title: Cervical Cancer Screening for Patients on the Female-to-Male Spectrum: a Narrative Review and Guide for Clinicians.
abstract: Guidelines for cervical cancer screening have evolved rapidly over the last several years, with a trend toward longer intervals between screenings and an increasing number of screening options, such as Pap/HPV co-testing and HPV testing as a primary screening. However, gynecological recommendations often do not include clinical considerations specific to patients on the female-to-male (FTM) spectrum. Both patients and providers may not accurately assess risk for HPV and other sexually transmitted infections, understand barriers to care, or be aware of recommendations for cervical cancer screening and other appropriate sexual and reproductive health services for this patient population. We review the evidence and provide guidance on minimizing emotional discomfort before, during, and after a pelvic exam, minimizing physical discomfort during the exam, and making adaptations to account for testosterone-induced anatomical changes common among FTM patients.
authors.affiliation: The Fenway Institute, Fenway Health, Boston, MA, USA. jpotter@bidmc.harvard.edu.|Harvard Medical School, Boston, MA, USA. jpotter@bidmc.harvard.edu.|Beth Israel Deaconess Medical Center, Boston, MA, USA. jpotter@bidmc.harvard.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Potter
authors.affiliation: The Fenway Institute, Fenway Health, Boston, MA, USA.|Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Peitzmeier
authors.affiliation: Harvard Medical School, Boston, MA, USA.
authors.forename: Ida
authors.initials: I
authors.lastname: Bernstein
authors.affiliation: The Fenway Institute, Fenway Health, Boston, MA, USA.|Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Sari L
authors.initials: SL
authors.lastname: Reisner
authors.affiliation: Department of Psychology, The George Washington University, Washington, DC, USA.
authors.forename: Natalie M
authors.initials: NM
authors.lastname: Alizaga
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Madina
authors.initials: M
authors.lastname: Agénor
authors.affiliation: The Fenway Institute, Fenway Health, Boston, MA, USA.
authors.forename: Dana J
authors.initials: DJ
authors.lastname: Pardee
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology / Q000592:standards*; D005260:Female; D006801:Humans; D065006:Papanicolaou Test / Q000523:psychology / Q000592:standards; D010817:Physician-Patient Relations; D057829:Gender-Affirming Procedures; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000523:psychology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult; D008297:Male
keywords: cervical cancer; female-to-male; transgender