Abstract
Trans-masculine (TM, i.e., persons who have a masculine spectrum gender identity, but were assigned female sex at birth) individuals face disparities in cervical cancer screening rates compared to cisgender women. Some unique barriers to screening in this population are specific to Pap tests. Introduction of self-collected frontal (i.e., vaginal) swabs for human papillomavirus (HPV) testing as a screening strategy may obviate these barriers. This study elucidates cervical cancer screening preferences among TM individuals. TM individuals participated in in-depth interviews (n = 31) and online surveys (n = 32) to explore perceptions and experiences regarding cervical cancer screening, including the acceptability of self-collected frontal HPV swabs for cervical cancer screening compared to provider-administered Pap tests. Provider-collected frontal HPV swab acceptability was also explored. Most TM individuals (94% in-person and 91% online participants) preferred either the self- or provider-collected frontal HPV swab to the Pap test. Participants perceived self- and provider-collected frontal HPV swabs to be less invasive, provoke less gender discordance, and promote a greater sense of agency compared to Pap tests. However, some participants expressed concern about HPV swab accuracy and, regarding the self-collected swab, discomfort about the need to engage with genitals they may not want to acknowledge. Individuals who reported positive provider relationships found Pap tests and provider-collected frontal swabs more acceptable than those who did not. Frontal HPV swabs have the potential to promote regular cervical cancer screening among TM individuals and to narrow screening disparities. Work is ongoing to establish swab accuracy and develop shared decision-making tools.
Highlights
Cervical cancer, which is caused by the sexually transmitted infection (STI) human papillomavirus (HPV), is associated with significant morbidity and mortality in individuals with a cervix [1,2,3,4]
The aims of this study were to 1) assess TM individuals’ experiences with cervical cancer screening to identify reasons for preference for frontal HPV swabs compared to Pap testing and 2) explore the acceptability of self- versus provider-administered frontal HPV swabs – options that do not require a speculum exam, but, in the case of the self-swab, require an individual to interact with genitals that might trigger gender discordance.* This study addresses critical gaps in current knowledge regarding cervical cancer screening method acceptability and preferences among TM individuals
Concerns with the frontal HPV swab Some participants expressed concerns about: 1) the accuracy of self-swabs, 2) the desire for a provider-conducted visual exam, and 3) discomfort about the need to engage with genitals during the self-collection process
Summary
Cervical cancer, which is caused by the sexually transmitted infection (STI) human papillomavirus (HPV), is associated with significant morbidity and mortality in individuals with a cervix [1,2,3,4]. Certain types of HPV are considered high-risk, as they cause cancer in different areas of the body, including the cervix [6]. A recently estimated prevalence in nontransgender women in the United States for high-risk genital HPV was 20.4% [6]. TM individuals are susceptible to cancers of the genital tract, including cervical cancer [10]. Recent research shows that TM individuals are at no lower risk for STIs and for cervical abnormalities as compared to non-transgender women [3,11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
