| dc.description.abstract | Background:
The rate of new cervical cancer cases and cervical cancer deaths in the United States has declined in the last fifty years due to the widespread use of cervical cancer screenings known as Papanicolaou (Pap) tests. Sexual minority women, or women who identify as lesbian, bisexual, queer or otherwise have sex with women, may be less likely to receive Pap test screenings than heterosexual women. Other studies that have been conducted on sexual minority women do not consider the intersection of sexual orientation and gender identity. This study examined sexual orientation disparities in Pap test screenings among cisgender women as well as individuals assigned female at birth with a cervix who identify as transgender (female-to-male, FTM), or gender nonconforming.
Methods: This study used data on adults aged 18-64 years who self-responded that their sex assigned at birth was female (n = 147,840) from the 2018 and 2019 Behavioral Risk Factor Surveillance Survey. We used descriptive statistics and logistic regression models to examine the associations between sexual orientation and Pap test use in the previous three years. All analyses were conducted in Stata.
Results: Individuals who reported that their sex at birth was female and identified as gay or lesbian were less likely to have had a Pap test in the last three years compared to heterosexual individuals (OR, 0.75; 95% CI, 0.55-0.99). Individuals who responded “something else” when asked about their sexual orientation were less likely to have had a Pap test in the last three years compared to heterosexual individuals (OR, 0.67; 95% CI, 0.48-0.83). Transgender (FTM) individuals were less likely to have received a Pap test in the last three years compared to cisgender women (OR, 0.55; 95% CI, 0.31-0.98). Gender non-conforming individuals were also less likely than non-transgender individuals to have received a Pap test in the last three years, but these results were not significant (OR, 0.90; 95% CI, 0.45-1.82 for gender non-conforming).
Conclusions/Implications: All individuals with a cervix are at risk of cervical cancer, regardless of their sexual orientation or gender identity. Sexual orientation and gender identity disparities in sexual and reproductive health services demonstrate a need to reconsider the way in which these services are provided. Our study found that some SGM individuals were less likely to be compliant in Pap test screenings than non-SGM individuals. Further research should be done to conclude the impact of sexual orientation and gender identity on Pap test screening compliance. | en_US |
