Promoting Pap Tests for Queer Women and Trans Men (Women's Health Matters article) (Web resource; WHM resource) Author: Patricia Nicholson Organization: Women's College Hospital, Women's Health Matters If you have a cervix, you need a Pap test – no matter who you have sex with. That’s the message from two new campaigns in Ontario promoting Pap testing for trans men and for lesbian, bisexual, queer and gay women, and other women who have sex with women. Check It Out, Guys: The Trans Men's Pap Campaign and Check It Out: Queer Women Need Paps Too! are intended to raise awareness not only among female-to-male trans men and the diverse community of women who have sex with women, but also among health-care providers. ‘We all have the opportunity to debunk the myth that transgender men and queer women don’t need Pap tests. Because the fact is, women who have sex with women are far less likely to access Pap test screenings than straight women,’ said Marilyn Emery, president and CEO of Women’s College Hospital in Toronto, at an information event for health-care providers held at the hospital on November 30, 2009. The event included presentations from doctors and nurses from Women’s College Hospital, the hospital’s Bay Centre for Birth Control, and Sherbourne Health Centre. ‘As health-care providers, we need to step forward to change these statistics,’ Emery said. ‘We have the opportunity to encourage, to educate and to create awareness of this issue.’ A recent Statistics Canada study found that only 64 per cent of lesbians reported having a Pap test in the past three years. That’s a significantly lower rate than heterosexual women (77 per cent) and bisexual women (76 per cent). There is a dangerous misconception that women who have sex with women don’t need Pap tests. A Pap test screens cervical cells for changes that can be precursors to cervical cancer, enabling early detection and prevention. HPV – the sexually transmitted virus that can lead to cervical cancer – can affect anyone who has ever been sexually active, with anyone. It has been found in women who report never having had sex with a man. HPV is transmitted through genital skin-to-skin contact, which can include fingers, sex toys and oral sex. There is a lack of research on sexually transmitted infections in women who have sex with women, so health-care providers may need up-to-date information. They may also need information on how to make their practices and their offices more inclusive and welcoming to queer women. As of Jan. 6, 2010, the Bay Centre for Birth Control is providing regular drop-in hours for queer women to get Pap tests. No appointment is required, and the drop-in is staffed by female clinicians. Check It Out, Guys is a separate campaign, launched in January 2010, designed to address the Pap-related needs and concerns of female-to-male trans men. An online survey of 76 trans men in Ontario found that 62 per cent did not get annual Paps. Of those, only 13 per cent reported getting occasional Paps. Respondents offered several reasons for not getting Pap tests: they’d had a hysterectomy their doctors told them they were low-risk if they had sex with women they associated pelvic exams with emotional and physical distress access issues such as clinics separated by gender, and transphobia among health-care providers Even trans men who have had complete hysterectomies, including removal of the cervix, may still need ‘cuff’ or ‘vault’ smears, which use cell samples taken from high in the vagina. Some of the survey respondents described methods they’d used to help make getting a Pap easier, or in some cases, to make it possible. Techniques included making a separate appointment to talk about the Pap before actually getting one; bringing a support person along; concentrating on something else; meditation or breathing exercises; or even taking a mild sedative prior to having a Pap. Check It Out is a project of the Queer Women’s Health Initiative, a partnership between Planned Parenthood Toronto, Sherbourne Health Centre, Rainbow Health Ontario and Women’s College Hospital. Check It Out, Guys is a project of the Sherbourne Health Centre. Version française :  Cliquez ici pour voir la description en français Purpose:  Consumer information/support; Health information Information Source:  Hospital/Clinic Geographic Origin:  Canada Language of Resource:  English Groups:  Adult women; Lesbians/Bisexuals/Trans; Middle-aged women; Older women; Teenagers; Young women Date Published:  Jan. 14, 2010 Last Reviewed by Women's Health Matters:  January 14, 2010