ArticleDiagnostic cytopathology2022
Cervicovaginal cytology, HPV testing and vaginal flora in transmasculine persons receiving testosterone.
Article in Diagnostic cytopathology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 11 citations in OpenAlex.
- "I don't know how to treat you": Testosterone and gynecological care for transmasculine and gender diverse adults.Social science & medicine (1982) · 2026Article
- In-Depth Assessment of Cytologic Features in 106 Cervical Papanicolaou Tests of Transgender Male Patients on Testosterone: An Institutional Experience.Diagnostic cytopathology · 2025Article
- Chronic pelvic pain among transgender men and gender diverse adults assigned female at birth.Andrology · 2025Article
- Incidence of cervical intraepithelial neoplasia and cervical cancer in transmasculine and gender diverse individuals using testosterone: a retrospective, single-centre cohort study.EClinicalMedicine · 2025Article
- Vaginal Cuff Dehiscence in Transgender Patients After Minimally Invasive Hysterectomy.Journal of minimally invasive gynecology · 2024Article
- Bacterial vaginosis testing gaps for transmasculine patients may exacerbate health disparities.Frontiers in reproductive health · 2024Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundTestosterone is one of the strategies that transmasculine persons can elect in order to align physical traits to their gender identity. Previous studies have shown morphologic changes in the genital tract associated with testosterone. Here, we aim to evaluate cervicovaginal cytology specimens (Pap tests) and high-risk HPV (HR-HPV) testing from transmasculine individuals receiving testosterone.
methodsThis is a retrospective cohort of 61 transmasculine individuals receiving testosterone from 2013 to 2021. Cytologic diagnoses from 65 Pap tests were correlated with HPV status and histologic follow-up and compared with the institutional data and a cohort of cisgender women with atrophic changes.
resultsThe median age was 28 years and median time of testosterone use was 3 years. Transmasculine persons showed significantly higher rates of HSIL (2%) and unsatisfactory (16%) when compared with the institutional data and atrophic cohort of cisgender women. After reviewing slides of 46 cases, additional findings were noted: atrophy was present in 87%, glycogenated cells were seen in 30%, and Lactobacilli were substantially decreased in 89%. Among 32 available HPV tests, 19% were positive for HR-HPV and 81% were negative. On histologic follow-up, all HR-HPV-positive cases with abnormal cytology showed HSIL, while none of the HPV-negative cases revealed HSIL.
conclusionOur study cohort demonstrated a high percentage of abnormal Pap tests in transmasculine persons receiving testosterone. Testosterone seems to induce changes in squamous cells and shifts in vaginal flora. HR-HPV testing can be a useful adjunct in the workup of abnormal Pap tests from transmasculine individuals.
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