Transgender Healthcare: Cervical Cancer Screening Guideline for Trans Men

Cervical cancer is one of the most common cancers around the world. There are effective screening tests available that catch cervical cancer early, when it’s still very treatable. 

Getting regular cervical screening is important for anyone with a cervix, including transgender men and nonbinary people. But a 2015 survey showed that fewer than 30% of transgender men were screened the previous year, compared to about over 40% of the general U.S. adult population. Different factors may contribute to this lower screening rate, including challenges interacting with the healthcare system and accessing primary care. 

In this article, we’ll focus on cervical screening guidelines for transgender men. We’ll talk about different factors that may affect transgender screening and other important screening tests that transgender men should have. 

What is cervical cancer screening?

Cervical cancer screening looks for changes in your cervix (part of the reproductive system) that could lead to cancer. It involves two different tests: a Pap smear, and an HPV test. The Pap smear looks for cancerous changes in cervical cells, and the HPV test looks for human papillomavirus, which can cause cervical cancer. 

You can do both tests during a regular pelvic exam, which is when a provider examines reproductive organs like the vulva, vagina, and cervix.

Who needs cervical screening?

All people with a cervix between the ages of 21 and 65 should get regular cervical screening at the intervals listed below — no matter what their gender is. Some people (like those with a weakened immune system) may need more frequent screening. 

• Ages 21 to 29: You should get a Pap smear every 3 years.

• Ages 30 to 65: You should get a Pap smear every 3 years, or an HPV test every 5 years, or both tests every 5 years.

• Over 65: You don’t need cervical screening if you’ve had normal, regular screenings in the past and aren’t at higher risk for cervical cancer. 

Can transgender men get cervical cancer?

Yes. Anyone with a cervix can develop cervical cancer. Data suggests that transgender men are less likely to be up-to-date with their cancer screening compared to cisgender women, which can actually increase their risk of getting cervical cancer.  

Are screening guidelines for transgender men the same as for cisgender women?

Right now there aren't established cancer screening guidelines that are specific to transgender people. This means that cervical screening guidelines for transgender men are the same as for cisgender women. 

But keep in mind: Screening for trans people isn’t always one-size-fits-all. Your need for screening may vary based on different factors — like whether you’ve had a gender-affirming surgery or are on hormone therapy (GAHT). That’s why it’s important to talk to your healthcare provider about the most appropriate screening for you. 

Factors affecting transgender cancer screening

If you’re a trans man, it can sometimes be hard to think about cervical cancer screening. Maybe you’re worried about being stigmatized or facing discrimination when you interact with the healthcare system. Or maybe you’re uncomfortable at the thought of a pelvic exam. Or maybe, like most folks, you simply don’t like thinking about cancer.  

That’s why it’s important to find a healthcare provider that you feel good about collaborating with. Organizations like GLMA can help you find a provider who has experience working with the LGTBQ+ community, including trans and nonbinary people. There are also clinics that specialize in trans healthcare, including cervical cancer screening.  

What if your cervix was removed?

It depends. If your cervix was removed for reasons other than having abnormal cervical cells or cervical cancer (like during gender-affirming surgery), then you no longer need cervical screening. 

If it was removed because of abnormal cervical cells or cervical cancer, then you should continue to get Pap and HPV tests. Your provider can help determine how often you should get tested. 

What other cancer screenings are recommended for transgender men?

As a general rule of thumb — if there’s a cancer screening available for a body part you have, you should get that screening. This may include screening for:

• Breast cancer

• Colon cancer

• Anal cancer

• Lung cancer

Talk to your provider to see what’s most appropriate for you.

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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