Reproductive health examinations are stressful experiences for anybody, but for those on the transmasculine spectrum, routine gynecological visits can become traumatic. Even the most well-intentioned clinician may fail to provide a safe environment for female-to-male (FTM) patients. To help address this issue, the specific needs and concerns of transmasculine people around cervical cancer screenings have been outlined in a new guide titled Cervical Cancer Screening for Patients on the Female-To-Male Spectrum: A Narrative Review and Guide for Clinicians.
Several researchers from The Fenway Institute co-authored the study, including Jennifer Potter, MD; Sarah M. Peitzmeier, MSPH; Sari L. Reisner, ScD, MA; and Dana J. Pardee, BS. Other contributing author include Natalie M. Alizaga, MPH, MPhil; Madina Agénor, ScD, MPH; and Ida Bernstein, BA.
“This publication gives clinicians guidance on how to provide comprehensive, sensitive gynecological care for people on the FTM spectrum,” explained Dr. Jennifer Potter, Director of Women’s Health at Fenway. “We know from previous work that there is a huge need for this, particularly in the area of cervical cancer.”
Transgender or gender-variant people are often reluctant to access reproductive health screenings, because these screenings may be conducted in an insensitive manner, Dr. Potter noted. Fearing transphobia in the doctor’s office, many transmasculine people choose to avoid preventative, potentially life-saving physical examinations.
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The problem is two-sided, Dr. Potter said, as providers frequently have misperceptions about the need for reproductive health screenings for transmasculine patients, especially those who possess natal organs such as a cervix, uterus, or ovaries.
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While writing this guide, researchers interviewed transmasculine community members about their experiences with pelvic exams, specifically exams involving the use of speculums. These interviews emphasized that providers should ask for and remember to use the preferred gender pronouns of all their patients. It’s also important for providers to be sensitive to the fact that individuals on the transmasculine spectrum may feel uncomfortable referring to their reproductive organs using female gendered terminology, such as “vagina,” so it is important to ask for and use each patient’s preferred medical/anatomical terms. And before, throughout and after the exam, it’s critical to talk through each step with the patient and make sure that their autonomy and sense of control are maintained at all times.
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While this guide is specific to cervical cancer screening, many of its instructions – particularly asking about pronouns and anatomical terminology – can pertain to other gynecological issues, such as STI screenings. “You never want to assume anything up front about any patient, no matter how they identify,” Dr. Potter said. “High quality care is a partnership, and we providers need continuous feedback from our patients to make sure we stay on point.”
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