Sexual health

Like any other group, many trans and gender diverse people have sex, and as a result, have sexual health needs. Sexual health isn’t something to be ashamed of, and doesn’t mean you’re dirty or have done something wrong, it’s just another part of looking after your health.

Sexual health covers a range of topics including preventing pregnancy, increasing pleasure, testing for sex souvenirs (like Sexually Transmitted Infections - STIs), and even treating HIV with medication that make the virus undetectable and onward transmission virtually impossible.

Sexual health also extends to how you talk about sex with a doctor or sexual health nurse, when to test and what bits to test, and simply having the knowledge to keep you and your sexual partners safe, hot, and informed.

No matter what your sex life look like, having some practical knowledge can go a long way to feeling safer, sexier, and having more fun.

This page was developed in collaboration with the Albion Centre’s T150. We also worked with the ACON teams responsible for Ending HIV and peer education programs.

You might have heard in high school that safe sex means one thing, from always using a condom, or only having sex with one person ever. However, what constitutes safe sex for you really depends on what kind of sex you’re having.

Sex includes things like oral sex, making out, penetration of body parts, penetration with body parts, grinding or humping, using other tools and toys, or more. What we get up to informs what we can do to stay safe. Sex where a fist enters a front hole will have different safety needs to sex where toys go into an anus, or a penis in a vagina, or kissing while your clothes stay on.

We talk more about sex here.

Barriers & Lube

Barriers - which include condoms and gloves - are an effective way of preventing the transfer of many bodily fluids or blood from one person to another, and can be an effective way of preventing STIs, and pregnancy.

It’s always important to use a new barrier with a different person or a different body part, e.g. Using a new condom when moving from anal to vaginal sex, or using a new glove when putting your hand inside a different person.

Barriers are often made out of latex, but are available in materials such as nitrile, which are safe for people with latex allergies. If you want to use a dental dam, you can cut a condom or glove in half rather than having to find dams, which are often not available or quite expensive.

Lube, which is short for lubricant, is a substance that reduces friction (making things more slippery). Some people and parts produce a lot of natural lubrication, and others don’t produce much at all - that’s not an indication of anything, including how turned on a person is, and lube is a tool in your kit that can make everybody’s sex better.

There are 3 main types of lube:

Water: The most common type of lube, water based lube is much easier to clean up. It will be safe to use a good water-based lube with any toys, condoms or body parts, and comes in a range of consistencies (from watery to thick and gooey). Water based lube washes away easily, so isn’t recommended for any kind of play in water.

Silicone: Silicone lube is made from silicone and is not only very slippery, it sticks around a lot longer than water based lube. Silicone lube is recommended for anal play or longer sessions, or for any play in the shower or bath (as it won’t dissolve in water). Silicone lube is safe to use with condoms, but can cause silicone toys to degrade over time.

Oil: Oil based lubes are used for heavier play, including fisting and large insertion. Products like olive oil, coconut oil and shea butter are natural oil lubricants, but be careful as they can break down latex condoms, other barriers, and some toys. Oil based lube can also stick around in a vagina/front hole longer than it’s wanted and be an infection risk.

Free condoms and lube are available at many sexual health services, but it can be more difficult to find free gloves and dental dams.

ACON also mails out kits including gloves, condoms, lube and Viraclean to any LGBTQ+ person in NSW, if you get in touch.

Contraception is the processes used to prevent pregnancy during sex. There are a range of options that can depend upon your body, wants and needs, existing or future hormonal affirmation, and more.

Sometimes pregnancy is a wanted and an intended outcome of sex, which you can find more out about on our page on pregnancy, but other times pregnancy is the last thing a person wants.

There are a range of options that depend on your body, wants and needs, existing or future hormonal affirmation, and more, such as:

• Barrier methods, like external or internal condoms, or diaphragms

• Copper IUDs & hormonal IUDs

• Contraceptive pills

• Contraceptive implants

• Contraceptive injections

Testosterone alone is not an effective form of contraception for people with a uterus, and estrogen and/or progesterone alone are not an effective form of contraception for people with penises, even after long term use.

If you are having sex in a way that could result in someone becoming pregnant when they don’t want to be, it’s important to use a method of contraception in addition to hormones.

You can find more out about each of these on our page on Contraception.

Routine testing is important, not only because it allows you to know your status, but also because most STIs don’t cause symptoms.

How often to get a sexual health tested really depends on how many people you’re having sex with, and how many people you think they’re having sex with, and so on.

There’s no shame or judgement in getting plenty of action or not much at all, it’s not a competition but keeping track can help you know when to book your next test.

Testing guidelines recommend that if you’re having sex with multiple people, or you’re having sex with people who are, screening every 3 months is a great routine to get into.

If you’re only having sex with one or two people, or you and everyone you’re having sex with haven’t slept with anybody new in over 9-12 months, screening every 6-12 months is just fine. If you’re in a long term relationship with one person, or a closed group of several people, you can test once per year.

It may seem silly to keep on testing when nothing has changed in your sexual circumstances, and can sometimes make someone feel like you don’t trust them or that you think they’re cheating, but it’s no different to going and getting a checkup for anything else.

The only person who is responsible for your sexual health is you.

You can screen for STIs as part of a regular blood test from your GP or health professional, at a specialist sexual health service or clinic, or through a clinic or service aimed specifically at LGBTQ+ sexual health service like trans[TEST] clinic in Sydney.

Sometimes talking about our bodies and any symptoms present can be daunting, especially with new doctors, or doctors who we’re uncomfortable talking about being trans to.

We developed a list 10 questions you can ask your doctor to find out if they are trans-friendly, available below.

We’ve also prepared some letters templates where you can fill in your details and take them to a doctor, the template below lets the doctor know your name, gender and pronouns, as well as any information you’d like to share about your body. This can help them to use language that feels comfortable and affirming for you.

Being in control of who looks after your health is a valid and okay thing to want, and something you are allowed to do.

Window periods

The window period of an STI or blood borne virus (BBV) is how long it takes between getting it and when it will show up on a test. Part of why we test regularly is to identify STIs no matter what their window period.

Consent means that you and everyone else involved in an activity (i.e. sex) want to be doing what you’re doing. Consent isn’t something you agree on once and then get on with it, but a process that takes place before, during and even after sex, and what it looks like might change gradually or suddenly depending on a whole range of factors.

Consent is an important part of sexual health, as it helps us stay safe not just physically but emotionally and mentally.

For more information about what consent is, how to talk about it and practice it, head to our sex and sexuality page.