Caracterização da população de homens transgêneros no Rio Grande do Norte e sua relação com o exame de Papanicolaou

Abstract

Trans men are individuals assigned female at birth but who later identify on the male gender spectrum. Those who have not undergone hysterectomy surgery retain a uterus and vagina, and therefore, like cisgender women, are subject to diseases associated with these organs, such as cervical cancer, necessitating the preventive measure known as the Pap smear. It is important to highlight that there is still no data on this topic in the state of Rio Grande do Norte. Considering the scarcity of such data, this study aims to characterize the socioeconomic and clinical-laboratory profiles of trans men attended in RN, with a focus on Pap smear adherence. Methodologically, it is a cohort study based on a quantitative and qualitative approach analyzing the medical records of trans men attended in RN. A total of 80 medical records from February 2020 to March 2024 were analyzed, representing all trans men followed by the multidisciplinary team of the Instituto de Medicina Tropical – IMT clinic in RN, specifically at the Transexual and Transvestite Outpatient Clinic in Natal (known as the TT clinic and associated with the Giselda Trigueiro Hospital - HGT). The analysis of the collected data was performed using IBM SPSS Statistics® 20.0 software. The results showed that only 16 trans men (20%) regularly underwent the Pap smear, with results mostly negative for intraepithelial lesions or malignancy, and all were non-hysterectomized. Most were aged between 20 and 29 years, were students or unemployed, were single or in a relationship, predominantly heterosexual, and 73.7% used hormones. It was observed that 70% of trans men in the age group prioritized for the exam did not regularly undergo it, with low adherence across all occupations and marital statuses. The data reveal the marginalization of trans men in public health policies and critical barriers, such as lack of awareness and discrimination by healthcare professionals. The absence of specific programs contributes to the underreporting of cervical cancer in this population. It is concluded that there is an urgent need for specific guidelines for trans men, training of healthcare professionals, and the promotion of inclusive clinics. The Pap smear should be recommended inclusively for individuals with a cervix, regardless of gender.