About the Project

Trans Masculine Sexual Health Collaborative: Preventive sexual health screening among female-to-male (FTM) transgender adult patients


myhealth-myhands

Background

Did you know?

Individuals who are on the female-to-male (FTM) trans masculine continuum* and who have a cervix may be at risk for cervical cancer. FTM individuals are recommended to undergo regular cervical cancer screening, known as Pap tests. Pap tests are an important tool to prevent cervical cancer caused by Human Papillomavirus (HPV), a common sexually transmitted infection. Yet for a variety of reasons, FTMs may be uncomfortable or find it difficult to access Pap testing.

There are more than 150 types of HPV. Approximately 70-80% of sexually active adults will become infected with at least one strain of HPV at some point during their lives*.

Most of them will never know they are infected. Furthermore, 8 or 9 out of every 10 cases of HPV will go away on their own, without medical intervention, in less than 2 years. People with persistent HPV are at greater risk of developing cancer or pre-cancerous changes. However, only a small fraction of people with high-risk HPV infections will ever develop precancerous cell changes or cancer. Those types of changes can be detected during a Pap smear but are NOT detected through HPV testing alone.

What’s so hard about a Pap?

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 can we do about it?

To help address the concerns of our community, we designed a study that examines the use of a “self-swab” to test for HPV, which may be a less invasive way to screen than a traditional Pap test performed by a healthcare provider. We want our community members to take their health into their own hands.

What’s the study?

The purpose of this study is to compare two methods of sexual health screening:

  • a standard provider-conducted sexual health screening, including a Pap test and STI testing
  • a self-administered screening, where the participant will self-swab for HPV and other STIs.
Not in Boston? Still want to be involved?

As part of this project, we are conducting national online focus groups to hear from patients, providers, and stakeholders across the US about the sexual health needs of trans masculine people. To learn more about the national online focus groups, click here

We will look to see if it is acceptable, practical, and effective for people to test themselves for HPV DNA by doing self-swabs of the frontal canal instead of having a provider do a cervical HPV swab or Pap test, as well as investigate how common other STIs are among sexually active FTM adults. The results of this study could possibly lead to new and less invasive sexual health screening practices at Fenway Health in Boston, and beyond.

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Study Details

Enrollment Period
  • We will be enrolling participants from April 2015 to August 2016.
  • We hope to enroll 150 FTM individuals.
Eligibility Criteria

Study participants will be eligible to participate if they:

  • Are 21 to 64 years of age;
  • Were assigned a female sex at birth and now identify on the FTM continuum*;
  • Have a cervix;
  • Have been sexually active within the past 3 years (36 months) (sexual partner(s) of any gender).
Study Visits

Participants who are enrolled in the study will be asked to participate in a one-time visit which will last 2-3 hours total.

This visit will include the following:

  1. Informed Consent
  2. Survey
  3. Randomization
  4. Provider examination for HPV, STIs and Pap test
  5. Self-Swabs for HPV and STIs
  6. Short survey about your experience with the provider.
  7. Blood draw for HIV and syphilis testing.
  8. Exit Interview.
Compensation

Participants will be compensated a $100 American Express gift card for participating in this study. 

Funding
  • This study is funded by the Patient-Centered Outcomes Research Institute (PCORI). The contract number is CER-1403-12625.
  • Information about this study can also be found at clinicaltrials.gov.
Location and Contact Information

All study visits take place at Fenway’s Health’s Ansin Building, located at 1340 Boylston Street, Boston, MA 02215.

If you have any questions or would you like to see if you’re eligible for this study, please contact Sarah or Dana by emailing transmaschealth@fenwayhealth.org or calling 617.651.1948.

 

*Other terms include but are not limited to: trans masculine, trans man, transgender man, male/man, transsexual man, trans male, man of trans experience, masculine of center, boi, genderqueer, or non-binary. We celebrate the diverse terms people use to describe themselves and their communities.

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