Expanding Access to Cervical Cancer Screening for Transgender and Nonbinary Individuals

Cervical cancer screening for transgender and nonbinary (TNB) people should be offered in accordance with guidelines for cisgender women. Testosterone therapy has been associated with higher odds of inadequate cervical cytology and benign cervical changes, which may be difficult to differentiate from high-grade dysplasia. Patients with testosterone-related atrophy may benefit from pretreatment with topical estrogen. Growing data support self-collected HPV as an acceptable method for screening among TNB individuals for whom pelvic examination poses a barrier.