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Let’s talk about it…smear tests for lesbian, gay and bisexual women

Posted on: Wednesday, 13th June 2018 by Meghan Herring, Support Services Officer

This blog was originally written for the LGBT Foundation

According to the LGBT Foundation, 17.8% of lesbian, gay and bisexual (LGB) women of eligible screening age (25 to 64) have never been for cervical screening.

Cervical screening (often called a smear test), prevents up to 75% of cervical cancers developing and not attending is actually the biggest risk factor to developing cervical cancer.

So, why are lesbian, gay and bisexual women less likely to take up their cervical screening invite?

Anyone with a cervix (aged 25 to 64) is eligible to attend cervical screening. Yet, as well as dealing with common barriers for not attending cervical screening, LGB women sadly face the myth that they don’t need to attend cervical screening, caused by common misconceptions, and lack of understanding around HPV and how cervical cancer develops. Research from the LGBT Foundation has shown that 40.5% of LGB women of screening age have incorrectly been told they don’t need to attend because of their sexual orientation.  This has had a lasting impact of declining smear test attendance in the LGB community.

Human papillomavirus (HPV)

"Surely only men pass HPV on!?”


HPV is a really common virus that 80% of us will get at one point in our lives. It can be passed on between women, even if neither of them has ever had sexual contact with a man. This is because HPV is spread by skin-to-skin contact in the genital area, which can include sexual touching, sharing sex toys, oral sex and penetrative sex.

Sometimes people are told not to have a smear test due to the common misconception that LGB women can’t get HPV. If you have a cervix and have been told you can’t have one because of your sexual orientation, you can speak to your GP surgery about your experience and to book a smear test. You can usually find contact details on their website. You can also request for someone else to take your smear test.

Anxiety about going to the doctor

For some LGB women, going to the doctors can cause anxiety. People are routinely asked standard questions by doctors, which may lead to them having to disclose their sexual orientation each time. For instance, being asked about whether you are sexually active, whether you use birth control and if there is a possibility that you may be pregnant. All of these queries, invariably, can lead to a discussion about sexual orientation that may be unwanted.

If this is your experience, please know you do not have to answer these questions. If your sexual orientation is not something you want to talk about, it may be helpful to pre-plan your answers.

The smear test itself…

For women who don’t have penetrative sex, smear tests can sometimes feel invasive or painful. If you are worried about this, you can ask for things to make the test more comfortable. Remember that the nurse doing the smear test should be supportive of your physical and emotional needs.

Here are some tips to make your smear test easier:

  • If it is your first smear test, you’re feeling nervous or you have had a bad experience in the past, tell your nurse. They can talk it through with you and suggest things that may help.
  • You can ask for a smaller speculum either by calling the GP before your appointment, or by asking the nurse. This may make the test more comfortable.
  • During the appointment, you will be offered a paper covering for your bottom half, but you may feel more comfortable bringing a shirt to cover up. You could also wear a dress or skirt.
  • If you don’t want to go to the appointment alone, you can take someone you trust with you. They can speak on your behalf or simply be there to offer support.
  • If you have vaginal dryness, you can ask the nurse to give you a vaginal oestrogen cream or pessary. This can make inserting the speculum easier.
  • Some women find different positions can reduce pain and make them feel more comfortable – for example, lying curled on their left side (left lateral position). Speak to your nurse to see what they suggest.

More information and support

The LGBT Foundation have specific cervical screening resources for LGB women, as well as a helpline where you can access support and information. You can also call the LGBT Switchboard as they are there to listen to anything you need to talk about.

If you are worried or want to talk through anything we mention in this blog, call our Helpline on 0808 802 8000. Our trained volunteers can offer guidance and support. Check our opening hours before ringing.

If you have a medical question, you may want to use our Ask the Expert service.

You could also join our online forum to talk with others going through similar experiences. We also have a specific section for the LGBTQ community.