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Safer sex education must be based on sexual behaviour and not on sexual orientation. It is important to take a full sexual history on all patients, regardless of sexual orientation, and to determine which sexual behaviours patients are engaging in.

There is little information about safe sex for lesbians[1]. Women who have sex with women have been largely ignored by HIV/AIDS prevention and safer sex education campaigns[2]. Because there are few public health campaigns directed at women who have sex with women health care providers need to fill this void and be knowledgeable about safer sex practices and comfortable discussing them with patients[2]. In one Canadian study of lesbian and bisexual women in the Atlantic provinces[2], the interview participants articulated concerns that the medical profession still enforces heterosexual norms by asking questions about sexual health that assume a woman is having sex with men. This heterosexism left participants feeling unable to get the required information and responsible for educating their providers on safe sex for women who have sex with women.

Safer Sex


Increasing Risk

Safer Sex

Dry Kissing

Considered a safe act

French Kissing (Insertion of the tongue while kissing)

Sores in the mouth

Avoid brushing teeth or flossing before kissing

Masturbation (either self or mutual masturbation with NO exchange of body fluids)

Considered a safe act

Tribadism/Dry Humping/Frottage

Tears or abrasions

Avoid if one partner has a contagious skin infection

Digital Stimulation/Fingering (Finger stimulation of the vagina or rectum)

Tears or abrasions

Use of latex gloves or individual finger cots

Cunnilingus/Going Down On/Eating Out (Oral sex on a woman)

Menstruation, open sores or lesions

Use of dental dams

Fellation/Giving Head/Giving a Blow Job (Oral sex on a man)

Ejaculation, open sores or lesions

Use of condoms

Sex Toys

Presence of blood or other body fluids on the toys

Use of condoms and changing condoms between partners or between orifices; cleaning toys using bleach between partners

Penile-Vaginal Intercourse

Tears or abrasions

Use of condoms or female condoms, use a new condom when using a new orifice

Penile-Anal Intercourse

Tears or abrasions

Use of condoms or female condoms

Analingus/Rimming (Oral-anal stimulation)

Tears or abrasions

Use of dental dams

Water Sports (Urinating, expelling a douche or an enema on one’s partner)

Tears or abrasions

Use of disposable nozzles, latex gloves, personal bags

Fisting (Insertion of the fist into the vagina or anus)

Tears or abrasions

Use of latex gloves

Sadomasochism/S&M/Bondage/ Whipping/Paddling/Not "Vanilla Sex"

Must have a safe word; physician should ensure that any wounds were obtained voluntarily



1. Solarz, AL Ed. Lesbian Health: Current Assessment and Directions for the Future. Washington DC. National Academy Press; 1999.

2. Bailey N, Gurevich M, Mathieson C. Voix Feminstes / Feminist Voices No. 10. Invoking community : rethinking the health of lesbian and bisexual women. Ottawa, ON. CRIAW = ICREF; 2000.

All references for this section