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However, gynecological recommendations often do not include clinical considerations specific to patients on the female-to-male FTM spectrum. Both patients and providers may not accurately assess risk for HPV and other sexually transmitted infections, understand barriers to care, or be aware of recommendations for cervical cancer screening and other appropriate sexual and reproductive health services for this patient population. We review the evidence and provide guidance on minimizing emotional discomfort before, during, and after a pelvic exam, minimizing physical discomfort during the exam, and making adaptations to account for testosterone-induced anatomical changes common among FTM patients. In an effort to close these gaps, we present recommendations to guide cervical cancer screening for FTM patients based on a review of the literature and qualitative interviews with patients and clinicians experienced in providing care to this population. We begin our discussion with two illustrative clinical examples; throughout the text, we also include representative quotes and corresponding gender identities and ages of some of the patients we interviewed in order to convey their lived experiences. Before then, he identified as a woman.
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