Sexual health and pap smears for trans men

pap smear trans men

Most people have heard of a Pap smear. It’s a test to check for precancerous changes in the cells of the cervix, the part of the body at the top of the vagina. Anyone who has a cervix and who has ever had penetrative sex (including with sex toys or fingers) should visit their GP for this test, including trans men.  If you’re trans masculine this means you too, unless you’ve had a hysterectomy which removes the cervix.

In the past, people went for this test every two years, but now a replacement test looks for the HPV (human papilloma virus) – the virus which causes most cancers in this area. You should go for the test every five years starting at age 25.

Having a Pap Smear

An examination of that part of the body can challenge just about anyone, but especially those with dysphoria.  Your doctor can help make it easier.  Sometimes we prescribe some oestrogen cream to use in the weeks beforehand to help make the examination more comfortable.  There is also the possibility that you can do a self-collected swab for the test. Check with your doctor to see if you are eligible.  The test will check for types of HPV known to cause cancer.  If you test positive for these – don’t panic! It doesn’t mean you have cancer!  But you will need a check-up with a specialist doctor (usually a gynaecologist) and the removal of any abnormal cells.

If you are under 25 then you were probably vaccinated against HPV at school.  This reduces your risk of getting HPV considerably, but even vaccinated people should still have the screening test.  If you haven’t had the vaccine, you can still get it, although it’s rather expensive.

Trans Men

If you are trans masculine and you have vaginal or front hole sex with someone who has a penis, it’s especially important that you talk to your doctor about sexual health matters – cervical cancer screening is just one component of your sexual health.  You should discuss contraception – remember that testosterone may not be relied upon to prevent pregnancy.  Implants are popular, but there’s also condoms, IUDs or pills.

Consider screening for sexually transmitted infections (STIs). A urine test, a self-collected swab and a blood test will screen for common STIs.  Condoms can help protect you against most but are not always 100% reliable.  Depending on your level of risk, you may also wish to consider PrEP, pre-exposure prophylaxis, a daily pill which prevents HIV infection.

Remember that your sexual health is a vital part of your overall health and should never be ignored.  Discuss any concerns with your doctor, and feel confident that you are looking after your sexy self!

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Dr Fiona Bisshop

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