Herts Aid strives for a society where HIV and sexual health is understood and accepted without prejudice or stigma.
Men: Gay, Bisexual and MSM
Whether it’s gay, bisexual or MSM (men who have sex with men) these labels to identify this group will never fit everyone. Men refer to themselves in different ways. So, MSM is used as a description to cover all the possibilities.
MSM are at the highest risk of contracting HIV.
Sexually Transmitted Infections
In addition, having unprotected penetrative sex, is the most likely way to pass on a STI, such as:
Gay and bisexual men should have a check-up at least every six months at a sexual health or genitourinary medicine (GUM) clinic. This is important, as with some STIs there are no symptoms.
It is recommended that tests are carried out at least once a year for HIV infection and more frequently if there are high risk behavior such as multiple partners and Chemsex.
Even with the arrival of PrEP (PreExposure Prophylaxis) and PEP (Post-Exposure Prophylaxis) the use of condoms is still the most effective way of preventing HIV and STI transmission.
Also, there is now resistance to some antibiotics used to treat some STI infections. So in basic terms, “if you’re not in a long term monogamous relationship” then USE CONDOMS.
The more partners we have sex with, the greater the risk of contracting any STIs, so clinic visits for a full sexual health check are really important.
Women: Gay, Bisexual
Compared to MSM, the risks are lower, but women who have sex with women can still pass on sexually transmitted infections. Moving vaginal or anal fluid between women with hands or toys is a higher risk activity than oral sex with a woman.
Barriers to prevent sex fluids moving between women such as dental dams, nitrile gloves and condoms on fingers, and changing condoms on sex toys between partners can vastly reduce risks.
It is also important to remember that although sex between women is usually a lower risk than sex with male-bodied people, many women have sex with men, or have in the past even if they define their identity as lesbian now.
STIs are important to test for and be aware of, even if you have never had sexual contact with a man. You should also take other sexual health considerations, such as smear tests and HPV vaccinations, if you are eligible.
The word ‘trans’ is often used as an umbrella term. It’s used to describe people who feel their gender is, or has been, different from the one they were labelled with at birth.
Trans describes someone’s gender identity rather than their sexuality.
Being Trans: Sex and STIs
Trans people’s health is often described only in terms of medical transition although there are many other elements of trans people’s lives, such as sexual pleasure or sexual wellbeing.
There is a lack of research and UK data for professionals to give advice as accurately as they would wish to, although the good news is this is changing.
Trans people as a group are more likely to be put at risk of STIs and HIV than the general population.
Advice for MSM is usually more accurate than advice for the general population. If you are a trans person, who has sex with cisgender (cis) men – particularly if it’s anal or vaginal sex, without a condom, or your partner has sex with men- this is still true, if:
- you are on testosterone hormone replacement, and you are using your front hole for sex with cis men. The way cis women’s vaginas prevent infection will not be working the same for you.
- You have a neo-vagina, that you are using for sex, particularly if there is a risk of small tears during sex.
Action for Trans Health
It is important for all trans people to look after their sexual health.
This can be difficult, for instance getting a smear test or prostate exam with different gender markers. However, this is improving.
You can leave feedback on the Action for Trans Health website of individual experiences. This will mean services can share best practise and improve.
When it comes to sexual health, it is important that you are not assumed to need identical treatment as a cisgender person. This is true, in particular, if you’ve had hormonal or medical changes to your genitals, specifically when it comes to PEP and PrEP.
If you are trans, you are likely to be eligible for the same vaccinations, services and PrEP trials that MSM are able to benefit from.
Trans and Descrimination
Unfortunately trans people sometimes experience prejudice – this is called transphobia and, apart from making people feel worried and vulnerable, it is illegal.
Two in five trans people (41 per cent) in the UK have experienced a hate crime or incident, because of their gender identity in the last 12 months.
This includes sexual crimes. To put in context, this compares to, the still high, one in six LGB people.
If you are a victim of hate crime please report it and receive support.
Report the hate crime by clicking here or calling 101 or 999 (if in immediate danger). For victim support in Hertfordshire please contact Beacon.
Further Help and Support
Below are links to organisations for you to read about & find out more!
Free holistic sexual health and wellbeing service for all trans* people, their partners and friends. The trans-led team offer a safe, confidential space for those who may not feel comfortable accessing standard health and wellbeing services. cliniQ’s range of services includes community support, gender identity counselling and group work.
Gender Identity Research and Education Society (GIRES)
UK wide organisation providing information. For trans people including those who are non-binary and non-gender, their families and medical professionals.
10am to 10pm switchboard for LGBT+ people (including trans and non-binary people).
Offer family and individual support for teenagers and children with gender identity issues.