Lesbian sexual practices

Lesbian sexual practices are many and sundry. As with most interpersonal behaviour any physical expression of intimacy depends on the context of the relationship along with social, cultural and other influences.

Behaviors
Sex educator and feminist Shere Hite's research (while subject to methodological limitations) showed "sex as we define it is a cultural institution, not a biological one," that most women need clitoral or exterior stimulation for orgasm which can be "easy and strong, given the right stimulation" and most women reach orgasm more easily by masturbation. Hite noted one of her female research subjects had written, "Sex with a woman includes: touching, kissing, smiling, looking serious, embracing, talking, digital intercourse, caressing, looking, cunnilingus, undressing, remembering later, making sounds, sometimes gently biting, sometimes crying, and breathing and sighing together." Other notable forms of intimate expression between lesbians can include gestures such as tribadism, use of a dildo and more rarely, anilingus. Some lesbians enter into a mixed-orientation marriage with a man.

Research
In 1953 Alfred Kinsey's Sexual Behavior in the Human Female noted 78% of lesbians had orgasms in 60% to 100% of their sexual encounters over the preceding five years of a relationship, compared with 55% of heterosexual women over the previous five years of their marriage.

A 1983 research study by Philip Blumstein and Pepper Schwartz found lesbians had sex significantly less frequently than homosexual male couples, married heterosexual couples or unmarried heterosexual couples. The study reported only one in three lesbian couples had sex once a week or more. Nearly half of the lesbian couples in the study reported having sex once a month or less. Their research quickly became the prevailing view and led to the popular expression lesbian bed death. However, this study was later challenged. The question, About how often during the last year have you and your partner had sex relations? was criticized as too ambiguous when applied to lesbian sexual behavior. Moreover, other meaningful measures of sexual behavior, such as duration or subjective measurement of sexual satisfaction, were not examined.

Studies by other scholars including Masters and Johnson and Marilyn Frye have found lesbian sexual behaviors more often have qualities associated with sexual satisfaction than their heterosexual counterparts. These can include aspects such as more full-body sexual contact, rather than genital-focused contact, less preoccupation or anxiety about achieving orgasm, more sexual assertiveness and communication about sexual needs, longer lasting sexual encounters and greater satisfaction with the overall quality of one's sexual life.

Health risks
Like most sexual behaviours these activities can carry increased risks of sexually transmitted and other pathogenic diseases. The Centers for Disease Control reported there is little data available regarding the risk of spreading sexually transmitted diseases between women. However they noted pathogens such as metronidazole-resistant trichomoniasis, genotype-concordant HIV, human papilloma virus (HPV, which has been linked to nearly all cases of cervical cancer) and syphilis can be spread through sexual contact between women. While the rates of these pathologies is unknown, one study showed 30% of lesbians and bisexual women had medical histories with sexually transmitted diseases. This does not mean sexually active lesbians are exposed to higher health risks than the general population. Health Canada noted "the prevalence of all types of HPV (cancer and non-cancer-causing) in different groups of Canadian women ranges from 20%–33%" and an American university study found 60% of sexually active females were infected with HPV at some time within a three year period.

HIV
The CDC did not recognize female-to-female transmission as a possible method of HIV infection until 1995. It is possible (though unlikely) for transmission to occur between female same-sex partners. The risk is not as high as male-to-female sexual transmission but the possibility is meaningful. HIV can be spread via blood (including menstrual blood), vaginal fluid and breastmilk. Infection through oral sex can happen if a woman has cuts or sores in her mouth, or poor oral hygiene, moreover if her partner is menstruating. HIV can also be spread through the sharing of penetrative sex toys if their use results in broken skin within the vagina or anus.