If you're sexually active it's important that you keep on top of your sexual health. This means screening for HIV and sexually transmitted infections (STIs) regularly. Your risk of exposure to HIV and STIs varies depending on who you have sex with, how often and what kind of sex you have.
If you change partners or have casual or new partners it is recommended you test every three months. It's always a good idea to test before sex with a new partner and test for HIV at least once a year.
Where and how to test
Postal testing, where you receive a kit in the post and take your own samples, has become increasingly available. It involves taking swabs from the body parts you use to have sex and/or a urine sample. This typically involves swabs for throat, anus and, depending on whether you have had any lower surgery, an additional swab for the front hole or a urine sample. These samples are easy to do and painless. You can also provide a finger-prick blood sample to test for HIV and syphilis. When ordering your kit, it’s best to always ask for what you need.
The samples are posted back to the laboratory and you will get your results back in a few days.
Postal testing kits are great if you want peace of mind. They're confidential, convenient and can be done on your own terms.
Screening at a clinic
Going to a sexual health clinic can be unnerving for anyone and it may be particularly difficult for trans and non-binary people. But if you think you have an STI it's important to get it diagnosed and treated.
At a sexual health clinic you will see a specialist sexual health clinician who you can discuss your needs with. Even at a clinic you can often do your own samples if you do not feel comfortable with a doctor or nurse taking them.
Sometimes they might need to examine you more intimately if clinically indicated. If this is the case, have a discussion with your doctor about what you feel comfortable with. There are often ways to make your experience more comfortable depending on your circumstances.
Some people feel embarrassed or fearful about talking about their sexual health or having their body examined. Clinicians have seen and heard it all before regarding STIs, so you won’t shock them. By being open and honest about how comfortable you feel being examined and the words you use about your body should help you work together effectively with your doctor.
If an infection is found or suspected, you will be given medication to treat it. Medication from sexual health clinics is free. It is important to take the medicine as prescribed and to abstain from sex during this time to avoid re-infection.
Trans and non-binary clinics
Some areas have sexual health clinics for trans and non-binary people. Contact THT Direct to find out what’s available where you live.
There are sexual health clinics just for trans and non-binary people, their partners, friends, and family. Some have gender inclusive waiting areas, toilets and screening rooms and will use your correct name and pronouns if these differ to those on your medical records.
Many monthly trans and non-binary sexual health clinics exist in many places in the UK so it’s a good idea to check to see if you have a local sexual health service.
Cervical screening for those with a cervix
If you have a cervix then it's important to get a cervical screening test every three years from the age of 25 (or every 5 years from 50 to 64). The test looks for a virus that can cause cervical cancer if it isn't treated. You will have a cervix if you were assigned female at birth and have not had a hysterectomy. If you are not sure, discuss with your doctor. If you've changed your name and gender with your GP, you may not receive letters to remind you to go for a screen.
You can make an appointment to have a cervical screen with your GP practice nurse. Some sexual health clinics will offer this service for trans masculine and non-binary people if they do not feel comfortable using their GP. Discuss with your healthcare provider if you feel uncomfortable to see if alternative arrangements are possible.
The test is quick and simple but can feel intrusive. Samples are taken from the cervix by a nurse or doctor.
While it can be uncomfortable and even distressing for some to undergo a cervical screening, by testing regularly and treating any abnormalities that might be found, you can prevent cancer from developing.
56 Dean Street in London offers a dedicated cervical screening service specifically designed for trans and non-binary people.
Many sexual health clinics provide fast-track testing for anyone who is working. They can also provide condoms, lube and contraception.
You have a right to be safe at work. You can anonymously report dangerous individuals to National Ugly Mugs, the sex worker safety scheme, who will then send out an alert to other sex workers in the local area. There's an NUM page dedicated to trans sex workers.