Majority of transgender and gender-diverse (TGD) people prefer self-collected HPV tests for cervical cancer screening, and/or preferred to forego screening altogether.
This is according to a study – “Cervical Cancer Screening Preferences in Transgender, Nonbinary, and Gender-diverse Patients” by Brittani Steinberg, Rachel Paul, Madison Copeland, Cynthia Herrick and Jennifer Reeves – that was published in O&G Open.
The researchers noted that transgender and gender-diverse (TGD) individuals assigned female at birth are subject to significant disparities in cervical cancer screening. This is because patients who have not undergone total hysterectomy still require cervical cancer screening, and yet previous research has shown that transgender male and nonbinary patients adhere to cervical cancer screening recommendations at lower rates than cisgender female individuals.
Here, the researchers administered a cross-sectional survey to a convenience sample of 50 patients 18–65 years of age assigned female at birth and self-identifying as transgender or gender-diverse (TGD) from a single academic endocrinology clinic. The 30-item survey, adapted from previous research in this population, included gender-neutral language and various multimedia. We used descriptive statistics to characterize preferences for cervical cancer screening in the form of a ranked list, as well as responses regarding comfort with self-swabs and past experiences with screening. The researchers also performed a post hoc content analysis of free-text responses related to respondent cervical cancer screening preferences.
Key findings included:
- 56.0% of respondents chose human papillomavirus (HPV) self-swab as their first-choice cervical cancer screening preference, followed by provider-collected HPV swab (18.0%), decline screening (14.0%), and Pap test (12.0%).
- Themes identified from free-text responses around cervical cancer screening included fear of provoking gender dysphoria, value of preventive health care, appreciation of privacy with self-swabs, and desire for gender-diverse–competent health care teams.
As noted by the researchers, majority of TGD people prefer self-collected HPV tests for cervical cancer screening, and/or preferred to forego screening altogether. This echoed past findings that emphasized that “this may be the result of discomfort or distress with the pelvic examination, high prevalence of past trauma, stigma and discrimination by health care providers, and woman-centered education materials.”
For the researchers, therefore, as emphasized by their respondents, it is important to “emphasize the importance of preventive health care and clinician competency in transgender health and trauma-informed care.”
