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    Cervical screening for trans men and non-binary people

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    1. How do I know if I need to have a cervical screening?
    2. Will I automatically be invited for a cervical screening?
    3. Do I have to go to my GP surgery for a screening?
    4. What should I say when I book my appointments? 
    5. What will happen during my cervical screening?
    6. Potential problems during a cervical screening for trans men
    7. Getting support

    Reviewed by our clinical team

    Person getting a smear test

    A cervical screening is a really important procedure that is designed to look for the warning signs of cervical cancer. It’s offered to all women and people with cervixes aged 25 to 64 in the UK, every three to five years.

    If you’re a trans man or a non-binary person and you have a cervix, it’s important to attend cervical screenings.

    How do I know if I need to have a cervical screening?

    You’ll need to have cervical screenings if you have a cervix – whether or not you identify as female. If you’ve had a total hysterectomy, you won’t have a cervix, which means you won’t need to go to cervical screenings. If you aren’t sure what you need, check with your healthcare team. 

    Will I automatically be invited for a cervical screening?

    You’ll automatically be invited for cervical screenings if you’re registered with your GP surgery as female. If you’re registered as male, automatic invitations won’t happen – instead, you can ask your GP for appointments. 

    In England, women and people with cervixes are invited for a cervical screening:

    • Every three years if they’re aged 25-49 
    • Every five years if they’re aged 50-64

    The schedule may be different if you live elsewhere in the UK e.g. Scotland, so it’s best to check with your GP surgery directly.

    Do I have to go to my GP surgery for a screening?

    No, not necessarily. There are specialist trans healthcare clinics that offer cervical screenings for trans men and non-binary people, including: 

    What should I say when I book my appointments? 

    If you need to book your appointments with your GP surgery directly because you’re registered as male, you might feel nervous about speaking to someone about your needs.

    One option is to send all relevant information in an email rather than booking an appointment over the phone; another is to ask a trusted person to speak to your GP on your behalf.

    It can also be a good idea when booking your appointment to request a specific, trusted doctor or nurse from the surgery, or a member of staff of a particular gender. You can also request a longer appointment so you have more time to prepare and to talk through your concerns.

    You can even request an appointment before your screening to talk through your needs. This will be a good opportunity to discuss your preferred pronouns and medical history, and learn more about what happens during a screening. 

    What will happen during my cervical screening?

    During a cervical screening you’ll need to undress from the waist down and lie down so that the doctor or nurse can see your vagina. They’ll insert a device called a speculum to open up your vagina – this allows them to insert a long, soft brush to sweep away some cells from your cervix. 

    During the procedure there are some things you can do to get more relaxed: 

    • Ask for the door to be locked or unlocked 
    • Ask to insert the speculum yourself 
    • Ask for a smaller speculum 
    • Listen to music or watch something on your phone

    Keep in mind that you can stop the process at any point if you feel very overwhelmed or uncomfortable. If you want to find out about whether smear tests are painful, read our article: Are smear tests painful?

    Potential problems during a cervical screening for trans men

    If you use testosterone, you might have less natural lubrication which might make a screening more uncomfortable. During the screening you can ask for a smaller speculum or for more lubrication. 

    You can also talk to the doctor or nurse about this potential issue in advance – there is the option to use topical oestrogen for a couple of weeks before your screening.

    As a trans man or non-binary person you might also experience some gender dysphoria during your appointment. Gender dysphoria is the term used to describe the feelings of mismatch a person might feel between their biological sex and their gender identity. 

    You might find it helpful to talk through the procedure beforehand and ask the doctor or nurse to use non-gendered language e.g. when describing body parts. 

    Getting support

    If you’re nervous about attending your screenings, support is available from services for trans people. You can find out more on this page on the Jo's Trust website.

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    References

    https://www.nhs.uk/common-health-questions/sexual-health/should-trans-men-have-cervical-screening-tests/
    https://www.jostrust.org.uk/information/cervical-screening/trans-non-binary
    https://www.nhs.uk/conditions/cervical-screening/what-happens-at-your-appointment/
    https://www.nhs.uk/conditions/gender-dysphoria/

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