What to Know About HPV, Cervical Cancer, & Being Trans

Apicha Community Health Center Feb 25, 2020  

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Taking care of all aspects of your health should be a priority for everyone.  But trans and nonbinary folks aren't always given the resources and knowledge they need to take care of their sexual health.

When it comes to sex education and health, most of us learn through a very cisgender heterosexual lenses. Meaning, much of what we are taught is based off heterosexual sex, health, and the gender binary of male and female.

This is a problem for transgender and nonbinary folks. Much of the health education we learn, especially in school as children and young adults, excludes trans and nonbinary people. This means it can be a challenge to make cervical cancer a priority when there isn't much information tailored to trans individuals. Without the right education and access to resources, this puts all LGBTQ+ people at a disadvantage.

In this blog, we're going to try and bridge that gap by talking about HPV and cervical cancer, and how it relates to trans and nonbinary individuals. However, you should talk to your medical provider about HPV and cervical cancer if you have concerns or questions. You can learn more about HPV and cervical cancer here. 

Anyone with a cervix has a risk of cervical cancer

Not everyone who has a cervix identifies as female, and not everyone who is female has a cervix. Often times, there are trans men who may have a cervix, and there are trans women who have a cervix via bottom surgery. But if you do have a cervix, you need to know you are still at risk for cervical cancer.

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Being trans and HPV

HPV is a very common sexually transmitted infection and at least half of sexually active people will have HPV at some point in their lives. The human papilloma virus, commonly referred to as HPV, is the top cause of cervical cancer. HPV is a common virus that is passed from one person to another during sex. HPV usually causes no symptoms, so you can’t tell that you have it.

For most women and trans men who have a cervix, HPV will go away on its own. However, if it does not, there is a chance that over time it may cause cervical cancer. Individuals who have a cervix are at a much higher risk for developing cervical cancer. For trans women who do have a cervix, there is a smaller risk -- but a risk nonetheless -- of also developing cervical cancer. 

Trans women and cervical cancer

As mentioned above, if you are a trans woman, you may still be at risk for cervical cancer. If you have not had bottom surgery, you are not at risk. But if you have had bottom surgery to create a vagina and possibly a cervix, you may be at risk for cervical cancer. And, the risk depends on the type of surgery you had, the type of tissue used to create your vagina and cervix, and your personal health history. Regardless, you should talk to your medical provider about your specific cancer screening needs and any other concerns about your pelvic health.

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Trans men and cervical cancer

For trans men and nonbinary people who have a vagina and cervix, there is still a risk for developing cervical cancer. If you are a trans male who has a cervix and have had sex with anyone, you need to be screened for cervical cancer.

If you are a trans male and have had bottom surgery, you still may need to undergo cervical cancer screenings. According to the Canadian Cancer Society and depending on the type of bottom surgery you had, these are some recommendations:

  • If you had a hysterectomy that left your cervix intact or partially intact, then yes, you will need regular Pap tests.
  • If you had a complete hysterectomy that included removing your cervix, AND you have no history of cancerous or precancerous cervical cells, then you will likely not need regular Pap tests.
  • If you had a complete hysterectomy and you had a prior history of cervical cancer or precancerous condition, you may need to have vaginal vault or cuff smears until you have three documented normal tests in a row.

No matter the circumstances, you should speak with your medical provider about cervical cancer screenings to find out what is the best option for you. 

Barriers to getting screened for cervical cancer

Taking care of your sexual health is important, but for trans folks that is sometimes easier said than done. In addition to the lack of easy-to-find sexual health information and resources, trans folks often face transphobia, stigma, dysphoria, and general discomfort in a medical setting.

This can make it extremely challenging to prioritize sexual as well as general health. However, there are medical providers that are LGBTQIA-friendly and specialize in trans health. If you're looking for a medical provider that is LGBTQIA-friendly and offers trans-specific health services, consider making an appointment with Apicha CHC.

Consider getting the HPV vaccine

One way to protect yourself against HPV is by getting the HPV vaccine. The HPV vaccine protects against some of the most common strains of HPV (there are many), especially the strains that can cause cancer and genital warts. If you're interested in getting the HPV vaccine, you should consult with your doctor. There can be some limitations and restrictions depending on your age.

How Apicha CHC can help you

At Apicha CHC, we offer trans-specific services through our Trans Health Program.  As part of this program we also offer primary care, short-term behavioral health services, care management resources, and referrals to specialists. If you're interested in scheduling an appointment, click the image below.

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