Editing Pap test (section)

=== In transgender individuals ===
Transgender men are also typically at risk for HPV due to retention of the uterine cervix in the majority of individuals in this subgroup.<ref>{{Cite book |last=Grant |first=Jaime M. |title=National Transgender Discrimination Survey report on health and health care : findings of a study by the National Center for Transgender Equality and the National Gay and Lesbian Task Force |date=2010 |publisher=National Center for Transgender Equality |oclc=707939280}}</ref><ref name=":4">{{Cite web |last= |date=2018-06-27 |title=Should trans men have cervical screening tests? |url=https://www.nhs.uk/common-health-questions/sexual-health/should-trans-men-have-cervical-screening-tests/ |access-date=2023-08-10 |website=[[NHS]] |language=en}}</ref> As such, professional guidelines recommend that transgender men be screened routinely for cervical cancer using methods such as Pap smear, identical to the recommendations for cisgender women.<ref>{{Cite journal |date=December 2011 |title=Committee Opinion No. 512: Health Care for Transgender Individuals |url=https://journals.lww.com/00006250-201112000-00051 |journal=Obstetrics & Gynecology |language=en |volume=118 |issue=6 |pages=1454–1458 |doi=10.1097/AOG.0b013e31823ed1c1 |pmid=22105293 |issn=0029-7844|doi-access=free }}</ref>

However, transgender men have lower rates of cervical cancer screening than cisgender women.<ref>{{Cite journal |last1=Peitzmeier |first1=Sarah M. |last2=Khullar |first2=Karishma |last3=Reisner |first3=Sari L. |last4=Potter |first4=Jennifer |date=December 2014 |title=Pap Test Use Is Lower Among Female-to-Male Patients Than Non-Transgender Women |url=https://linkinghub.elsevier.com/retrieve/pii/S0749379714003985 |journal=American Journal of Preventive Medicine |language=en |volume=47 |issue=6 |pages=808–812 |doi=10.1016/j.amepre.2014.07.031 |pmid=25455121|url-access=subscription }}</ref> Many transgender men report barriers to receiving gender-affirming healthcare,<ref>{{Cite book |last=Grant |first=Jaime M. |title=Injustice at every turn : a report of the National Transgender Discrimination Survey |date=2011 |publisher=National Center for Transgender Equality |oclc=777348181}}</ref><ref>{{Cite journal |last1=Snelgrove |first1=John W |last2=Jasudavisius |first2=Amanda M |last3=Rowe |first3=Bradley W |last4=Head |first4=Evan M |last5=Bauer |first5=Greta R |date=December 2012 |title="Completely out-at-sea" with "two-gender medicine": A qualitative analysis of physician-side barriers to providing healthcare for transgender patients |journal=BMC Health Services Research |language=en |volume=12 |issue=1 |pages=110 |doi=10.1186/1472-6963-12-110 |issn=1472-6963 |pmc=3464167 |pmid=22559234 |doi-access=free }}</ref> including lack of insurance coverage and stigma/discrimination<ref>{{Cite journal |last1=Poteat |first1=Tonia |last2=German |first2=Danielle |last3=Kerrigan |first3=Deanna |date=May 2013 |title=Managing uncertainty: A grounded theory of stigma in transgender health care encounters |url=https://linkinghub.elsevier.com/retrieve/pii/S0277953613001019 |journal=Social Science & Medicine |language=en |volume=84 |pages=22–29 |doi=10.1016/j.socscimed.2013.02.019|pmid=23517700 |s2cid=5339596 |url-access=subscription }}</ref><ref>{{Cite journal |last1=Reisner |first1=Sari L. |last2=Gamarel |first2=Kristi E. |last3=Dunham |first3=Emilia |last4=Hopwood |first4=Ruben |last5=Hwahng |first5=Sel |date=September 2013 |title=Female-to-Male Transmasculine Adult Health: A Mixed-Methods Community-Based Needs Assessment |url=http://journals.sagepub.com/doi/10.1177/1078390313500693 |journal=Journal of the American Psychiatric Nurses Association |language=en |volume=19 |issue=5 |pages=293–303 |doi=10.1177/1078390313500693 |pmid=23963876 |s2cid=3285779 |issn=1078-3903|url-access=subscription }}</ref> during clinical encounters, and may encounter provider misconceptions regarding risk in this population for cervical cancer. Pap smears may be presented to patients as non-gendered screening procedures for cancer rather than one specific for examination of the female reproductive organs. Pap smears may trigger gender dysphoria in patients and gender-neutral language can be used when explaining the pathogenesis of cancer due to infection, emphasizing the pervasiveness of HPV infection regardless of gender.<ref>{{Cite journal |last1=Potter |first1=Jennifer |last2=Peitzmeier |first2=Sarah M. |last3=Bernstein |first3=Ida |last4=Reisner |first4=Sari L. |last5=Alizaga |first5=Natalie M. |last6=Agénor |first6=Madina |last7=Pardee |first7=Dana J. |date=2015-07-10 |title=Cervical Cancer Screening for Patients on the Female-to-Male Spectrum: a Narrative Review and Guide for Clinicians |journal=Journal of General Internal Medicine |volume=30 |issue=12 |pages=1857–1864 |doi=10.1007/s11606-015-3462-8 |pmid=26160483 |pmc=4636588 |issn=0884-8734}}</ref>

Transgender women who have not had [[Vaginoplasty|vaginoplasties]] are not at risk of developing cervical cancer because they do not have cervices. Transgender women who have had vaginoplasties and have a neo-cervix or neo-vagina have a small chance of developing cancer, according to the Canadian Cancer Society.<ref>{{Cite web |title=As a trans woman, do I need to get screened for cervical cancer |url=https://cancer.ca/en/cancer-information/find-cancer-early/screening-in-lgbtq-communities/as-a-trans-woman-do-i-need-to-get-screened-for-cervical-cancer |publisher=Canadian Cancer Society}}</ref> Surgeons typically use penile skin to create the new vagina and cervix, which can contract HPV and lead to [[penile cancer]], although it is considerably rarer than cervical cancer.<ref name=":5">{{Cite web |date=2019-10-10 |title=I'm trans or non-binary, does this affect my cancer screening? |url=https://www.cancerresearchuk.org/about-cancer/cancer-symptoms/spot-cancer-early/screening/trans-and-non-binary-cancer-screening |access-date=2023-08-10 |website=Cancer Research UK |language=en}}</ref> Because the risk of this kind of cancer is so low, cervical cancer screening is not routinely offered for those with a neo-cervix.<ref>{{Cite web |date=2020-09-04 |title=Cervical screening for trans men and/or non-binary people |url=https://www.jostrust.org.uk/information/cervical-screening/trans-non-binary |access-date=2023-08-10 |website=Jo's Cervical Cancer Trust |language=en |author1=Anonymous }}</ref><ref name=":4" /><ref>{{Cite web |date=2023-03-17 |title=Tweet misleads on cervical cancer guidance for trans women |url=https://apnews.com/article/fact-check-cervical-cancer-trans-testing-249098855574 |access-date=2023-08-10 |website=AP News |language=en}}</ref><ref name=":5" />