Queers have all different types of relationship structures and sexual practices! There is NO ONE WAY to be QUEER! At QueerDoc, we recognize sexual health as part of health. We celebrate all consensual relationship structures, and we are experienced at navigating sexually transmitted infection (STI, previously known as STD) screening recommendations for the beautiful diversity of queer relationships.
The current coronavirus pandemic makes regular STI screening more difficult. Some providers aren’t taking non-emergency appointments, and many patients are trying to avoid in-person medical services. Some of us have trauma around screening tests. We may still need access to routine or symptomatic STI testing.
There are minimal contact options!
Several companies provide testing kits through the mail – they are convenient to order online, but are certainly not perfect. We have three main criticisms here at QueerDoc:
- They tend to be costly
- They are often not gender inclusive
- They often come as standardized test packs which
- May not have the tests you need
- May have more tests than you need
Cost
Most of the home kits cost $150 – $350 out of pocket and do not offer sliding scale options or take insurance. This is not accessible for many people. If you have insurance, you can try to get reimbursed for out-of-network costs with a receipt and a letter of medical necessity from your provider. If you have FSA/HSA through your work, you can use that to pay. Cost (and paperwork!) can be prohibitive compared to sliding scale or free services from Planned Parenthood or Public Health.
Gender
Most of these companies sort and group tests assuming a binary gender! While the type of genitals we have – and how we use them – affect, our STI risks, gender doesn’t. Selling STI testing by gender is not only culturally insensitive and lacking in inclusivity, it doesn’t make sense medically. As doctors, we don’t need to know your gender to help make recommendations on STI testing. I need to know what genitals you have (bio vagina, neo vagina, bio penis, neo penis, intersex). I also need to know what goes where when you have sex with people (do genitals go in your mouth? Your bottom?, etc.). Lastly, I need to know certain risk factors of you and your partners. GENDER IS NOT A PART OF THIS.
Test Packs
Most of the available STI home test kits are package deals, and don’t allow you to add or subtract individual tests. You may pay for and get tests that aren’t recommended for you or you don’t need and you might not get some tests you do need!
Online STI Testing Companies as Ranked and Reviewed by QueerDoc:
1. NURX.com
Pros:
- Gender-neutral kit option
- Takes some insurance
- Profile allows you to pick non-binary and intersex
- Pre-selected tests for the “Full Control Kit” the best fit for many people
- Has oral and rectal gonorrhea and chlamydia testing
Cons:
- Default is a “Healthy Woman Kit”
- $75 copay with insurance
- Profile options are incomplete
- No build your own kit option for individualized care
2. MyLabBox.com
Pros:
- Nod to LGBTQ community (very small nod)
- Has oral and rectal gonorrhea and chlamydia testing
- Allows you to individually order STI tests
Cons:
- Must choose MALE or FEMALE to enter website
- Does not take insurance
- Costs $190-$450
3. Letsgetchecked.com
Pros:
- Gender-neutral kit option
Cons:
- No oral or rectal gonorrhea or chlamydia testing
- Does not take insurance
- Costs $99-$269
- No build your own kit option for individualized care
- Still some gender triggers
4. Everlywell.com
Pros:
- Gender-neutral individual test options
- Build your own kit options
Cons:
- No oral or rectal gonorrhea or chlamydia testing
- Does not take insurance
- Costs $39-$200
- Still some gender triggers
Other creative options to have safer sexual practices during coronavirus:
- Talk to your primary care provider: they may be able to set up home testing by mail for you
- Talk to QueerDoc about our home testing options
- Minimize your number of in-person partners and partner’s partners
- The safest strategy is no partners outside of your COVID bubble. However, this can also impact your well-being. If your mental heath is negatively impacted by a closed bubble, we like how this article provides detailed risk assessment information and strategies for risk reduction: https://www.thebody.com/article/sex-corona-lockdown. (Check out their green list for more fun things you can do that are low risk!)
- Got a webcam or phone? Get creative with your remote partners via technology!
- Negotiate new kinks or activities and try them out virtually
- Mutually masturbate while on video chat
- Write erotica together in a shared document
- Get creative with yourself
- Check out new-to-you erotica or porn
- Try new toys
Having a tough time being creative in the moment? At our house, each of us has a “sexy jar”! When we have an idea for future sexy-times, we write it down on a slip of paper and put it in the applicable jar. Our power dynamics determine who can put slips in other people’s jars. Later, if we’re feeling like getting sexy but can’t decide how, we pull 5 slips from the jar and pick one idea to act on.
A note on COVID-19 vaccines and risk:
COVID-19 vaccines reduce your risk of serious illness from COVID-19, but they do not eliminate it, and they can’t be used as a screening tool for sexually transmitted infections.
Viruses replicate quickly, and every time a virus makes another copy of itself, there is a chance of a change in the genetic code – this is a mutation.
Some mutations can change how the virus ‘plays out’ in the body. A mutation may make symptoms more or less severe, or change how easily the virus spreads, or who is more likely to get sick. One important thing to remember is that the more active a virus is in a community, the more chances it has to replicate and potentially mutate: one key strategy to prevent new dangerous mutations is to keep practicing responsible physical distancing, even if you’re vaccinated.
Information about vaccine effectiveness against the strains that are active in your area may be difficult to find. As of April 2021, the CDC is publishing data about the mix of variants in the United States as a whole and regionally here: https://covid.cdc.gov/covid-data-tracker/#variant-proportions.
Another tool to manage your personal risk is to be aware of how active COVID-19 is in your area. This COVID-19 risk assessment tool – https://covid19risk.biosci.gatech.edu/ – can provide up to date information about risk of exposure in your area.
There is building evidence that the risk of indoor activities is more dependent on time spent inside together and active air circulation rather than physical distance (the six feet rule!) If you need to be indoors with people not in your bubble, opening windows and/or running fans are a risk-reduction strategy, but gathering outdoors is safer. We’re summarizing this information from a brand new (at time of re-publishing this blog) study. You can read it at https://www.pnas.org/content/118/17/e2018995118. If you’re someone who finds data sexy, the study includes a link to their dataset and an online app for estimating indoor risk. Stay sexy!
Revised April 27, 2021