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Cited by 212Cervical Cancer and HPV ResearchWomen's cancer prevention and managementLGBTQ Health, Identity, and Policy

Pap test use is lower among female-to-male patients than non-transgender women.

Peitzmeier, Sarah M., Khullar, Karishma, Reisner, Sari L., Potter, Jennifer·2014·American Journal of Preventive Medicine
DOI 10.1016/j.amepre.2014.07.031
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Abstract

Background A paucity of empirical research to date has examined cervical cancer screening in female-to-male (FTM) transgender men who retain their natal reproductive structures compared to non-transgender women.Purpose To examine patient and provider characteristics associated with being up-to-date on Pap tests, with a focus on gender identity and sexual orientation.Methods Retrospective chart review of 5,232 patients (4,882 women, 350 FTM transgender men) at an urban community health center. All HIV-negative primary care patients aged 21-64 years (inclusive) with at least one medical visit during the 2012 calendar year and who had a cervix as of December 31, 2012, were included. Data were analyzed in 2013 using a multilevel logistic regression model nesting patients within providers.Results FTM patients were significantly less likely to be up-to-date on Pap tests (AOR=0.63, 95% CI=0.47, 0.85) compared to non-transgender women, after adjusting for individual- and provider-level factors. Behaviorally bisexual patients, compared to patients who had sex with men exclusively, were more likely to be up-to-date (AOR=1.73, 95% CI=1.32, 2.26); patients reporting only sex with women were not significantly more or less likely to be up-to-date (AOR=1.01, 95% CI=0.83, 1.23).Conclusions Transgender patients are not accessing the same level of preventive cervical screening care as non-transgender female patients. There is a need to better understand barriers to care in this population. Contrary to findings in other settings, history of sex with women was not negatively associated with Pap utilization.

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  • Transgender men who have not undergone hysterectomy often avoid cervical cancer screening because of multiple factors, including discomfort with medical examinations and fear of discrimination.

    “These persons often avoid cervical cancer screening because of multiple factors, including discomfort with medical examinations and fear of discrimination (338,370).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [370]

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Authors
Peitzmeier, S. M., Khullar, K., Reisner, S. L., & Potter, J.
Affiliations
  • Harvard University (US)
  • Beth Israel Deaconess Medical Center (US)
Corresponding author
Potter, Jennifer
ORCID
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2014-12
Volume
47
Issue
6
Pages
808-812
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/j.amepre.2014.07.031
OpenAlex
W2063154931
Cited by
212
References
32
Citations by year
2026: 11 · 2025: 12 · 2024: 25 · 2023: 29 · 2022: 23 · 2021: 15 · 2020: 30 · 2019: 22 · 2018: 14 · 2017: 16 · 2016: 7 · 2015: 7
FWCI
7.56
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (H80CS00303)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Keywords
cervical cancer screening, transgender health, gender identity, sexual orientation, bisexual men, barriers to preventive care, primary care, community health centers
MeSH terms
Adult, Uterine Cervical Neoplasms, Female, Gender Identity, Humans, Male, Middle Aged, Retrospective Studies, Sexual Behavior, United States, Logistic Models, Early Detection of Cancer, Health Services for Transgender Persons, Transgender Persons, Papanicolaou Test

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