Uptake, experiences and barriers to cervical screening for trans and non‐binary people in Aotearoa New Zealand

Abstract

Background: Little is known about experiences and barriers for trans and non- binary (TGNB) people eligible for cervical screening in Aotearoa New Zealand. Aims: To identify uptake, barriers and reasons for delaying cervical cancer screen-ing among TGNB people in Aotearoa. Materials and Methods: The 2018 Counting Ourselves data on TGNB people as-signed female at birth aged 20– 69 years who had ever had sex, were analysed to report on experiences of those who were eligible for cervical screening (n = 318). Participants answered questions about whether they had taken part in cervical screening and reasons behind any delays in receiving the test. Results: Trans men were more likely than non- binary participants to report that they did not require cervical screening or were unsure if they needed it. For those who had delayed cervical screening, 30% did so due to feeling worried about how they would be treated as a trans or non- binary person and 35% due to another reason. Other reasons for delay related to general and gender- related discomfort, previous traumatic experiences, anxiety or fear of the test and pain. Material bar-riers to access included cost and lack of information. Conclusions: The current cervical screening program in Aotearoa does not con-sider the needs of TGNB people, leading to delayed and reduced uptake of cervical screening. Health providers require education on the reasons TGNB people delay or avoid cervical screening in order to provide appropriate information and affirm-ative healthcare environments. The human papillomavirus self- swab may address some of the existing barriers.