What is a gynecological Pap smear?
In a Pap smear or Pap test, a sample of cells is taken from a person's cervix or vagina. The sample is sent to a lab, which looks for abnormal cells that can indicate cancer and reveal conditions that may develop into cancer later, such as human papillomavirus (or HPV).
Who should get a Pap?
Anyone adult with a vagina -- regardless of gender expression, sexual identity, or sexual activity -- should be getting regular Paps. If you are sexually active, you should get your first Pap within two years of your first sexual experience. Although most cases of cervical cancer are linked to having HPV, there are additional risk factors. For these reasons, even if you have never had sex, you should start getting Paps by the time you hit 21.
Lesbians Aren't Exempt!
Although some mistakenly believe HPV is only a risk for heterosexual women, there's no evidence to suggest that rates are lower among lesbians. In addition, some lesbians have had sex with men, may currently have sex with men, or have partners who have had sex with men. HPV is commonly spread through skin-to-skin contact so the use of condoms and dental dams is only partially preventative. Bottom line: Lesbians need Paps too.
Trans Women, You Too
Although little research has been done about the risk of cervical or vaginal cancers developing in trans women, you may still be at risk. If you are a woman who has had a vaginoplasty, you should also have a Pap, or the less common "cuff" or "vault smear."
You Too Guys
Trans men who still have a uterus, ovaries, or a vagina, should get regular Pap tests. But doing so is often a daunting experience for trans men, who may need to go to women's clinics or ob-gyn offices for the procedure. As trans author Mitch Kellaway noted in Everyday Feminism, "Body shame, combined with fears over transphobic treatment from medical providers and an increased likelihood of gynecological care not being covered by health insurance, amounts to a potentially deadly health disparity that's unique to trans men."
How often do I need a Pap?
Generally, sexually active vagina owners should get a Pap every one to two years. People over 65 can stop getting regular Paps if three consecutive Pap smears have normal results. If you have cancer in your family history, you may need them as frequently as every six months.
How is a Pap smear performed?
The patient lies down on an exam table and their feet are placed in stirrups. The health care provider gently places an instrument called a speculum into your vagina. This opens the vaginal canal slightly so they can see the cervix. The doctor then gently scrapes a sample of cells from the cervix using a very small spatula tool.
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