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J Womens Health (Larchmt). 2019 Nov;28(11):1487-1492. doi: 10.1089/jwh.2018.7384. Epub 2019 Aug 14.

Gynecologic Health Care Providers' Willingness to Provide Routine Care and Papanicolaou Tests for Transmasculine Individuals.

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School of Social Work, Michigan State University, East Lansing, Michigan.
Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Kitchener, Canada.
School of Social Work, Wayne State University, Detroit, Michigan.
Michigan Institute for Healthcare Policy and Innovation, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.


Background: Transmasculine individuals who have a cervix may be at risk of cervical cancer, but they face a number of barriers to accessing care, including difficulty finding knowledgable and culturally sensitive providers who are willing to care for transgender patients. We examined gynecologic health care providers' willingness to provide routine care and Papanicolaou tests (Pap tests) to transmasculine individuals, including the role of personal, clinical, and professional factors. Materials and Methods: We surveyed attending physicians, advanced practitioners, and residents in the Women's Health department of a large, integrated Midwest health system (n = 60, 74.1% response rate). Results: A majority of participants were female (68.3%) and white (73.3%). Most had met a transgender person before (79.7%), and 40.7% had cared for a transgender patient in the past 5 years. Most reported willingness to provide routine care (74.6%) and Pap tests (85.0%) to transmasculine people. Bivariate analysis suggests that having met a transgender person (p = 0.028), higher empathy scores (p = 0.015), political views (p = 0.0130), and lower transphobia (p = 0.012) were associated with willingness to provide routine care to transmasculine individuals. Lower transphobia (p = 0.034) and political views (p < 0.001) were also associated with willingness to provide Pap tests to transmasculine people. Conclusions: Providers' willingness was not associated with barriers related to training or knowledge-only with personal biases and experiences. Transgender-inclusive health care training that addresses personal attitudes should be a routine part of training for all health professionals.


Pap test; access; barriers to care; cervical cancer screening; gender minorities; health disparities; obstetrics-gynecology; prevention; preventive care; screening; transgender; transmasculine; underserved populations


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