Centre for Genomics and Computational Biology, Queen Mary University of London; specialty doctor in gender identity medicine, Gender Identity Clinic, Tavistock and Portman NHS Foundation Trust, London.
Geriatric Medicine, Whipps Cross University Hospital, Barts Health NHS Trust; visiting researcher, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London.
Br J Gen Pract. 2021 Jul 29;71(709):e614-e625. doi: 10.3399/BJGP.2020.0905. Print 2021 Aug.
Transgender men and non-binary people assigned female at birth (TMNB) who have not had surgery to remove the cervix are recommended to undertake cervical screening with the same frequency as cisgender women, but evidence suggests that TMNB have lower odds of lifetime and up-to-date cervical screening uptake.
To understand the attitudes towards and preferences for cervical screening among UK-based TMNB.
Cross-sectional survey of TMNB at an NHS gender identity clinic (GIC) and an NHS sexual health service specialising in care of transgender people.
Recruitment was via email invitations to patients of the GIC and sexual health service. Inclusion criteria were: female sex assigned at birth; transgender man, masculine, or non-binary gender identity; aged ≥18 years; and UK resident. Quantitative results were analysed using descriptive statistics, and free-text comments were analysed thematically.
In total there were 137 participants; 80% identified as transmasculine,18% as non-binary, and the remaining participants reported other noncisgender identities. Sixty-four participants (47%) were eligible for cervical screening and 37 (58%) of those had been screened. Only 34 (53%) of those eligible felt they had sufficient information about cervical screening. Just over half ( = 71/134, 53%) stated they would like the option to self-swab for high-risk human papillomavirus. Only half ( = 68/134, 51%) of participants were in favour of an automatic invitation for cervical screening. Thematic analysis identified a number of additional barriers to and facilitators of screening.
TMNB have identified numerous potential areas for change that may improve cervical screening uptake and patient experience.
未接受子宫颈切除术的出生时被指定为女性的跨性别男性和非二元性别者（TMNB）被建议与顺性别女性一样频繁地进行宫颈癌筛查，但有证据表明，TMNB 终身和最新的宫颈癌筛查接受率较低。
了解英国 TMNB 对宫颈癌筛查的态度和偏好。
在 NHS 性别认同诊所（GIC）和 NHS 专门为跨性别者提供护理的性健康服务机构对 TMNB 进行横断面调查。
通过向 GIC 和性健康服务的患者发送电子邮件邀请进行招募。纳入标准为：出生时被指定为女性；跨性别男性、男性或非二元性别认同；年龄≥18 岁；和英国居民。使用描述性统计分析对定量结果进行分析，并对自由文本评论进行主题分析。
共有 137 名参与者；80%的人认同跨性别男性，18%的人认同非二元性别，其余参与者报告了其他非顺性别认同。64 名参与者（47%）符合宫颈癌筛查条件，其中 37 名（58%）已接受筛查。只有 34 名（53%）符合条件的人认为他们对宫颈癌筛查有足够的了解。略多于一半（=71/134，53%）的人表示希望选择自行采集高危型人乳头瘤病毒样本。只有一半（=68/134，51%）的参与者赞成自动邀请进行宫颈癌筛查。主题分析确定了筛查的一些额外障碍和促进因素。
TMNB 已经确定了许多可能改善宫颈癌筛查参与度和患者体验的改变领域。
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