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Did you know LGB cisgender women are less likely to receive regular cervical cancer screenings compared to cisgender heterosexual women? LGB cis women often face significant barriers to care, such as stigma, lack of access, and non-affirming providers. At FOLX, we’re here to break down those barriers and make sure you have access to affirming, compassionate care.
Why Cervical Cancer Screenings Matter
Cervical cancer screenings with a Pap smear is the most effective way to detect early changes in cervical cells that can lead to cervical cancer. Regular screenings ensure that abnormalities are caught and treated before they become life-threatening. If you’re between the ages of 25 and 65 and haven’t had your cervix removed, routine screening is recommended by the American Cancer Society.
Breaking Down the Barriers
Systemic Barriers:
- Limited Access to Gynecologic Care: Many LGB women avoid or are excluded from routine care due to past negative experiences.
- Lack of Inclusive Sex Education: Without accurate and accessible health information tailored to LGB communities, you may not know they need regular screenings. Many clinicians used to believe that LGB women didn’t need screenings, and some still have this misconception today. Misinformation like this continues to perpetuate gaps in care.
Provider-Patient Dynamics:
- Misjudged Risk Levels: Some healthcare providers mistakenly assume LGB women’s risk is low if they have fewer cisgender male partners. This overlooks other transmission risks, such as HPV through non-penetrative sexual activity, and fails to recognize that sexual orientation and behavior change over our lives. Many women identifying as LGB have had cisgender male partners.
- Low Screening Recommendations: Providers often fail to encourage LGB patients to stay up-to-date with cervical cancer screenings due to bias and risk assumptions.
- Negative Experiences: Stigma and dismissive attitudes from healthcare professionals deter many LGB women from returning to care. Having providers assume your sexual identity and then having to correct them can feel uncomfortable. Pelvic exams can also be physically uncomfortable, especially if you don’t have penetrative sex. This can cause people to avoid care.
Access Challenges:
- No Regular Source of Care: Nearly 1 in 5 LGBTQIA+ people lack a primary care provider (PCP), compared to 12% of non-LGBTQ+ people (KFF).
- Cost: Financial constraints, especially for uninsured individuals, make screenings less accessible.
- Finding Affirming Providers: Many struggle to locate providers who are trained in LGBTQIA+ care and create safe, inclusive spaces.
Take Action
- Speak Up for Your Needs: Don’t hesitate to request accommodations that make you feel more comfortable. Your clinician may be able to use alternate equipment (like a smaller speculum or more lube) if exams are painful or distressing. Letting them know how you feel can help them come up with the right approach for you or explore alternatives to a pelvic exam.
- Bring a Friend: If it helps, bring a friend or your partner with you to the exam. Whether you need them to help speak up for you if someone misgenders you or you want them to hold your hand during the exam, having someone else there may make things easier. Some people even hire a doula who is experienced with trauma to help during the exam.
- Seek Affirming Clinicians: Look for providers experienced in working with LGBTQIA+ patients. They are more likely to provide a respectful and comfortable experience. LGBTQIA+ health directories, local community centers, and FOLX can help connect you to affirming providers. If a designated clinic is not available in your area, when you call to make an appointment ask if any of the providers have experience with the LGBTQIA+ community.
Cervical cancer screening saves lives. If you have a cervix and are between the ages of 25 and 65, talk to a trusted provider about getting screened. Remember, you deserve care that respects your identity and supports your well-being.
In addition to a cervical screening, you can also get STI testing done at the same time if you would like to.
Why Having a PCP Matters
A trusted PCP is your go-to for preventive care. They help ensure you stay on track with screenings, address health concerns early, and build a comprehensive understanding of your medical history. For LGB cisgender women, having a PCP increases the likelihood of staying current on cervical cancer screenings by 93%.
LGBTQIA+-affirming providers help create a welcoming environment, fostering trust and open communication. Comprehensive provider training can further reduce stigma and encourage proactive care for LGB patients.
How FOLX Can Help
Our clinicians can be your PCP! They are well-versed in LGBTQIA+ care and can answer any questions you have, ensuring you get the proper screenings for your age and the body parts you have. While we can’t perform your Pap smear, we can walk you through the process, help you find an affirming provider, or even provide medications to help with the discomfort or anxiety around cervical cancer screening.
We can provide referrals to affirming specialists from our nationwide network for any in-person care and screenings. FOLX goes beyond standard care by connecting members with clinicians who provide affirming, compassionate support at every step.
If having a pelvic exam and Pap smear simply isn’t feasible, an at-home HPV test is a suitable alternative. Your FOLX clinician can order and set this up through our partners, making it easier for you to stay on top of your health. Although at-home HPV screening doesn’t fully replace a Pap smear, research shows that HPV-only tests can help detect cervical cancer. In other words, it’s certainly better than forgoing screening altogether.
Resources
The CDC’s Screening Tool: The CDC’s screening tool helps individuals find low-cost or free cervical cancer screening locations.
See also our Cervical Cancer Screening Guide for Trans Men and Nonbinary AFAB Folks
