Purpose

Although national medical organizations often neglect to include trans and gender diverse (TGD) people in their breast and cervical cancer screening recommendations, the World Profession Association of Transgender Health recommends that TGD people who are at risk for these cancers follow existing guidelines for cisgender women. Despite WPATH’s recommendations, TGD people are less likely to get screened in large part due to discrimination. The COVID-19 pandemic has limited access to cancer screenings among cisgender people, but it is unknown how this has impacted TGD people.

Methods

Using national survey data from the Behavioral Risk Factors Surveillance System (BRFSS), we examined differences in cervical and breast cancer screening noncompliance across gender identity at two time points: before and during the COVID-19 pandemic.

Results

Screening noncompliance increased during the COVID-19 pandemic among cisgender and TGD people (e.g., transgender men, gender non-conforming people). Compared to cisgender women, transgender men and gender non-conforming respondents had higher odds of breast cancer screening noncompliance before and during COVID-19. Transgender men had lower odds of cervical cancer screening noncompliance than cisgender women before COVID-19, but higher odds during the pandemic. Gender non-conforming respondents also had lower odds of cervical cancer screening noncompliance during COVID-19 compared to cisgender women.

Conclusions

Screening noncompliance for breast and cervical cancer was more common among TGD people than cisgender women; while these disparities existed before the COVID-19 pandemic, they were exacerbated during the pandemic. Future work should move beyond descriptive statistics and elucidate underlying causes to inform interventions.

中文翻译：

---

跨性别认同的乳腺癌和宫颈癌筛查：COVID-19 大流行之前和期间行为风险因素监测系统的结果

目的

尽管国家医疗组织经常忽视将跨性别者和性别多样化 (TGD) 人群纳入其乳腺癌和宫颈癌筛查建议中，但世界跨性别健康专业协会建议有患这些癌症风险的 TGD 人群遵循针对顺性别女性的现有指南。尽管 WPATH 提出了建议，但 TGD 人群接受筛查的可能性较小，这在很大程度上是由于歧视。COVID-19 大流行限制了顺性别人群接受癌症筛查的机会，但尚不清楚这对 TGD 人群有何影响。

方法

利用行为风险因素监测系统 (BRFSS) 的全国调查数据，我们研究了两个时间点（即 COVID-19 大流行之前和期间）不同性别认同的宫颈癌和乳腺癌筛查不依从性的差异。

结果

在 COVID-19 大流行期间，顺性别者和 TGD 人群（例如跨性别男性、性别不合格者）的筛查不依从性有所增加。与顺性别女性相比，跨性别男性和性别不合格受访者在 COVID-19 之前和期间不遵守乳腺癌筛查的几率更高。在 COVID-19 之前，跨性别男性不遵守宫颈癌筛查的几率低于顺性别女性，但在大流行期间则更高。与顺性别女性相比，性别不合格受访者在 COVID-19 期间不遵守宫颈癌筛查的几率也较低。

结论

TGD 人群中不遵守乳腺癌和宫颈癌筛查的情况比顺性别女性更为常见；虽然这些差异在 COVID-19 大流行之前就已经存在，但在大流行期间却进一步加剧。未来的工作应该超越描述性统计，并阐明根本原因，为干预措施提供信息。