I’ve answered a sample of the most commonly asked questions submitted to us this Pride month by our patients. This is not exhaustive so if you have any further questions, please speak to our Babylon clinicians, we are LGBTQ+ healthcare allies.
What does LGBTQ+ stand for?
L = lesbian
G = gay
B = bisexual
T = Transgender
Q = queer/questioning
+ = intersex / asexual / pansexual / non-binary
The word “queer” has been reclaimed positively by the community. Compared to the late 80s when it was used as a negative slur word. Many people simply identify as queer in all of the above groups as it’s implied the Q covers all other subgroups.
If I tell my doctor that I am LGBTQ+, can they tell my family/partner?
No, a doctor can only defensibly break patient confidentiality if you reveal a risk to yourself or others.
What proportion of people are LGBTQ+?
UK data suggests that 2%-10% of the population are born in the LGBTQ+ spectrum. International census data is less widely available however the scientific consensus suggests that 2-10% represents global populations. LGBTQ+ people exist in every community among all ethnic groups at all socioeconomic levels. There are examples from every locality and time-period, from prehistoric rock paintings in South Africa to ancient Indian medical texts and early Ottoman literature.
It is important to note that recent polling has shown that up to 50% of millennials do not identify as exclusively heterosexual.
What makes someone LGBTQ+?
Although much research has examined the possible biological, developmental and social influences on sexual orientation, no one particular factor has been identified. The general scientific consensus is that multiple genes are involved.
What’s the commonest age to come out?
16-20 is the most common age range when people feel ready to acknowledge their sexuality and choose to tell those around them. However, people can come out at any age.
Is being LGBTQ+ legal?
Of the 195 countries in the world, 126 countries have legalized homosexual sex but 69 countries still criminalize it. The countries criminalizing homosexual sex are often nations where BAME (black, Asian and minority ethnic) people originate and therefore, it is all the more reason why we should support people of colour in our community.
What is an LBGTQ+ clinician ally?
An LGBTQ+ clinician ally is a term used to describe a healthcare worker who is supportive of inclusive care and actively advocates for LGBTQ patients. They often have increased experience of looking after LGBTQ+ people and increased training.
What are your tips for coming out?
The definition of being out is personal. The most important part of being out is that you feel comfortable being yourself around people you care about.
Coming out is a spectrum too. Depending on your circumstances, you may choose to slowly tell people over the course of your life or in bursts.
If you feel certain people may be intolerant (including some families), you do not have to tell them. Instead, you may choose to surround yourself with friends “chosen family” who will support you with unconditional love.
What is PrEP?
PrEP (pre-exposure prophylaxis) is medicine people at risk for HIV can take to help prevent getting HIV from sex or injection drug use.
If you start taking prep without knowing you are HIV +, will you still test positive for HIV?
At the point of starting PrEP, you are tested for HIV first and you must be negative. If the clinic thinks that you are high risk, they may ask you to re-test 3 months after they start your PrEP so that there is the certainty of your status.
Why can we not donate blood while on PrEP?
Whether on PrEP or not - anyone who has had anal sex with a new partner or multiple partners in the last three months, regardless of their gender or their partner’s gender, must wait 3 months before donating.
This is because 3 months is considered the maximum length of time it takes for HIV to be detected in the blood.
PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed. Therefore, the transfusion services consider that there is still a risk of HIV and so they often do not allow people on PrEP to donate. This may change in the future.
Can women give each other HPV and how?
Yes, women can give HPV to each other.
HPV is transmitted by skin-to-skin contact. Therefore, women can contract the virus via female genital contact, mouth to genital contact, or fingering. Furthermore, HPV has been detected on inanimate objects such as dildos and sex toys.
So even if you are a woman that only has sex with women, please do yourself a favour and always get your smear test!
If your partner is HIV+ undetectable, do you need to take PrEP?
If your partner is living with HIV and uses HIV treatment to maintain an undetectable viral load, there’s no risk of them transmitting HIV to you. However, if they have missed any medication, their viral load has missed regular monitoring or they have been run down significantly, there is a chance they could be carrying the virus again.
Therefore, it is wise to take PrEP to reduce the chance further. This may help provide extra reassurance for you both. I would recommend discussing this with your partner so you can be inclusive and happy with the decision.
What happens if someone born female takes testosterone? Any bad side effects?
If someone born female takes testosterone, they will develop masculinizing features such as increased hair growth on the face and chest, deepening of the voice, and increased muscle/bone mass.
Yes, there are lots of side effects so it is not recommended to take testosterone without medical supervision. If taken at an excessive dose, the side effects include heart deformities, acne, anxiety, infertility, weight gain, and swings in mood/libido.
If you feel you are trans, please speak to me or your doctor and we will try and find a way for you to safely have hormones if needed.
If I think I may be asexual, what can I do to explore my sexuality and know for sure?
You are not alone. Asexuality (Ace) is a sexual orientation, like being gay or straight. Although asexuals may have little interest in having sex, most desire emotionally intimate relationships.
I think the best way to explore your sexuality is to speak to like-minded and open-minded people. Pride month is a great time to do this as there are lots of events. Other people who identify as asexual can really help you be proud and confident in who you are, no matter what stage of being out you are at.
I suggest searching Ace groups on MeetUp and following #asexual on Instagram to at least see what others are saying and deciding if you want to engage.
“Knowing for sure” is totally personal and may change over your life. The most important part of being out in any sexuality is that you feel comfortable being yourself around people you care about.
I think I may be aroace, is this normal?
Aromantic asexual, also known by the abbreviation aroace, is a term for someone who does not experience romantic or sexual attraction, making them both aromantic and asexual.
Please remember 3 truths:
(1) You are normal no matter what sexual orientation you are, including aroace
(2) There is no one-size-fits-all approach, follow what feels right for you
(3) It gets better
Does taking T make it less likely to get pregnant?
Yes, taking testosterone (also known as “T”) does make it less likely to get pregnant in a female-to-male transgender person. This is due to the fact that long-term use of testosterone will suppress the body’s own sex hormone regulation. Ultimately, this will likely make periods irregular or stop in some cases.
However please note that testosterone is not a guaranteed contraceptive so please ensure appropriate protection to prevent an undesired pregnancy.
Does taking T make it more likely to go bald?
Taking testosterone (also known as “T”) can increase the chance of baldness but this will depend on individual factors:
- Whether testosterone dosing is within the target range for men - high levels can increase the chances of hair loss
- Genetic predisposition to baldness - if baldness is common in your mother’s family (those assigned male at birth), you can be more likely to develop baldness in later life.
Taking any sex hormones as medication can affect the body’s own sex hormone regulation. Therefore, please always seek medically approved prescriptions and monitoring to prevent side effects and complications.
How do I get my HPV vaccine?
In the UK, the HPV (Human Papilloma Virus) vaccine is routinely offered to all children aged 12-13. It requires 2 doses 6 months apart. Anyone that missed this can still get the vaccine up until their 25th birthday usually from their primary care practice. Anyone outside of the above can often get it free from STI clinics after risk assessment.
In the US, most health insurance plans cover routine vaccinations. Please check with your provider regarding your eligibility or private options.