LGBTQ+ vaginal health is being ignored by medicine. This is why research shows higher concordance of bacterial vaginosis between partners who both have vaginas.
If one partner is dealing with BV, the other is significantly more likely to develop it as well. This is not about blame or hygiene. It is microbial ecology, a basic biological mechanism that was simply never taught to most people.
What’s especially notable is that long-term partners often develop similar vaginal microbiome profiles over time. Their ecosystems begin to resemble each other.
If one partner’s microbiome is imbalanced, depleted of protective Lactobacillus species and overgrown with BV-associated bacteria, that imbalance can more easily take hold in the other partner’s vagina as microbes move between two compatible environments.
But the reverse is also true. If one partner maintains a healthy, Lactobacillus-dominant microbiome, that balance can positively influence the other partner’s vaginal environment.
This is exactly why proactive microbiome support matters, and why it matters doubly for couples where both partners have vaginas.
Yet nearly all clinical research on sexually transmitted vaginal conditions is conducted exclusively on heterosexual couples.
BV studies focus on penile-vaginal transmission. UTI prevention advice centers on post-coital urination after penetrative sex with a male partner. Yeast infection guidance assumes a heterosexual framework.
The entire body of accessible sexual health education operates as though LGBTQ+ people with vaginas do not exist.
This erasure has tangible consequences.
People in my community have told me publicly, in comment sections with thousands of viewers, that their gynecologists advised them to skip cervical screenings because they are in same-sex relationships. But HPV does not require penile penetration to transmit.
Cervical cancer screening is critical regardless of a patient’s sexual orientation. The fact that licensed clinicians are dispensing this advice reveals how deeply the heteronormative framework has embedded itself in clinical practice.
What needs to change is not complicated. First, we need more research on vaginal microbiome dynamics between partners who both have vaginas.
The data that does exist confirms what microbial ecology would predict: that transmission and concordance of vaginal flora between same-sex female partners is real and clinically significant. But the body of research remains small, underfunded, and largely invisible to practicing clinicians.
Second, sexual health education — whether delivered in clinical settings, schools or public health campaigns — must be inclusive by design rather than as an afterthought. When we talk about BV prevention, UTI risk factors, or the benefits of probiotic support for the vaginal microbiome, we need to address the specific dynamics that apply to all people with vaginas, regardless of the gender of their partners.
Third, clinicians need better training. No patient should ever be told they don’t need a Pap smear because of their sexual orientation. No patient should leave a gynecologist’s office without understanding how their intimate relationships, whatever form those take, interact with their vaginal health.
When I started With Meraki Co., I built it on a simple premise: that people deserve honest, science-backed information about their own bodies. That mission does not stop at heterosexual couples. Inclusivity in health is not a marketing strategy. It is a clinical and moral imperative.
This Pride Month, I am asking the medical and research communities to do more than wave a rainbow flag. Fund the studies. Update the guidelines. Train the clinicians.
And start having the conversation that millions of people with vaginas have been waiting to hear. n
Giana Jarrah is a biomedical engineer and founder and CEO of With Meraki Co.