LGBTQIA Safer Sex Guide

Who this is for 

Only 5 (ish) percent of LGBTQIA students saw any LGBTQIA representation in health class.

This guide is for the 95 percent of students whose manymanymany sexual health questions went woefully unanswered in school.

It’s also for any LGBTQIA person who’s ever wondered:

• “What conversations should I have with a partner before sex?”
• “Is there a risk of pregnancy or STI transmission during [insert sex act here]?”
• “What can I do to make sex even better?”
• “How do I become comfortable with my own body?”

Or anything else related to sexual health, sexual pleasure, and sexual play.

If you haven’t already, get to know your body 

“The idea that someone is going to come along and introduce you to out-of-this-world sensations makes good fantasy,” says Andy Duran, queer sex specialist and education director for Good Vibrations. Case in point: the movies “Call Me By Your Name,” “Moonlight,” and “Below Her Mouth.”

But IRL nobody can magically deduce what brings you pleasure. “Our partners are best able to pleasure us when we can tell them how to pleasure us,” Duran says.

That’s why he recommends getting acquainted with your body via body mapping and masturbation.

Body mapping is the process of becoming familiar with your own body. It’s all about exploring what different parts of your body look, smell, taste, and feel like.

“This is especially important to queer and trans folks, because it allows them to learn the ways they like to be touched that they find most affirming and pleasurable,” Duran says.

While similar, masturbation is typically more sexual. “It’s a way to learn what brings you pleasure, what helps you orgasm, and what doesn’t do it either,” he says.

A nonexhaustive list of things your solo sesh might include:

• stimulating your genitals or bum
• dancing erotically
• watching erotic films
• self-massage

Determine your individual risk for pregnancy and STIs

Birds and the bees, but make it queer.

Trauma-focused therapist and sexuality educator Aida Manduley, LCSW, explains that for pregnancy to happen, two things need to be present:

1. sperm
2. an egg

“One person needs to have testicles (where sperm is produced), prostate and bulbourethral glands (to create the other components of semen), and a urethra (for the sperm to travel through),” Manduley says.

And another person needs to have an ovary (where eggs are produced) and a uterus (where the sperm meets the egg).

Your anatomy and the anatomy of your partner(s) are the key factor here, not your gender identity or sexual orientation.

People assigned female at birth on testosterone may still be able to get pregnant, says Manduley.

“Similarly, folks assigned male at birth who are taking estrogen or other hormone replacement may still be able to get partners with a uterus pregnant,” they say.

Assume pregnancy is a risk, unless a medical provider has told you you’re sterile or unable to get someone pregnant, adds Manduley.

As for sexually transmitted infections (STIs)? No gender identity or sexuality is immune to STIs. The only way to know your STI status is to get tested after every new sex partner.

There are great websites, such as Get Tested, that’ll help you find a local testing center. STD Test Express and SH:24 are great resources for those interested in at-home STI kits and testing.

Stay up to date on medications, vaccines, and screenings 

Prevention, as they say, is the best medicine. Luckily, in the case of STIs and pregnancy, there are a number of risk reduction measures you can take.

1. Stay up to date on vaccines

Specifically:

• hepatitis A
• hepatitis B
• HPV vaccine

Note: While the HPV vaccine was previously only recommended for people assigned female at birth, the current Centers for Disease Control and Prevention (CDC) guidelines recommend the vaccination for all folks between the ages of 11 and 26.

Some 27- to 45-year-olds who aren’t already vaccinated may also decide to get the vaccine after assessing their risk for HPV.

2. Consider PrEP

Pre-exposure prophylaxis (PrEP) is a medication that an HIV-negative person can take daily to reduce their risk for contracting HIV while being sexual with an HIV-positive person.

The CDC guidelines recommend PrEP for:

• people who are sexual with an HIV-positive person
• people who don’t consistently use barriers
• anyone who’s been diagnosed with another STI within the last 6 months
• anyone who uses or has a partner who uses intravenous substances and shares needles, syringes, or other equipment to inject

If you fall into one or more of those groups, chat with your doc.

Note: If you’re not on PrEP and suspect recent HIV exposure, you can take post-exposure prophylaxis (PEP) within 72 hours to reduce transmission risk.

3. Birth control

Again, “Pregnancy is a risk when the involved parties have the anatomy for it,” Manduley says. If you’re looking to avoid pregnancy, talk to your doctor about your birth control options.

If you aren’t on birth control and recently engaged in unprotected play with a partner who could get you pregnant, an emergency contraceptive can be used within 3 to 5 days (depending on the method) to stop a pregnancy before it starts.

Make sure you use condoms and other barrier methods correctly 

Raise your hand if the limited sex education you did receive involved avoiding eye contact while your teacher rolled a condom over a banana. Well, spoiler alert, safer sex goes way beyond condoms.

Oh, and FYI: You don’t need to have a banana (ahem) to use a condom. Here’s what you need to know.

Outside condoms

Outside condoms can be used for penetrative and oral sex involving a penis to contain the bodily fluids (e.g., semen, ejaculate, and pre-ejaculate).

Outside condoms can also be used with sex toys for easy cleanup. “For sex toys made out of porous materials, they’re a must,” Duran says.

How to use an outside condom

1. Place the rim of the condom over the penis or toy and leave a small space for bodily fluids to go by pinching the tip.
2. Roll the condom over the outside of the shaft until the rim of the condom meets the base.
3. Apply lube to reduce friction.
4. When done, hold the rim of the condom with your hand as it’s removed from the body.
5. Dispose.

“Make sure to use lube that’s compatible with whatever toys or barriers you’re using,” Manduley says.

“Oil-based lubes aren’t compatible with latex barriers, for example.” And silicone-based lubes shouldn’t be used with silicone toys.

Inside condoms

Designed to line the walls of the front hole, vagina, or anus, an inside condom can be used for penetrative sex involving the front hole, vagina, or anus.

Only one brand is available in the United States, but health clinics often have them. Woot!

A note on terminology

For the purposes of this guide, we’ve chosen to include alternative words for readers to use for their genitals.

Whenever we use the medical term “vagina,” we’ll also include “front hole,” as clinically recommended by researchers in the BMC Pregnancy and Childbirth journal.

How to use an inside condom

1. Inside condoms have a closed and open ring. Apply a small amount of lube on the outside of the closed end.
2. Pinch the closed ring with fingers, then push it as far back as possible, allowing the condom to line as much of the internal hole as possible.
3. Allow the open rim of the condom to hang out of the hole opening.
4. During penetration, a body part or toy will go into the open rim of the inside condom.
5. After, remove the toy or body part from the inside condom slowly. Then pinch the open rim of the condom together and remove from the body.

Dams

More than dental office fodder, dams also serve as a barrier for cunnilingus or analingus.

How to use a dam

1. Open the package (carefully!), then unfold the dam all the way.
2. Have the receiver apply lube to their bits to boost feel-good sensation.
3. Have the giver place the dam over the body part where oral sex will be performed, and hold it in place.
4. When finished, throw away.

“If during play you can’t tell which side was touching what body part, or it gets super covered in bodily fluids, get a new one,” Manduley suggests. After all, if the barrier is compromised, it’s not effective.

Note: Dams can be pricey and hard to find. Luckily, you can make your own dam by cutting open an outside condom. This step-by-step guide can help you get started.

Gloves and finger cots

Finger cots protect genitals from the germs found on your finger or nail during one-finger fingering, as well as keep that finger bodily fluid-free.

Engaging in fisting or external manual stimulation? Grab a five-finger cot — aka a glove — instead.

How to use cots or gloves

1. Wash and dry hands, then slide on the cot/glove.
2. Apply lube to barriers and bits to increase pleasure.
3. Use one glove for only one body part. New body part = new glove.
4. When finished, pinch the base of the barrier and pull it toward your fingers, turning it inside out to keep fluids where they are.
5. Dispose.

Pro tip: “Get them in a color that feels fun or sexy to you and your partners,” Manduley says. “Black nitrile gloves, for instance, are a key part of many folks’ sex toolkit.”

Get clear about communication and consent 

The best sex = consensual and communicative. Here’s what you need to know.

Consent 101

Sexual consent is the ongoing, enthusiastic agreement to participate in a sexual act that’s granted before it takes place.

It’s required before:

• any sexual activity (including kissing!)
• any new sexual activity (consenting to one thing doesn’t imply consent for another)

Beyond being legally and ethically required, checking in with your sexual partner(s) before and during a ~sexual encounter~ can help create a safe environment where sex can be a mutually pleasurable and positive experience grounded in respect and understanding. Love that!

Some ways to ask for consent:

• “I’d love to taste between your legs. Is that something you’d like?”
• “Can I kiss you?”
• “Do you want to tease yourself with that new vibrator you got in the mail?”
• “Can I send you the hot nude I just snapped of myself?”

You might be wondering, “Can consent be nonverbal?” Implied consent is tricky business. Why? Because it’s easy to misread cues.

“It’s best to get verbal consent,” Duran says.

Communicate, communicate, communicate

For the most pleasurable experiences, communication needs to go beyond just consent.

That means:

• telling your partner how and where you like to be touched
• asking your partner how and where they like to be touched
• asking/knowing/using nouns, verbs, and adjectives that your partner finds affirming
• being on the same page about safer sex practices

Some questions you might ask ahead of getting down:

• “I want to make sure we’re using language that feels good to both of us. Can we talk about the words we each use for our bits and the words we like different acts called?”
• “I like having my genitals called my ‘girl dick’ and for oral sex to be called ‘going down on.’ What terms do you like?”
• “Hey, I’m wondering if we can check in about what safer sex practices we want to use.”
• “There are usually a few conversations I like to have before having sex. Do you mind if we talk about the sex acts we want to explore and how to do so safely?”

If alcohol or other substances are in the mix 

Most safer sex guides will say that sobriety is a prerequisite to consent. But as Manduley notes, “It’s silly to expect people to not hook up while under the influence of some substance.”

That’s where harm reduction comes in.

According to Manduley, harm reduction can look like some combination of the following:

• Discuss what kind of sex will be taking place (and what barriers will be used) before any substances are consumed.
• Mix less substances (e.g., keep it to alcohol instead of alcohol and also coke).
• Openly discuss what substances people are currently on or using.
• Make sure there’s water available, as some substances can cause dehydration.
• Discuss if this is someone’s first time using a substance or not. If it is, consider delaying or going slower than you would otherwise.
• Get familiar with the effects of popular substances so you can better recognize if someone else may be on or using them.
• Check in periodically with your partners and pause/slow/stop if you have a hard time understanding them, or they’re slurring their words.
• Carry safer sex supplies in the same kit as your substances (if relevant) so you don’t lose them and will remember to use them.

“If the next day you can’t remember what barriers were used, the next day you might consider post-exposure prophylaxis or emergency contraception,” Manduley adds.

What to expect from erogenous play 

Don’t want to take your clothes off? No sweat, you can still get it on!

Enter: Outercourse.

“Dry humping, kissing, and over-the-clothes grinding are often forgotten about after high school, but these are super-duper pleasurable, sensual, and intimate, and should be enjoyed by folks of all ages,” Duran says.

To make outercourse better:

• Add a little lube against skin.
• Use seams and buttons to benefit (or avoid, depending on preference).
• Add in a wearable sex toy.
• Practice eye-gazing.

“Many people experience orgasm more early through outercourse without the risk of STI transmission,” he says.

Safety considerations

Assuming both partners keep their clothes on and there’s no bit-to-bit contact or bodily fluid exchange, STIs aren’t a risk. And neither is pregnancy.

However, sitting in your own fluids after the fact can ramp up your risk for bacterial vaginosis or yeast infection, so consider a changeroo afterward.

What to expect from hand sex

“Exploring your partner’s body with your own hands is incredibly intimate,” Duran says. “Plus, it can feel really good for them, depending on the types of strokes and pressures you use.”

The hand = the OG sex toy, after all.

Hand sex includes:

• external stimulation of genitals
• chest and nipple stimulation
• fisting
• fingering

Pro tip: All of these are made better with lube.

Safety considerations

Please for the love of “Didn’t you learn anything during COVID-19?!” wash your hands before touching anyone’s bits.

Your hands are covered in bacteria that could mess with the natural pH of you or your partner’s front or back hole and lead to:

• discomfort
• bacterial vaginosis
• urinary tract infection (UTI)
• yeast infection
• other infections

Duran also recommends giving yourself a lil manicure. “Hangnails and fingernails can tear the delicate external internal tissues or puncture a hole in your barrier,” he says. Yikes.

Can you engage in manual play with long nails? Actually, yes. “It will just require a little more prep,” Manduley says.

“Put cotton balls inside the fingertips of a cot or glove before putting it on,” they explain. “If your nails are sharp, this will keep them from puncturing the glove.” Crafty.

Note: While hand sex is generally considered a safer sex option, the hand can act a vector for infectious agents. So, if your partner has an STI, you touch them, and then use that same hand to touch yourself, infection is possible.

What to expect from oral sex 

“Cishet culture makes it seem like oral sex is just a precursor act, but oral sex is an amazing activity that deserves to be thought of as the whole show,” Duran says.

What’s so hot about it?

“The giver gets to literally taste their partner, smell their partner, learn their partner’s anatomy with their own mouth, and practice communicating with their partner,” Duran says.

Meanwhile, the receiver’s nerve-rich bits (think: clit, penis, perineum, anal sphincter, anal canal) get a lot of attention!

Safety considerations

Despite common discourse, it is possible for STIs to be transmitted via oral play.

So, talk with your partner(s) about the last time they were tested for STIs. If it’s been a while since one or all of you were tested or one or all of you have an STI, use a dam.

Oh, and hold off if you notice cuts, sores, bumps, or high-risk bodily fluids — such as blood — on their genitals or in their mouth, as this can be a sign of an infection and can increase the chances of transmitting an STI.

What to expect from penetrative sex 

Intercourse! Fisting! Fingering! Strap-on sex and pegging! Anal beads, prostate stimulators, and plugs! Internal vibrators, wearable vibrators, and thrusters!

The wonderful world of penetrative sex is vast and wide.

“In queer culture, typically the partner doing the penetrating is the ‘top,’ while the partner being penetrated is the ‘bottom,’” Duran says.

“A bottom might enjoy penetration because of the physical sensation, the feeling of fullness, the power dynamics it creates with their partner, or because they like sharing that part of themselves with their partner,” he says.

“A top can enjoy being able to feel their partner’s anatomy from the inside or the sensation of being in control,” he adds.

A top can also enjoy the way penetration feels against their own body, or against a toy that they’re in control of.

Safety considerations

Beyond just knowing your own current STI status and your partners, and (correctly) using a condom, glove, or finger cot — use lube!

“Lube is especially important during penetrative anal sex,” Duran says. “The anus doesn’t produce any natural lubricant, and the tissue in the anal canal is super thin.”

Without lube, there’s too much friction, which, in addition to being painful, can damage the anal lining. Duran says this increases the risk of STI transmission.

Also: “Make sure any toy that’s going in the booty has a flared base so it doesn’t get accidentally lodged up there and require an ER trip.”

The flared base keeps it planted firmly outside the body.

If you experience pain, discomfort, or other dysfunction

Sex is supposed to make you feel good physically, emotionally, mentally, and spiritually.

“If you find that sex has become a challenge for you — whether that’s because it fills you with shame, makes you feel dysphoric, or is physically uncomfortable — it’s time to bring in a professional,” Duran says.

A professional here could mean a:

• pelvic floor therapist
• therapist
• sex therapist
• psychologist
• psychiatrist
• clinician
• OB-GYN
• sex educator

Finding a healthcare provider who’s the right match can be another key factor in sexual health and wellness. So, no matter which type of professional you seek out, make sure they’re queer-inclusive and gender-affirming.

Where you can learn more

Now that you’ve got a basic framework on safer and more-pleasurable sex practices for LGBTQIA folks, you might have other questions. Below, find additional reading material based on category.

On specific sex acts:

• Everything You Need to Know About Scissoring
• A Beginner’s Guide to Anal Fisting
• A Beginner’s Guide to Vaginal Fisting
• Solo Sex Is for Everyone — Here’s How to Get Started
• Into Solo Play? Here’s How to Turn Things Up a Notch with Mutual Masturbation
• Is Outercourse the Same Thing as Abstinence? And 5 Other Questions, Answered
• Does Anal Hurt? What to Know for Your First Time
• 26 Things to Know About Pain and Pleasure During Your First Time

On STIs:

• What to Expect from Anal STI Testing — and Why It’s a Must
• How to Test for Nongenital STIs and Why You Should
• Your 13 Most-Googled STI Q’s, Answered
• Can You Get an STI from a Hand Job? And 9 Other Questions, Answered
• Everything You Need to Know About At-Home STI and STD Tests
• How to Access Free or Low-Cost STI Testing in Each State (and Why You Should!)

On contraception:

• What Happens If a Cisgender or Trans Man Takes Hormonal Birth Control?
• Which Birth Control Is Right for You?

Mere Abrams is a researcher, writer, educator, consultant, and licensed clinical social worker who reaches a worldwide audience through public speaking, publications, social media (@meretheir), and gender therapy and support services practice OnlineGenderCare.com. Mere uses their personal experience and diverse professional background to support individuals exploring gender and help institutions, organizations, and businesses to increase gender literacy and identify opportunities to demonstrate gender inclusion in products, services, programs, projects, and content.

Gabrielle Kassel is a New York–based sex and wellness writer and CrossFit Level 1 Trainer. She’s become a morning person, tested over 200 vibrators, and eaten, drunk, and brushed with charcoal — all in the name of journalism. In her free time, she can be found reading self-help books and romance novels, bench-pressing, or pole dancing. Follow her on Instagram.