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If you're queer, you still need a smear test

Friday 5th May 2017

That advice goes for anyone with a cervix. 


Cells from a smear test.
Cells from a smear test.

Photo: Ed Uthman/Flickr

After being wrongly told she didn't need a smear test, Nicola* wants to warn other queer women about being given bad advice.

She says that during a routine checkup, a nurse at the Newmarket Family Planning clinic advised her against undergoing a smear test because she has a female partner and that she wasn’t at risk of contracting HPV viruses, which lead to cervical cancer. 

This goes against official guidelines from the Ministry of Health stating that “any woman who has ever been sexually active should have a cervical smear from the age of 20 up until she turns 70.”

A spokesperson for the Ministry says the advice is the same for all women, regardless of their sexuality and that this has been “strongly communicated to health professionals over a long period of time”.

After Nicola insisted, the nurse followed through with the test.

The Family Planning New Zealand policy regarding smear testing follows the Ministry of Health guidelines. “We’re obviously disappointed that this has happened, it’s clearly not our policy,” says spokesperson Sue Reid.

She acknowledges that the advice given to Nicola* highlights the need to remind staff about the organisation’s policy and commitment to cervical smear testing for all clients.

HPV viruses are largely, but not exclusively sexually transmitted and can be sexually transmitted between sexual partners of any sex or gender. It is estimated that 80 percent of sexually active women will be affected by them within their lifetime. In New Zealand, cervical cancer is the third most frequent cancer among women between the ages of 15 and 44. 

Without smear testing, about one of every 90 women will develop cervical cancer and one out of 200 will die from it, compared to the one in 1280 who have undergone testing.

Women’s Health Action Trust strategic advisor George Parker says there are systemic issues that affect how healthcare is provided for sex, sexuality and gender diverse people in this country.”

Globally, sex, sexuality and gender diverse people are underrepresented in preventative healthcare and are therefore over-represented in deaths from preventable cancers including cervical cancer, Parker says.

Nicola’s case is one of three The Wireless has been told about where patients say they were told they didn't need a smear because of their sexual orientation.

Takatāpui woman Lois Hawley-Simmonds says on many occasions she has also been provided with misinformation and advised against smear testing.

During a routine check-up at her GP, the education professional was referred to a Manukau clinic for a smear test, where a nurse then told her it wouldn’t be necessary.

“One of the women actually said, ‘I don’t know why you need to have a smear because you’re in a gay relationship. You’re a lesbian so there’s no need for you to have a smear’.”

In her twenties she was told the same thing by another Manukau-based medical centre and last year this was the advice of a nurse at her local medical centre in Manurewa.

“We were confused,” says Hawley-Simmonds, whose wife was told that because she previously had a male partner and has children, she would need regular testing.

“If it wasn’t for [my wife], I probably wouldn’t have gone back.

“It’s terrible… You just kind of think to yourself that you’re going to the doctors to get yourself fixed up and then that happens, you’re misinformed.”

She says for Māori women and survivors of sexual abuse like her, this is yet another barrier to treatment.

“There are other Māori women out there that have gone through what I’ve gone through and are too whakamā to come forward.”

One of these women, Jess* says that when she and her partner, both in their twenties, went to get tested at clinic in West Auckland they were also told they didn’t need testing because they are in a same-sex relationship.

The encounter left her really confused. “It's a big thing to build yourself up to go and get a smear…” she says.

“I'd had one before and always been encouraged to have them by my regular university doctors. So hearing this from a sexual health team made me second guess what I'd been told.

In an attempt to find answers, she went back to her regular GP who confirmed “if you have a vagina, you need to get smears.”

*Name has been changed to protect source's identity.

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Sarah is a freelance writer with a soft spot for poetry and prose. When she’s not writing or practicing her Spanish, she can be found riding the streets of Auckland with the Lady Gang.
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