Analysis Sexual Health

Cervical Health Awareness Month: Trans Men and Genderqueer/Gender Nonconforming People

The National Center for Transgender Equality

January is cervical health awareness month, and NCTE wants to remind everyone that cervical health is a critical issue for trans men and genderqueer/gender nonconforming folks.

This article is cross-posted from the National Center for Transgender Equality, and is published as part of a series on cervical cancer in partnership with the National Latina Institute for Reproductive Health.

See all our coverage of Cervical Cancer Awareness Month 2012 here.

January is cervical health awareness month, and NCTE wants to remind everyone that cervical health is a critical issue for trans men and genderqueer/gender nonconforming folks.

Anyone with a cervix can contract cervical cancer, so this means that lots of trans men and genderqueer/gender nonconforming people are at risk. But because trans people face widespread discrimination from health care providers and insurance plans, they often avoid seeking or cannot access preventive care. According to the National Transgender Discrimination Survey, nearly half (48%) of trans men reported postponing or avoiding preventive care out to fear of discrimination and disrespect. One in five trans men also reported being refused health care because of their gender identity. Cervical cancer is preventable through regular screening and treatment where necessary, which means that trans men who aren’t getting preventive care are likely at greater risk of developing the disease.

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Trans men and genderqueer/gender nonconforming people are at risk of developing cervical cancer even if they do not have penetrative sex. The major cause of cervical cancer, the Human Papillomavirus (HPV), is transmitted through genital skin-to-skin contact with anyone who has the virus. This includes oral sex, sex with fingers or hands, genital rubbing, and sex with toys. So if you’re sexually active and you have a cervix, you may be at risk for cervical cancer regardless of who you are and you have sex with.

Here are four ways we can prevent cervical cancer among trans men and genderqueer/gender nonconforming people:

1. If you have a cervix, keep it healthy. Here’s how:

  • If you’re between 9 and 26, you can get vaccinated against most forms of HPV.
  • Beginning at age 21, or within 3 years of your first sexual activity, you should get Pap tests every year (even if you’ve been vaccinated).
  • Get HPV tests when recommended.
  • Using condoms, gloves, and other barriers during sex can significantly reduce but not eliminate your risk of transmitting HPV and other infections.
  • Visit http://www.checkitoutguys.ca for more info on cervical health for trans men.

2. Public and private insurance companies should ensure coverage for Pap tests and other preventive health care for transgender men and gender nonconforming people. Starting in late 2012, most plans are required by law to cover these screenings at no cost for individuals. But whether out of confusion or discrimination, trans men frequently have coverage for these crucial preventive screenings rejected by insurance plans. Plans should take steps, as the Medicare program has done, to eliminate these coverage denials. If you have problems with coverage, you can learn about filing an appeal here.

3. Health care providers should provide culturally competent care. To treat transgender and genderqueer/gender nonconforming patients effectively, providers must be knowledgeable about their unique health needs and be able to communicate with them respectfully. The American Congress of Obstetricians and Gynecologists (ACOG) has formally urged OB-GYNs to provide routine treatment and screenings to transgender patients, including Pap tests. OB-GYNs, other providers, and health facility administrators should consult resources such as the ACOG statement and the Joint Commission’s field guide to serving LGBT patients to ensure that these screenings are given routinely, properly, and respectfully.

4. The U.S. Department of Health and Human Services should continue working to add gender identity questions to federal health surveys. There is currently no data on cervical cancer among trans men. To combat this disease in our community, we need to know more about how it affects us. Data on the rates and demographics of cervical cancer among trans men will help us advocate for more competent health care and health policies.

Commentary Human Rights

Love, Respect, Accountability: What We Need in This Time of Tragedy and Crisis

Jodi Jacobson

Speaking up, speaking out, changing systems... This is not disrespect or lack of love and support. It is the essence of the struggle for the rights of all people. It is democracy.

In a time of great strife, in which those who seek to divide us have a very large platform, I remember that these things are all true:

You can oppose an illegitimate or unnecessary war, and still individually and collectively honor and love the troops that serve.

You can honor and love the troops that serve, but protest the ways in which war is waged and abhor the behavior of individual soldiers who abuse human rights and dehumanize the civilians in a population. You can honor and love and support the troops that serve but still work to change the systems, and hold politicians and individuals responsible for crimes they perpetrate.

You can honor and love any and all public servants—as I do deeply—but still abhor systemic problems in civil services that lead to racist behaviors and outcomes (or those based on class, immigrant status, gender, ability, or any other basis for discrimination).

You can honor, love, and respect police, but abhor the militarization of our police forces; racial and ethnic profiling; abuses of fines, fees, and arrests that both target and most adversely affect the poorest individuals; and the growing dependency of the budgets for police forces based on fines drawn from those who can least afford it. You can honor, love, and respect the police, but still understand why there is a great level of distrust of policing in some communities. You can honor, love, and respect the police, but still recognize real abuses of power by individuals or groups among them, and seek to hold those responsible accountable for their actions.

You can honor and love police for putting their lives on the line for public safety, but recognize the very deeply legitimate concerns of movements—like Black Lives Matter, immigrants’ rights groups, women’s rights groups, LGBTQ rights groups, and others for whom policing often is not about public safety, but is itself a source of fear—because law enforcement is and has been too often used against these groups in ways that are disrespectful, demeaning, and sometimes deadly.

You can honor, respect, and love the police, but support the work of Black Lives Matter, immigrants’ rights groups, women’s rights groups, and LGBTQ rights groups, and defend them against blame for the behavior of someone acting in their name who is not actually acting in their name at all.

You can honor and respect the work of prosecutors, judges, and other law enforcement officials, but recognize when the systems in which they are working are not working for the people or to promote justice, or when individuals within those systems operate more on bias than on integrity.

You can protest and advocate for change in any and all of these systems without dishonoring the individuals within them. Indeed, by protesting and seeking to make them better, you make the world better for those within and outside of law enforcement and, hopefully, promote a more universal justice.

You can and we all must honor and treasure the freedoms of speech and of assembly, and abhor violence, while also recognizing that sometimes it is perpetrated by people, like veterans, whose own needs for health care, love, and honor have not been met by the country that sent them to war, or by people who feel so alienated that they—wrongly but nonetheless—resort to violence.

You can be confused by or even irritated by something you don’t understand, but it is on you, not others, to try to understand it. As Proverbs 4:7 says, “The beginning of wisdom is this: Get wisdom. Though it cost all you have, get understanding.” Read, discuss, challenge yourself. Try to open yourself up to what may seem like radical ideas. Make yourself vulnerable to learning. If you don’t understand the movement for Black lives, women’s rights, LGBTQ rights, immigrant rights, then listen to the very people fighting for their rights in order to better understand them. You may have started from a very different place than they do; you may stand in a very different place today. The issues may seem alien at first. But just because you don’t have cancer does not mean cancer does not exist. Try hard to understand why there is distance, what you don’t understand, and what you can—what we all must—do to narrow that distance in understanding each other.

We can love, honor, and respect each other and still recognize and raise awareness of our collective weaknesses. Indeed, that is the essence of progress and of democracy. Don’t fight it. Try to help it along.

People are human and therefore flawed. The systems we create also are therefore often flawed. We need mutual love and respect, along with vigorous debate and sometimes protest, to right the wrongs that are the inevitable result of our flawed selves and our flawed systems.

Love, honor, respect, and accountability: We need them all. Accountability, along with freedom, is the essence of a functioning democracy and part of the struggle for justice. The right to speak, the right to protest, the right to agitate for changes in systems that are flawed because we are all flawed in some way. The right to make things better.

Speaking up, speaking out, changing systems… This is not disrespect or lack of love and support. It is the essence of the struggle for the rights of all people. It is democracy. Some will tell you that in speaking out you are being disrespectful, but the opposite is true. You are respecting the many who have fought and given their lives—and who continue to be placed in harm’s way—on behalf of all of us so that we may all exercise our basic freedoms.

Let’s embrace the struggle. We can love, honor, respect police and other public servants, politicians, soldiers, and ourselves, and still work to hold them and ourselves accountable. These things are all true. I can hold these true simultaneously.

Can we all hold these things true simultaneously? I hope so, because I fear our failure to do so will only result in more violence and hatred.

Commentary Human Rights

North Carolina’s Policies Don’t Keep Anyone Safe

Emma Akpan

Gov. McCrory’s claims to want to protect North Carolinians are not holding water if he and state Republicans continue to ignore policies that will keep all citizens safe and healthy and, instead, show support for legislation that would make it easier for people to access guns.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

We all watched the news of the Pulse nightclub massacre in horror.

In my state, on June 13, one day after the shooting, the North Carolina General Assembly moved forward on reading an amendment that would lift restrictions on our right to carry a concealed weapon. Currently, people have to take classroom training and pass a background check. The new measure would allow concealed weapons in public without many requirements. While it’s unclear when state legislators will take action on this bill, it’s troubling to know that some state leaders are not bolstering comprehensive gun control in light of the massacre.

These same legislators claim that they are supporting and passing policies that will keep citizens safe. But at the same time that hate has fueled deadly shootings in this country, state Republicans have introduced anti-trans legislation that has coincided with a wave of violence against trans people.

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Earlier this spring, North Carolina Gov. Pat McCrory signed into law a much talked about bill that discriminates against transgender people in the state, a group of citizens already at risk for violence and harassment not only in bathrooms, but in most public places.

While there is no clear link connecting the shooting to these discriminatory bathroom policies, we know that hateful beliefs and violent actions preluded the brutal killings in Orlando, and that intolerance can fuel laws like North Carolina’s HB 2.

Just this week, state lawmakers were considering revising the law, but those changes would effectively privilege trans people who are able to, or wish to, have gender reassignment surgery over other transgender or gender-nonconforming people. Rightly so, advocacy groups were quick to criticize the proposals, which would do nothing to allow individuals to use the bathroom of their gender identity.

Gov. McCrory and state leaders talk about protecting women, but they should be concerned with protecting the safety of all residents, especially the most vulnerable: transgender residents. HB 2 puts transgender individuals more at risk of violence in public spaces. We cannot continue to have these safety and privacy arguments at the expense of transgender North Carolinians.

This cannot be overstated: There have been no incidents of transgender individuals attacking people in public bathrooms. However, there has been an uptick of attacks in public bathrooms in response to the fear HB 2 has incited. The disgraceful conversation about “scary” trans women in women’s bathrooms has people mistaking cis women for trans women and harassing them in bathrooms. A woman entering a Walmart bathroom sporting a short hairstyle was told by a stranger, “you’re disgusting!” and, “you don’t belong here!” Trans women experience this quite frequently, which is why Charlotte passed the ordinance to allow North Carolinians to use the bathroom of their gender identity, to keep trans women safe in public spaces. But then HB 2 gave license to individual citizens to police who enters public bathrooms, adding to the violence marginalized groups already experience—not reducing it.

As actress and activist Candis Cayne explained on CNN, “[HB 2] will stop people from being comfortable in this society. It will stop people from wanting to leave their house, because going to the bathroom is such a natural function. You leave your house every day. You want to go shopping. You want to go to the post office, but if you have to go to the bathroom along the way, you’re not allowed to. It’s a bill that’s really kind of making people in my community have to stay home, have to not be a part of our society.”

After Gov. McCrory signed and was heavily criticized for HB 2, he claimed that the state government was looking out for women’s privacy.

His claims have been debunked over and over again, and based on past legislation, we can see that state Republicans have not prioritized the needs of the state’s most marginalized populations over their own need to breed intolerance and government interference in the health and well-being of those populations.

I’m sure many of Rewire’s readers remember HB 465, signed into law last summer. The law stipulates that women must wait 72 hours to access an abortion. The medically unnecessary legislation directly contradicts McCrory’s statements in support of the anti-trans law HB 2 about the need to protect women’s privacy and safety, considering doctors are now required to send private ultrasounds of women who have had abortions to a governmental agency. North Carolina pro-choice advocates have been pushing that this stipulation is unnecessary and downright creepy. It also fuels stigma around a basic health-care service. That law went into effect January 1, but if McCrory and other legislative leaders truly believed in women’s privacy, they would look again at HB 465.

While we’re on the subject of privacy and safety, state Republicans leaders have forgotten that a great way to keep women safe is to ensure their economic sustainability. Many have noted that HB 2 not only affects those who can or cannot enter a public restroom, it takes away municipalities’ power to raise the minimum wage. Who will be most affected by this stalemate? Women, of course, who make up two-thirds of the people who work minimum-wage jobs.

A couple of years ago, the North Carolina state budget also reduced after-school care for children. Does this policy protect women and families? No. Not only that, it further stigmatizes low-income mothers, who are hard-hit by such budget cuts. For North Carolina women, the fear is not in bathrooms, but in the low-wage positions we are placed into.

Gov. McCrory’s claims to protect North Carolinians are not holding water if he and state Republicans continue to ignore policies that will keep all citizens safe and healthy and, instead, show support for legislation that would make it easier for people to access guns. We haven’t expanded Medicaid, we have continued restrictions on reproductive health care, and so many North Carolina women don’t make a living wage.

Trans-inclusive policies, like the Charlotte ordinance that intended to allow transgender individuals to use the bathroom of their gender identity, are not a threat to the safety of North Carolinians, but lifting gun requirements may threaten our safety. It’s time for state Republicans to give North Carolinians what we are demanding: an inclusive, safe, and healthy state that we all want to live in.