Abstract PO-248: A UK-based pilot cervical screening clinic tailored to trans men and non-binary people

Abstract

Trans men and non-binary people experience numerous barriers to accessing cervical screening, including dysphoria related to the procedure, anticipated or experienced stigma and discrimination, lack of provider knowledge and exclusion from routine recall systems. As a result, this population are less likely to attend regularly and a recent UK study showed that the majority prefer to access screening via a trans-specific sexual health service. This pilot sought to trial a weekly dedicated cervical screening clinic for trans men and non-binary people to gauge acceptability and to explore how best to promote the service. Organisations with the expertise of working with this population in the UK collaborated on the project. A communications plan was developed which included promotion of the project to local area stakeholders. A promotional video was produced as well as three patient testimonials from trans people who had attended for screening. The social media campaign comprised initial promotional material on six platforms with post-hoc analysis and a second stage using the two most popular platforms. The clinic commenced in October 2019 within an existing trans-specific sexual health service in London, UK. It was staffed by healthcare professionals with training and experience in performing cervical screening for trans people, including sensitive communication and techniques to facilitate a more comfortable procedure. Appointments could be accessed via a dedicated booking email and telephone number. Patients were asked to complete an evaluation after the procedure. From October 2019, nine people were screened prior to the outbreak of Covid-19 in March 2020. The project was suspended immediately after the first social media campaign launched, having had over 40,000 views over 10 days. In July 2020 the project recommenced, and the second social media campaign ran on Facebook and Twitter for 14 days, with over 50,000 views. A targeted email advertising the service was sent to eligible patients currently under the Gender Identity Clinic London in August 2020 and the service advertised via their website. Between July and February 2021, 35 trans men were screened in the clinic, despite another lockdown. Participant surveys from 20 attendees showed 100% positive feedback. The majority of respondents stated that if the service was unavailable, they would not have attended cervical screening (12/20 respondents). However, when asked if their GP could provide a similar service, nine respondents stated that they would attend (9/20 respondents). This pilot suggests that bespoke cervical screening clinics for trans men and non-binary people are highly acceptable, and support patients to engage with screening who otherwise would not have done so. Patients may benefit from such clinics embedded within services across several healthcare settings, in order to maximise access. Targeted promotion via social media is effective and may encourage screening beyond the service being advertised but should be concentrated on platforms most accessed by the community. Citation Format: Alison M. Berner, Tara Suchak, Aedan Wolton, Jacob Bayliss, Katue Craven, Imogen Pinnell, Ricki Ostrov, John Burchill. A UK-based pilot cervical screening clinic tailored to trans men and non-binary people [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-248.

Transgender and non‐binary peoples experiences of cervical cancer screening: A scoping review

“…Of the 23 papers, 17 were research studies, 11 of which were qualitative (Agénor et al., 2016; Bernstein et al., 2017; Carroll et al., 2023; Dutton et al., 2008; Gibson et al., 2021; Johnson et al., 2016, 2020; Kerr et al., 2020; McDowell et al., 2017; Peitzmeier et al., 2017, 2019), two mixed‐methods (Berner, Connolly, et al., 2021a; Potter et al., 2015) and four quantitative (Harb et al., 2019; Roznovjak et al., 2023; Seay et al., 2017; Shires et al., 2019). Three of the papers were literature review articles (Connolly et al., 2020; Dhillon et al., 2020; Gatos, 2018), two were recorded conference presentations (Berner et al., 2021c; Berner, Connolly, et al., 2021b) and one was a conference abstract (Semlyen & Kunasegaran, 2016). Additionally, two research articles, (Bernstein et al., 2017; McDowell et al., 2017), were doctoral dissertations.…”

“…The lack of published literature in this area is a potential limitation of this review as many TMNB experiences have not yet been captured. Additionally, 3 papers (Agénor et al., 2016; Peitzmeier et al., 2017, 2019) and a further paper and conference abstract (Berner et al., 2021c; Berner, Connolly, et al., 2021b) used data from the same participants which potentially limits the diversity of participants included in this review. Additionally, of the six papers which included providers, three (Agénor et al., 2016; Bernstein et al., 2017; Peitzmeier et al., 2019) used the same 17 providers recruited from a trans‐specialist clinic, which limits the diversity of providers discussed in this review.…”

“…For example, all those who reported a positive experience of CCS in a study by Harb et al (2019) were screened in LGBTQ+ clinics or by a provider who specialised in trans healthcare. Furthermore, a service for TMNB to access CCS was piloted in the UK in which 12/20 patients who were screened there said they would not have accessed screening if the clinic had not existed (Berner, Suchak, et al, 2021). However, many TMNB patients have reported positive experiences with non-specialist providers who carry out the procedure with patience and understanding, and provide good aftercare (Berner, Connolly, et al, 2021a).…”

“…Of the 23 papers, 17 were research studies, 11 of which were qualitative (Agénor et al 2016;Bernstein et al 2017;Gibson et al 2021;Johnson et al 2016;Johnson, Wakefield, and Garthe 2020;Kerr, Fisher, and Jones 2020;McDowell et al 2017;Peitzmeier et al 2017;Peitzmeier et al 2019;Dutton, Koenig, and Fennie 2008;Carroll et al 2023), two mixed-methods (Potter et al 2015;Berner, et al 2021a) and four quantitative (Seay et al 2017;Shires et al 2019;Roznovjak et al 2023;Harb et (Connolly, Hughes, and Berner 2020;Dhillon et al 2020;Gatos 2018), two were recorded conference presentations (Berner et al, 2021b;Berner et al, 2021c) and one was a conference abstract (Semlyen and Kunasegaran 2016). Additionally, two research articles, (Bernstein et al 2017;McDowell et al 2017), were doctoral dissertations.…”

“…There is a lower uptake of CCS among patients who are not connected to LGBTQ+ competent clinics (Seay et al, 2017). TMNB report feeling more comfortable attending CCS at a trans-specialist health clinic as the providers have a better understanding and experience, meaning trans people feel less anxious about stigma or discrimination (Berner et al, 2021c). For example, all those who reported a positive experience of CCS in a study by Harb et al (2019) were screened in LGBTQ+ clinics or by a provider who specialised in trans healthcare.…”