Why trans and non-binary people are missing their cervical cancer screenings

‘As a trans person I often feel like I’m walking on eggshells with calling out inadequacies in healthcare, but this issue scares me,’ says Jamie Raines, a 28-year-old trans man who advocates for trans and non-binary inclusivity.

When we talk about cervical cancer screenings, we often talk about cis women and forget about the transsexual and non-binary people that have a cervix.

These people can still get cervical cancer.

In the UK, only those with ‘female’ on their medical records will be invited to a screening – so that means female-to-male trans and AFAB non-binary people with a cervix are not being invited.

‘I’m one of these people, and I’m only aware of the rough timeframe of when I’d need to pursue screening because I have a cisgender partner who receives her reminders,’ says Jamie.

‘Despite being aware that this is something I need to have done, it’s still something I feel too uncomfortable with at the moment to actually do at my local surgery.

‘Honestly, I’ve never attended one to date because I’m too nervous about having a non-knowledgeable or non-accepting medical professional carry it out.

‘I know it’s something I need to do, and I hopefully will soon when I can find a less stigmatised provider.’

Jamie knows that on an anatomical level, these screenings are for him too – but the messaging around cervical cancer screenings excludes anyone that’s not a cisgender woman.

This obstacle is just one of many.

Research in the British Journal of General Practice reveals trans men and non-binary people with a cervix face ‘complex personal and systemic barriers to cervical screening’.

They conclude there is: a lack of information, gender dysphoria and discrimination.

This results in low attendance, while 39% are unaware that if they’re registered as male with their GP, they won’t automatically be told to come for a screening.

Jamie continues: ‘I think if the NHS were to send me a letter that said “Hey Jamie, as a trans guy, these are the checks that we strongly encourage you to do, this is how it’s done, this is how to book it, and here are some alleviations of concerns we expect you to have”, I would absolutely feel more inclined to ensure I’m getting checked as I need to.

‘Even just receiving an invite would significantly reduce the embarrassment and hesitation that I feel over pursuing these tests.’

The British Journal of General Practice shared that in the study, among the trans men and non-binary people eligible for screening, only 57% attended.

Those that don’t attend are put off by female-focused invitations or are even being discouraged and turned away when they enquire.

Plus, going for a cervical cancer screening as a trans or non-binary person can be a distressing and mentally triggering bodily experience.

Jamie’s experience shows the importance of inclusivity and understanding around this issue.

His first-hand encounters with GPs make him ‘worried’, as he recalls: ‘A majority of medical professionals – certainly all the ones I’ve interacted with – have had no meaningful knowledge on trans bodies and their specific healthcare needs.

‘I don’t have the medical expertise to know what I need, let alone be able to walk a medical professional through it – and that’s without considering the judgement and stigma I face, particularly with the intimate nature of cervical screening.

‘Overall this makes me feel quite scared and very frustrated, as there’s clearly a long way to go for trans people to get the very basic medical care we deserve.’

Studies show that almost all affected people want more training for healthcare professionals around supporting LGBTQ+ patients.

Only 35% say they’ve had sufficient information about cervical screening. 

Jamie adds: ‘Trans people when requesting inclusion in anything are often labelled as ‘whiny’, ‘demanding’ or ‘dramatic’, which just reinforces discomfort and fear around pursuing elements of healthcare that we shouldn’t have to fight for.

‘The reality is, a national healthcare system that cannot cater for the nuances of different bodies, and recognise when somebody needs a potentially life-saving check, is not an adequate system at all.

‘Making the small change of sending out reminders to everybody is a relatively small act that could have a large impact to the community.’

Will I be invited for cervical screening?

Only people who are registered as female with their GP surgery or clinic are automatically invited for cervical screening. 

If you are registered as male, aged between 25 and 64, and want to go for cervical screening, you can:

  • ask your GP surgery to send you invites directly – they may be able to add a reminder to your medical record
  • put a reminder in your phone or calendar to ask for an appointment every 3 or 5 years, depending on your age and where you live

– Jo’s Cervical Cancer Trust

Some expert clinics in this area are:

  • 56T at 56 Dean Street in London
  • The Butterfly Clinic in Liverpool
  • Clinic T in Brighton
  • CliniQ in London
  • My Body Back in London
  • My Body Back in Glasgow

You, me & HPV

This week, Metro.co.uk is looking at HPV and its related cancers from a range of perspectives.

By and large HPV isn’t something to worry about – but it is something to be aware of.

HPV is something that eight in 10 of us will encounter at some stage of our lives. It’s spread through skin-to-skin contact, not just penetrative sex. There is even some evidence to suggest it can spread through deep kissing.

It isn’t tested for in a standard sexual health screening, so it’s near impossible to know when or where a person might have contracted it or who they might have passed it onto.

For most people, their bodies will fight the virus off in around one to two years without any lasting effects. For some people however, it can make them more vulnerable to cancers of the cervix, anus, head and neck, penis, vagina and vulva.

Over this week, we’ll be exploring the human issues that come with HPV and its related cancers.

For more health information, please visit Jo’s Cervical Cancer Trust, The Eve Appeal, the No Man campaign and The Anal Cancer Foundation.

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