Pap Smear for Transgender Men: Cervical Cancer Screening Guidelines

Cervical cancer is one of the most common cancers around the world. Fortunately, 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 research shows transgender men are almost 40% less likely to be up-to-date on cervical cancer screening than cisgender women. Different factors may contribute to this lower screening rate, including challenges interacting with the healthcare system and accessing primary care. 

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 a human papillomavirus (HPV) test. The Pap smear looks for cancerous changes in cervical cells. The HPV test looks for human papillomavirus, which can cause cervical cancer. 

You can do both tests during a regular pelvic exam. This is when a healthcare professional 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 — including transgender men. Data suggests that transgender men are less likely to be up-to-date with their cancer screening compared to cisgender women. They’re also less likely to have an adequate Pap smear specimen collected when they do get screened. This highlights the importance of HPV testing to make sure there’s effective screening for cervical cancer in transgender men. 

Cervical cancer screening guidelines now include an option for self-collected HPV testing for people ages 30 to 65 of average risk. This may help to improve access for transgender men who are less likely to have regular cervical cancer screening. 

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 gender-affirming surgery or are taking gender-affirming hormone therapy (GAHT). That’s why it’s important to talk to a healthcare professional about the most appropriate screening for you. 

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 a healthcare professional 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:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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