New Study Greenlights Self-Swab Pap Tests for Transmasculine Patients

The latest in medicine recommends that folks who need pap tests should get them every three years. For many transmasculine people, that averages out to about never. The experience can be so uncomfortable that many skip going.

But a new study out of Fenway Health in Boston suggests an alternative to the dysphoria-inducing HPV screenings.

Self-swab testing for HPV could be a good alternative to pap tests for transmasculine people, says Sari Reisner, principal investigator of the study and Assistant Professor of Pediatrics at Harvard Medical School and Boston Children’s Hospital, also in the Department of Epidemiology at Harvard T.H. Chan School of Public Health.

”Basically, because we see a high proportion of transmasculine folks who are not getting screened, [we] talked to people and found out some of the challenges associated with that,” Reisner tells INTO.

Some said the gendered nature of testing discouraged them from getting screened. For others, the exams were physically painful because hormones can cause vaginal atrophy. And transmasculine people often face discrimination and misgendering by healthcare workers.

Self-swab screening aims to remove those barriers. And Reisner’s study shows it’s effective.

Reisner’s study looked at 131 participants. The self-swab test was able to detect 70 percent of HPV cases. Provider-collected tests are still the gold standard, says Reisner. Those have an 86 detection rate.

So why use the less effective self-swab tests? They’re far better than nothing at all, says Reisner. And of course, they’re more comfortable for many.

“It’s a harm reduction approach to getting people screened,” says Reisner.

Over 90 percent of participants favored the self-swab method over the provider-collected screening, according to the study.

“The common piece of this was really around saying ‘Thank you for providing gender-affirmative care,’” Reisner says. “‘That was the best pap test I’ve ever had.’”

Self-swab HPV screening is nothing new. It has been used by female cisgender patients with similar success. Multiple studies have shown that self-swab tests offer an effective alternative for in communities where lack of trust in doctors may prevent cisgender women from seeking pap tests.

Reisner hopes the study prompts creative thinking about gender-affirming care.

“The study is really done with community at all levels,” he says. “The slogan is ‘hands on health’ and ‘taking my health into my own hands.’ And those were developed by our task for, which is mostly transmasculine folks. I think that notion of taking one’s health in one’s own hands is part of what this is.”