Can Lesbians Get STDs? Transmission, Risks, and Prevention

Women who have sex with women can and do get sexually transmitted infections, including chlamydia, genital warts, trichomoniasis, herpes, syphilis, bacterial vaginosis, HPV, and in rare cases HIV. In one study, about 13% of women who reported only female sexual partners had been diagnosed with an STD at some point in their lives, and 15% of women who self-identified as lesbians reported the same.

Why the Myth of Zero Risk Persists

For decades, public health messaging around STDs focused heavily on heterosexual intercourse and sex between men, creating the impression that sex between women carried negligible or no infection risk. Research has documented how lesbians often assess their STI risk through the lens of identity rather than behavior, locating “risk” in categories like gay men or bisexual women rather than in specific sexual practices.

This perception has consequences. A qualitative study of lesbian safer-sex narratives found that many women relied on culturally circulated ideas about identity to gauge risk, with some participants saying they had never realized that sex between two women could be unsafe.¹ Meanwhile, an interview-based study of lesbian and bisexual women found that knowledge of the potential for STD transmission between women was limited, and that preventive measures like gloves or cleaning shared sex toys were rarely used.²

The problem is compounded by a lack of language around lesbian safer sex. Without clear, widely shared guidance on which activities carry risk and how to reduce it, many women default to the assumption that female-to-female contact simply does not transmit infections. That assumption is wrong.

How STDs Pass Between Women

STDs do not require penile-vaginal intercourse to spread. The pathogens involved in most STDs travel through skin-to-skin contact, mucous membrane exposure, or the exchange of vaginal fluids, saliva, and blood. During sex between women, several common activities create those opportunities.

Oral-genital contact: Herpes (HSV-1 and HSV-2), HPV, and syphilis can all spread this way. A published case report documented female-to-female syphilis transmission specifically through oral-genital sex.³
Shared sex toys: Inserting a toy vaginally (or anally) and then passing it to a partner without cleaning it or covering it with a new condom can transfer bacteria and viruses between partners. Researchers have noted that sharing toys during a sexual encounter without barrier protection is common among women who have sex with women.²
Finger and hand contact: Digital penetration can transfer vaginal secretions from one partner to another, especially if there are small cuts or abrasions on the skin.
Genital-to-genital contact: Tribbing or other forms of vulva-to-vulva contact can expose both partners to skin-based infections like herpes, HPV, and molluscum contagiosum.

The key point is that risk is tied to specific practices, not to the gender of the people involved. Any activity that allows mucosal fluids, blood, or direct skin contact between an infected area and a susceptible site can serve as a route for infection.

Bacterial Vaginosis Between Female Partners

Bacterial vaginosis (BV) deserves special attention because it is particularly common among women who have sex with women and because its transmission dynamics are still underappreciated. BV occurs when the normal balance of vaginal bacteria shifts, with certain types of bacteria overgrowing. It can cause discharge, odor, and discomfort, though many women have no symptoms at all.

A cross-sectional study of 101 women in monogamous same-sex relationships found that about 29% had BV. The striking finding was the concordance between partners: when one woman in a couple had BV, her partner also had it roughly 73% of the time. When the index partner did not have BV, her partner had it only 10% of the time. A woman’s odds of having BV were almost 20 times higher if her partner had it, leading the researchers to conclude that BV is likely sexually transmitted between women.⁴

BV matters beyond discomfort. It is associated with increased susceptibility to other STDs, pelvic inflammatory disease, and complications during pregnancy. Women in same-sex relationships who experience recurrent BV sometimes find it frustrating because clinicians may not recognize or discuss the sexual transmission component, focusing instead on individual microbiome factors.

HPV and the Cervical Cancer Screening Gap

Human papillomavirus is one of the most common STDs globally, and it spreads easily through skin-to-skin genital contact. Because HPV transmission does not require penetrative sex, women who have sex exclusively with women can and do contract it. Certain strains of HPV cause genital warts; others increase the risk of cervical cancer. This makes regular cervical screening (Pap tests) important regardless of the gender of your partners.

Yet research consistently shows that lesbians screen for cervical cancer at lower rates than heterosexual women. A national survey found that the prevalence of up-to-date cervical cancer screening was about 10% lower among LGB cisgender women compared with heterosexual women.⁵ Another study found that lesbian women had roughly 42% lower odds of having had a Pap test within the recommended period compared with heterosexual women who reported no same-sex partners.⁶

Part of the gap comes from perception. A study of barriers to cervical screening among lesbians found that women who were behind on screening perceived fewer benefits from Pap tests, faced more perceived barriers, and were less knowledgeable about screening guidelines than those who screened on schedule.⁷ The belief that cervical cancer is mainly a concern for women who have sex with men likely fuels this gap. But HPV does not care about sexual orientation, and skipping screening can mean HPV-related cervical changes go undetected until they become harder to treat.

HIV Between Women

Female-to-female sexual transmission of HIV is rare, and for years public health authorities described the risk as essentially theoretical. The virus does not survive well outside bodily fluids, and the most efficient routes of transmission involve blood exposure, anal intercourse, or vaginal intercourse with a male partner. But “rare” is not “impossible.”

In 2014, the CDC published an investigation of a case in Texas where a woman was likely infected with HIV by her female partner during a six-month monogamous relationship. The newly diagnosed woman had no other recognized risk factors, and laboratory analysis showed that her virus shared over 98% genetic sequence identity with her partner’s virus across three genes. Her partner had stopped taking antiretroviral treatment two years earlier. The couple reported sexual practices that involved exchange of body fluids, including during menstruation.⁸

The case was notable enough to warrant its own CDC report precisely because confirmed female-to-female HIV transmission is so uncommon. The practical takeaway is that the risk is very low compared with other sexual routes, but it is not zero. Exposure to menstrual blood, contact during outbreaks of other genital infections (which create breaks in mucous membranes), and sharing toys that have blood or secretions on them all represent plausible routes. If you know your partner is HIV-positive, the same prevention principles apply as in any serodiscordant relationship: treatment that keeps viral load undetectable effectively eliminates transmission risk, and pre-exposure prophylaxis (PrEP) is available for the HIV-negative partner.

The Role of Sexual History With Men

Many women who identify as lesbians have had sex with men at some point, and this part of their history can matter for STD risk in ways that are sometimes overlooked. A study of over 6,000 self-identified lesbians found that women who reported six or more lifetime male sexual partners were most likely to have had an STD. Younger lesbians, those with lower incomes, and those who had not graduated from college were more likely to have had a recent male partner.⁹

This does not mean that STD risk among lesbians comes only from male partners. As the BV, HPV, and syphilis evidence makes clear, woman-to-woman transmission is real. But it does mean that a clinician who assumes a patient has never had sex with men simply because she identifies as a lesbian may miss an important piece of her health picture. It also means that infections acquired during previous relationships with men can enter a sexual network of women who have sex with women and then be passed along through female-to-female routes.

The broader point is that sexual identity labels do not map neatly onto sexual behavior. About 15% of self-identified lesbians in one large study reported ever having been diagnosed with an STD, including chlamydia, genital warts, trichomoniasis, and pelvic inflammatory disease. Among the subset who had only ever had female partners, the figure was about 13%.¹⁰ The second number is lower but nowhere near zero.

Prevention That Actually Works

The basics of STD prevention apply regardless of who your partner is, but several methods are especially relevant for sex between women.

Dental dams: These thin sheets of latex or polyurethane are placed over the vulva or anus during oral sex. They reduce skin-to-mucous-membrane contact and the exchange of fluids. Despite being simple to use, they remain underutilized because many people do not know about them, find them difficult to buy, or have never been taught how to use them by a health educator.¹¹ You can also cut a condom open lengthwise to create a makeshift barrier in a pinch.
Gloves: Latex or nitrile gloves during digital penetration reduce the chance of transferring vaginal secretions from one partner to another and protect against transmission through small cuts on the hands.
Cleaning or covering sex toys: Washing shared toys with soap and water between partners, or covering them with a fresh condom each time they are switched, prevents direct fluid transfer.
HPV vaccination: Vaccination remains one of the most effective ways to prevent HPV-related cancers and genital warts. A national survey of lesbian and bisexual women found that about 45% had received at least one dose, with the most common reason being a healthcare provider’s recommendation.¹² Among younger participants aged 18 to 26 in a more recent cross-sectional study, 77% of LGBTQ+ individuals had received at least one dose, suggesting uptake is improving over time.¹³ However, one study found that lesbian-identified women did not differ significantly from heterosexual women in vaccination rates and remained behind bisexual women, who were most likely to be vaccinated.¹⁴
Regular screening: Pap tests, STI panels, and conversations with a healthcare provider about your actual sexual practices (rather than assumptions based on identity) are the backbone of catching infections early and preventing long-term complications.

None of these methods are complicated, but all of them require awareness that risk exists in the first place. That awareness has been slow to develop in part because safer-sex education has historically been framed around heterosexual intercourse and condom use.

Healthcare Barriers That Make Things Worse

Even when women who have sex with women want to take care of their sexual health, the healthcare system can make it harder than it should be. The barriers are not imaginary. Health inequalities for lesbian and bisexual women are well documented and largely stem from experiences of discrimination, homophobia, and heterosexism, which can lead to avoidance of routine healthcare and reduced disclosure of sexual orientation during consultations.¹⁵

Disclosure itself is a significant hurdle. A qualitative study found that when clinicians framed conversations in heteronormative ways, such as asking “what kind of birth control do you use?” instead of open-ended questions about sexual activity, patients felt the door to discussing their actual sexual lives was closed. Participants felt the burden fell on them to decide whether their sexual identity was clinically relevant, and many chose not to bring it up.¹⁶ An experimental study tested this directly and found that when a doctor communicated in a heteronormative manner, patients were less likely to disclose health-relevant information and reported lower trust in the physician.¹⁷

The downstream effect is predictable: if you do not tell your doctor who you are having sex with, your doctor cannot give you the right advice. And if your doctor assumes you are heterosexual, they may not bring up cervical screening, may not ask about female partners, and may not discuss the specific STD risks that apply to your situation. Participants in one study suggested that the burden of disclosure could be eased if physicians simply asked about sexual identity early and directly, rather than waiting for the patient to volunteer it.¹⁶

What You Can Do on Your Own

If you have sex with women and feel like your healthcare provider is not covering the STD conversation, there are a few practical things worth keeping in mind. First, if you are under 45 and have not been vaccinated against HPV, it is worth asking about. The vaccine protects against the strains most likely to cause cervical cancer and genital warts, and it works regardless of your sexual orientation. Second, Pap tests are for everyone with a cervix who falls within the recommended age range, full stop. Having only female partners does not exempt you from cervical screening guidelines. Third, if you or a partner experiences symptoms like unusual discharge, sores, itching, or a persistent change in vaginal odor, getting tested is straightforward and a standard STI panel will cover most of the relevant infections.

For barrier methods, dental dams and gloves are available at most pharmacies and online. They are not glamorous, and uptake is low across the board, but having them around normalizes the idea that protection during sex between women is a real thing and not a theoretical concern.

Finally, talking with your partner about sexual health history, recent testing, and current symptoms is one of the simplest and most effective prevention tools available. It costs nothing, requires no supplies, and directly addresses the information gap that research keeps identifying as a driver of STD risk among women who have sex with women.

1
Taylor & Francis Online / PubMed Central. ‘I never realised that sex between two women was not safe’: narratives of lesbian safer sex
2
PubMed Central. Sexual practices, risk perception and knowledge of sexually transmitted disease risk among lesbian and bisexual women
3
PubMed. Female-to-female transmission of syphilis: a case report
4
PubMed. Bacterial vaginosis in lesbians: a sexually transmitted disease
5
JAMA Network Open. Sexual Orientation and Cervical Cancer Screening Among Cisgender Women
6
PubMed Central. Sexual orientation differences in cervical cancer prevention among a cohort of U.S. women
7
PubMed Central. Barriers to Cervical Cancer Screening Among Lesbians
8
PubMed Central. Likely female-to-female sexual transmission of HIV–Texas, 2012
9
JAMA Internal Medicine. Lesbians’ Sexual History With Men: Implications for Taking a Sexual History
10
PubMed Central. Beyond Assumptions of Negligible Risk: Sexually Transmitted Diseases and Women Who Have Sex With Women
11
PubMed Central. Dental dams in dermatology: An underutilized barrier method of protection
12
Vaccine. HPV vaccination among lesbian and bisexual women: Findings from a national survey of young adults
13
PubMed. Evaluation of Human Papillomavirus Vaccination and Cancer Prevention Behaviors among LGBTQI + Individuals: A Cross-Sectional Study
14
PubMed. Changing HPV vaccination rates in bisexual and lesbian women
15
PubMed. Lesbian health inequalities: a cultural minority issue for health professionals
16
PubMed Central. Exploring lesbian, gay, bisexual, and queer people’s experiences with disclosure of sexual identity to primary care physicians: a qualitative study
17
PubMed. Heteronormativity and practitioner-patient interaction