Tips for your screening appointment

Cervical screening can be daunting. There isn’t much information out there if you are trans, non-binary or intersex. We have created expert approved tips to help you during your appointment:

• Get booked in: If you’re registered as male at your GP surgery, you may not receive an invitation letter to go for your cervical screening. If you are 25 or over and have a cervix, you can call your GP to find out if you are due and get an appointment booked. You can also be screened at some local sexual health services if you prefer.
• Expectations: There is no pressure to have your screening test done in your first appointment. Sometimes multiple appointments are needed so that trust is built up between you and your nurse or doctor. If you are finding your screening difficult for whatever reason, it’s absolutely fine to need extra time or another appointment in order to feel ready and prepared.
• Ask questions: Try not to be afraid to ask questions or talk through any concerns you may have. Knowing what to expect can help make things seem less scary. It can be useful to see the equipment first and talk through the procedure step by step. Writing down what questions you have beforehand can help you remember to get all of the information you need. If your nurse or doctor doesn’t ask for your pronouns, if you have had any relevant surgeries or if you have preferred words you use for your body parts, then try and tell them early on to help them make the appointment as positive as possible.
• Start small: A speculum is the plastic instrument inserted in order to give the nurse or doctor a good view of the cervix. Speculums come in different sizes, so if you think you might find the screening test painful, ask for the smallest speculum suitable for you and for it to be well lubricated.
• Ask Eve: Our nurse led information service, Ask Eve, is also here to help you. You can contact Ask Eve with any of your questions around gynae health and screening. You can email them on nurse@eveappeal.org.uk or call 0808 802 0019. The service is completely free and confidential, so please do get in touch if you want to talk to someone before (or after) your appointment.
• Relaxation is key: As humans, when we hear the words ‘just relax’, we often do the exact opposite! But try to relax in whatever way you can. What normally relaxes you? Whether it’s playing your favourite music or having a friend or partner with you for support, then use these tools to help you during your screening. Whatever you can do to try and feel as calm as possible.
• Control: Remember, you are in control of this situation! You can tell your nurse or doctor to stop and change your mind at any time for any reason.
• Lubricate: If you are post-menopausal or taking testosterone, you will have less natural lubrication, which can make a cervical screening test more uncomfortable. Try using a vaginal moisturiser before the appointment to make using a speculum easier and more comfortable. This is different from a lubricant. Your GP or nurse can prescribe an oestrogen cream or pessary for you to use for a few weeks before your cervical screening, to reduce your vaginal dryness. It is safe to use as it only works on the vaginal tissues to increase lubrication and is not absorbed into the body, so will not affect gender affirming care.
• You first: If you are finding the appointment really difficult, or taking the sample is causing a lot of discomfort or pain, it may be better for you to not go through with the screening test at this point in time. There might be a time in the future where it might be better for you. Your overall wellbeing is a priority, particularly if the risk of cervical cancer is low. Your doctor or nurse will be able to discuss your risk with you and help you make the decision which is best for you and your overall health. You can also speak to Ask Eve.
• Plan B: If your GP/practice nurse finds it difficult to take your screening test, you can ask to be referred to your local colposcopy clinic where there is often a wider variety of equipment to make the process as comfortable as possible. There are some specialist LGBTQ+ clinics across the country too, which if possible, you can book into for your screening.
• Plan C: Sometimes it just isn’t possible to finish the test or you would prefer not to go ahead with the appointment. If you think it is a better option for you, you might want to consider a self-testing kit which looks for high-risk HPV that can be done at home. If you do have high-risk HPV you would then need to try and have a cervical screening test done by a medical professional. The at home HPV test will come at a financial cost, and the chances of a poor sample or inaccurate result are higher, but it may be a better option if you would really like to be screened but are finding it too difficult.
• If you have a bad experience: You may encounter health care professionals who lack knowledge of trans, non-binary, and intersex identities. This can make discussing your needs more difficult or result in a bad experience. If there is one nearby, you may feel more comfortable attending a trans specific clinic.

Information updated: November 2024. Next review due: November 2027