know much about your partner’s sexual history.
So make sure you know your risks; use condoms, lube, and dental dams; and get tested regularly for STDs such as HIV and HPV. If you see sores or wounds on your sex partner’s genitals, it may be best to avoid having sex.
Oral sex is often considered one of the lower risk sexual activities, but you may still want to use a condom or dental dam to avoid getting your mouth in contact with warts or herpes blisters – since STDs can also infect your mouth and throat.
Anal sex is the riskiest when it comes to STDs. That’s because the anus doesn’t have any ‘built-in’ lubrication and can hence rip and tear easily, which, in turn, increases the risk of getting infected with STDs. That’s the case even if you aren’t having insertive anal sex; tears can also happen during other forms of anal play. So, while lube isn't a contraceptive method, it's important to mention when talking about STD prevention. Especially with anal sex, lube can reduce friction, and using it lowers the risk of small wounds that make it easier for viruses and bacteria to enter the body.
Vaginal sex is somewhere in the middle in terms of STD risk. However, it’s riskiness can be decreased by using condoms and dental dams.
It’s important to keep in mind that while barrier methods can reduce the risk of infection, there is no method that will keep you 100 per cent safe.
Hygiene is important when it comes to good sex. The scent of smelly feet can be a big turn-off in bed, not to mention bad breath or foul-smelling genitals.
One aspect of hygiene is often overlooked, though. Nails. Long fingernails can hurt the delicate skin or your partner's genitals or anus, or damage a condom. So, if you are planning on having sex, it might be worth to spend some time trimming your nails. Short, round nails ensure that there aren't any sharp edges that could cause damage or pain.
Sometimes, it can be dangerous to tell people about your sexual orientation or gender identity. We can hope that healthcare providers and chemists honour your right to privacy, but unfortunately, this isn’t always the case.
So be mindful when you discuss your safe sex needs with a new person, even if they are in the medical profession.
In order to get the best medical care and have all your questions answered, it might be best to see someone who is already known for working with people of different sexual orientations and gender identities – and who will not out you or put you at risk.
Care after violence
Unfortunately, LGBT-people are often more at risk of violence than their straight, cis-gender peers.
If you have experienced sexual violence, please seek help immediately. See a trusted healthcare professional, get treated, and discuss if you need to go on PEP or take e-pills.
We know it’s a very difficult thing to do for a variety of reasons but please also consider reporting this crime.