Cervical screening

Cervical screening checks for the presence of the Human Papillomavirus, or HPV, which can cause cervical cancer. If a person has a cervix and has ever had sex (of any kind), it is important to have regular cervical screening, this includes trans and gender diverse people.

To develop this page, we worked with the ACON team responsible for The Inner Circle and who lead ACON’s work addressing cancer prevention in LGBTQ+ communities.

Trans people who have a cervix and are aged 25 or over require cervical screening, no matter your hormonal history or gender identity. If you’ve had a full hysterectomy (meaning you used to have a cervix and don’t anymore), talk to your doctor about whether you need to continue to have the test – it will depend on your medical history before you had the hysterectomy.

If you’ve had genital reconstruction surgery, and collected a vagina along the way, you are still able to test for the presence of HPV and look for any changes to the vaginal cells.

HPV is a virus that often causes no symptoms and clears up on its own - genital HPV is very, very common, and most people who have had sex have HPV at some point in their lives, with most of those viral infections clearing up by themselves.

There are over 40 strains of HPV, and each is slightly different. Cervical cancer most often results from two particular strains (16 and 18), which are both inoculated against as part of a HPV vaccine, and are tested for in every cervical screening test.

For some trans people, cervical screening can be a difficult or traumatic time, whether because of previous experiences, or due to the manner of the doctor or nurse doing it.

A cervical screening test (CST) is similar to a Pap test, which you may have heard of before. To do the CST, a doctor will insert a speculum and collect a swab from the cervix, which is located at the far end of the vagina/front hole. This sample will then be sent off for pathology, after which you can find out your results.

In NSW it is also possible to do a self-collected CST, depending on your age and circumstances. To find out more, watch the video below or talk to your doctor.

There are a range of things you can ask for during a CST, such as:

• Self-insertion of the speculum, and/or using the smallest available

• Having a friend, family member or partner present

• To sit up rather than lying down for the test

• A safe word to stop the procedure entirely

• A quiet space afterwards

• A detailed description of what is happening, or a minimal description

• To make small talk, or to have silence, or to be on your phone

The downloadable template below, prepared by The Inner Circle, includes all these options, and some further detail for your doctor, including room for your gender, name and pronouns.

Services like ACON’s Check OUT and trans[TEST] clinics provide safe and inclusive cervical screening for all trans people with a cervix.

It can be confronting to do a test around this part of your body at the best of times, and even more difficult if you don’t feel affirmed by your health professional.

Finding a clinic, and a doctor or nurse that you trust is a great way to make what can be an uncomfortable experience as okay as possible.

Do I need a cervical screen if I’ve had the HPV vaccine?

While the different vaccines available protect against the strains of HPV which are most likely to cause cervical cancer, they don’t protect against all types of HPV, so regular cervical screening is still important even if you’re vaccinated.