I was in seventh grade when our value education book came along with a very inconspicuous looking booklet. Everyone read it. Hardly anyone understood it. The boys made crude jokes while the girls giggled uncomfortably and gossiped in hushed curious whispers about things we had learned and read about in it. I personally remember, hiding my book beneath an old pile of papers in my desk like contraband and reading it only when I was sure my parents wouldn’t turn up unexpectedly to check on me.
My sex education came almost entirely from the free 50 page booklet I got with my value education textbook in fifth grade. And with no one to explain better, I carried the misconceptions of sex being a term used exclusively for penetrative sex, pregnancy being the greatest dangers of sexual exploration and condoms being the only way to prevent pregnancy for longer than I possibly should have; along with lots of other equally misinformed and outrageously ignorant ideas.
Discussions on sex scarcely ever happen in the Indian social context. The little information that we gather from multi-media consumption, often predominantly in the American context with little to no relatability to the Indian relationship dynamics is almost always confusing and lacking. When straight sex, a traditional patriarchy approved practice is hardly talked about, it is not a surprise that sexual directives rarely include the queer population.
Dispelling Misconceptions around Queer Sex
Taboo surrounding sex, stops us from seeking to learn about our own body while the phobia surrounding the existence queer individuals prevents us from completely understanding and meeting our sexual needs which don’t fit the traditional sexual narrative.
While sex in general has a lot of stigma attached to it and is often grossly misrepresented in popular media and porn, LGBTQIA+ sex in particular suffers from ridiculous and exaggerated myths surrounding it, when not completely ignored in the broader context.
So the biggest question that might arise however, amidst all the confusion and misinformation surrounding the term– what exactly is sex?
Understanding the Definition of Sex
The definitions might vary greatly even individually. The limited idea of sex being strictly a term for penetrative intercourse has been drilled into the collective social subconscious for ages.
While experts now refuse to give a fixed definition to it with the aim to prevent putting sex under the usual social limitations- it is often defined as intimate action of letting the partner or partners touch genitalia and other erogenous parts of the body and vice versa. The idea that sex can be defined however we see fit, is fortunately gaining traction due to positive media coverage.
Challenging the traditional definition of sex as strictly penetrative intercourse
Lesbian or gay sex does not necessarily qualify into the traditional idea of equating sex with procreation and hence faces the usual disregard for non-conformist ideas which challenge established patriarchal narratives. Penetration might or not not happen and there might or might not be a penis involved.
Sex is an intimate act involving the mutual exploration of erogenous zones.
But the misconception that lesbian sex always involves strap-ons, a sexual toy which is basically a dildo that can be put on with a harness and typically used for penetration- is just that, a misconception arising from limited information on how sex between non cis-het individuals work.
Diversity of sexual expressions within the queer community.
If the sexual attraction is there, sex, however we define it, can happen between consenting individuals. No specific pair of genitalia or specific action like penetration is required for the sexual intimacy to qualify as sex, since several other intimate actions and stimulations like rubbing, licking or exploration of erogenous zones can easily be done, specifically catering to individual needs and preference.
Safe Sex Practices
Irrespective of gender or sexual orientation, it is extremely important to be aware of our own body and be able to make safe sexual choices. Sex, in addition to being enjoyable and an expression of individuality or intimacy should be guided by sufficient information and tools to make it a truly fulfilling experience with no pitfalls. Knowledge truly holds a lot of power and understanding sex makes life a lot easier.
As such, there are several devices and practices that can be used to ensure safety during sexual encounters. However, to decide which would work for any specific individual, there are several factors that have to be taken into consideration including but not limited to preference.
And in any case it is essential that we only accept correct and individually appropriate information. Visually appealing sexual encounters shown on movies and television shows- sex scenes ranging from teenage car seats to romantic beaches or expensive hotel rooms with barely a condom in use much less anything else should not be considered to be the true representation of real bodies or real life situations.
External Condoms
Condoms are the first and often the only thing that comes to mind when the term sexual safety comes up for the average person. Pregnancy being the only danger everyone seems to be ultra cautious about. However, while talking about queer sex, the question becomes- whether or not condoms are actually needed when there is no penis in vagina penetration.
Condoms are a thin rubber sheath which can be worn on a penis or used to cover any other phallus shaped penetration devices during sexual intercourse as a contraceptive or as a protection against infection. They are very misleadingly marketed as just a contraceptive. While it is true that they do act as a preventative measure for pregnancy, they are additionally also a great protective device that can be used to prevent STIs in a variety of sexual situations- especially in the case of anal intercourse. And yes, queer or not, condoms should essentially be used by practically everyone practicing sex.
Unless someone is allergic to latex or any other material used in the manufacture of condoms- in which case, we find condoms made of stuff our body does not rebel against. Either way, condoms are important for safe sex in addition to being a popular contraceptive.
Among the types of condoms available, external condoms are usually the most easily available type. It is used to traditionally cover a penis but can be quite versatile in its usage as well. They can be used in penetrative anal or vaginal sex with a penis involved, penetrative anal or vaginal sex with a sex toy and can even make sharing of sex toys between partners a lot safer. Corinne Werder, the resident sex educator at GO Magazine, has written about how external condoms can be used in various different kinds of sex acts, not limited to the heteronormative sexual dynamics.
Internal Condoms and Dental Dams
Originally designed to be inserted into a vagina, internal condoms are also a great alternative and can be used to aid in the same situations an external condom is normally used. It is made from thin latex or polyurethane and has two rings; one inner ring that fits against the cervix/anus, and one external ring that fits against the outside of the vagina/ anus. The internal condom is a barrier contraceptive which means it prevents semen and other bodily fluids from passing from one partner to the other.
Because it covers some of the outer vaginal lips/the outside of the anus, it can also help protect against skin-contact viruses like herpes and warts which other contraceptive methods don’t. An added benefit of using internal condoms could be the fact that due to their constituent material being polyurethane, any kind of lube, including oil based can be used which is not the case with external condoms.
Oral sex, including acts like the cunnilingus and analingus. In these scenarios, dental dams can also be beneficial to prevent the spread of STIs. Dental dams are small squares or rectangles made of thin sheets of latex or polyurethane. Anyone using it can hold the material against their partner’s genitals to block direct skin-to-skin contact.
Regular STI Testing
As mentioned in a Forbes article titled, Here’s what queer people with vaginas need to know about condoms and STI protection, dams have a long history as sexual wellness tools. Some of the most common STIs that can spread through oral sex include gonorrhea, genital herpes, and syphilis. Dental dams can help reduce the risk of contracting these conditions or other STIs as well.
External condoms however are comparatively much easier to obtain when compared to internal condoms or dental dams, which generally belong to a higher price range as well. Because speciality sex products might not be usually available in local pharmacies the only alternative present to us, is to be prepared beforehand.
While using devices like the ones already mentioned really help, ensuring sexual safety requires more of an active and in depth approach. Sexual safety must therefore include a better understanding and promotion of regular STI testing as well. Regular STI profiling and having an honest discussion on STI status with potential sexual partners is the key to sexual safety and empowerment.
Understanding and Addressing STIs
According to the data presented in the article, Sexually Transmitted Diseases- Statistics and Epidemiological profile of India, about 340 million new cases of the four main curable sexually transmitted infections, gonorrhea, chlamydial infection, syphilis and chancroid are recorded every year according to the World Health Organization (WHO). And every year, 6% of the adult Indian population is affected by sexually transmitted infections (STIs) and reproductive tract infections.
STIs like any other infection and communicable disease are painful, annoying, treatable to a great extent( except in more serious cases of an HIV infection) and avoidable to a great extent.
Common STIs and Their Implications
Among the eight common STIs listed in an article by Pfizer are the HPV, Herpes Syphilis, Hepatitis, Trichomoniasis, Gonorrhea, Chlamydia and HIV infections.
Familiarity with the causes can help in taking the required protective measures. Subsequently knowledge and understanding of the symptoms and remedial measures make it significantly easier to address the disease, before it causes severe harm to self or the community.
The Human Papillomavirus (HPV) is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex. Sexually transmitted HPV types fall into two groups: low risk and high risk.
High-risk HPVs can cause several types of cancer. There are 12 high-risk HPV types: HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. Two of these, HPV 16 and HPV 18, are responsible for most HPV-related cancers. High risk infections rarely cause symptoms making them harder to detect early.
Low-risk HPV types rarely cause cancer, although a few low-risk HPV types can cause warts on or around the genitals, anus, mouth, or throat. When warts form in the larynx or respiratory tract, you may have a condition called respiratory papillomatosis, which can cause breathing problems.
Public awareness surrounding HPV has increased in recent years, due in large part to the availability of an HPV vaccine. Healthcare providers can detect HPV, with a routine PAP smear. For those not already vaccinated, seeking a vaccination can reduce much of this risk by protecting against strains most likely to cause cancer.
Herpes simplex virus (HSV), known as herpes, is a common infection that can cause painful blisters or ulcers. It primarily spreads by skin-to-skin contact. It is treatable but not curable.
There are two types of herpes simplex virus.
- Type 1 (HSV-1) mostly spreads by oral contact and causes infections in or around the mouth (oral herpes or cold sores). It can also cause genital herpes. Most adults are infected with HSV-1.
- Type 2 (HSV-2) spreads by sexual contact and causes genital herpes.
Most people have no symptoms or only mild symptoms. The infection can cause painful blisters or ulcers that can recur over time. Medicines can reduce symptoms but can’t cure the infection. Like syphilis, herpes can affect fetuses, especially following a new infection in the first trimester.
Prevention and Public Awareness
To avoid communication of the disease people with symptoms of oral herpes should avoid oral contact with others (including oral sex) and avoid contact with saliva of each other. Ideally individuals with symptoms of genital herpes should abstain from sexual activity while experiencing symptoms. Both HSV-1 and HSV-2 are most contagious when sores are present but can also be transmitted when no symptoms are felt or visible.
For sexually active people, consistent and correct use of condoms is the best way to prevent genital herpes and other STIs. Condoms reduce the risk; however, HSV infection can still occur through contact with genital or anal areas not covered by the condom. Medical male circumcision can provide life-long partial protection against HSV-2 infection, as well as against HIV and human papillomavirus (HPV).
People with symptoms suggestive of genital herpes should be offered HIV testing.
Despite not being entirely curable, people with herpes can have normal sex lives, usually by accepting their condition and moving forward accordingly. Like in a lot of cases, talking about it honestly and helping potential partners understand every aspect definitely helps.
Syphilis
Syphilis, a STD quite well known for its infamous victims throughout history, is caused by a bacterium called Treponema pallidum.
Direct contact with a syphilis sore, called a chancre, can lead to transmission. The infection may begin with a round, firm, painless sore located on the penis, vagina, anus, or mouth. Sometimes, these sores go unnoticed, because they are painless, and then symptoms clear. However, the infection continues to advance, during this stage. If untreated, later stages of the disease can damage the heart, blood vessels, liver, bones, joints, and skin.
Syphilis is again an infection which can be treated with the right antibiotics. However since there is no vaccine available as a precautionary measure, the only way to prevent it is by being vigilant and careful about practicing protected sex.
Trichomoniasis
Unlike the other STDs, trichomoniasis, sometimes called “trich,” is a parasitic infection caused by the parasite Trichomonas vaginalis. Though one of the most curable STDs through antibiotic treatments, trichomoniasis has serious implications for pregnant women, according to a 2021 International Journal of Obstetrics and Gynaecology review. This parasitic infection can lead to preterm delivery, low birthweight, and pre-labor rupture of membranes, researchers have found.
In women, symptoms of trichomoniasis can include itching, burning, redness or soreness of the genitals; discomfort with urination is common, as is a thin discharge that can be clear, white, yellowish, or greenish with an unusual smell. In men, symptoms can include itching or irritation inside the penis, burning after urination or ejaculation, or some penile discharge.
Because men generally don’t experience symptoms, they often don’t know they’re infected, don’t seek medical attention and so spread this parasite to additional partners on accident. Without treatment, this infection can stretch on for months or years.
Chlamydia and Gonorrhea
Among other infections, Chlamydia and Gonorrhea, though caused by different bacteria, cause painful genital discharge and issues with pregnancy. Both can give rise to severe complications if left untreated and are preventable by the correct use of condoms and limiting the number of unverified safe sex partners.
STIs already occupy a space defined by fear, misinformation and embarrassment. Amidst this, the Human Immunodeficiency Virus (HIV) is one name which commands the most immeasurable terror.
According to the Mayo clinic, HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood and from illicit injection drug use or sharing needles. It can also be spread from mother to child during pregnancy, childbirth or breastfeeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS(which is the progressive variation of HIV. Untreated, HIV typically turns into AIDS in about 8 to 10 years).
CDC, among new cases of HIV in 2019, 65% stemmed from male-to-male sexual contact, 23% originated from heterosexual contact, 7% came from injection drug use, and 4% stemmed from male-to-male sexual contact and injection drug use. A mother can also pass HIV to her child.
HIV Prevention: PrEP and PEP
During early-stage HIV, people may experience swollen glands, fever, muscle aches, headaches, or extreme fatigue lasting for 2-4 weeks. Then, the disease progresses to “clinical latency,” during which symptoms can vanish for years, depending on whether a person receives treatment.
During late-stage HIV or AIDS, the virus has so weakened the immune system so that unexplained and significant weight loss can occur, along with night sweats, fever, frequent and severe rare infections, swollen lymph nodes, persistent dry cough, chronic diarrhea, and unusual skin rashes.
However in recent years two positive developments have been made which have proved beneficial in prevention of HIV and AIDs.
PrEP, or pre-exposure prophylaxis, is taken before possible HIV exposure.
It’s available as the brand-name pills Truvada and Descovy. It is essentially used in cases where individuals prepare beforehand to be exposed to the HIV virus. It can be applicable to situations where condomless sex with HIV positive partners or partners with unknown HIV status is involved or the sharing of needles. PrEP needs to be taken daily, prior to possible exposure to the virus and reduces chances of sexual transmission of the disease by 90%.
PEP, or post-exposure prophylaxis, is taken after possible HIV exposure.
It requires the intake of more than one medication. PEP, as opposed to the usage of PrEP, is only used in emergency situations, within 72 hours of possible HIV exposure. Situations where it might be needed extends to accidental office injuries or assault cases in addition to the practice of condomless sex with partners with HIV or unknown HIV status. PEP reduces chances of sexual transmission of the infection by almost 80%.
PrEp and PEP have no doubt reduced the risk of HIV significantly. It is however still extremely important to use condoms, other proper barrier methods and try to follow all other safety procedures to limit the chances of any infections including HIV.
The only guaranteed way to avoid sexually transmitted diseases would be to never practice sex and lead the life of celibacy. While not being sexually active might still be the valid choice for some individuals, avoiding sex is not the realistic answer for many. Therefore the effort should be put on educating ourselves- making sure we are not taking any chances when it comes to our individual wellbeing and subsequently the well being of the community. Bottom line being- queer sex or not, the only things that matter should be education and safety, followed by personal preference and enjoyment.
While prevention of sexually transmitted infections to ensure an overall fulfilling sexual experience and healthy life should be the goal, STIs should not be a topic that is avoided out of fear or shame. It should also be understood that STIs if they happen are not the end of the world. It is possible to live a healthy sexually fulfilling life and all that we need is a better understanding of our bodies and others.