LGBTQ+ Women’s Sexual Health: What You Need to Know for Better Care

When you’re a woman who identifies as LGBTQ+, your sexual health needs don’t fit neatly into the standard checklist most doctors use. Too often, the system assumes you’re straight, cisgender, and sexually active with men. That leaves a lot of gaps - in care, in conversation, and in trust.

Why Standard Gynecology Falls Short

Most clinics still use forms that ask: "Are you sexually active?" and then list only heterosexual options. If you’re a lesbian, bisexual, or queer woman, you might skip that question - not because you’re not sexually active, but because none of the choices reflect your life. This isn’t just awkward. It’s dangerous.

A 2023 study from the CDC found that LGBTQ+ women are 30% more likely to delay gynecological care than straight women, mainly because they’ve been misgendered, judged, or ignored in the past. One woman in Portland told me she hadn’t seen a gynecologist in eight years because the last time she went, the nurse asked if she needed a pregnancy test. She wasn’t even dating men.

When providers don’t ask the right questions, they miss real risks. HPV, STIs, and cervical cancer don’t care who you sleep with. You can get HPV from skin-to-skin contact. You can pass trichomoniasis between partners with shared toys or fingers. And yes - even if you’ve never had penetrative sex with a man, you still need regular Pap smears if you have a cervix.

What Sexual Health Screenings Do You Actually Need?

Here’s the truth: your screening needs aren’t based on your orientation. They’re based on your body and your behaviors.

• If you have a cervix: Pap smears every 3-5 years (depending on history and HPV status). Start at 21, even if you’ve never had sex with a man.
• If you use toys: Clean them after every use. Share them only with protection (condoms or gloves). Bacteria from one partner can infect another.
• If you have sex with multiple partners: Get tested for chlamydia, gonorrhea, syphilis, and HIV at least once a year. Some clinics offer at-home kits - no judgment, no forms.
• If you use hormones: Talk to your provider about how estrogen or testosterone affects your vaginal tissue. Low estrogen can cause dryness, thinning, and discomfort - even if you’re not sexually active.

Many LGBTQ+ women don’t realize that their symptoms - like chronic yeast infections, burning during sex, or pelvic pain - could be signs of something treatable. But if you’ve been told "it’s just because you’re a lesbian," you might have stopped asking. That’s not normal. That’s neglect.

Barriers to Care Are Real - And Fixable

The biggest obstacle isn’t your body. It’s the system.

Transgender men and nonbinary people with vaginas face the same issues: outdated forms, assumptions about pregnancy, and providers who don’t know how to talk about their anatomy without misgendering them. One clinic in Seattle started using gender-neutral language on intake forms: "Do you have a cervix?" instead of "Are you a woman?" Results? 60% more patients completed screenings in six months.

Language matters. So does representation. A 2024 survey by the National LGBTQ Task Force found that LGBTQ+ women were 4x more likely to return to a provider who used inclusive language and had visible queer staff or symbols (like a rainbow pin or pronoun stickers).

Don’t be afraid to ask: "Do you have experience caring for LGBTQ+ patients?" If they say "no," ask for a referral. Many community health centers now have LGBTQ+ specialists. In Portland, clinics like Cascade AIDS Project and Q Center offer low-cost, affirming gynecology care.

Sexual Health Isn’t Just About STIs and Pap Smears

It’s also about pleasure, safety, and consent - and those things matter just as much.

Many LGBTQ+ women report that their partners don’t know how to talk about boundaries, lubrication, or pleasure. There’s a myth that same-sex relationships are naturally "easier" or "more intuitive," but that’s not true. Communication takes practice. So does comfort.

Use lubricant. Even if you’re "naturally wet." Hormones, stress, and aging can change that. Water-based lubes are safest with toys. Silicone-based lasts longer - just don’t use it with silicone toys.

Get comfortable talking about what feels good - and what doesn’t. Your partner doesn’t have to read your mind. And you don’t have to pretend something hurts less than it does. Pain during sex is not normal. Ever.

What to Look for in an Affirming Provider

You deserve care that doesn’t make you feel like a lab experiment. Here’s what to look for:

• Gender-neutral language on intake forms - "partner" instead of "husband/wife," "vagina" instead of "female anatomy."
• Pronoun stickers on staff badges - even if it’s just "she/her" or "they/them."
• Training listed on their website - phrases like "LGBTQ+ competent care" or "affirming reproductive services."
• Waiting room materials - brochures that show diverse couples, not just straight couples.

If you walk in and feel like you have to explain yourself before you even sit down, that’s a red flag. You shouldn’t have to teach your doctor your own identity.

Resources You Can Use Right Now

You don’t have to figure this out alone. Here are a few trusted places to start:

• Planned Parenthood - All locations offer LGBTQ+-affirming care. You can request a provider trained in queer health.
• GLMA (Health Professionals Advancing LGBTQ+ Equality) - Their provider directory lists doctors who specialize in LGBTQ+ sexual health.
• The Trevor Project - Offers free, confidential peer support and can help you find local clinics.
• Local LGBTQ+ centers - Many, like Q Center in Portland, offer free or sliding-scale gynecology referrals.

And if you’re unsure where to go? Call ahead. Ask: "Do you provide care for women who have sex with women?" If they hesitate, try another clinic. Your health is worth it.

It’s Not Just a Medical Issue - It’s a Human Right

Sexual health isn’t about checking boxes. It’s about feeling safe, seen, and respected. Too many LGBTQ+ women have been failed by a system that never asked them what they needed. But change is happening - slowly, but steadily.

More clinics are training staff. More insurance plans now cover gender-affirming care. More providers are learning that a Pap smear doesn’t care who you love - it only cares if you have a cervix.

You don’t have to be perfect. You don’t have to know all the terms. You just have to show up. And when you do, demand better. Because your body, your pleasure, and your health matter - no matter who you love.