ArticleCancer causes & control : CCC2025
Preferences of High-Risk HPV-Based Cervical Cancer Screening among Transgender Men and Gender Diverse People Assigned Female at Birth: A Cross-Sectional Study at a Single Academic Center.
Article in Cancer causes & control : CCC, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe purpose of this study was to evaluate the willingness of gender diverse people assigned female at birth with a cervix for different high-risk HPV (hrHPV) methods of cervical cancer screening (CCS). We examined provider-collected hrHPV, at-home, self-collected hrHPV, and in-clinic, self-collected hrHPV, as well as their impact on gender dysphoria and screening barriers.
methodsThis cross-sectional survey study was conducted in 2024 among transgender men, non-binary, genderqueer, and agender individuals at a single academic medical center. Data from 123 participants included demographics, gender dysphoria, screening barriers, past experiences, and willingness to receive hrHPV testing. Statistical analyses identified differences in gender dysphoria, barriers to CCS, past Pap test experiences, and hrHPV testing preferences via logistic regression analyses.
resultsMost transgender men (63%) preferred at-home, self-collected hrHPV, and 37% of transgender men were unwilling to provider-collected hrHPV. Gender diverse people with gender dysphoria preferred at-home, self-collected hrHPV (60%), while those without gender dysphoria preferred alternating at-home, self-collected and provider-collected hrHPV (38%). Logistic regressions showed 78% (p < 0.005) and 53% (p < 0.001) lower odds of provider-collected hrHPV for those with gender dysphoria and screening barriers, respectively. Our findings showed that the concealment of procedural steps (Adjusted Odds Ratio = 0.01, p < 0.02), use of gendered language (AOR = 0.17, p < 0.01), and misgendering (AOR = 0.31, p < 0.05) reduced the willingness to undergo provider-collected hrHPV. However, these experiences did not show a difference between self-collected hrHPV testing methods.
conclusionThis is one of the largest U.S. studies assessing the preferences for hrHPV testing among gender diverse people. Our findings emphasize that transgender men prefer at-home, self-collected hrHPV, which can reduce gender dysphoria and screening barriers. This underscores the need for patient-centered screening and gender-inclusive care to help reduce disparities in CCS among gender diverse people.
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