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Can I refuse pap tests?

Discussion in 'Gender Identity and Expression' started by RainbowGreen, Aug 11, 2015.

  1. RainbowGreen

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    So, my doctors have been talking more and more lately about pap tests. They say that if I don't have a hysterectomy, I'll have to have pap tests annually. The thing is, I don't want a hysterectomy. At least, not right now. Doing this might have terrible consequences for when I want to have children and I don't want to shoot myself in the foot at 18.

    On the other hand, I also don't want pap tests. They say that they need to check because of testosterone, but I don't care. It's really uncomfortable to even think about. I don't believe I'm at risk at all of any kind of cancer. On top of that, why is it that they never do such a detailed exam for the other body parts. Have you ever heard of an anual throat exam? What about lungs? No, I haven't.

    Still, can I refuse to have them or will they pester me with it? :/
     
  2. thepandaboss

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    I mean, they can't technically force you to have one. But I'd recommend at least having one once in a while. It sucks, but I can tell you from personal experience that having regular exams makes sure that worse things won't happen. I've never heard about pap smears on T but not super surprised. There is a belief that going on testosterone can contribute to things like uterine cancer developing but the thing is, there's never really been a concise, long-term study performed on the FTM community.

    If you plan on keeping the uterus, get it examined, especially if you think you may want kids later on (which you seem to be leaning towards). It's always better to be safe than sorry.

    If you can, maybe have someone come with you? There's measures you can take to maybe make it a more comfortable experience. As comfortable as it can be anyway. I fucking hate that shit. Shirt on, get a doctor who knows who trans people are, make pronouns super, super clear and try looking for a clinic who might be willing to do it (you don't necessarily have to go to a gyno or whatever).
     
  3. RainbowGreen

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    I did my research on the test and from I found until now, I don't see anything that would put me at risk. I don't smoke, don't take drugs, don't drink and I'm not sexually active. Is T so dangerous that it would require a test once a year? From what I heard, it can even give false results.

    I've been vaccinated for HPV. I don't like the idea of the test in the slightest.
     
  4. Keahi

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    You can refuse, although it won't necessarily stop your doctors from pestering you. They may be able to refuse to continue your prescription if they feel it's unsafe for you (if they feel they're opening themselves up for a malpractice suit, for example), but you're also free to shop around for new doctors, right?

    That said, pap smears DO save lives, and, while unpleasant, they're really not much more "detailed" an exam than a throat culture: reach in, scrape off a few cells, pull them out, send them to a lab, the end. Finding an efficient, understanding doctor may make a world of difference, especially if you can manage to convey that you want JUST the pap smear, not a full pelvic exam. Plus, as has already been mentioned, you don't need an ob/gyn to do it.

    Of course, if you're not receiving penetrative sex, that lowers your risk of cancer (and may be worth mentioning to your doctors). Also, have you been vaccinated against HPV? That can make a huge difference in your cancer risk, especially if you get it done early.

    Edit for ninja: Yeah, if you've told your doctors you've been vaccinated and aren't sexually active, then the once a year recommendation is really unusual, regardless of whether or not you're on T.
     
    #4 Keahi, Aug 11, 2015
    Last edited: Aug 11, 2015
  5. MichaelJTritter

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    Yes, you can refuse pap tests. I did and never had one. T doesn't require you to have a pap either. Get the HPV shot, don't engage in vaginal sex and theres no need for you to have a pap smear done.

    The only time I did OK one was when I had my hysto done and I was under general anesthesia.
     
    #5 MichaelJTritter, Aug 11, 2015
    Last edited: Aug 11, 2015
  6. RainbowGreen

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    I'm quite happy that my generalist doctor is not the one prescribing T to me, then. She can't withraw my prescription.

    If she asks again, I'll just refuse and tell her why.
     
  7. BradThePug

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    T can sometimes cause ovarian cysts. There also is always the genetic factor. You can be perfectly healthy in your life, but if it is in your genes then it could happen. In reality, you could be shooting yourself in the foot if you do not have the test done, since ovarian problems of any sort could lead you to not being able to have children.

    So, it's a rock and a hard place situation really.
     
  8. RainbowGreen

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    There's no such thing in my family as far as I know. I honestly prefer taking this small risk over having pap tests that don't seem necessary.
     
  9. thepandaboss

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    Hell, I developed problems without even being on T. But testosterone can contribute to cysts developing. Believe me, I have them. They don't really bother me anymore but it was still important to monitor them anyway just in case. It's like getting any other kind of check-up. Better to know if something's up early so you can develop an attack plan. And if nothing's done, you have a clear picture of your health and some piece of mind. It's like an STD test. Sure, no one's forcing you to do anything. But wouldn't you rather get it over with so you don't have to wonder what might be wrong?
     
  10. RainbowGreen

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    But, what even could be wrong? I'm not even thinking something could be wrong here. I'm as likely to have something wrong there than anywhere else. I know that ovarian cysts are still a possibility, but what danger are they really? From what I've read, they are most often benign and symptomless as well as go on their own. If I'm really that unlucky to get something like that in the maybe five years that I'll still have my parts, then so be it honestly :/
     
  11. thepandaboss

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    Mine were painful. However, you are right. Usually they're symptomless. I probably had bad cyst pain for about two months. Once I managed it with over the counter anti-inflammatories (recommended by doc), pain was gone and now I never really have pain anymore. I mean, sometimes they're painful if your ovaries twist or the cysts rupture (badly designed organ, who knew?) But if you get them checked out, there's a lot they could be so a smear is a way to sort out potential problems if you ever have anything develop. I've only ever had one done. Funny enough it was actually earlier this year and it was how I discovered I had the cysts- at the ER. And I didn't specifically ask for it. A CT scan pulled up a dark spot, they did the smear to make sure it wasn't cancerous or whatever.

    Again, ovarian cysts are very common. In fact, most people with our junk will probably develop them at some point even without T. The only time they're a major concern is if there's discharge, the pain's so bad you can't function, or so on. But that's pretty rare and usually something else is behind that. Most of the time you wouldn't really know you have them. I don't even really know why mine were painful in the first place. But just pay attention to your body.
     
  12. middleageguy

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    Even if you have no risk factors pap tests/gyn exams are necessary. 5-10 minutes a year and a little momentary discomfort is worth it to maintain good heath/catch issues before they become serious. Low risk is not zero risk.
    I am a man but to honor the identity I have fought so hard to for I accept that some things I have to do female. I get my exams because I love me more than I dislike these yearly reminders of my birth gender.
     
    #12 middleageguy, Aug 12, 2015
    Last edited: Aug 12, 2015
  13. greatwhale

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    You can of course refuse any test whatsoever, you are now an adult and have final consent over how your body is treated. On the other hand, the medical advice that was given to you is based on certain probabilities associated with taking testosterone.

    For example, in males with prostate cancer, certain drugs are given to suppress testosterone, i.e. chemical castration, as T is a know inducer of cancer growth. If the chemical route doesn't work, actual surgical castration is another option. The effect on prostate cancer is either stopping growth of the cancer or even reversal, for a time.

    I know that, at eighteen, one can feel as if nothing seriously bad can happen to you, but this is a relatively short and very briefly uncomfortable test that can give you some peace of mind for a whole year in between the tests. Peace of mind, and not worrying about your health are valuable things to have as the years progress.
     
  14. Keahi

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    Some clarifications & follow-up:

    1. Most authorities recommend a pap smear once every 2-3 years for any cervix-owning person who has ever been sexually active, broadly defined (toys, fingers, oral sex, etc.), regardless of vaccination status. (The American College of Obstetricians and Gynecologists used to recommend annual screening, but they scaled back their recommendation to the aforementioned 2-3 years in 2009.)
    2. Recommendations for cervix-owners who have never been sexually active vary from one authority to the next, honestly. It's a topic of debate among health care providers and experts alike.
    3. Some organizations do, however, suggest a further reduced frequency for low-risk patients with a history of three consecutive normal tests.
    4. CancerCare Manitoba recommends testing once every three years for ciswomen and once every two years for transmen, but only for those who have at some point in their life been sexually active, as defined above.
    5. The University of California, San Francisco's Center for Excellence in Transgender Health recommends that transmen follow the same guidelines as ciswomen. What this means, of course, depends on whose guidelines you follow, but as noted above, is generally once every two or three years.
    In summary, annual exams are probably unnecessary for all but the highest-risk patients, but it may be worth your while to consider at least an occasional exam at some point, ESPECIALLY should you ever choose to become sexually active.