Attitudes of Trans Men and Non-binary People to UK Cervical Screening

Abstract

Background: Transgender men and non-binary people assigned female at birth (TMNB) who have not had surgery to remove the cervix are recommended to undertake cervical screening with the same frequency as cisgender women but evidence suggests that TMNB have lower odds of lifetime and up-to-date cervical screening uptake. Aim: To understand the attitudes towards and preferences for cervical screening among UK-based TMNB. Design & Setting: Cross-sectional survey of TMNB at an NHS gender identity clinic (GIC) and an NHS sexual health service specialising in care of transgender people. Method: Recruitment was via email invitations to patients of the GIC and sexual health service. Inclusion criteria were: female sex assigned at birth, trans man, masculine, or non-binary gender identity, age ≥18 and UK resident. Quantitative results were analysed using descriptive statistics and free text comments were analysed thematically. Results: There were 137 participants, 79% identifying as transmasculine and 18% as non-binary. Sixty-five participants (46%) were eligible for cervical screening and 56.9% of those had ever been screened. Only 53.1% of those eligible felt they had sufficient information about cervical screening . Just over half (53%) stated they would like the option to self-swab for high-risk HPV. Only half of the participants were in favour of an automatic invitation for cervical screening . Thematic analysis identified a number of additional barriers and facilitators of screening. Conclusions: TMNB have identified numerous potential areas for change that may improve cervical screening uptake and patient experience.