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Transgender Men's and Non-Binary People's Experiences of Cervical Cancer Screening-A Journey Mapping Approach
Mälardalen University, School of Innovation, Design and Engineering, Innovation and Product Realisation. Reg Canc Ctr Stockholm Gotland, Stockholm, Sweden; Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.ORCID iD: 0000-0003-4036-707X
Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden; City St Georges Univ London, Sch Hlth & Med Sci, London, England.
2026 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 35, no 3, p. 1433-1445Article in journal (Refereed) Published
Abstract [en]

Background Research indicates various barriers to cervical cancer screening for transgender people, contributing to cancer inequities. Further research is required to better understand how these barriers affect experiences along the screening trajectory, from engaging with information, through invitation and testing, to receiving test results. Research exploring how transgender people navigate these barriers is also required.Aim To explore the experiences of cervical cancer screening in Sweden among transgender people who were assigned female at birth, and to identify touchpoints in need of improvement along the cervical cancer screening trajectory.Design Qualitative interview study inspired by journey mapping.Methods Semi-structured interviews (n = 18) and interpretive description analysis.Results Five phases were identified comprising participants' cervical cancer screening journey, with touchpoints in each phase indicating key experiences, barriers, and strategies to navigate barriers. Experiences of touchpoints were affected by four interrelated dimensions: The embodied person-personal gender identity, relationship with own body, and transition process; System factors-policies, routines, and practices; Gender norms and transphobia; and Prior healthcare experiences. Significant barriers included a lack of trans-specific screening information; an invitation system that does not automatically invite male-registered individuals with a cervix; lack of trans competency among clinics and staff; female-centred clinics; gender dysphoria; anticipation or fear of being mistreated; distrust of healthcare authorities; and participant-staff power dynamics.Conclusion To make cervical cancer screening more equitable for transgender people, barriers need to be addressed by considering the four dimensions that affect these barriers.Implications for the Profession and/or Patient Care Findings show that staff involved in policy and clinical practice can improve transgender people's experiences of cervical cancer screening by promoting agency and self-determination in each screening phase. This involves providing inclusive information, continuing invitations for male-registered individuals with a cervix, enhancing trans-competency, and addressing power dynamics in staff-participant interactions.Reporting Method The Standards of Reporting Qualitative Research (SRQR).Patient or Public Contribution Representatives from the Regional Cancer Centre Stockholm-Gotland were involved in the conceptualisation of this study. Representatives from trans and LGBTQI+ organisations, Regional Cancer Centres, and the National Board of Health and Welfare have provided feedback during the analysis and writing phases.

Place, publisher, year, edition, pages
Wiley , 2026. Vol. 35, no 3, p. 1433-1445
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Health Sciences
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URN: urn:nbn:se:mdh:diva-73930DOI: 10.1111/jocn.70113ISI: 001574399500001PubMedID: 40970568Scopus ID: 2-s2.0-105016514863OAI: oai:DiVA.org:mdh-73930DiVA, id: diva2:2010864
Available from: 2025-11-03 Created: 2025-11-03 Last updated: 2026-02-09Bibliographically approved

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