What is Human Papillomavirus (HPV)?

HPV is the most common sexually transmitted infection in the United States.¹ You can get HPV by having vaginal (front hole), anal, or oral sex with someone who has the virus.² It is passed by skin-to-skin contact, not just penetration.² There are usually no signs or symptoms of infection. HPV can cause cervical, head, neck, penile, and anal cancer. Pap/HPV tests can find any cell changes that might lead to cervical cancer.³

Do I need a PAP test?

Cervical cancer screening is also known as a Pap test. Anyone assigned female at birth who has a cervix and has not had a hysterectomy and/or bottom surgery needs a Pap test. This exam is not just for women; it is for all people with a cervix and is an act of self-care.

What happens during the test?

You will meet with your provider. They will ask you to put on a robe and undress from the waist down. They will use a speculum, a device to see the cervix. The cervix is found at the back of the vagina (front hole). They will use a small, soft brush to sweep the cervix to collect a sample of cells. These cells are then sent to a lab to look for abnormal cell changes and/or the presence of a cancer-causing type of HPV.

How often should I get tested?

How often you need to get a Pap test depends on your age. If you are under the age of 21, you do not need a Pap test. If you are 21 – 65, screening is recommended every 3 – 5 years.⁴ If you have an abnormal result, you may need further testing or another screening test sooner. Getting screened regularly can prevent cervical cancer by getting treatment early.

Do transgender men need a Pap Test?

You still need a Pap test if you are on gender-affirming hormone therapy (GAHT). Some individuals on GAHT can experience front hole dryness, making the exam uncomfortable.⁵ Pap tests may increase feelings of gender dysphoria.⁶ We know this can be challenging. Some helpful tips are to talk to your provider and ask if you can place the speculum yourself.

References

1. Centers for Disease Control and Prevention. (2021a). Sexually transmitted infections prevalence, incidence, and cost estimates in the United States. Retrieved January 27, 2023, from linked text.
2. Centers for Disease Control and Prevention. (2022). Genital HPV infection: Basic fact sheet. Retrieved June 21, 2023, from linked text.
3. Centers for Disease Control and Prevention. (2022). HPV cancers. Retrieved June 21, 2023, from linked text.
4. American College of Obstetricians and Gynecologists. (2021). Committee opinion number 823: Health care for transgender and gender diverse individuals. Obstetrics & Gynecology, 137(3), e75–e88. linked text
5. Center of Excellence for Transgender Health. (2016). Guidelines for the primary and gender-affirming care of transgender and nonbinary people (2nd ed.). University of California, San Francisco. linked text
6. Dhillon, N., Oliffe, J. L., Kelly, M. T., & Krist, J. (2020). Bridging barriers to cervical cancer screening in transgender men: A scoping review. American Journal of Men’s Health, 14(3), 155798832092569–1557988320925691. linked text.