Women who have sex with women (WSW) is a term used to describe people who identify as women who engage sexually with other people who identify as women. The term WSW may apply to transgender and cisgender women. It should not be used to describe transgender men. The health concerns listed below are intended to be general and may not apply to you simply because you identify as gay, bisexual, lesbian and/or WSW. We acknowledge that there is a wide range of diversity with women’s bodies, and we cannot assume that all women have the same reproductive organs or genitals. It is important to find a medical provider that you trust to respond to your questions and concerns.
Safer sex is proven to reduce the risk of receiving or transmitting HIV and sexually transmitted infections (STIs). Some STIs that may be transmitted through sex include those for which effective treatment is available (syphilis, gonorrhea, chlamydia, pubic lice, and others), as well as those which no cure is available (HIV, Human papillomavirus, and hepatitis A, B, or C virus). Human papillomavirus (HPV)—which causes anal and genital warts—may play a role in the increased rates of cervical cancers in WSW. Getting the HPV vaccine and practicing safer sex is highly recommended.
Regardless of gender identity, sex without the use of barriers (e.g., condoms) or prophylactic medication (i.e., PreP) increases the risk of HIV infection.
For trans women or people on the trans feminine spectrum who produce sperm and engage in penetrative sex, there may be a possibility of pregnancy. Even after years of hormone therapy, some people continue to produce viable sperm. Using condoms may be the best method of contraception, and there are other options that could be considered if your sexual partner has ovaries. If you are interested in pregnancy or fertility preservation, it is best to explore options with your doctor.