As a trans* man, it can be very confronting to talk about things like Pap smears.  For some guys, any discussion of what they have “downstairs” can bring up a resurgence of dysphoria regarding their genitals.  And as for letting anyone see their junk, that’s a big ask.

This is why it’s so important to be able to have an honest discussion with your doctor around things like Pap tests.  After all, we’re talking about your health and something that could be a lifesaving test for some people.  Early detection of cervical cancer is the key to surviving it, and it is one of the few wholly treatable cancers in its early stages.  Anyone who has ever had any penetrative vaginal sex, even with a sex toy or fingers, may have been exposed to HPV, the virus which causes most cervical cancer, and the only way to detect it is with a conventional pelvic examination.  Newer tests are in development but have not yet been approved or funded, so the good old Pap smear is still the test you have to have.

For trans* guys, I recommend talking to your doctor about it beforehand.  If you’ve been on testosterone for a number of years, you may need some oestrogen cream applied to the vagina for a couple of weeks prior to the test, in order to make the test more comfortable and reliable.  Don’t be alarmed, it’s a tiny amount of hormone and won’t in any way affect your body’s masculine changes.

If you’re feeling quite vulnerable about the whole thing (and that’s pretty understandable), you might want to bring a friend along with you.  Make sure your doctor knows what terms you prefer to use to refer to your genitals, and what terms you would prefer they not use.

Of course, if you’ve had a hysterectomy then you don’t have to worry about such things, but if you’ve got a cervix, then get a Pap!


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