As a trans man or non-binary person assigned female at birth, do I need to get screened for cervical cancer?
Trans, non-binary and gender-diverse people face significant barriers to accessing healthcare and are less likely than cisgender people to be screened for cancer. Barriers that can make participating in cancer screening challenging for people in the trans community include:
- transphobia and discrimination
- limited healthcare provider knowledge about issues affecting trans people (such as gender dysphoria)
- a lack of trans-specific resources
- concerns about physical and emotional safety
But getting screened for cancer is an important part of regular medical care for everyone because the earlier cancer is found, the better the outcome and treatment options will be.
As a trans man or non-binary person assigned female at birth, do I need to get screened for cervical cancer?
If you are a trans man or non-binary person assigned female at birth, talk to your healthcare provider about screening.
Our recommendation
If you have a cervix and have ever had sexual contact with anyone, regardless of gender or sexual orientation, you should start having regular Pap tests by the time you’re 25. You’ll need a Pap test every 3 years or as recommended by your healthcare provider, whether or not you’re taking testosterone. It’s important to tell your healthcare provider if you are taking testosterone because this can cause changes to cervical tissue that can affect your test results.
- Even if you are no longer sexually active, you should continue to have regular Pap tests.
- You should continue to be screened for cervical cancer until the age of 70. But if you are 70 and you have not had 3 negative Pap test results in the last 10 years, you should continue to be screened every 3 years until this is achieved.
Your cervical cancer screening needs also depend on your medical history and if you have had any of the following types of surgery.
Total hysterectomy: If you’ve had the entire cervix removed as part of a total hysterectomy, talk to your healthcare provider about whether you still need a Pap test. If you have a personal history of cervical cancer or cervical dysplasia (a precancerous condition), you may still need to have regular screening.
Partial hysterectomy: If you have had a partial hysterectomy where the cervix was not removed, you should continue to have regular Pap tests.
Vaginectomy: If you have had a vaginectomy as part of gender-affirming surgery such as metoidioplasty (creation of a penis), you will not be able to have cervical cancer screening as the cervix will not be visible or accessible. A vaginectomy is a colpectomy (removal of the vagina) plus a colpocleisis (closure of the vagina). These procedures often occur after (or as part of) a full hysterectomy, during which the cervix would have been removed.
If you have never had sexual contact including sexual intercourse, genital skin-to-skin contact or oral sex, you do not need cervical cancer screening.
Your healthcare provider should help you understand the benefits and limitations of cancer screening. They should affirm your gender and perform any tests in a way that reduces your discomfort and any feelings of gender dysphoria you may have as much as possible. Bringing a trusted friend or loved one with you to your appointment may also help you feel more comfortable. And if you don’t feel comfortable, you are allowed to leave and book another appointment with a different provider.