Safe and pleasurable LGBTQ+ sex, as told by experts

By Mari Devereaux, Managing Editor

Due to a lack of sex education regarding lesbian, gay, bisexual and transgender relationships, those in the community can have trouble navigating sexual encounters.

Christopher Belous, associate professor and clinical director for Purdue University Northwest’s Marriage and Family Therapy program, said sex for LGBTQ+ people can be challenging due to fear of the stigma surrounding same-sex relations, media sensationalization of risky sexual practices and a lack of knowledge about what same-sex intercourse actually looks like.

In an effort to combat this, the Chronicle compiled advice and intimacy tips from certified sex experts for members of the LGBTQ+ community looking to engage in safe and pleasurable sex.

1. Consent and communication are key

The first and most important requirement for pleasurable sex is an enthusiastic, verbal “yes,” said Janet Brito, a psychologist who runs the Center for Sexual and Reproductive Health in Honolulu, Hawaii.

Consent, like trust, must be completely earned in a sexual relationship. It is essential to discuss boundaries and advocate for your own safety, needs and desires during sex.

Brito said it is important for people to acknowledge the needs of their transgender partners while affirming their existence.

For example, people who are transgender can often experience gender dysphoria—conflict between their gender identity and their sex assigned at birth—and can be insecure about how their body looks during sex, Belous said.

“What I’ve seen is when people are not comfortable with their identity, whether it’s gender or sexual[ity], it’s harder to be intimate,” Brito said.

Belous said transparency and communication surrounding sexual health history are also important in making informed decisions before engaging in sexual activity. And sometimes that lack of information sharing can pose health risks. 

According to a 2018 Sexually Transmitted Disease Surveillance report by the Centers for Disease Control and Prevention, gay and bisexual men are more likely to contract STDs, and in 2017, 2.3 million cases of STDs were diagnosed.

While HIV does not only affect the LGBTQ+ community, it is still something to be wary of. There are currently 1.1 million people in the U.S. living with HIV, and more than half of young people with HIV are unaware they have it, according to the U.S. Department of Health & Human Services.

HIV does not have to be a death sentence for your sex life—the spread can be reduced by regularly going for health checkups and being honest with sexual partners.

2. Pre-sex necessities, better safe than sorry

No matter your gender identity or sexuality, safety is key. Regular use of condoms, vaginal condoms and dental dams—thin sheets placed over the vaginal area during oral sex—can all be used to protect against STDs and sexually transmitted infections.

If you are allergic to latex, try polyisoprene or polyurethane condoms. A good rule of thumb is to pick the protective options that work best for the type of sex you will be having.

For transgender people, hormone therapy alone is not an effective contraceptive. Women taking estrogen can still ejaculate, and men taking testosterone can still ovulate, said Aleece Fosnight, an American Association of Sexuality Educators, Counselors and Therapists, certified sexuality counselor and educator. For transgender people, the effects of hormones can cause fluctuations in sexual libido and mood, Fosnight said.

“If [they are] a trans-male patient and they still have their internal reproductive anatomy, pregnancy is always a concern despite being on testosterone and suppressing their menstrual cycles,” Fosnight said.

In preparing for sex, lubricant can be used to reduce friction, pain and dryness. Some options include silicone lubricant, water-based lubricant—which is compatible with latex—or edible lubricant if you are planning on having oral sex.

Belous said hygiene is a primary concern. Cleanliness can range from cutting nails and removing nail polish, or wearing gloves, before fingering, to douching—the process of cleaning the rectum with water to avoid fecal matter transmission—to sanitizing sex toys.

Keep in mind that porous sex toys, including ones made from jelly rubber or polyvinyl chloride, can transmit dirt and bacteria even after being thoroughly washed, so inert toys made from silicone are often a safer option.

Fosnight said bacterial infections, bacterial vaginosis and urinary tract infections are also concerns for women, although men can also contract them.

HPV, increased risks of anal and rectal cancer, along with constipation and anal fissures, are health issues men having sex with men should watch out for, Fosnight said.

3. Pleasure is more than the birds and bees

There is much more to sex than penetration, avoiding pregnancy or STDs. Sex can be fun and there is no shame in enjoying it.

Aside from the basics of fingering, oral and anal, much of intercourse is about foreplay, such as kissing, touching and cuddling.

Belous said a few ways to increase intimacy and pleasure are to keep the lights on during sex, increase in-bed communication and incorporate new, arousing activities into couple play.

Extra lubricant is necessary for trans-men using testosterone, and trans-women who have had gender confirmation surgery in the form of vaginoplasty, because the vagina tends to get very dry in both situations, leading to thinning tissues, micro-tears and bleeding.

For trans men who have had metoidioplasty, or sex assignment surgery, positioning might be complicated, but malleable implants may be used to assist with penetration, Fosnight said.

Above all else, Belous said people should talk to their partner about what they both like, even if it feels corny or uncomfortable.

“You’re not having sex right, you’re not talking about it right; you’re not having a good relationship, unless you’re laughing,” Belous said. “It’s messy. It’s fun. And it’s hilarious.”