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  • The mortality rate for cervical cancer has been reduced by 75% due to the advent of the highly effective pap smear test allowing for early detection.
  • Cervical cancer remains one of the most deadly cancers.
  • Early stages of cervical cancer are asymptomatic. So cervical cancer screening is critical to survivability.
  • Screening for cervical cancer is recommended for nearly all transmen, as well as for transwomen who have had surgical vaginoplasty.
  • Cervical cancer is now closely linked to HPV, a sexually transmitted disease that is transmitted through skin-to-skin contact.

The cervix is the cone-shaped neck of the uterus that sticks out into the vagina. Cervical cancer is strongly associated with human papilloma virus (HPV), which is transmitted through sex. Cervical cancer is closely related to vaginal cancer and penile cancer, though cervical cancer is the most common.

HPV infection is by far the most critical risk factor for cervical cancer, but smoking, HIV, age, race, multiple sexual partners, and lack of access to health care (and cervical screening) are also factors which may increase your risk.

What are the risks for transwomen?

Cervical cancer is a risk for some transwomen, depending on the types of surgeries they have undergone.

  • Transwomen who have not had a vaginoplasty (surgical creation of a vagina) do not have a cervix so are not at risk for cervical cancer.
  • Some types of vaginoplasty use the head of the penis to form a cervix; in these cases there is a risk of cervical cancer. Regular screenings should be performed.*
  • There is also a theoretical risk of vaginal cancer after vaginoplasty, but vaginal cancer is a rare type of cancer (in both transwomen and non-trans women). There may be higher risks of vaginal cancer in transwomen who have HPV and have a compromised immune system (e.g. due to HIV).

* When no cervix is present a pap smear of the vaginal cuff may still be taken.

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What are the risks for transmen?

Cervical cancer is a risk for most transmen.  Cervical cancer and the related pap smears may be a particularly uncomfortable topic for transmen.  However, cervical cancer is one of the most deadly cancers. And the pap test is arguably one of the most effective cancer tests of all time.  Routine pap smears really do save countless lives.

  • Transmen who have been sexually active at any time in their lives should get cervical screening at least once every two years. HPV can lie dormant for years.
  • A transmen who has never had fingers, toys, or a penis inside his vagina, has very low risk for HPV (and thus cervical cancer). His doctor/nurse may agree that a pap smear is not necessary.
  • Transmen who have sex with men should be especially vigilant about cervical screenings, if they receive frontal penetration of any kind (e.g. genital, fingers, toys, etc).
  • Testosterone causes changes to the cervix that are similar to early cancerous changes, so if you are taking testosterone your doctor/nurse should note this on the lab form. If you are taking testosterone but are at low risk of cervical cancer, an abnormal pap result most likely does not mean you have a pre-cancerous condition.
  • For transmen who find pap smears highly traumatic or are at high risk for cervical cancer, a total hysterectomy that includes removal of the cervix is often recommended. As with any surgery this is a highly personal decision and you should have the chance to consider the risks/benefits.
  • Transmen who have had their cervix removed, but have a history of cervical cancer, should still get pap smears regularly.*

* When no cervix is present a pap smear of the vaginal cuff may still be taken.

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What's all this about HPV?

Human papillomavirus (HPV) infection is the most important risk factor for cervical cancer. HPVs are a group of more than 80 types of viruses that may cause warts and other types of cell changes in various parts of the body.

About 30 strains of HPV can be passed sexually and infect genital organs and the anal area. Condoms do not fully prevent transmission of HPV.

The particular strains of HPV that cause genital warts rarely develop into cancer and are called "low risk" viruses. 

Other sexually transmitted HPVs have been linked with genital or anal cancers in both men and women. These "high risk" HPV types can cause pre-cancerous cell changes on the cervix or vagina that are not visible and cause no symptoms. Over time and without treatment, these pre-cancerous cell changes may develop into cervical or vaginal cancers.

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Highlighted Resources:

More LGBT Cancer Resources

National LGBT Cancer Network: http://www.cancer-network.org/

Out With Cancer: www.outwithcancer.com

LGBT Cancer Survivor Program: lgbtcancer.com

Disclaimer: The information provided through TransFaith InterSections is intended to help educate transgender people and our allies about transgender health concerns. The information provided is general in nature and is not intended to be used for the diagnosis or treatment of a health problem or as a substitute for consulting a licensed medical professional. If you suspect you have a disease or health-related condition of any kind, you should contact your health care professional immediately. Feedback, suggestions, and corrections are welcome. Please contact us by email or by phone (215-840-2858)!

 

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