Rethinking Cervical Cancer Screening

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Why are Pap tests difficult for FTMs?

Pap tests are uncomfortable for everyone. But Pap tests are particularly difficult for trans masculine individuals because it heightens feelings of gender dysphoria. The Pap test experience is a very female gendered experience, from having to sit in a waiting room with all female-identified people, to the terminology used throughout the exam (i.e., front hole, panties, etc.). Many trans masculine individuals have also had negative experiences accessing healthcare or have faced outright discrimination, and are therefore reluctant to undergo invasive medical procedures.

What is a Pap test?

Your cervix is the narrow end of the uterus which has a small opening (called the os) that connects the uterus with the front hole.

A Pap test (sometimes called Pap Smear) is a test that looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

During the Pap test, the provider will use a plastic or metal instrument, called a speculum, to widen the frontal opening/front hole. This helps the provider examine the front hole and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are then placed on a slide or in a bottle of liquid and sent to a laboratory. The laboratory will check to be sure that the cells are normal.

Why are Pap tests so important?

Cotton-tipped swabs (ear sticks). Macro view. White background. Copy space. soft focus

If you get a Pap test regularly (currently recommended every 3 years for most people), you may be able to prevent cervical cancer by detecting and treating precancerous cervical changes.

Deaths from cervical cancer have gone down by over 60% in the last 30 years, mostly due to screening using regular Pap tests (Cancer Care Ontario). Many who have cancer of the cervix have never had a Pap test. Having regular Pap tests and early treatment, if necessary, can prevent most cancers of the cervix.

What is a Self-Swab?

Unlike a Pap test, a self-swab is a type of STI test that you can perform on yourself, in private, without the assistance of a medical provider. While the Pap test is looking for abnormal, precancerous cells on the cervix, a self-swab will look for the presence of the HPV virus. You will insert a swab into your own front hole or rectum (depending on the test) and then put it into a small tube. It will then be processed in a laboratory, and your results will be communicated to you in about two weeks.

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