Gender Inclusion in the Cytopathology Laboratory: Review of Current Practice and Call to Action

Ensuring equitable laboratory patient care within diverse populations is a priority. The cytopathology laboratory has an important role in providing gender-inclusive care, particularly with regard to screening and prevention of human papillomavirus-related carcinoma, for individuals who are transgender, gender nonbinary, intersex, and with same-gender sexual orientation. Providing equitable care necessitates an understanding of gender-inclusive processes within the cytopathology laboratory. Many barriers to implementation exist and include sociocultural, legal, ethical, and financial hurdles.

To review the current literature regarding gender-inclusive care within a multi-institutional setting and identify challenges and opportunities for future growth in cytopathology. Specific areas of focus include appropriate terminology in laboratory information systems and requisitions, and variables affecting Papanicolaou test interpretation, human papillomavirus testing, and anal Papanicolaou test screening.

Primary literature was searched within the areas highlighted throughout the article. Multi-institutional experiences from the authors, in addition to editorials and expert opinion, were used.

The cytopathology laboratory has an important role in providing care that is inclusive and accurate for all patients. Gaps in care exist and further work is needed to address these disparities. This review attempts to increase awareness, educate, and share our own multi-institutional experiences, and calls for improvements in cytopathology to optimize quality in gender-inclusive patient care.