The CPHS wishes to remind everyone that January is Cervical Health Awareness Month, and that cervical health is a crucial problem for trans men and those who identify as genderqueer or nonconforming. Cervical cancer can affect anyone, which puts many trans guys and genderqueer/gender nonconforming individuals at risk. However, due to pervasive discrimination from healthcare professionals, trans persons frequently choose not to seek or are unable to get preventive treatment. Trans males who don’t receive preventative care are probably more prone to develop cervical cancer because the disease is avoidable by routine screening and treatment when necessary.
Even if they do not engage in penetrative intercourse, trans guys and genderqueer/gender nonconforming individuals run the risk of developing cervical cancer. Human Papillomavirus (HPV), the main contributor to cervical cancer, is spread by genital skin-to-skin contact with infected individuals. Therefore, regardless of who you are or who you have sex with, if you have a cervix and are sexually active, you may be at risk for cervical cancer.
Lesbian, bisexual and Queer Women
Those who are lesbian, bisexual, gay, queer, or otherwise sexually active with women: You should get screened for cervical cancer if you are sexually active and over 21. Cervical cancer can affect anyone who has one. You should obtain a Pap test if you’ve ever had genital skin-to-skin contact with anyone, regardless of gender.
Get screened even if you:
- have no symptoms
- are no longer sexually active
- have only had one sexual partner in your lifetime
- have been through menopause
- have had the HPV vaccine
- have no family history of cervical cancer
- have only ever had sex with women
- have only ever had sex with trans men
You might not have given Pap screenings and cervical cancer much thought if you’re a trans woman. Remember, you need a cervix—the structure that joins the vagina and the uterus—in order to get cervical cancer.
If you are a trans woman who has not had bottom surgery, cervical cancer is not a risk for you.
However, there is a very small chance that you could develop cancer in the tissues of your neo-vagina or neo-cervix if you’re a trans woman who has had bottom surgery to build a vagina (vaginoplasty) and possibly a cervix. Your personal medical history, the type of tissue utilized to build your vagina and cervix, and the sort of surgery you underwent all affect the risk. As part of your general pelvic health after surgery, discuss your unique needs for cancer screening with your healthcare practitioner.
Although none of us prefer to consider it, cervical cancer screening raises special concerns for many trans guys and others who identify as transmasculine/female to male/FtM.
Making cervical screening a top priority can be challenging, particularly if the idea of having a cervix makes you uncomfortable. Perhaps you worry that you might encounter transphobia at the screening location. You could be concerned that getting a Pap test will be unpleasant or upsetting, or that it will exacerbate gender dysphoria. Or perhaps you simply don’t want to consider cancer.
But if you’re a trans guy aged 21 or older who has ever had sex — with anyone — then you need to get screened for cervical cancer if you have a cervix.
Your type of hysterectomy will determine this. You should speak with your healthcare practitioner if you are unsure of the type you had.
- Yes, you will require routine Pap tests if your cervix was completely or partially intact after your hysterectomy.
- You probably won’t require routine Pap tests if you underwent a total hysterectomy that removed your cervix AND you don’t have a history of malignant or precancerous cervical cells.
- If you underwent a full hysterectomy and have a history of cervical cancer or another precancerous disease, you might need to undergo vaginal vault or cuff smears until three consecutive tests show that you are cancer-free.
Talk to your doctor about the necessity for and the timing of your screenings.