Traditional sex education wasn’t designed with queer people in mind. Most of us sat through classes that assumed everyone was straight, cisgender, and having the exact same kind of sex which introduced confusion and sometimes shame from the offset.
This guide is here to fill in the gaps. Not everything will apply to your specific situation, but there’s useful information here for everyone in the LGBTQ+ community. Here’s how to keep yourself and your partners safe, healthy, and informed.
Safer Sex for People with Penises
Whether you’re having sex with other people who have penises or with partners of any gender, here’s what you need to know about protection.
Barrier Methods
Condoms are your most reliable protection. Use them during anal sex, oral sex, and even on shared sex toys to protect against most STIs, including HIV.[^1]
Internal (receptive) anal sex carries the highest risk for HIV transmission, which is why consistent condom use is so crucial. External condoms are highly effective when used correctly every time.[^2]
For oral-anal contact (rimming), dental dams create a barrier between your mouth and your partner’s anus. These thin latex or polyurethane sheets protect both of you from STIs. Can’t find dental dams in shops? You can make one from a condom by cutting off the tip and ring, then cutting down one side to create a flat sheet.[^3]
HIV Prevention
Regular testing keeps you and your partners informed. The NHS recommends testing every three to six months if you’re sexually active with multiple or new partners.[^4]
PrEP (Pre-Exposure Prophylaxis) is a game-changer for HIV prevention. This daily pill is now available on the NHS and stops HIV from establishing infection in your body. When taken as prescribed, PrEP is over 99% effective at preventing HIV from sex.[^5] PrEP takes about seven days to reach maximum protection for receptive anal sex and up to 20 days for receptive vaginal sex.[^6]
PEP (Post-Exposure Prophylaxis) is emergency medication you can take within 72 hours after a possible HIV exposure. The sooner you take it, the better it works. Contact your local sexual health clinic, A&E, or call 111 immediately if you think you’ve been exposed to HIV.[^7]
Important: PrEP and PEP only protect against HIV. You still need condoms to prevent other STIs like syphilis, gonorrhoea, and chlamydia.
Safer Sex for People with Vulvas
Whether you’re having sex with other people who have vulvas or with partners of any gender, protection matters.
Barrier Methods
Sharing sex toys is a common way to spread STIs. Put a fresh condom on toys before sharing them, and wash thoroughly between uses. If you’re switching the toy between partners, change the condom.[^8]
Dental dams work brilliantly for oral-vulval sex and rimming. Place the dam flat over the vulva or anus before oral contact. You can add water-based lube to the receiving side for better sensation. Hold it firmly in place and don’t flip it over mid-use.[^9]
For penetrative sex with fingers or hands, you can use latex or nitrile gloves if you or your partner has cuts, sores, or skin conditions. Trim your nails and file any sharp edges to prevent internal cuts.
STI Testing
The myth that people with vulvas who have sex with other people with vulvas don’t need STI testing is just that: a myth. Research shows that over half of lesbian and bisexual women have never been tested for STIs, but infections like herpes, gonorrhoea, and syphilis can absolutely be transmitted through oral sex and shared toys.[^10]
Get tested every six months or after unprotected sex with a new partner. This applies whether you’re in a relationship or not.
HIV Prevention
Anyone can contract HIV, regardless of their anatomy. While transmission rates are lower for receptive vaginal sex compared to receptive anal sex, the risk is real. If you have sex with people who have penises and people who have vulvas, regular testing and considering PrEP are important options to discuss with a healthcare provider.[^11]
Safer Sex for Trans and Non-Binary People
Body-Inclusive Safer Sex
Your safer sex approach depends on your body, not your gender identity. If you have a penis, follow the guidance for penile safer sex. If you have a vulva, follow vulval safer sex guidance. If you’ve had gender-affirming surgery, work with your healthcare provider to understand any specific considerations.[^12]
Hormone therapy can affect your sexual health in various ways. Testosterone can increase sex drive and may cause vaginal dryness, making water-based lube helpful. Oestrogen can change your sex drive and erectile function. These are normal changes to discuss with your provider.[^13]
Accessing Services
You deserve respectful, affirming healthcare. NHS sexual health services are committed to providing inclusive care for trans and non-binary people. If you experience discrimination or misgendering, you have every right to complain through the NHS complaints procedure.[^14]
Many areas have trans-specific sexual health clinics or LGBTQ+ community health services that provide more specialized care. Organizations like Terrence Higgins Trust and LGBT Foundation can help you find local services.
For People of All Genders Having Sex with Partners of Any Gender
If you’re bi, pan, poly, or your relationships don’t fit neat categories, the same principles apply: use barrier methods, get tested regularly (every three to six months or after new partners), and don’t forget about contraception if pregnancy is a possibility.
Contraception and STI prevention are separate. Methods like the pill, implant, or IUD prevent pregnancy but don’t protect against STIs. You need barrier methods like condoms for STI protection even if you’re using hormonal contraception.[^15]
Understanding Skin-to-Skin STIs
Here’s something many people don’t realize: some of the most common STIs spread through skin-to-skin contact, not just through penetrative sex or bodily fluids. This is especially important for queer people to know because there’s a persistent myth that if you’re not having penetrative sex, you’re protected from STIs. That’s not quite true. 
HPV: Nearly Everyone Will Get It
Human papillomavirus (HPV) is incredibly common. Research suggests around 80% of sexually active people will contract HPV at some point in their lives.[^23] It spreads through genital skin-to-skin contact, including touching, rubbing, and all forms of sex (oral, anal, vaginal). You don’t need penetration for HPV to pass between partners.
Before you panic, here’s the important bit: most HPV infections cause absolutely no problems. Your immune system typically clears the virus within two years without you ever knowing you had it.[^24]
There are over 100 types of HPV. Most are harmless. Some types (like HPV 6 and 11) cause genital warts, which are annoying but not dangerous. About 14 types are considered “high-risk” for cancer. The two most important to know about are HPV 16 and 18, which together cause around 70% of cervical cancers.[^25]
What you need to do:
- If you have a cervix: Attend your cervical screening (smear test) appointments every three years from age 25 to 49, then every five years from 50 to 64. These check for high-risk HPV and abnormal cells.[^26]
- Look out for genital warts: They appear as small bumps or cauliflower-like growths on your genitals or anus. They’re treatable, so see a healthcare provider if you notice them.
- Get vaccinated if you’re eligible: The HPV vaccine (Gardasil) protects against HPV 16, 18, and the types that cause most genital warts. It’s offered free on the NHS to young people.[^27]
- Remember: Trans men and non-binary people with a cervix also need cervical screening. You won’t be automatically invited if you’re registered as male with your GP, so contact your surgery directly.[^28]
The key message here is that HPV is normal and common, not something to feel ashamed about. Regular screening catches problems early when they’re easily treatable.
Herpes: More Common Than You Think
Genital herpes (HSV-2) and oral herpes (HSV-1, which can also cause genital herpes) spread through direct skin-to-skin contact. This includes kissing, genital rubbing, oral sex, anal sex, and sharing sex toys.[^29]
Here’s what makes herpes tricky: it can spread even when there are no visible sores or symptoms. Many people with herpes don’t know they have it because they’ve never had noticeable symptoms.[^30] About six in ten adults carry HSV-1 by age 25, and around one in ten carries HSV-2.[^31]
Herpes isn’t included in standard STI screenings because most infections cause mild or no symptoms and there’s no cure (though it’s very manageable with medication). If you do get outbreaks, antiviral medication can reduce their frequency and severity.[^32]
Barrier methods help but aren’t perfect: Condoms and dental dams reduce herpes transmission risk by around 50%, but the virus can still spread from areas not covered by the barrier.[^33]
The Bottom Line
Don’t let this information scare you away from intimacy. The point isn’t to create fear, but to fill in the knowledge gaps. Many queer people avoid penetrative sex thinking they’re avoiding all STI risk, but skin-to-skin infections like HPV and herpes don’t discriminate based on what kind of sex you’re having.
What you can do:
- Get regular STI tests (every 3-6 months if sexually active)
- Attend cervical screening if you have a cervix
- Use barrier methods when you can
- Have honest conversations with partners
- Get the HPV vaccine if you’re eligible
- Seek treatment if you notice symptoms
Remember: having HPV or herpes doesn’t make you dirty or damaged. These are incredibly common viruses that most sexually active people will encounter. What matters is staying informed, getting screened regularly, and treating yourself with kindness.
Common Questions
Will my doctor tell my parents I’m LGBTQ+?
No. In the UK, sexual health services are completely confidential and free for everyone, regardless of age. If you’re 13 to 16, you have the same confidentiality rights as adults. Healthcare providers can only break confidentiality if they believe you’re at risk of serious harm.[^16]
I think I might have been exposed to HIV. What should I do?
Go to a sexual health clinic, A&E, or call 111 immediately. PEP must be started within 72 hours of exposure, and sooner is better. PEP is a 28-day course of medication that can prevent HIV infection after exposure.[^17]
I’m trans and worried about accessing sexual health services. Will I face discrimination?
While some trans people have had negative healthcare experiences in the past, NHS services are working to improve inclusivity. You have the right to respectful care. If you experience discrimination, you can complain through official channels. Organizations like Terrence Higgins Trust offer trans-specific sexual health information and can help you find affirming providers.[^18]
Do I need to worry about STIs if I only have sex with people who have vulvas?
Yes, absolutely. STIs can be transmitted through oral sex, shared toys, and genital contact. Regular testing and barrier methods are just as important. The idea that women who have sex with women don’t need protection is a harmful myth.[^19]
If I take PrEP, do I still need condoms?
Yes. PrEP is highly effective at preventing HIV, but it doesn’t protect you from other STIs like chlamydia, gonorrhoea, syphilis, or hepatitis. Condoms remain the best protection against the full range of STIs.[^20]
How often should I get tested?
The Terrence Higgins Trust and NHS recommend testing every three to six months if you’re sexually active. Test more frequently if you have multiple partners, new partners, or condomless sex. If you’re using PrEP, you’ll have regular testing as part of your monitoring appointments.[^21]
Where can I get free condoms and dental dams?
Many sexual health clinics offer free condoms, and some provide free dental dams. C-Card schemes operate across the UK, offering free condoms and lube to young people under 25. Check your local sexual health clinic or organizations like Brook, Terrence Higgins Trust, and LGBT Foundation for local schemes.[^22]
Key Takeaways
Your sexual health matters, regardless of your gender, body, or who you’re having sex with. Regular testing, barrier methods, and open communication with partners are the foundations of safer sex. If you’re at higher risk for HIV, talk to a healthcare provider about PrEP.
Sexual health services exist to support you, not judge you. If you experience discrimination, it’s not acceptable, and you deserve better care.
References
[^1]: Terrence Higgins Trust (2024). Navigating happy, healthy sex. Available at: https://tht.org.uk/sexual-health [^2]: Centers for Disease Control and Prevention (2024). HIV Risk Behaviors. Available at: https://www.cdc.gov/hiv/ [^3]: CDC (2024). How to Use a Dental Dam. Available at: https://www.cdc.gov/condom-use/resources/dental-dam.html [^4]: NHS (2024). Sexual health. Available at: https://www.nhs.uk/live-well/sexual-health/ [^5]: NHS (2024). About Pre-Exposure Prophylaxis (PrEP). Available at: https://www.nhs.uk/medicines/pre-exposure-prophylaxis-prep/ [^6]: BASHH/BHIVA (2024). UK Guideline for the Use of HIV Pre-Exposure Prophylaxis (PrEP). Available at: https://www.bashh.org/ [^7]: NHS (2024). Post-exposure prophylaxis (PEP). Available at: https://www.nhs.uk/conditions/post-exposure-prophylaxis-pep/ [^8]: LGBT Foundation (2024). Sexual Health Resources. Available at: https://lgbt.foundation/sexualhealth-resources/ [^9]: Cleveland Clinic (2024). What Is a Dental Dam & How to Use It. Available at: https://my.clevelandclinic.org/health/drugs/22887-dental-dam [^10]: LGBT Foundation (2024). Sexual Health for LB+ Women. Available at: https://lgbt.foundation/women/sexual-health [^11]: Terrence Higgins Trust (2024). Sexual health for trans and non-binary people. Available at: https://tht.org.uk/sexual-health/trans-people [^12]: Terrence Higgins Trust (2024). Navigating sex as a trans person. Available at: https://tht.org.uk/sexual-health/trans-people [^13]: Terrence Higgins Trust (2024). Trans feminine sexual health. Available at: https://tht.org.uk/sexual-health/trans-people/trans-feminine [^14]: NHS (2024). How to complain to the NHS. Available at: https://www.nhs.uk/using-the-nhs/about-the-nhs/how-to-complain-to-the-nhs/ [^15]: NHS (2024). Contraception. Available at: https://www.nhs.uk/conditions/contraception/ [^16]: NHS (2024). Can I see a doctor on my own without my parents? Available at: https://www.nhs.uk/common-health-questions/childrens-health/ [^17]: CDC (2025). Clinical Guidance for PEP. Available at: https://www.cdc.gov/hivnexus/hcp/pep/ [^18]: Terrence Higgins Trust (2021). New resources for trans, non-binary and gender diverse people. Available at: https://www.tht.org.uk/ [^19]: Richters, J., et al. (2010). Do women use dental dams? Sexual Health, 7(2), 165-169. Available at: https://pubmed.ncbi.nlm.nih.gov/20465981/ [^20]: NHS (2024). PrEP: a medicine to reduce the risk of getting HIV. Available at: https://www.nhs.uk/medicines/pre-exposure-prophylaxis-prep/ [^21]: Terrence Higgins Trust (2024). Sexually transmitted infections (STIs). Available at: https://www.tht.org.uk/hiv-and-sexual-health/sexual-health [^22]: Brook (2024). Free condoms. Available at: https://www.brook.org.uk/ [^23]: Royal Marsden NHS Foundation Trust (2024). Your guide to HPV. Available at: https://www.royalmarsden.nhs.uk/your-guide-hpv [^24]: Gloucestershire Hospitals NHS Foundation Trust (2024). HPV (Human Papilloma Virus). Available at: https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/hpv-human-papilloma-virus-ghpi0787/ [^25]: Cancer Research UK (2024). Cervical screening results and questions about HPV. Available at: https://www.cancerresearchuk.org/about-cancer/cervical-cancer/getting-diagnosed/screening/results [^26]: NHS (2024). Cervical screening (smear test). Available at: https://www.nhs.uk/conditions/cervical-screening/ [^27]: NHS (2024). HPV vaccination. Available at: https://thamesvalleycanceralliance.nhs.uk/our-work/patient-engagement-patient-experience/campaigns/hpv-vaccination/ [^28]: Cancer Research UK (2024). Men can’t routinely get a HPV test for free through the NHS. Available at: https://www.cancerresearchuk.org/about-cancer/cervical-cancer/getting-diagnosed/screening/results [^29]: WHO (2025). Herpes simplex virus. Available at: https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus [^30]: American Sexual Health Association (2023). Five Things You Should Know about Herpes. Available at: https://www.ashasexualhealth.org/five-things-you-should-know-about-herpes/ [^31]: Herpes Viruses Association (2024). How can herpes be transmitted? Available at: https://herpes.org.uk/frequently-asked-questions/passing-transmitting-herpes/ [^32]: MIT Health (2024). FAQ: Herpes. Available at: https://health.mit.edu/faqs/herpes [^33]: Minnesota Department of Health (2024). Genital herpes. Available at: https://www.health.state.mn.us/diseases/herpes/genitalherpes.html
This guide was created using information from Terrence Higgins Trust, LGBT Foundation, NHS, CDC, and other reputable LGBTQ+ sexual health organisations. Information current as of December 2024. For the most up-to-date guidance, consult your local sexual health service or visit the organisation websites listed above.
Need support? Contact Terrence Higgins Trust’s helpline: 0808 802 1221 (Mon-Fri 10am-6pm) or LGBT Foundation’s helpline: 0345 3 30 30 30 (Mon-Fri 9am-9pm, Sat 10am-6pm).
Founder and CEO of Cliterally The Best, Evie Plumb is a qualified sex educator and nearing the completion of her training in Psychosexual & Relationship Therapy. She’s on a mission to provide accessible, inclusive sex education for those of us who had a sh*tty sex ed – because when we truly understand our bodies and relationships, life is so much better (and, more importantly, way more fun!).
