Sexual health testing for transgender people
Reviewed by our clinical team
In the UK, sexually transmitted infections are common – in fact, in 2020 there were 317,901 diagnoses of STIs at sexual health services in England, marking a 32% decrease compared to 2019. This might be due to the coronavirus pandemic. It is not known whether this reflects a real decrease of STIs across England or whether fewer people were getting tested, or a combination of both.
If you’re someone who is sexually active and you’re sex with new or casual partners, it’s really important to get regular STI tests. This is because there are lots of different infections you can catch during sex, and not all of them can be prevented by using condoms. What’s more, not all STIs initially cause symptoms, which means you might not know you have anything.
For trans people, STI testing is just as important as it is for cis people. Globally speaking it is thought that infection rates for HIV are much higher amongst trans and non-binary communities. This may be due to stigma and lack of access to health care, but it might also be due to a reluctance to get tested for fear of repercussions that a HIV diagnosis might have on their lives and livelihood.
To find out more, including how you can get tested in your local area, read on for our simple guide.
Why are trans people more at risk of STIs?
There are a few reasons why trans men and women might be more high-risk for STIs. For trans people living in the UK this seems to mainly due to difficulties with condom use rather than access to health care. There may also be a misconception that sex with someone who is trans can’t lead to pregnancy, which results in reduced condom use.
Another big factor is that certain types of treatment for trans men and women make transmission during sex more likely.
If you’re a trans woman and you’ve had lower surgery, you’ll be more susceptible to infection while you’re healing or when using vaginal dilators. STI transmission may also be more likely if your vagina was made using part of your colon, as opposed to skin from the penis or scrotum.
If you’re a trans man and you’ve had lower surgery, you’ll be more susceptible to infection while you’re healing. Trans men who are using testosterone are more prone to some STIs because testosterone weakens the lining of the front hole/ vagina. This means that viruses such as HIV can enter the blood stream more easily.
If you’re healing from surgery or experiencing tearing or bleeding during sex, it’s a good idea to speak to your surgeon or doctor about what to do. And when in doubt, always use condoms!
Which STIs should I be tested for?
Generally, it’s a good idea to get a general STI check-up about every three months if you’re having sex with new or casual partners.
If you visit your nearest sexual health or GUM clinic for an appointment you can be checked and tested for a few different STIs. You can also get tested for multiple STIs using home test kits like those available from Online Doctor.
STIs that you might be tested for include:
- HIV
- Chlamydia
- Gonorrhoea
You might also need to be checked for genital warts and genital herpes if you’ve got any growths or sores around your genitals.
What happens when I visit a clinic for STI testing?
When you visit a clinic for an STI test you’ll need to have a chat with the health advisor, nurse or doctor about your medical and sexual history. They’ll ask you when you last had sex, whether it was protected, whether you have any symptoms, and why you think you might be at risk of an infection.
You’ll usually need to give a few samples, which might include:
- Urine
- Blood
- Swabs of the urethra, vagina/front hole, anus or throat
You might also need an examination of your genitals.
To make you feel more comfortable, you can request a male or female nurse or doctor.
Where can I get STI tests as a trans person?
You don’t have to go to a specific type of clinic if you’re trans or non-binary – anybody can walk into an NHS sexual health or GUM clinic and ask for a test. However, you might feel more comfortable going to a clinic that’s specifically for trans and non-binary people, like Clinic T in Brighton or the Butterfly Clinic in Liverpool.
To find your nearest NHS sexual health clinic, click the links below:
To find your nearest trans and non-binary clinic, you can contact the Terrence Higgins Trust directly.
You can also get tested through Online Doctor. We stock a range of easy and reliable home test kits for HIV, chlamydia, gonorrhoea, syphilis and trichomonas. You can use these tests provided you’re not having any STI symptoms.
Do trans men need to have cervical screenings?
If you’re a trans man and you’ve had a hysterectomy to remove your uterus and cervix, you don’t need to attend cervical screenings. However, if you still have a cervix, it’s strongly recommended that you attend your scheduled screenings, as this can help prevent cervical cancer.
Cervical cancer is caused by certain high-risk strains of HPV, which is a common virus affecting humans. Most strains are harmless, but some can lead to cell changes which can cause cancer of the cervix, as well as cancer of the penis, vagina, anus, throat and mouth.
It’s not easy to avoid catching HPV, which is why people with cervixes need to have scheduled checks to make sure they aren’t at risk of developing cancer. Trans men and trans women can also benefit from getting the HPV vaccine if they didn’t get it during school – depending on your risk level, you might be able to get it for free on the NHS. Find out more here.
References
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1015176/STI_NCSP_report_2020.pdf
https://www.tht.org.uk/hiv-and-sexual-health/sexual-health/trans-people/trans-feminine/safer-sex
https://www.tht.org.uk/hiv-and-sexual-health/sexual-health/trans-people/trans-masculine/safer-sex
https://www.tht.org.uk/hiv-and-sexual-health/sexual-health/trans-people/trans-feminine/testing-hiv-stis
https://www.nhs.uk/live-well/sexual-health/visiting-an-sti-clinic/
https://www.nhs.uk/common-health-questions/sexual-health/should-trans-men-have-cervical-screening-tests/
https://www.avert.org/professionals/hiv-social-issues/key-affected-populations/transgender
