{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:01:53Z","timestamp":1791219713120,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Testosterone is one of the strategies that transmasculine persons can elect in order to align physical traits to their gender identity. Previous studies have shown morphologic changes in the genital tract associated with testosterone. Here, we aim to evaluate cervicovaginal cytology specimens (Pap tests) and high\u2010risk HPV (HR\u2010HPV) testing from transmasculine individuals receiving testosterone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective cohort of 61 transmasculine individuals receiving testosterone from 2013 to 2021. Cytologic diagnoses from 65 Pap tests were correlated with HPV status and histologic follow\u2010up and compared with the institutional data and a cohort of cisgender women with atrophic changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age was 28\u2009years and median time of testosterone use was 3\u2009years. Transmasculine persons showed significantly higher rates of HSIL (2%) and unsatisfactory (16%) when compared with the institutional data and atrophic cohort of cisgender women. After reviewing slides of 46 cases, additional findings were noted: atrophy was present in 87%, glycogenated cells were seen in 30%, and\n                      <jats:italic>Lactobacilli<\/jats:italic>\n                      were substantially decreased in 89%. Among 32 available HPV tests, 19% were positive for HR\u2010HPV and 81% were negative. On histologic follow\u2010up, all HR\u2010HPV\u2010positive cases with abnormal cytology showed HSIL, while none of the HPV\u2010negative cases revealed HSIL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study cohort demonstrated a high percentage of abnormal Pap tests in transmasculine persons receiving testosterone. Testosterone seems to induce changes in squamous cells and shifts in vaginal flora. HR\u2010HPV testing can be a useful adjunct in the workup of abnormal Pap tests from transmasculine individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.25030","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T07:08:40Z","timestamp":1659942520000},"page":"518-524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Cervicovaginal cytology,\n                    <scp>HPV<\/scp>\n                    testing and vaginal flora in transmasculine persons receiving testosterone"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9603-9783","authenticated-orcid":false,"given":"Lawrence Hsu","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pathology NYU Langone Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology NYU Langone Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Elishaev","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Khader","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Pathology NYU Long Island School of Medicine  Mineola New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Marcus","sequence":"additional","affiliation":[{"name":"Department of Pathology NYU Langone Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Pathology NYU Langone Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"The Report of the 2015 U.S. Transgender Survey","author":"James SE","year":"2016"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1557988320925691"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2020.106071"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.11.009"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2014.07.031"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2021-0199-OA"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.12.021"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2020.05.029"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0000000000000548"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-013-2753-1"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12525"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22259"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2021.01.004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2018.293654"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004421"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01719659"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910450408"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2013.855701"},{"key":"e_1_2_10_20_1","first-page":"205","article-title":"HPV co\u2010testing of unsatisfactory papanicolaou tests: implications for follow\u2010up intervals","volume":"34","author":"Chen F","year":"2021","journal-title":"Mod Pathol"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000525"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0190172"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2016.0187"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12985-020-01420-z"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2164-11-488"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1258\/0956462001916371"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(03)00858-5"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.25030","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.25030","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.25030","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T05:14:23Z","timestamp":1692681263000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.25030"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,8]]},"references-count":26,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1002\/dc.25030"],"URL":"https:\/\/doi.org\/10.1002\/dc.25030","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,8]]},"assertion":[{"value":"2022-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}