Breaking Down Stigmatized Language Related to STI Testing (Queer-Affirming Therapy)

We’ve all heard someone say “I’ve been tested, I’m clean;” maybe we’ve even said it ourselves. When people use the notion of cleanliness to describe their STI status, it implies that anyone who tests positive is “dirty.” This language has roots that go back centuries: religion and culture have framed sexual health as a moral matter rather than medical. Many religious traditions have historically positioned STIs as “divine punishment” for sex outside of marriage, or for same-sex relationships. As Dr. Gunter notes, “shame and stigma are effective weapons of control that have been used throughout history to marginalize women, people of color, and the [2S]LGBTQ+ community.”

This ethical framework slowly led to the stigmatization of STIs, thus associating them with shame, social disapproval, prejudice and judgment of people’s sexual choices. Those who bore the heaviest burden of this stigmatization were women and queer people. A striking example of this stigmatization took place during the HIV/AIDS crisis of the 1980s, where the global pandemic was framed as a consequence of “immoral” behaviour, and was referred to in media and political discourse as the “gay plague.” Beyond being a hurtful framing for those affected by HIV, it delayed government funding, slowed research, and cost many lives. Therefore, the use of terms such as “clean” and the implication of the other side of the spectrum being “dirty” is not neutral; it is inherited directly from history.

This history lives on in the words we use daily, and the following section will invite you to examine and reflect on how normalized this language has become. Remember, this is an invitation to look inward, reflect, learn, and hopefully, adapt our language.

“I tested clean” or “I’m clean.”

This might be the most common example, and the one most of us have said without giving it a second thought. When we describe a negative STI result as “clean,” we implicitly frame a positive result as “dirty.” This language is rooted in a long-standing purity discourse around sex, the idea that sexual activity outside of specific boundaries (such as sexual intercourse outside of marriage) taints a person in some way. An STI is a medical condition, not a reflection of someone’s hygiene or worth. The words we use around test results shape how people feel about seeking care, and how shame remains a barrier to testing and disclosure. As Jenelle Marie Pierce, board president of the STI Project, puts it, language "has the power to entirely change someone's perception of themselves by either generating shame or eliminating it."A simple alternative is “my results came back negative.”

“I only have sex with clean people.”

Once again, this example reinforces the notion that someone having tested negative is more worthy than someone who tested positive. It is also worth noting that someone who tested negative can still transmit an STI (for example, if the testing happened too soon after exposure), and that someone who is managing an STI responsibly can be a safe partner. This phrase dehumanizes people living with STIs by reducing them to their status. It also creates a notion of false binary: clean versus dirty, safe versus dangerous, worthy versus unworthy. A more accurate and compassionate alternative would be “I ask that partners are up to date with their testing,” or simply having an open conversation about sexual health, without moral judgment.

“Are you safe?” as a synonym for STI-negative.

This is a subtle one but it is still worth unpacking; equating “safe” with “STI-negative” implies that anyone with an STI is inherently unsafe. This erases the reality of many people living with STIs, particularly those on treatment for HIV, who carry no risk of transmission. Safety in a sexual health context is related to informed consent, communication, and responsible care, not status alone. A more accurate question would be “are you up to date with your testing?” or “Can we talk about our sexual health?”

When we inherit language that is rooted in shame, we pass that shame on without even realizing it. Replacing words like “clean” and “safe” with neutral, accurate ones is a small shift, but it carries big weight. It tells people that their health status does not define their worth, and that they are safe to seek care without fear of judgment.

So the next time that you catch yourself reaching for this type of phrasing, pause and find a word that heals instead of harms.