TOPLINE

In a small survey, most transgender and gender-diverse individuals preferred self-collected human papillomavirus (HPV) testing for cervical cancer screening. 

METHODOLOGY

• Researchers administered a cross-sectional survey to transgender, nonbinary, and gender-diverse individuals assigned female at birth receiving care at a single academic center's Transgender Center from October to December 2024.
• A total of 50 participants aged 18-65 years were included; about two-thirds were younger than 25 years (66%), 76% identified as transgender men, and 96.0% were currently using or had used gender affirming hormone therapy with testosterone.
• The 30-item survey used gender-neutral language, multimedia, and both closed-ended and open-ended questions on screening preferences, familiarity, prior screening, and comfort with self-swabs.
• The primary outcome was ranked preferences for cervical cancer screening: Pap test, provider-collected HPV test, self-collected HPV test, or decline screening.
• The secondary outcomes were familiarity with cervical cancer screening, previous screening experiences, and concerns regarding screening through quantitative and qualitative methods.

TAKEAWAY

• Self-collected HPV testing was ranked as the first choice by 56% of participants, compared with 18% for provider-collected HPV testing, 12% for Pap testing, and 14% for declining screening.
• Among the 21 participants who had previously undergone Pap testing, 28.6% rated the experience as negative (14.3% very negative, 14.3% slightly negative), while 52.4% rated it as neutral.
• More than half of the participants (54%) reported feeling comfortable or very comfortable with self-collection for HPV testing.
• Qualitative analysis showed that participants valued prevention and privacy but feared pain, dysphoria, and doing the test incorrectly; they wanted trauma-informed, gender-diverse-competent care.

IN PRACTICE

"Although the HPV self-swab represents a promising method to increase uptake of cervical cancer screening in this marginalized population, patient interest should not be assumed, and health care professionals’ use of trauma-informed care principles and gender identity diversity competency play as critical a role in decreasing TGD-specific barriers to care," the authors concluded.

SOURCE

The study was led by Brittani Steinberg, MD, Department of Obstetrics and Gynecology, WashU Medicine in St. Louis, Missouri. It was published online on August 2026 in O&G Open.

LIMITATIONS

The sample was limited to individuals seeking gender-affirming healthcare at a single academic center, which may not represent the broader transgender and gender-diverse population. The survey was administered shortly after FDA approval of vaginal self-collection kits, preventing pre-post comparison and potentially affecting awareness. The high rate of gender-affirming hormone therapy use in this sample may have limited generalizability.

DISCLOSURES

The study was supported by the Lucy, Anarcha, and Betsey Award from the Department of Obstetrics and Gynecology at WashU Medicine. The authors did not report any potential conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.