“It may be genital warts, so let’s take a skin biopsy and send it to the lab. You’ll have your results within a week or so. Are you using protection? I had to tell a girl your age she has HIV. A married woman came in and tested positive for an STI because her husband was cheating on her. These men claim they’re STI-negative and having safer sex but you can never trust them...”
As my provider spouted off judgmental anecdotes about people who had tested positive for sexually transmitted infections (STIs), I nodded my head in agreement that unprotected sex is “bad.” But on the inside, I felt numb. Me, the young, college-educated woman who wants to be a midwife and women’s health provider, was being tested for human papillomavirus (HPV). I felt mortified and confused. I’d always used condoms when having sex with cisgender men. I had been on the birth control pill in high school and in college. I started seeing a gynecologist and got my first pap smear after I turned 21. I took all the necessary steps to protect myself during sex. So why was I being tested for HPV?
As it turned out, I wasn’t entirely practicing safer sex. Sure, I used condoms when having sex with folks with penises, but what about the people I slept with who didn’t have penises? I came out as queer during my second year of college and began exploring sex with people of various gender and sexual identities. It was exciting, exhilarating, and entirely void of any protection. It never occurred to me that I needed to use a dental dam or gloves because I just assumed no penis meant no pregnancy, so there was no reason to use protection. Now I know this was completely inaccurate information.
No one had ever told me I should use protection when having sex with non-cisgender, non-heterosexual people.
I knew what dental dams were. I worked at my college’s health services center and literally handed them out to students as part of my job. Yet, despite the knowledge I had about different types of protection, I never properly learned how to apply that knowledge to safer queer sex. My health education teachers only ever talked about penis-in-vagina intercourse, not what to do when both partners had vaginas, so most of what I’ve learned has come from the Internet.
Sex education is already lacking in many schools throughout the U.S. Only 27 states and D.C. require both sex education and HIV education to be taught in schools, and of these states, just 17 require that content to be medically accurate. Furthermore, many of these states have full discretion over the content taught. Many states do not cover same-sex relationships and some even discourage homosexuality. According to a 2015 study published by the Public Religion Research Institute, only 12 percent of millennials said their sex education included same-sex relationships. Seven states, including Alabama, Arizona, Florida, Illinois, Oklahoma, South Carolina, and Texas, require only negative information to be taught about homosexuality or to positively emphasize heterosexuality. A bad sex education has damaging consequences on young people, like myself. The U.S. education system needs to improve its approach to queer sex education because every single person deserves to have access to inclusive, medically-accurate knowledge so they can make well-informed decisions.
Two agonizingly long weeks after my appointment, I received the results of the biopsy: it was merely a skin tag, not genital warts. I could breathe again. The midwife had told me from the start it was unlikely the results would come back positive, but the entire ordeal forced me to reevaluate why I had always used condoms with cisgender men, but nothing with women or non-binary, genderqueer folks. Since this STI scare, I realized I need to be upfront about asking partners if they have been tested before we have sex, regardless of their sexual or gender identity.
A part of me feels ashamed to write this essay because of my career goals. I wonder if people will doubt my abilities to be a good healthcare provider based on my past actions. There is social stigma that people with STIs are dirty, unclean, or slutty. I have been told that I am a sinner for having homosexual sex outside of marriage, and by putting this story out into the world, I worry that my peers and future patients will think all those things about me too. But I also believe my experiences will make me an even better nurse because I know exactly what it is like to be confused, uncertain, and scared when it comes to practicing safer sex.
When the midwife told me the stories of women who had tested positive for STIs, I felt like I was being reprimanded. I did not want to speak freely around her for fear of being judged. This encounter reminded me to never treat patients like they have done something bad or shameful by having unprotected sex. I am inspired now to normalize safer sex culture, to empower all my patients to take control of their bodies and to teach them to never be afraid of asking their partner to get tested or to use protection. My goal is to become a certified nurse-midwife who provides obstetric and gynecological care for adolescents to adults, and I plan to be open with my patients about my sexuality so they do not ever fear opening up to me. I also hope to teach sex education classes or workshops to adolescents that are all-inclusive of various sexualities and identities. I want to educate as many people as possible. Because safer sex is the best kind of sex.