I like to talk about sexually transmitted infections (STIs) more than your average person. Sure, it’s not the most glamorous topic — or the sexiest — and sometimes it can be downright awkward, but STIs should be a more accepted part of our conversations. If you don’t think that your latest herpes screening is a great topic for brunch (though I definitely do), at the very least it’s important to be talking about STIs with your sexual partners.
The Centers For Disease Control (CDC) says that STI rates in the U.S. are at a record high — and show no sign of slowing down. So before you become sexually active with anyone, it’s important to not only have safe sex but talk about STIs, too. In a recent Bustle survey of 226 women ages 18 to 34, only 54 percent of survey participants said they bring up STI prevention with a new sexual partner immediately, and 21 percent said they wait until they’re exclusive, so it’s clear there’s still hesitation around this topic that’s preventing people from having important discussions.
I’ve had a lot of STI conversations — with a lot of different people. Because I’m bisexual, I’ve seen firsthand the way both men and women respond to the conversation. And while in both genders I’ve seen the good, the bad, and the ugly, in my experience I have noticed some definite differences between how men and women react. And in a way, that’s no surprise. Men and women are socialized in such different ways when it comes to sex. In our culture, men are praised for having sex with multiple partners, where women are slut-shamed or judged for their sexual choices — and this seems to inform how they talk about STIs. As one woman surveyed by Bustle put it, “There’s still a lot of shame directed towards women who are vocal about their sexual preferences and their sexual health — as if we can’t be sexual beings like men can be.”
It’s not that talking about STIs is easy. I’ve never had a conversation about testing or history where both of us didn’t seem at least a little vulnerable. In some cases, that vulnerability manifested in unhelpful, even toxic ways — defensiveness, aloofness, or just avoidance. In others, it was clear that we were both nervous, awkward, but trying our best. The thing is, you can’t just talk about STIs in a vacuum. As soon as you start talking about STIs, people start to wonder things about you — your sexual history, people you may have slept with recently, your sense of responsibility or lack thereof. It’s really easy to immediately feel judged and on the spot, even if both of you are doing your best to keep it a judgment-free zone. “I believe people still view women as ‘whores’ if they are open about their sexual health,” another woman surveyed by Bustle said.
And yet, despite all of these pressures, it’s definitely been my experience that men and women respond differently to the STI talk. In both cases, I’m usually the one to initiate it, but I attribute that to my personality and also to the fact that I write about sex for a living, more than anything else.
Once the conversation is going, however, there are some very telling differences I’ve noticed in how people respond. Here’s what I’ve found.
Women Often Lean Toward Feelings Of Embarrassment and Responsibility
Talking to women about STIs can be really complex. Not only is birth control not a part of the discussion when you’re talking about women who have sex with women (like it is when you’re sleeping with a man and using condoms), but you also have to contend with some stereotypes about queer women and STIs.
One of the most frustrating conversations I had was with one queer woman who thought she was basically immune from STIs because she was a lesbian (something that isn’t true, but friends of mine have run into that myth as well). And while most women I’ve met are open to talking about STIs, that false stereotype has very much informed the conversations I’ve had. I’ve had sex with at least two lesbians who know they should get tested but, because STI rates are lower in lesbian women, haven’t bothered. Most worryingly, I’ve also had sex with one woman who was refused testing by her doctor because she was in a lesbian relationship. She was told that there was no point, which is not just insulting and unhealthy, but infuriating — especially since she was bisexual and bisexual women have much higher STI rates than lesbian women.
Sometimes, this question about STIs and testing can tumble into a much bigger conversation about sexuality, because if your partner sleeps with other genders, then you may start discussing that. Depending on how comfortable someone is with their sexuality, it can be a tricky conversation to have early on.
Besides the one woman who seemed to think she was invincible, every other woman I’ve talked to has been at least willing to have the conversation — even when they’re clearly uncomfortable with it. And that could have something to do with women feeling like they have to be responsible when it comes to taking care of their sexual health. According to the CDC, women see their doctor more often than men do. In fact, in a study of 594 adolescents published in the National Library of Medicine National Institutes of Health (NIH), 70 percent of women versus only 37 percent of men reported receiving an STI test in the past year.
Women are socialized to feel responsible for the consequences of sex — good and bad. Women bear the brunt of birth control, we get tested more, we face the stigma of an abortion or a teenage pregnancy far more than the men who also made it happen — and we feel like it is somehow all our fault. Only 39 percent of women surveyed by Bustle said they feel their partner is as equally involved in STI and pregnancy prevention as they are. And as one Bustle survey participant said, “Having a lot of sex or sexual partners is still considered ‘slutty’ so people are less likely to talk about the risks, because the blame falls on the women for being too sexually active.”
Even for women who sleep with women and don’t have to worry about birth control, there’s still often an absorption of these social pressures. The fact that the one woman I know who was refused testing seemed to feel guilty about it, like she had done something wrong, was particularly telling.
It may also be that women fear STIs more — both because of the likelihood of transmission, and the stigma attached to women who are sexually active. Because of the thin tissue of the vagina, women can also contract STIs more easily,according to the CDC. Whereas men who sleep with women might not want to get an STI, they are also not as actively encouraged to get tested. In 2015, the CDC’s recommendation for STI testing targeted women and queer men — but left straight men off completely, like they’re simply not responsible for carrying that burden.
Of course, there are plenty of women who are avoidant when it comes to their sexual health, especially because of the lasting myth that lesbians don’t get STIs. I’ve met women who haven’t been tested for years, who are flippant or even difficult — but there’s usually a “my bad” or “sorry” buried in there, and a lingering sense of guilt. But I do have to say, that doesn’t always happen for me with men.
Men Tend To Vary Between Apathy And Defensiveness
When it comes to talking to men about STIs in my experience, it’s much more common to run into the devil-may-care attitude. The vast majority of male sexual partners I’ve had have been pants-down and ready to go, without ever asking about STIs or safe sex — and a couple have pretended not to hear me when I’ve brought it up. With women, I can normally bring it up before things have gone far but, in my experience, with men it has to be a “TIME OUT!” moment, like I’m stopping a moving freight train. That’s partially just because, in my experience, sex with a woman often starts a little slower, while a hookup with a guy can feel a little more rushed. That being said, I have had two long-term hookup buddies who were men and totally considerate and consistent in their condom use, with no prompting needed from me — so I don’t want to put all men in the same boat.
In my experience, a whole lot of the issue comes down to condoms. Some men I’ve slept with have been definitely weird or flippant about STIs because they don’t want to wear one — and the good news is that’s a 100 percent fool-proof indicator that they are a total jerk. I once told a guy to get a condom and he told me, “It’s OK, I’m the king of pulling out.” When I said I didn’t care and asked him the last time he was tested, he just shrugged. It was a pretty clear sign that this was not going to be a long-term, meaningful connection, let alone someone I was having sex with that night. (OK, I did have sex with him — but I made him wear a condom.)
But other times, men have been very aware of the fact that they have been less-than-perfect with their testing history. And, while some men have been perfectly mature and lovely about owning up to it, on the whole, I’ve also found men are more likely to get defensive — like I’ve accused them of doing something wrong — or offer an apathetic“Pffffff…” mentality, which I personally find incredibly off-putting. And I’m not alone. “Guys are always SO shocked when I ask them to get tested if they’ve never been,” one Bustle survey participant said. “I don’t ask for their number! I get tested every year but they make me feel guilty for asking the same of them.”
When I’ve discussed STIs with women, I’ve never been met with a meltdown, like I’m accusing them of being dirty. It seems to be an accepted, even expected question. With men, the conversation tends to be trickier. And sometimes, it’s especially tough. One man, who was about 10 years my senior, was so aggressive about trying to have sex without a condom that I had to push him off me and kick him out of my apartment, which remains one of the worst sexual experiences of my life.
The truth is, very few of us know how to talk about STIs or our sexual history in a comfortable way. It’s an inherently vulnerable place to be in. But the more we talk about it, the more we can normalize it. Seeing firsthand that men have often been taught that their sexual health isn’t as much their responsibility shows why it’s even more important, as women, that we bring the issue up. And as many queer women think they’re immune from STIs, you may have to initiate the conversation. Ultimately, it’s your health — and it’s in your hands.
Originally posted on Bustle