[oasis] [columns]

Michael Walker and Dr. Katherine Fordham

March 1997

Life, Love and AIDS

Dear Dr. Kate,

First thing, I want to say that I am so glad that there is an article that addresses the health issue that concerns gay teens. Thank you for taking on the task.

It is a very important issue today, with so many diseases out there that are sexually transmitted.

But I have a question that has been bothering me almost as long as the question about my sexuality. My question is, what can lesbians do to make there sexual activities safer. I have looked. Don’t get me wrong. I have found plenty of literature on lesbian sex, but I can’t find anything on lesbian safer sex. Please answer, because it may not be as (what some have said) easy to get AIDS or other transmittable diseases, it is important to know how to protect ourselves.

Thank you,


Dear Mel,

You are right that there is little information available concerning lesbian-related sexual issues. This is something which has irritated me for years; my sister is a lesbian, and that is how I became interested in homosexual health topics to begin with, so I have always noticed that there is a great deal more information on gay male sexual matters than on lesbian issues. I think this is due in part to male ignorance of the female body in general, and because there are still more men in medical careers than women. (I have even had male doctors address me as “Mrs. Fordham” or ask if I am a nurse! But I’m Dr. Fordham, -and not Dr. Paglia- so let us return to the topic at hand.)

First, let’s consider the matter of female oral sex. Dental dams are a must, but if you have trouble finding a place where you can purchase dental dams; you can also use a condom if you cut down one side so that it will cover the entire frontal area of the female genitalia. The idea here is to prevent anything pathogenic (any disease-causing organism) which the person you are performing oral sex on has from being transmitted to you from her genital secretions. You are right in saying that it is less common for a woman to transmit pathogenic organisms (such as HIV and other STDs) to their partners than for a man to transmit to another man or to a woman; but it still is possible. If your partner is having her period, it is even more important to be very careful to protect yourself due to the extra secretions.

Oral hygiene is always significant, because if you have poor oral health you may have small sores or lesions which will encourage the transmission of pathogens during oral sex. You can think of it this way: if it was storming outside and you wanted to stay dry inside your house, you would close all the windows and doors, wouldn’t you? Any opening could allow that rain to get in easily. Following the same logic, you do not want to have any “openings” in the interior of your mouth which would allow easy passage for pathogenic organisms. If you have gingivitis or periodontal disease, it is especially essential to be quite careful during oral sex; bleeding or raw gums are a perfect way for most any disease-causing agent found in the female genitalia to enter your body through an oral route. I cannot stress just how important oral hygiene is: do all that you can to keep your mouth healthy. If you feel comfortable talking about sexual matters with your dentist; he or she may have some useful ideas which I have not mentioned here. I am sure it might be hard to approach your family dentist on a matter like this, but remember that dentists, like medical doctors, have an obligation to protect and encourage the protection of your good health.

Any sort of anal sex with an implement of some kind between lesbians should involve the same amount of protection which experts recommend for gay men and male/female sexual relations: a condom or other barrier. Any oral-anal contact (rimming) should also involved a barrier; as I stated in the January 1997 column, the anus presents an area where there is high risk of some bleeding during the sexual act. The fact that the anus is a route of waste elimination is also crucial to keep in mind because there can be bacterial pathogens present from the feces. These organisms may not cause life-threatening diseases like AIDS, but they can lead to a variety of unpleasant infections.

I encourage all of our readers to send questions to Mike or myself at either of our e-mail addresses. I also encourage everyone to stay safe and to stay healthy!

Yours in health,


Katherine A. Fordham, M.D.

[About the Author]

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