Cervical Cancer Screening Preferences in Transgender, Nonbinary, and Gender-diverse Patients.

OBJECTIVE: To describe the cervical cancer screening preferences of transgender and gender-diverse individuals presenting for care at the study institution. METHODS: We administered a cross-sectional survey to a convenience sample of 50 patients 18-65 years of age assigned female at birth and self-identifying as transgender or gender-diverse (TGD) from a single academic endocrinology clinic. The 30-item survey, adapted from previous research in this population, included gender-neutral language and various multimedia. We used descriptive statistics to characterize preferences for cervical cancer screening in the form of a ranked list, as well as responses regarding comfort with self-swabs and past experiences with screening. We also performed a post hoc content analysis of free-text responses related to respondent cervical cancer screening preferences. RESULTS: We enrolled 51 patients, and 50 completed the survey (98% response rate). Overall, 56.0% of respondents chose human papillomavirus (HPV) self-swab as their first-choice cervical cancer screening preference, followed by provider-collected HPV swab (18.0%), decline screening (14.0%), and Pap test (12.0%). Themes identified from free-text responses around cervical cancer screening included fear of provoking gender dysphoria, value of preventive health care, appreciation of privacy with self-swabs, and desire for gender-diverse-competent health care teams. CONCLUSION: In this sample of TGD patients, the majority of respondents preferred self-collected HPV tests for cervical cancer screening, and some respondents preferred to forego screening altogether. Participants emphasized the importance of preventive health care and clinician competency in transgender health and trauma-informed care.