LGBTQ Guide

FOR GIRLS WHO LIKE GIRLS (EVEN JUST SOMETIMES!)

You deserve to be happy and healthy, period. Whether you identify as lesbian, bisexual, transgender, straight, gay, or even if you don’t like labels at all, this section is about sexual health for girls who have sex with other girls.

We know this sounds like some pretty binary language. That’s because your sexual healthcare needs are based mostly on your anatomy, your partner’s anatomy, and the things you do together. (Basically, this is mostly info for people with vulvas who like other people with vulvas.) If you’re transgender, here’s some additional info. [link to trans section])

Regardless of your anatomy or your partner’s anatomy, there is always some risk that comes with sexual contact. Sexual contact = oral, vaginal and anal sex. It also includes touching, kissing and sharing sex toys.

Most of the info on The Playbook works for every body, no matter who you’re into. This section is here to fill in some blanks, just for you!

STIs

Girls can transmit STIs to each other through skin-to-skin contact, mouth-to-vagina contact, contact with vaginal fluids or menstrual blood, and sharing sex toys. There are two big ways you can prevent STIs: Use barriers, and make testing routine so you and your partner can get treated if/when you need it. For HIV prevention, ask your doctor about adding PrEP into the mix.

Barriers are really effective at stopping most STIs. Our top picks:

  • Condoms (latex, polyurethane or polyisoprene, but not lambskin!) on a sex toy or penis
  • Dental dams between a mouth and vulva, mouth and anus, or vulva and vulva
  • Gloves, latex or synthetic (check the label for nitrile or neoprene) on hands

Barriers aren’t 100% perfect. Some STIs can still spread through skin-to-skin contact. That’s part of why going to a doc to get tested (and treated if you need it) is a big part of staying healthy. Use our nifty search tool to find a doc.

Birth Control

Girls take birth control for lots of reasons – to manage heavy periods, for cramps, for acne control and, yes, to prevent pregnancy. If you have sex with guys sometimes, a birth control plan can help you stay baby-free until you’re ready.

Our birth control method finder can help you choose the method that’s right for you:

  • IUDs and the Implant offer low-maintenance coverage that’s over 99% effective. Bonus: These methods work for up to 12 years!
  • The pill and other hormonal methods like the patch and ring can protect you from pregnancy and help you deal with stuff like cramps, heavy periods and acne.
  • Condoms and female condoms stop sperm and most STIs.
  • Emergency contraception (EC) is a great backup method. If you had vaginal sex and didn’t use another method, or if another method (like a condom) fails, you can buy EC over the counter at the drugstore. Anyone, at any age, can buy EC.

 

Healthcare and Privacy

Worried about getting sexual health care? Don’t be! In North Carolina, you can get confidential STI tests and treatment, birth control, mental health care, and treatment for substance abuse without a parent’s or guardian’s permission. That means your healthcare is private unless you decide otherwise. Use our nifty search tool to find a doc.

The more information a doctor has about you, the better they can help you be healthy. A good doctor should ask you a lot of questions about your health – including your sexual health. Usually they ask these questions in a pretty neutral way – “Are you having sex? With men, women, both?” (Your doctor isn’t judging you! The more information they have, the better they can take care of you.) Answer these questions if you feel safe doing it.

If you don’t feel safe sharing your sexuality with your doctor, you can still request the services you need, like birth control or STI tests. Remember these healthcare services are the same for you, no matter who your partner is. Just say, “I think I need to be tested for STIs” or “I need birth control.” Your doc doesn’t have to know why.

 

Talking About Sex

Learning to talk about sex can be nerve-wracking for anybody. This is especially true if you didn’t talk about different kinds of sex and relationships growing up, or if you’re in a kind of relationship that’s new to you. But talking about sex is important for your health and safety – and it’s the key to happier sex.

So where do you even start? Here are some tips:

  • Consent: When it comes to sex, you have a right to decide when you do it, where you do it and how you do it. So does your partner. Giving and getting permission to have sexual contact with someone is called consent. It goes way beyond “no means no”. In the real world, the smartest rule to follow is anything other than a “yes” is a “no”.
  • STI prevention: Have you been tested in the last six months? Has your partner? What is their status? Do you have the barriers you need?
  • Birth control: What birth control will you use if there’s a sperm involved?

 

FOR GUYS WHO LIKE GUYS (EVEN JUST SOMETIMES!)

You deserve to be happy and healthy, period. Whether you identify as gay, bisexual, transgender, straight, or even if you don’t like labels at all, this section is about sexual health for guys who have sex with other guys.

Yes, we know this sounds like some pretty binary language. That’s because your sexual healthcare needs are based mostly on your anatomy, your partner’s anatomy, and the things you do together. Basically, this is mostly info for people with penises who like other people with penises. If you’re transgender, here’s some additional info. [link to transgender section])

Regardless of your anatomy or your partner’s anatomy, there is always some risk that comes with sexual contact. Sexual contact = oral, vaginal and anal sex. It also includes touching, kissing and sharing sex toys.

Most of the info on The Playbook works for every body, no matter who you’re into. But, we also know that most sexual health info is written for girls who have sex with guys. This section is here to fill in some blanks just for you!

 

STIs

Guys can get STIs through oral sex (mouth to penis or mouth to anus), anal sex, vaginal sex, skin-to-skin contact and sharing sex toys. There are two big ways you can prevent STIs: Use barriers and make testing routine so you and your partner can get treated if/when you need it. For HIV prevention, ask your doctor about adding PrEP into the mix.

Barriers are very effective at stopping most STIs. Our top picks:

  • Condoms (latex, polyurethane or polyisoprene, but not lambskin!) on a sex toy or penis
  • Dental dams between a mouth and anus or mouth and vulva
  • Gloves, latex or synthetic (check the label for nitrile or neoprene) on hands
  • Female condoms [aka internal condoms] inside the anus or vagina

While you’re looking at barriers, don’t forget lube! Water-based lubricants reduce the risk of STIs by helping to prevent irritation to delicate areas of the body (especially during anal sex). Steer clear of oil-based lube; it can damage latex condoms, making them break more easily, and then they’re pretty useless.

Barriers aren’t 100% perfect. Some STIs can still spread through skin-to-skin contact. That’s part of why going to a doc to get tested (and treated if you need it) is a big part of staying healthy. Use our nifty search tool to find a doc.

Worried about getting tested? Don’t be! In North Carolina, you can get confidential STI tests and other sexual health services like birth control without a parent’s or guardian’s permission. You’re in control, and your healthcare is private unless you say otherwise.

 

Birth Control

If you have sex with girls – even just sometimes – birth control can help you stay baby-free until you’re ready. While most birth control methods are marketed to girls, you have options too:

  • Condoms provide amazing STI coverage and are also really effective at preventing pregnancy. For best results, use condoms correctly every time you have vaginal sex.
  • Emergency contraception (EC) is a great backup for moments when you weren’t expecting vaginal sex, or if another method (like a condom) fails. Anyone, any age – guys included – can buy EC over the counter at a drug store.

 

Healthcare and Privacy

In North Carolina, you can get confidential STI tests and treatment, birth control, mental health care, and treatment for substance abuse without a parent’s or guardian’s permission. That means your healthcare is private unless you decide otherwise. Use our nifty search tool to find a doctor near you.

The more information a doctor has about you, the better they can help you be healthy. A good doctor should ask you a lot of questions about your health – including your sexual health. Usually they ask these questions in a pretty neutral way – “Are you having sex? With men, women, both?” (Your doctor isn’t judging you! The more information they have, the better they can take care of you.) Answer these questions if you feel safe doing it.

If you don’t feel safe sharing your sexuality with your doctor, you can still request the services you need, like STI tests. Remember these healthcare services are the same for you, no matter who your partner is. Just say, “I think I need to be tested for STIs”. Your doc doesn’t have to know why.

 

Talking About Sex

Learning to talk about sex can be nerve-wracking for anybody. This is especially true if you didn’t talk about different kinds of sex and relationships growing up, or if you’re in a kind of relationship that’s new to you. But talking about sex is important for your health and safety – and it’s the key to happier sex.

So where do you even start? Here are some ideas:

  • Consent: When it comes to sex, you have a right to decide when you do it, where you do it, and how you do it. So does your partner. Giving and getting permission to have sexual contact with someone is called consent. It goes way beyond “no means no”. In the real world, the smartest rule to follow is anything other than a “yes” is a “no”.
  • STI prevention: Have you been tested in the last six months? Has your partner? What is their status? Do you have the barriers you need?
  • Birth control: What birth control will you use if there’s a uterus involved?

If You're Transgender

You deserve to be happy and healthy, period.

Regardless of your anatomy or your partner’s anatomy, there is always some risk that comes with sexual contact. Sexual contact = oral, vaginal and anal sex. It also includes touching, kissing and sharing sex toys.

Most of the info on The Playbook works for every body, no matter who you’re into. But, we also know that most sexual health info is written for cis girls who have sex with cis guys. This section is here to fill in some blanks, just for you!

STIs

STIs can be transmitted in all kinds of ways: Oral sex (mouth to penis, anus or vulva), anal and vaginal sex, through skin-to-skin contact, and by sharing sex toys. There are two big ways you can prevent STIs. Use barriers and make testing routine, so you and your partner can get treated if/when you need it. For HIV prevention, ask your doctor about adding PrEP into the mix.

Barriers are very effective at stopping most STIs. Our top picks:

  • Condoms (latex, polyurethane or polyisoprene, but not lambskin!) on a sex toy or penis
  • Dental dams between a mouth and vulva, mouth and anus, or vulva and vulva
  • Gloves, latex or synthetic (check the label for nitrile or neoprene) on hands
  • Female condoms [aka internal condoms] inside the anus or vagina

Just remember that some STIs can spread through skin-to-skin contact, so barriers can’t give you 100% protection. That’s part of why going to a doc to get tested (and treated if you need it) is a big part of staying healthy. Use our nifty search tool to find a doctor near you.

Birth Control

If one of you has a uterus and ovaries, and one of you can produce sperm, a solid birth control plan can help you stay baby-free until you’re ready. Trans men receiving testosterone can still ovulate and get pregnant (even without a period), and trans women receiving estrogen can still produce sperm.

It’s important to work closely with your doc to find a birth control method that fits your life, your health and your identity goals. If you’re currently seeing a doctor about your hormones, they might have some good advice on your birth control needs too.

So what birth control methods are available for you? In general, trans men can use any of the methods available for cisgender women, and trans women can use any method available for cisgender men (condoms are our top pick). Our birth control method finder can help you choose a method that works for you.

For trans men:

  • Paragard, the copper IUD, offers over 99% protection with no hormones.
  • Condoms and female condoms are another hormone-free method that stop both sperm and most STIs.
  • Hormonal methods may be an option for some trans men. Progesterone-based IUDs (Mirena, Skyla, and Liletta) and the progestin-based Implant and shot Depo-Provera are widely used options because they’re more compatible with testosterone and can suppress periods. Talk to a doc about how these methods might affect your hormone needs.
  • Emergency Contraception (EC) is a great backup if you had penis-in-vagina sex and didn’t use another method, or if another method (like a condom) fails. Anyone, no matter their age or gender, can buy EC over the counter at a drug store.

For trans women:

  • Condoms and female condoms stop sperm and most STIs
  • Emergency Contraception (EC) is a great backup if you had penis-in-vagina sex and didn’t use another method, or if another method (like a condom) fails. Anyone, no matter their age or gender can buy EC over the counter at a drug store.

Just remember, every trans person has different needs. Talking to a doctor can help you get the care that’s right for you!

Healthcare and Privacy

In North Carolina, you can get confidential STI tests and treatment, birth control, mental health care, and treatment for substance abuse without a parent’s or guardian’s permission. That means your healthcare is private unless you decide otherwise. Use our nifty search tool to find a doc.

The more your doctor knows, the better they can help you be healthy. A good doctor should ask you a lot of questions about your health – including your sexual health. Usually they ask these questions in a pretty neutral way – “Are you having sex? With men, women, both?” (Your doctor isn’t judging you! The more information they have, the better they can take care of you.) Answer these questions if you feel safe doing it.

If you don’t feel safe sharing your sexuality or gender identity with to your doctor, you can still ask for the services you need, like birth control or STI tests. Remember these healthcare services are the same, no matter who your partner is. Just say, “I think I need to be tested for STIs” or “I need birth control.” And you don’t have to explain why, unless you want to.

 

Teen-Friendly Vs. T-Friendly Healthcare

The Playbook specializes in connecting teens to teen-friendly healthcare services. But it’s also important for you to know where to find trans-friendly services.

Some docs specialize in transgender care or have specialties (like endocrinology) that can be helpful for transgender patients. Doctors mean well and want to help, but some of them just don’t have a lot of experience with trans patients. Your regular doc might be able to provide you with the health services you need. In addition, health departments can also provide services, and Planned Parenthood can often provide trans-friendly STI and birth control services.

Here are some organizations that can help you find a trans-friendly doc in North Carolina:

Worried about healthcare costs? New provisions of the Affordable Care Act say that most insurers must cover transgender healthcare, including hormone therapies, if they provide similar services for non-transgender patients. Most of the ways teens can pay for care are covered by these rules.

 

Talking About Sex

Learning to talk about sex can be nerve-wracking for anybody. This is especially true if you didn’t talk about different kinds of sex and relationships growing up, or if you’re in a kind of relationship that’s new to you. But talking about sex is important for your health and safety – and it’s the key to happier sex.

So where do you even start? Here are some ideas:

  • Consent: When it comes to sex, you have a right to decide when you do it, where you do it, and how you do it. So does your partner. Giving and getting permission to have sexual contact with someone is called consent. It goes way beyond “no means no”. In the real world, the smartest rule to follow is anything other than a “yes” is a “no”.
  • What does sex look like to me? Sex doesn’t always look the same to trans people as it does to cis people. Sometimes there will be parts of your body that you’re not comfortable being touched or used during sex. You have the right to decide what parts of your body are okay to touch, what shouldn’t be touched, and what sexual contact means to you.
  • STI prevention: Have you been tested in the last six months? Has your partner? What is their status? Do you have the barriers you need?

Birth control: What birth control will you use if there are both sperm and a uterus involved?

QUESTIONING???

The “Q” in LGBTQ can mean a lot of different things, but one meaning is “Questioning.” Identifying as questioning (or not quite knowing how to identify your gender or sexual orientation) is pretty typical during the teen years. Some people know for sure that they’re lesbian, gay, bisexual, heterosexual, transgender or cisgender – and others just don’t know yet.

You might consider yourself “Questioning” for a lot of reasons:

  • Maybe you haven’t really developed a strong sense of attraction to anyone yet, so it all just feels kinda…???
  • Maybe you feel somewhere in between different orientations or include yourself in multiple orientations.
  • Maybe you haven’t felt safe or empowered to question things before.
  • Maybe the feelings you have now are different from what you expected.
  • Maybe you have a better sense of your own feelings, but you aren’t ready to express them to others.

Sexual Health Care

No matter what you’re feeling about your gender or sexual orientation, you deserve to be happy and healthy, period.

Your sexual health needs are based mostly on your anatomy, your partner, and the kinds of sexual activity you participate in. The Playbook has information that can help you…

  • …if you’re a guy who has sex with guys (even just sometimes). [link to section]
  • …if you’re a girl who has sex with girls (even just sometimes). [link to section]
  • …if you’re transgender. [link to section]
  • …if you’re a girl who has sex with guys or a guy who has sex with girls. [link to guys/girls guide]

Getting PrEP

PrEP stands for Pre-Exposure Prophylaxis. It’s a daily pill that can help reduce your chance of getting HIV if you participate in sexual activity that carries a higher risk for contracting HIV. It does not help prevent other STIs.

How does it work?

It’s basically an HIV drug that keeps the virus from attaching to your system if you get exposed to the virus through sex or sharing needles.

Using PrEP isn’t a substitute for other strategies to avoid HIV. Using condoms consistently and correctly every time you have sex, getting tested, and knowing your status and your partner’s status are the best ways to avoid HIV. For those participating in sexual activity that carries a higher risk for contracting HIV, taking PrEP every day can lower their HIV risk by more than 90%. When used with condoms, the risk of HIV is almost completely eliminated.

Who is PrEP for?

One in five new HIV infections happens to someone under the age of 24. But some teens are more at risk than others.

PrEP is for people who have tested HIV negative and are:

  • A girl or guy in a sexual relationship with someone who is at higher risk for HIV (for example, your partner injects drugs or you’re a girl with a bisexual male partner)
  • A guy who has had anal sex with another guy without a condom in the past six months
  • A guy who has sex with other guys (even just sometimes) and has been diagnosed with an STI in the past six months
  • In a sexual relationship with someone who is HIV positive

 

How to Get PrEP

Any doctor can prescribe PrEP, but not all docs are familiar with it. Many health departments offer PrEP. The North Carolina AIDS Training and Education Center maintains a database of PrEP-friendly healthcare providers.

You can use our nifty doc search to find a place to get tested for HIV.

PEP – Emergency Post-Exposure Prophylaxis

The same drug used for PrEP can be used in emergencies for up to 72 hours after you’ve been exposed to HIV. It’s called PEP – or post-exposure prophylaxis. It’s not a replacement for other HIV prevention strategies like condom use and PrEP.

PEP is generally used for people who:

  • Might have been exposed to HIV during sex – like the condom broke and you think your partner might have HIV
  • Are sexually assaulted
  • Get exposed to needles

Some emergency departments, urgent care clinics and health departments offer PEP.