Cervical screening if you are trans or non-binary

Cervical screening checks for the human papillomavirus (HPV) that can lead to changes in the cells of the cervix. The NHS says everyone with a cervix should be offered screening, whatever their gender identity or who they have sex with. In England, all women aged 25 to 64 are invited every 5 years. If you are 65 or older you are only invited if a recent test was abnormal, but you can ask for a test.

How invitations work in England

• Registered with your GP as female: you are invited routinely. You may be invited even if you do not have a cervix, and you can ask to stop the letters.
• Registered as male or anything other than female: you are not invited automatically, but you can opt in by contacting your GP, a sexual health clinic or a gender clinic.
• GOV.UK recommends that you consider screening if you have not had a total hysterectomy and still have a cervix, especially if you have had an abnormal result before.
• Make sure your GP records are up to date so letters reach you in the right way.
• Scotland, Wales and Northern Ireland run their own programmes, so check with your local service.

Making it more comfortable

• You can ask for a nurse or doctor you feel comfortable with. The NHS says most screening is done by a female nurse or doctor, so tell the clinic if that is a barrier.
• Ask them to explain each step, to stop at any point, and to use the language that suits you.
• GOV.UK says that if you have taken testosterone for a long time, screening may be uncomfortable or painful. You can ask about a smaller speculum and extra lubricant.
• If you have a period on the day, contact your GP to rearrange.

The NHS is also introducing an HPV self-test you can do at home. It is for people with a cervix aged 30 to 65 who have not attended screening after being invited before, and you need an invitation to get one. It does not replace routine screening, and a positive result means you will need a clinic test.