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Background <p>Limited evidence exists regarding sexual and reproductive health (SRH) utilization among transgender and gender diverse (TGD) populations in South Korea. This study examined cervical cancer screening and human papillomavirus (HPV) vaccination uptake among assigned female at birth (AFAB) TGD individuals and explored associated factors.</p> Methods <p>Data were derived from the Korean Initiative for Transgender Health Cohort Study (KITE), which recruited TGD participants from transgender-affirming healthcare facilities. Cervical cancer screening followed the Korean National Cancer Screening Program guideline (age ≥ 20), and HPV vaccination was defined as receipt of ≥ 1 dose.</p> Results <p>Among 302 AFAB TGD participants, 295 were eligible for the National Cervical Cancer Screening Program (age ≥ 20). The guideline-concordant screening rate within the past two years was 17.6%. After indirect age standardization, this corresponded to 29% of the screening rate observed in the general population. Screening rates were lower among those with exclusively cisgender woman partners, while a history of non-consensual sexual contact was associated with higher uptake.</p> <p>The overall HPV vaccination rate was 25.5%. Among the HPV National Immunization Program recipients aged 18–20, vaccination rates reached 69.2%, comparable to cisgender counterparts. Vaccination was positively associated with younger age, college education, and Seoul residence, but negatively associated with longer hormone therapy duration and exclusively cisgender woman partners.</p> Conclusions <p>Despite the existence of national screening and vaccination programs, AFAB TGD individuals in the KITE cohort experience substantial gaps in preventive SRH services. Structural assumptions that link cervical cancer risk primarily to heterosexual intercourse and cisgender women may contribute to reduced screening uptake among TGD populations. Anatomically based screening recommendations and gender-neutral immunization policies are needed to ensure equitable access to preventive care.</p>

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Cervical cancer screening and HPV vaccination among assigned female at birth transgender and gender-diverse individuals in South Korea: findings from the KITE cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月13日

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  • Jung-won Yoon,
  • Gaeun Kim,
  • Eun Sil Lee,
  • Sun Young Lee,
  • Ssirai Kim,
  • Kuylhee Kim,
  • Na-hyun Hwang,
  • Yehoon Choi,
  • Hyein Chu

摘要

Background

Limited evidence exists regarding sexual and reproductive health (SRH) utilization among transgender and gender diverse (TGD) populations in South Korea. This study examined cervical cancer screening and human papillomavirus (HPV) vaccination uptake among assigned female at birth (AFAB) TGD individuals and explored associated factors.

Methods

Data were derived from the Korean Initiative for Transgender Health Cohort Study (KITE), which recruited TGD participants from transgender-affirming healthcare facilities. Cervical cancer screening followed the Korean National Cancer Screening Program guideline (age ≥ 20), and HPV vaccination was defined as receipt of ≥ 1 dose.

Results

Among 302 AFAB TGD participants, 295 were eligible for the National Cervical Cancer Screening Program (age ≥ 20). The guideline-concordant screening rate within the past two years was 17.6%. After indirect age standardization, this corresponded to 29% of the screening rate observed in the general population. Screening rates were lower among those with exclusively cisgender woman partners, while a history of non-consensual sexual contact was associated with higher uptake.

The overall HPV vaccination rate was 25.5%. Among the HPV National Immunization Program recipients aged 18–20, vaccination rates reached 69.2%, comparable to cisgender counterparts. Vaccination was positively associated with younger age, college education, and Seoul residence, but negatively associated with longer hormone therapy duration and exclusively cisgender woman partners.

Conclusions

Despite the existence of national screening and vaccination programs, AFAB TGD individuals in the KITE cohort experience substantial gaps in preventive SRH services. Structural assumptions that link cervical cancer risk primarily to heterosexual intercourse and cisgender women may contribute to reduced screening uptake among TGD populations. Anatomically based screening recommendations and gender-neutral immunization policies are needed to ensure equitable access to preventive care.