Acceptability of At-Home hrHPV Cervical Cancer Screening For Transmasculine Individuals: A Qualitative Descriptive Study
Mollie Aleshire, Rhiannon Huffines, Jennifer S. Tinman, Aubree Croghan, Ratchneewan Ross, Shuying Sha, Jennifer HatcherBackground:
Transmasculine individuals are less likely to complete cervical cancer screening than cisgender individuals, thus increasing their risk for cervical cancer. Multidimensional socioecological determinants may contribute to cervical cancer disparities for transgender people.
Objective:
This study explored cervical cancer screening barriers and facilitators, acceptability of high-risk human papillomavirus (hrHPV) at-home self-sampling cervical cancer screening, and cervical cancer health promotion methods among transmasculine individuals.
Methods:
This qualitative description examined socioecological factors affecting cervical cancer screening in transmasculine individuals in 2022 to 2023. Through purposive sampling, 9 participants were interviewed in-depth using semi-structured interviews. Data were analyzed using thematic analysis.
Results:
Cervical cancer screening decisions were shaped by socioecological barriers and facilitators, including dysphoria, negative healthcare experiences, and exclusionary clinical spaces, alongside healthcare provider support and social network encouragement. At-home hrHPV self-sampling was conditionally acceptable and valued for autonomy and privacy. Affirming communication and culturally competent healthcare providers were central to effective cervical cancer screening promotion.
Conclusion:
Addressing these findings requires an approach that integrates healthcare provider and staff LGBTQ+-specific training, cultural humility, patient-centered care, affirming healthcare provider communication, targeted LGBTQ+-specific education, hrHPV self-sampling options, inclusive clinical environments, cervical cancer screening cost and coverage solutions, and healthcare systems that identify cervical cancer screening eligibility by anatomy. By addressing multilevel socioecological barriers while amplifying patient-identified facilitators such as autonomy, privacy, trusted provider recommendations, and social support; healthcare providers and systems can improve equitable access to cervical cancer screening and reduce preventable cervical cancer disparities among transmasculine and other underscreened populations.