Cancer Screening

Cancer screening is an essential part of our health that many of us might prefer not to think about, especially when it involves specific parts of our bodies. For trans and gender diverse folk, this can be particularly challenging. However, screening is crucial for everyone, regardless of gender or sexuality, because cancer can affect any body. Regular screening allows for early detection of changes, which can significantly improve your outcomes if you receive a diagnosis. It’s a routine part of looking after your health, not an indication that you’re unhealthy.

Cervical Screening

Cervical screening is vital for anyone with a cervix who’s had any kind of sex. The primary purpose is to check for the Human Papillomavirus (HPV), which can cause cervical cancer. Folks with a cervix who are 25 or older should undergo cervical screening, regardless of hormonal history or gender identity. If you’ve had a complete hysterectomy (removal of the cervix), consult your doctor to find out if further screening is necessary, as this will depend on your medical history. For those who have undergone genital reconstruction surgery and now have a vagina, it is still possible to test for HPV and monitor any changes in vaginal cells. Even if you’ve had the HPV vaccine, regular cervical screening every five years is still necessary.

HPV

HPV is a virus that often shows no symptoms and usually clears up on its own. Genital HPV is extremely common; most people who have been sexually active will contract HPV at some point, with the majority of infections resolving on their own. There are over 40 different strains of HPV, each with slight variations. Cervical cancer is most commonly caused by two specific strains, 16 and 18, which are covered by the HPV vaccine and are checked for in every cervical screening test.

What is a Cervical Screening Test?

A Cervical Screening Test (CST) is similar to the Pap test you may have heard of before. During the CST, a healthcare provider inserts a speculum and uses a long thin swab to collect cells from the cervix, which is located internally, at the end of the vagina. The sample is then sent to a pathology lab, and you’ll receive your results afterward.

In the ACT, depending on your age and circumstances, you may have the option to perform a self-collected CST. Discussing these options with a trusted healthcare provider can make the process less intimidating.

The process of cervical screening can be daunting, especially for those who have faced previous difficulties or feel uncomfortable with the procedure. Here are some tips to make the experience more comfortable:

• Self-insert the speculum or request the smallest one available.
• Have a support person such as a friend, family member, or partner present during the test.
• Choose your preferred position for the test, like sitting up instead of lying down.
• Establish a safe word to pause or stop the procedure if needed.
• Request a quiet space afterward to recover if the experience is distressing.
• Communicate your needs: whether you prefer detailed explanations, minimal talk, or silence, your preferences should be respected.

@messyvoices – Trans man.

I’ve had issues with my reproductive system my whole life. Once I transitioned it was really hard to not get feel safe during a CST. What really helped was taking someone else with me, particularly someone else from my community. They held my hand throughout the procedure but helped me navigate some hard questions when they came up.

Undergoing a test that involves this part of your body can be confronting at the best of times, and it can be even more challenging if you don’t feel supported by your healthcare professional. Finding a clinic, or healthcare provider that you trust can make this uncomfortable experience more manageable. 

For more information on understanding your Cervical Screening Test results and the next steps, visit Cancer Council Australia.

Breast/Chest Screening

Breast or chest screening, commonly referred to as a mammogram, is crucial for anyone with breast tissue to assess the risk of breast cancer. This includes those who have had top surgery or breast implants. Screening is generally recommended every two years starting at age 50, but your doctor may suggest more frequent or earlier screening (age 40+) based on your personal or family history.

Specific recommendations for trans and gender diverse folk aged 50-74 include:

• Been on feminising hormones for 5+ years? You should screen every two years.
• Haven’t had top surgery? Regular screening every two years is recommended.
• Had top surgery? Consult your doctor about the need for ongoing screening.

If you notice symptoms such as a lump, thickening, or discharge from the nipple, it’s important to see a doctor as soon as possible. Screening is not available for people with symptoms.

Mammograms

A mammogram is a low-dose x-ray of breast/chest tissue. This x-ray can detect the presence of breast cancers as small as a grain of rice, often before they can be seen or felt. For folks living in the ACT, BreastScreen ACT offers free mammogram appointments to all eligible people aged 40 and above. Here’s more information for trans and gender diverse folk accessing Breast Screen ACT: Information for trans and gender diverse people (BreastScreen ACT) – Canberra Health Services

@messyvoices

Take a buddy if you’re uncomfortable, but at the end of the day your body (ALL OF YOUR BODY) needs to stay healthy and the only person who can take control of this, is you!

Self-Examination

Self-examinations are another important method for monitoring breast or chest health. While not a replacement for mammograms, they can be done at any age. Here’s how:

• Visual check: Look for any noticeable changes, lumps, redness, or swelling.
• Check while standing: Raise your arm and use your opposite hand to feel around your breast/chest and armpit.
• Check while lying down: Repeat the process with your arm raised, feeling for any abnormalities.

If you notice anything unusual, don’t hesitate to see your doctor for further examination. Remember, while most lumps are benign, it’s always best to get checked to ensure your health and peace of mind.

Sometimes, interacting with your chest can cause distress or exacerbate dysphoria. If self-examinations feel difficult or impossible, it’s important to talk to your healthcare provider about alternative methods and timeframes to ensure your health is monitored without compromising your mental well-being.

Other Cancers + Reducing Your Risk

In addition to cervical and breast/chest cancer, it’s important to remember that other types of cancer can affect anyone, regardless of gender, sexuality, or body type. Bowel cancer is one example, and regular screening from the age of 50 is crucial for early detection. You can find more information about bowel cancer screening at LGBTQ+ Bowel Cancer Screening & Prevention Info | CAN WE.

There are also proactive steps you can take to reduce your risk of cancer. These include limiting your alcohol intake, quitting smoking, and making sure you’re protecting yourself properly from the sun. The team at ACON developed Can We, a platform dedicated to providing sexuality and gender-diverse people in NSW, along with their supporters, with valuable resources on cancer prevention. For more information and tips on how to protect your health, visit Can We.

To understand cancer risks relevant to you and your health, speak to a trusted healthcare provider. If you need support navigating these topics, visit our support page.