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Provision of cervical screening for transmasculine patients: a review of clinical and programmatic guidelines
Emily Jay Nicholls1,2, Catherine R McGowan3,4, Sam Miles1
1Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK.
Background:
Most cervical cancer can be prevented through routine screening. Disparities in uptake of routine screening therefore translate into disparities in cervical cancer incidence and outcomes. Transmasculine people including transgender men experience multiple barriers to cervical screening and their uptake of screening is low compared with cisgender women. Comprehensive evidence-based guidelines are needed to improve cervical screening for this group.
Methods:
We searched for and synthesised clinical and programmatic guidelines for the provision of cervical screening for transmasculine patients.
Findings:
The guidelines offer recommendations addressing: (1) reception, check-in and clinic facilities; (2) patient data and invitation to screening; (3) improving inclusion in screening programmes; and (4) sexual history taking, language and identity. Guidelines offer strategies for alleviating physical and psychological discomfort during cervical screening and recommendations on what to do if the screening procedure cannot be completed. Most of the guidelines were from and for high-income countries.
Discussion:
The evidence base is limited, but existing guidelines provide recommendations to ensure life-saving screening services are available to all who need them. We were only able to identify one set of guidelines for a middle-income country, and none for low-income countries. We encourage the involvement of transmasculine people in the development of future guidelines.
