I went to the doctor today. I gave her the letter from my therapist, had blood drawn, and if the labs come back proper, I should be able to start T in a couple of weeks. The catch? I'm supposed to get a pap smear.

The doctor says it's required for her to prescribe hormones. I know a guy who's been on T for a few months, and he most definitely did not have to have one done. We go to different doctors, and I realize that different doctors require different things, but I was just curious as to whether or not this comes up a lot? I'm considering trying to sneak my way past it, but if it really does turn out to be a deal-breaker... I'm willing to do it, just once.

Could it be that you're due for one anyway so they want to make sure you're healthy? I mean, I know the purpose of the test, but I don't think it has to be done before starting hormones. Personally, I had one done in June by a different doctor than the one who prescribed T in November. The current doctor looked at the chart, commented that I didn't need one, and just ordered the blood stuff and once that cleared me, gave me the prescription for T.

Welllll...

Yeah, okay. I've never had one before, so I'm long overdue I guess. I only turned eighteen last year though, so not too long overdue. I've always avoided thinking about that type of thing, I didn't know it was... required? Not technically required, I suppose, if you just skip on going to the doctor. I don't know, I just always figured that was something you could opt out of.

Quote from: democration on January 18, 2013, 09:59:40 PM
Welllll...

Yeah, okay. I've never had one before, so I'm long overdue I guess. I only turned eighteen last year though, so not too long overdue. I've always avoided thinking about that type of thing, I didn't know it was... required? Not technically required, I suppose, if you just skip on going to the doctor. I don't know, I just always figured that was something you could opt out of.

Haha.. Okay, I get where you're coming from. You can probably sneak past it, but given that we sadly have those parts, it's best to make sure everything is good. I don't suggest lying to get out of it, but if you have very bad dysphoria and the exam could trigger it, just talk to the doc and see how that goes. (Otherwise, if the dysphoria is manageable, I'd suck it up and get it out of the way. Heads up, they order one every three years. I think to really get out of not needing one is a hystio, but someone correct me if I'm wrong there.)

It is a pain but it's a doctor and they look at people's junk all day long. They might be doing it because you've never had one. A pap smear isn't bad just embarrassing but over quickly. Now a cervical punch hurts but they would have told you before hand if they were going to do one of those.

As a transman you will have to get tested periodically to know you're remaining healthy. Testosterone increases the risk of cervical cancer. Unless you get a complete hysto with removal of the cervix. (My last test down there is in March. Can't wait to get it over with.  )

Yikes. Every three years.

Well, no big deal then. I'll get it out of the way, I just wondered if they were more optional. Cervical cancer does run in the family, too, so it's probably not a bad idea to go through with it...

Thanks for the info, guys. : )

I'll be 23 in February and I've never had one. Granted up until I started hormones in August I hadn't been to the doctors since I was 18 but still my doctor never mentioned it before giving me hormones.

Quote from: AlexD on January 18, 2013, 10:51:33 PM
As far as I'm aware, pap smears aren't necessary unless you've had penetrative sex, since it's an STD that causes most cases of cervical cancer. So if you're a virgin, I'd imagine you should be able to skip the smear test.

No, that's incorrect info. I've never had penetrative sex, my doctors have known that, and I've had many gyno visits.

I'm thinking they're wanting to test him especially if they know about the cervical cancer in his family.

Quote from: Simon on January 18, 2013, 10:58:54 PM
No, that's incorrect info. I've never had penetrative sex, my doctors have known that, and I've had many gyno visits.

I'm thinking they're wanting to test him especially if they know about the cervical cancer in his family.

Ah, my bad then. Sorry for the misinformation.

Good luck, dude.

I had one a couple of years before starting transitioning. It was never mentioned as a necessity before starting T or anything, so I didn't have my next one until last month, when I had to go in for a check up related to my upcoming (yet date not set) hysto. Technically I *should* have had one in the time between those two, but I was a bad boy and cancelled the appointment.*



*They would set them up automatically, and I got a letter shortly after starting T and having changed my name, so the name had been automatically updated in their system. Oh boy was the nurse confused when I called to cancel.
"Yes, but, you've reached the women's clinic.."
"I know. I have an appointment I wish to cancel."
"No but this is the women's clinic, so you.."
"I know. I have an appointment. Look me up."
"Oh.. Ok.. I'll.. just cancel it then."

It was actually quite amusing.

If you've never had sex, making it a requirement to get one is really lame. My doctor and plenty of others agree with that, but the majority still force female bodied people to undergo it. A pelvic exam is something different. If you've had one of those, there were no abnormalities, and you've not been having sex, and you have no symptoms going on then a yearly pelvic exam is unnecessary.

I've not heard that testosterone makes you more prone to cervical cancer? I thought it was ovarian stuff that it effected more?

Ask for the CSA blood test or the delphi screener in place of the pap smear/pelvic exam. The blood is a little easier to take, but the delphi screener allows you to collect adequate material for a lab to diagnose. It may be easier to do things for yourself rather than have a stranger mess with you.

Huh...Well, I didn't HAVE to get one to get on hormones.
I'm twenty-three, have never been sexually active, and have never gone to a gyno.
But my doctor says that despite my ever so pure virgin-ness, that I really should think about having one soon.
However, I've never heard of a doctor requiring it,
Regardless, it would probably be good for you to get one done.

Quote from: Simon on January 18, 2013, 10:09:37 PM
Testosterone increases the risk of cervical cancer.

The last time I looked, there was no empirical evidence to support this claim. Has a new study come out in the last couple of years?

Quote from: Arch on January 20, 2013, 01:27:31 AM
The last time I looked, there was no empirical evidence to support this claim. Has a new study come out in the last couple of years?

Everything I have read says it is a possibility but there are no long term studies because our population is so miniscule.

I'm a strong believe in, "better safe than sorry".

Quote from: Simon on January 20, 2013, 01:55:54 AM
I'm a strong believe in, "better safe than sorry".

So am I, but there's a big difference between that attitude and a claim that one's cancer risk is noticeably higher. Even if I saw one study that claimed it, I would want corroboration, just as I would for any other claims of health risk (whether for HRT or for something else).

Quote from: Arch on January 20, 2013, 11:56:52 AM
So am I, but there's a big difference between that attitude and a claim that one's cancer risk is noticeably higher. Even if I saw one study that claimed it, I would want corroboration, just as I would for any other claims of health risk (whether for HRT or for something else).

It's unfortunate that the trans population isn't being studied on long term hormone use. Part of the reason I'm always interested in talking with older trans folks is just to ask them what they've experienced after being on hormones for 5 – 10+ years. Part of the problem though is the whole point of most people's transitions is to be "stealth". If there was a way to reach out to people and assure them they could still be stealth but participate in a study that would be cool. I'm just thinking out loud here ...

I do know for a fact that higher T levels can make internal female parts atrophy. When they do, they're not necessarily more of a cancer risk though either. Cancer is basically cells gone crazy and there are thousands of things that can trigger cells to go crazy. There are more symptoms associated with cervical and uterine cancers and those are easier to test for. Ovarian cancer is still pretty sketchy. One can have it and not know it for a long time. Having a family history of it is supposed to make you more prone to it. And there is a more specific test for that now too. Most cervical cancers come about because of sexual activity. Uterine cancers sometimes develop when one has a condition like endometrosis (which is already a kind of cells gone crazy condition).

The thing that pisses me off most is how women are basically coerced and frightened into getting into the "stirrups" once a year. Thankfully, there are doctors that are not doing that anymore but stills so many are just saying, "well it's a good idea". The last 3 doctors I've seen were pretty frank with me. All basically said that a large portion of pap smears are unnecessary.

Probably not useful but I'll add my .02.

It is probably a good idea to get a pap smear if you never have. Depending on your lifestyle though, getting it done often can be really unnecessary. When I was in the military they forced me to get one every year. After I got out, the first civilian gyno I saw rolled her eyes and said that was total overkill, especially if you either aren't sexually active or are in a stable monogamous relationship. I think in those situations they recommend every three years?

I do, however, suggest a yearly pelvic exam. It's uncomfortably and awkward and all that good stuff, but female bits are complex and things can go wrong, and a quick yearly check is a great method of catching things early. Plus the docs are generally professional and good at keeping it low stress. Because if there is one thing you don't want (I speak from experience here) it's an emergency room pelvic exam. I still have nightmares about that, lol.

Quote from: insideontheoutside on January 20, 2013, 01:38:19 PM
It's unfortunate that the trans population isn't being studied on long term hormone use.

I'm sure it also doesn't help that so many of us have those parts yanked out. Once that happens, we aren't worth studying anymore, unless we had the parts removed because they were actually cancerous.

Quote from: Arch on January 20, 2013, 03:45:36 PM
I'm sure it also doesn't help that so many of us have those parts yanked out. Once that happens, we aren't worth studying anymore, unless we had the parts removed because they were actually cancerous.

That's true as far as the bits are concerned. Still would be interested to see what long term T does on female physiology.