Trans men and non-binary people ‘discouraged’ from life-saving cervical screenings, research finds

Doctor patient appointment cervical screening results

Trans and non-binary people experience barriers to accessing cervical screenings due to discrimination, new research has confirmed.

The findings from Jo’s Cervical Cancer Trust, which were published in the British Journal of General Practice on Tuesday (18 May), surveyed 137 trans men and non-binary people about their experiences with cervical screening.

Among the respondents, 47 per cent reported they were eligible for cervical screening – but just over half (58 per cent) of this group had ever been screened for cervical cancer. Only 53 per cent of those eligible felt like they had sufficient information about cervical screening.

According to the research, trans men and non-binary people faced a range of factors impacting their ability and intention to attend cervical screenings. This included female-focused information, not receiving invitations for screenings and being discouraged or turned away from attending cervical screenings. Some participants felt they would not be able to attend the test because of of medical professionals’ lack of expertise in gender dysphoria.

Almost all the participants in the study, which was conducted in partnership with the Gender Identity Clinic at the Tavistock and Portman NHS Foundation Trust, felt that training for healthcare professions would be useful. Participants said this should include LGBT+ awareness training, education on inclusive language and terminology and “reports from those with lived experience of gender diversity”.

The NHS says any person with a cervix between the ages of 25 to 49 should be invited to a cervical screening every three years. All people with a cervix who are registered with a GP and aged 50 to 64 are invited for a cervical screening every five years.

But according to the charity’s report, the NHS cervical screening programme invites only people who are registered as women or female to take part. The researchers said this means trans and non-binary people, who are registered at their GP as male, will usually have to request a test.

Laurie Hodierne, a trans man and doctor, told the BBC that he was re-registered as male by his GP surgery, meaning he could potentially miss out on being flagged for life-saving cervical smear tests.

He said, as a doctor, he understands “how the systems work and the language”, but he still finds it “exhausting” to keep asking for appointments and chase up on results.

“You keep coming up against a brick wall,” Hodierne said. “It’s a healthcare inequality in the sense that you aren’t able to get access to the screening programme in the same way.”

Of the participants in the research, only 61 per cent were aware that being registered with the GP as male meant they are not routinely called for cervical screening appointments.

Rebecca Shoosmith, acting chief executive at Jo’s Cervical Cancer Trust, said in a statement that accessing the live-saving screening can be difficult for many people but especially for trans and non-binary people.

“This can be exacerbated for trans men and/or non-binary people with a cervix who face many barriers to accessing routine cervical screening, as well as discrimination because of their gender identity,” Shoosmith said. “Just as cervical cancer does not discriminate, cervical screening shouldn’t either.”

Dr Alison Berner, the lead author and doctor at the Gender Identity Clinic, said facilitating cervical screening for trans and non-binary people requires a “multi-pronged approach” which involved “improved clinical and awareness training for providers, more welcoming and inclusive clinical environments, invitations and information and embracing new testing methods such as self-taken swabs”.

The study also highlighted several factors that could help increase screening among trans men and non-binary people. These included the use of inclusive screening invitations and the option to self-sample.