Multilevel Barriers and Facilitators to Cervical Cancer Screening Among Trans Masculine People: A Narrative Review

Purpose: This narrative review synthesized empirical evidence on barriers and facilitators to cervical cancer screening among trans masculine people. Methods: PubMed, Scopus, and Web of Science were searched through February 7, 2026, for English-language empirical studies published from January 1, 2015. Findings were organized using a socioecological framework and interpreted through the Gender Minority Stress and Resilience model. Results: Nineteen studies from eight countries met the inclusion criteria. Individual barriers included procedure-triggered gender dysphoria, pain, trauma activation, low perceived risk, and limited sexual health literacy. Interpersonal barriers included misgendering, non-preferred anatomical terminology, provider unfamiliarity, gatekeeping, and anticipated discrimination. Institutional barriers included the framing of screening as women’s health, non-inclusive materials, loss of invitations or coverage after a gender-marker change, and cost. Facilitators included self-sampling for high-risk human papillomavirus testing, gender-affirming therapeutic relationships, trauma-informed care, inclusive environments, peer support, and invitation systems independent of the gender marker. Conclusions: The reviewed studies identified interacting barriers across the screening pathway. Self-sampling was acceptable to many participants and was described as reducing procedural burden, but preferences varied and relational and institutional barriers persisted. The findings supported offering modality choice alongside gender-affirming, trauma-informed care, and anatomy-based eligibility; evidence of intervention effectiveness remained limited.