January is cervical health awareness month, and NCTE wants to remind everyone that cervical health is a critical issue for trans men and genderqueer/gender nonconforming folks.
Anyone with a cervix can contract cervical cancer, so this means that lots of trans men and genderqueer/gender nonconforming people are at risk. But because trans people face widespread discrimination from health care providers and insurance plans, they often avoid seeking or cannot access preventive care. According to the National Transgender Discrimination Survey, nearly half (48%) of trans men reported postponing or avoiding preventive care out to fear of discrimination and disrespect. One in five trans men also reported being refused health care because of their gender identity. Cervical cancer is preventable through regular screening and treatment where necessary, which means that trans men who aren’t getting preventive care are likely at greater risk of developing the disease.
Trans men and genderqueer/gender nonconforming people are at risk of developing cervical cancer even if they do not have penetrative sex. The major cause of cervical cancer, the Human Papillomavirus (HPV), is transmitted through genital skin-to-skin contact with anyone who has the virus. This includes oral sex, sex with fingers or hands, genital rubbing, and sex with toys. So if you’re sexually active and you have a cervix, you may be at risk for cervical cancer regardless of who you are and you have sex with.
Here are four ways we can prevent cervical cancer among trans men and genderqueer/gender nonconforming people:
1. If you have a cervix, keep it healthy. Here’s how:
- If you’re between 9 and 26, you can get vaccinated against most forms of HPV.
- Beginning at age 21 you should get Pap tests every two to three years (even if you’ve been vaccinated, and more frequently if recommended by your doctor), and sexual health screenings every year.
- Get HPV tests when recommended.
- Using condoms, gloves, and other barriers during sex can significantly reduce – but not eliminate - your risk of transmitting HPV and other infections.
for more info on cervical health for trans men. (Note, however, that some information on this site reflects Canadian medical guidelines that differ from those followed by U.S. health care providers.)
2. Public and private insurance companies should ensure coverage for Pap tests and other preventive health care for transgender men and gender nonconforming people. Starting in late 2012, most plans are required by law to cover these screenings at no cost for individuals. But whether out of confusion or discrimination, trans men frequently have coverage for these crucial preventive screenings rejected by insurance plans. Plans should take steps, as the Medicare program has done, to eliminate these coverage denials. If you have problems with coverage, you can learn about filing an appeal here.
3. Health care providers should provide culturally competent care. To treat transgender and genderqueer/gender nonconforming patients effectively, providers must be knowledgeable about their unique health needs and be able to communicate with them respectfully. The American Congress of Obstetricians and Gynecologists (ACOG) has formally urged OB-GYNs to provide routine treatment and screenings to transgender patients, including Pap tests. OB-GYNs, other providers, and health facility administrators should consult resources such as the ACOG statement and the Joint Commission’s field guide to serving LGBT patients to ensure that these screenings are given routinely, properly, and respectfully.
4. The U.S. Department of Health and Human Services should continue working to add gender identity questions to federal health surveys. There is currently no data on cervical cancer among trans men. To combat this disease in our community, we need to know more about how it affects us. Data on the rates and demographics of cervical cancer among trans men will help us advocate for more competent health care and health policies.
This blog post was originally submitted as part of the National Latina Institute for Reproductive Health’s blog carnival on Cervical Cancer Awareness Month.