For trans men and non-binary people, cervical screenings aren’t a debate. They can be life-saving

Jo's Cervical Cancer Trust issues smear test info for people with cervixes

It’s vital that trans men and non-binary people with cervixes go for regular cervical cancer screenings.

Anyone with a cervix can develop cervical cancer.

Cervical cancer kills more than 850 people a year in the UK, with medical experts estimating that cervical screenings save around 5,000 lives every year.

Everyone with a cervix, which is most cis women and many trans men and non-binary people, between the ages of 24 and 64 should go for a cervical screening every three to five years.

The screening, also known as a “smear test”, takes only a few minutes and can help stop cervical cancer before it starts by detecting abnormal cells and preventing potentially harmful cells from developing. Screening is crucial, because cervical cancer often has no symptoms in its early stages and can be fatal.

However, because much of the public health messaging around cervical cancer screenings is aimed solely at women, many trans people who need the screenings miss their appointments – or aren’t invited in the first place.

Trans people who are registered as male at their GP surgery don’t receive an invite for cervical cancer screening, despite having a cervix – highlighting the importance of developing trans-inclusive healthcare services in the NHS.

In other cases, the trans person might be invited and attend their cervical cancer screening appointment, only to be met with NHS staff unsure of how to offer the service to a trans person.

Trans man faced tense wait after hospital was ‘confused’: ‘Why have you sent us this guy?’

As 29-year-old trans man Jamie, from Hull, told the BBC in September, confusion around his transness caused a three-month delay in getting the results of an abnormal cervical screening result – rather than the standard two weeks.

Despite the nurse who referred him to hospital following the abnormal screening result explaining that he is trans in an accompanying note, the hospital still said “Why have you sent us this guy?”. His case had to go through multiple NHS managers before he was able to attend the appointment. Luckily, although he had a tense three-month wait for results, they came back negative.

On top of this, Jamie explained that he has to remember to go for a screening himself every three years, because – as he is legally male – his GP doesn’t send him appointment reminders.

“There is no notification to tell me I need a screening, so it’s something I need to manage myself,” Jamie said.

He said because screening was normally done every three years “it’s really easy to forget”.

“That’s why women are sent letters,” he said.

“Everyone that needs a screening needs that reminder and that will prompt more people to go.”

Failing to invite trans people for cervical screenings ‘a healthcare inequality’, says trans doctor

Another trans man, Laurie Hodierne, also told the BBC about his exhausting experience trying to get a cervical cancer screening.

Laurie explained that he was re-registered as male at his GP surgery without him requesting the change. As a result, he is not automatically invited for cervical cancer screenings.

“I understand how the systems work and the language – and despite all of that I find it exhausting,” he says.

“You keep coming up against a brick wall.

“It’s a healthcare inequality in the sense that you aren’t able to get access to the screening programme in the same way.

“It also puts a lot of extra work on to the GPs, who are already pretty stretched.”

A 2019 study found that 40 per cent of trans and non-binary people who are eligible for cervical cancer screenings have never been screened. Many had missed appointments because they were afraid of outing themselves as trans, afraid of how others would react, or because they had found it hard to be accepted as male by their doctors and couldn’t face the additional stress.

This compares to around 25 per cent of cis women who have missed their latest cervical smear test.

Other studies have also shown that trans and non-binary people are being “discouraged” from life-saving cervical cancer screenings.

This year, findings from leading charity Jo’s Cervical Cancer Trust, which were published in the British Journal of General Practice on 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 only 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.

Charities push for inclusive language to ensure everyone with a cervix attends screening appointments

According to research, trans men and non-binary people face a range of factors impacting their ability and intention to attend cervical screenings.

This includes female-focused information, not receiving invitations for screenings and being discouraged or turned away from attending cervical screenings. Some trans people feel they would not be able to attend the test because of of medical professionals’ lack of expertise in gender dysphoria.

In an information pack for trans men and non-binary people with cervixes, Jo’s Cervical Cancer Trust explains the process of going to a cervical screening (smear test) appointment, what to do if you are registered male with your GP but have a cervix and need a smear test, and points people to other organisations that offer trans-specific healthcare.

Jo’s Cervical Cancer Trust issued the new information for trans men and non-binary people in the wake of increasingly toxic public commentary about which genders need cervical cancer screening, with anti-trans campaigners wrongly insisting that “only females get cervical cancer” – a claim that was elevated by Labour MP Rosie Duffield.

“This information is specifically for trans men and/or non-binary people with a cervix,” Jo’s Trust said in a tweet as it launched the new information. “We do not use the word woman in this piece of work simply because it does not apply when talking to this community.”

The charity uses the word woman elsewhere on its website.