By Marie Geoffroy, Associate Director of Research at CBRC, and collaborators (listed below)

Content warning: this blog post contains data on sexual violence.

What does health – and, more precisely, sexual and reproductive health – currently look like for Two-Spirit, lesbian, gay, bisexual, trans, and queer (2S/LGBTQ+) women, femme, and gender-diverse communities? 

This question has been difficult to answer, in part due to lack of data, funding, and conversation about women and gender-diverse folks in broader queer health spaces (see footnote on language used in this post)¹. Fortunately, this is starting to shift, as more data are collected, and as our communities gather and mobilize to define and address our sexual and reproductive health needs. For decades, cis and trans lesbians and queer women, and gender-diverse communities, have been organizing and advocating alongside many movements, including HIV/AIDS mobilizations and feminist movements. CBRC’s mandate expansion to serve all 2S/LGBTQ+ communities beyond gay men in 2021 is still relatively recent, and critical reflections and work to affirm the experiences of 2S/LGBTQ+ women and gender-diverse communities are still nascent.  

Data collected by CBRC and other community-based organizations, like the Quebec Lesbian Network, are helping us understand the discrimination and violence experienced by 2S/LGBTQ+ women and gender-diverse communities – including sexism, transmisogyny, anti-fatness, and racism. This violence impacts our daily lives, including the way we interact with the medical system. For instance, CBRC’s Our Health data published in 2024 indicated that 59% of 2S/LGBTQ+ women and gender-diverse lesbian participants had a chronic health condition, 54% lived with a mental health condition, and 23% experienced discrimination in the healthcare system since 2020. In their 2024 national survey, the Quebec Lesbian Network found that 47% of 2S/LGBTQ+ women and gender-diverse participants had experienced sexism in the medical system. They also found that 67% of participants had experienced sexual violence at least once in their lifetime. Work by Egale has also documented the important labour needed to access care, and the harmful interactions and discrimination rooted in sexism, racism, weight bias, medical gaslighting, ageism and cisheterosexism experienced by LBQ women, trans, and non-binary people in Canada when accessing healthcare.

For this year’s Lesbian Visibility Day, we took a closer look at the preliminary data from CBRC’s 2025 Sex Now survey about how queer women and femme folks in Canada navigate their sex lives. For context, Sex Now was created in 2002 as a community-led survey on HIV, sexually-transmitted and blood-borne infections (STBBIs), and sexual health, initially focused on cisgender gay men. Over the years, the survey has undergone multiple evolutions. In 2025, following community mobilisation and focused consultation with select CBRC staff and collaborators who are 2S/LGBTQ+ women, femme, and gender-diverse, the Sex Now eligibility criteria was expanded to include the lived and living experiences of queer and trans women – communities historically underrepresented in sexual health research and previously excluded from Sex Now.

FromSex Now 2025, which included a total of 2,072 participants, a subsample of 338 participants was analyzed. This subsample included participants who identified their gender as woman (n=299, 89% of this subsample), trans woman (n=45, 13%), and/or transfeminine (n=41, 12%). 

Here are some of the first insights we have on the sexual and reproductive health of queer women and femmes in Canada.

Sexually active queer women participants reported having many types of sex. The most frequently reported in the past year were someone masturbating or fingering them (73%); masturbating or fingering someone else (72%); giving oral sex (71%); receiving oral sex (66%); sex with prosthetics, strap-ons, or sex toys (59%); scissoring or frotting (42%); BDSM, kink, or fetish play (37%); and vaginal/front hole sex as bottom/receptive partner (37%). As this is one of the first Canada-wide studies to collect these types of data in our communities, these findings indicate a need to dig deeper into queer and sapphic sexuality to fully grasp what our sex lives looks like in order to inform sexual health education and queer health research that truly centres our sexual wellbeing, autonomy and pleasure. 

Many queer women participants reported not using barriers when engaging in sexual practices. 97% of participants reported at least one instance in the past year of not using a barrier when giving or receiving oral sex, 95% reported this for masturbating someone or being masturbated, and 59% reported at least one instance in the past year of not using a barrier for anal sex when being the penetrative partner. More work is needed to understand reasons for not using barriers, which may be due to a lack of awareness, choices related to specific body parts and objects at play, desire for intimacy and pleasure, closed monogamous relationships, and/or navigation of other prevention strategies depending on partners. 

More than half (52%) of queer women participants had never been offered STBBI testing by their regular family doctor or nurse practitioner. This is likely in part due to a lack of knowledge among clinicians about lesbian sexuality and the biased invalidation of lesbian sex as not being “real sex”, as cited by participants in the Quebec Lesbian Network’s national survey. In Sex Now 2025, 1 in 5 queer women and femme participants had never had STBBI testing, while for 36% of participants, their last test was over a year ago. Queer women and femme participants most frequently reported skipping or delaying STBBI testing in the past year for reasons such as reduced or no sexual partners (41%); being in a closed sexual relationship (36%); being too busy (14%); testing being offered at inconvenient hours (12%); not knowing where to go to access testing (10%); and being too stressed out, anxious, or depressed (9%). Notably, despite these barriers, 24% of participants did not delay or skip STBBI testing in the past year.

The most common STBBI reported by queer women and femmes in Sex Now 2025 was bacterial vaginosis, with 27% reporting having had a diagnosis in the past year, followed by chlamydia (13%) and herpes (8%). Much more information is needed to understand the frequency of these infections as well as the factors for queer communities. For instance, we know that bacterial vaginosis can be asymptomatic, and can reoccur for some folks if their sexual partner(s) are not also receiving treatment, or simply with new partners. Further, while recurring antibiotic treatment can have side effects, a lack of treatment for bacterial vaginosis may also lead to complications. Bacterial vaginosis has also been linked to increased HPV infection. More conversation is needed to understand what the needs are for our communities in terms of bacterial vaginosis.

Queer women participants were asked about HPV vaccination and Pap testing in the past three years, which are important ways of preventing cervical and other reproductive cancers. Among participants, 62% had been vaccinated against HPV, 27% had not, and 11% were unsure if they had been vaccinated. Further, amongst queer women and femmes who have a cervix and were 25 years or older, 71% had received a Pap test in the past 3 years, 28% had not, and 1% were unsure about whether they had received a Pap test. As HPV testing begins to replace Pap tests as the recommended cervical screening method across Canada, it is important to understand the impacts of this change on communities and maximize ways to remove barriers to preventative care. Screening guidelines differ across Canada as it stands, with HPV testing requiring screening every 5 years instead of every 3 years with Pap tests, and self-sampling is only available in a few provinces. HPV testing and self-sampling have the potential to become more widely adopted by all than Pap tests, especially those living in rural and remote communities, though the potential widespread impact of this change for our communities remains untapped.

Alarming numbers of queer women participants in Sex Now 2025 reported experiencing sexual violence. 59% reported experiencing forced sex at least once in their life; 40% reported having experienced, specifically from a partner, forced or unwanted sex, rape, or sexual abuse. In terms of intimate partner violence, 63% reported being insulted or verbally abused by a partner, and 23% had experienced physical violence such as being hit, kicked, or slapped. Our communities deserve that we pay deep attention to this, which includes addressing the compounded impacts of misogyny, lesbophobia and transmisogyny (to name a few) on our communities’ safety and wellbeing. Beyond conversation, important investments are needed for programming and community-based research aimed at preventing these experiences from taking place, and also at ensuring sufficient affirming services are accessible for our communities when they do.

Queer women participants have varied feelings of connection to 2S/LGBTQIA+ communities. 29% felt extremely or very connected, while 33% felt moderately connected, and 38% felt a little or not at all connected. This lack of connection may partly be due to the lack of visibility of lesbian and queer women within 2S/LGBTQ+ events like Pride and spaces such as gay villages, where lesboqueer women often report feeling disconnected as well as experiences of sexism and misogyny. This data illustrates the importance of truly opening up and adapting spaces and programs to a broader spectrum of the 2S/LGBTQ+ community, in order for all people to reap the documented health benefits of community connection.

While the expansion of Sex Now to include 2S/LGBTQ+ women is an important milestone, these results highlight the need to push conversations and community-based work further. Importantly, the subsample of women (trans and cis) and femme folks presented above only made up 16% of the overall survey population. While the increased community engagement of 2S/LGBTQ+ women and gender-diverse folks in regards to their sexual health and wider wellbeing is promising, much more work is needed to further refine our surveys, recruitment methods, and community-based research approaches to ensure they truly capture what is important for lesbian, queer women, femme and gender-diverse communities. In other words, are we asking the questions that our communities care about and doing so in ways that they feel engaged and seen? This work also requires centering intersectional approaches since the impacts of systems of oppression like misogyny, homophobia, and transmisogyny are particularly heightened for for 2S/LGBTQ+ people who are also Indigenous, Black, and People Of Colour (IBPOC), im/migrants, newcomers, refugees, and people living with a disability or a chronic health condition. 

Through collaboration, we can come together to define what is needed for our communities. During Summit 2025, CBRC partnered with Dr. Celeste Pang to organize a gathering to provide opportunities to catalyze community-based research by, with, and for 2S/LGBTQ+ women and gender-diverse people. Discussions at the gathering shone light on the concrete ways that structural and systemic forces create and drive social inequities that impact the social inclusion, research participation, and overall wellbeing of 2S/LGBTQ+ women and gender-diverse communities daily and across their life course.  The report from this important gathering, including recommendations, was published earlier this year and can be accessed on our website. Click here to read “Catalyzing Community-Based Research By, With and For 2S/LBTQIA+ Women and Gender-Diverse People.”

In the coming months, data from Our Bodies, Our Health, CBRC’s large national community-based survey conducted in 2025, will allow us to dig deeper into the experiences of queer women and femmes in terms of sex and pleasure; access to sexual and reproductive healthcare including gender-affirming care and family planning; experiences of violence, sexual education and so much more. 

We can be hopeful that with data in our back pockets, and growing community mobilization, we will continue to lead important conversations and community-based initiatives to better understand and address the needs and experiences of queer women and femmes. It’s already happening. Together, we get to decide what our wellbeing, our health, and our sex look like. Stay tuned and join the rapidly expanding conversation.

With contributions from:

• Tara Chanady, Executive Director, Quebec Lesbian Network
• Malhar Shah, Data Analyst, CBRC
• Ren Lo, Social Epidemiologist, CBRC
• Fowzia Huda, Associate Director of Programs, CBRC
• Katie O’Brien, Research Coordinator, CBRC
• Malek Yalaoui, Research Coordinator, CBRC
• Nathan Lachowsky, Professor, School of Health Sciences, University of Northern British Columbia, and former CBRC Research Director from 2017-2025
• Ben Klassen, Associate Director of Research, CBRC

Disponible en français.