Moving beyond sex: Assessing the impact of gender identity on human papillomavirus vaccine recommendations and uptake among a national sample of rural-residing LGBT young adults

• Type of Material: Article
• Authors: Robert A. Bednarczyk, Emory University; Jennifer L. Whitehead, Northwestern University; Robert Stephenson, Emory University
• Language: English
• Date: 2017-06-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2017 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pvr.2017.04.002
• Title of Journal or Parent Work: Papillomavirus Research
• ISSN: 2405-8521
• Volume: 3
• Start Page: 121
• End Page: 125
• Grant/Funding Information: This project was supported in part by United States National Institutes of Health (NIH) grant K01AI106961.
• Keywords: Vaccine; Gender identity; Human papillomavirus; Transgender
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Oncology; Health Sciences, Public Health

Abstract

Background While national human papillomavirus (HPV) vaccination estimates exist by sex, little is known about HPV vaccination rates by gender identity. Methods We conducted a self-administered, anonymous online cross-sectional survey, with recruitment through Facebook ads, of lesbian, gay, bisexual, and transgender individuals in rural areas of the US. We compared HPV vaccine recommendation and uptake by self-reported sex assigned at birth and current gender identity. Results Six hundred sixty respondents were age eligible for HPV vaccination: 84% reported gender identity aligned with their sex assigned at birth, while 10% reported gender identity the differed from their sex assigned at birth; an additional 6% reported non-binary gender identity. Only 14% of male sex assigned at birth and 44% of female sex assigned at birth received HPV vaccine, similar to estimates by current gender identity. Transgender respondents’ HPV vaccination experience mirrored that of cisgender respondents with regard to sex assigned at birth. Conclusions Providers may base HPV vaccine recommendations on individuals’ sex assigned at birth, which may impact transgender individuals’ vaccine coverage. Future HPV vaccine uptake studies should account for gender identity. With sex-specific catch-up HPV vaccination recommendations, the role of gender identity on provider recommendation and reimbursement needs to be addressed.