HIV and other STIs can sit in your body, sometimes for a long time, without any symptoms, so getting a sexual health test (sometimes called a sexual health check) is the only way to really know what your sexual health status is.
Testing regularly means that any infections can be detected and treated early and also helps you make informed choices about the sex you have, and help protect the sexual health of your partners.
How often you should test really depends on how much sex you’re having and what type of sex you’re having. It is recommended that all guys into other guys get tested at least twice a year, but every 3 months if you’re getting action with multiple guys.
What to expect
Sexual health tests usually start with a registration process, which might be filling in a paper form or answering questions on a computer kiosk. Your confidentiality is always paramount and there is no requirement for you to disclose that you are trans, particularly if you have no STI symptoms. If the client registration system has moved into the modern era though, you may be asked how you identify your gender and also what gender you were assigned at birth. This is helpful data for a service to know so they get a sense of how many trans people they are seeing (or not) and how they can better orient their services to our communities.
Once you have got past the first step, a doctor or other sexual health clinician will want to chat about the kind of sex you’ve had over the last 3–6 months. They’ll ask you some pretty direct questions about your sexual activity, talk to you about collecting tests samples from various parts of your body (which are usually ‘self-collected’), and sometimes ask you a few questions to gauge your general knowledge about sexual health.
A standard sexual health screen usually checks for HIV, syphilis, chlamydia, gonorrhoea and sometimes hepatitis C (and hep A and B if you haven’t been vaccinated).
The window period for HIV, which is the period of time between infection and when the virus will show up on a test, can be up to three months. This means that an HIV negative result is only valid from three months ago.
Sexual health screening when there are no physical symptoms (asymptomatic) should be the same, regardless of gender experience: urine (self-collected in a cup), arse swabs (self-collected swab, use water to lube it up), and clinician collected blood and throat swabs. Having symptoms means that the clinician may want to take other swabs. It can be awkward but it’ll be over quickly. You can also decline a clinician swab: they can’t force you.
Most people who choose to work in sexual health are largely unflappable and not in the least bit concerned about your body and how it relates to your identity. To them you are a man if you say so and that’s it. However, there will be times when you will encounter a curious or less-educated clinician—you probably already have if you’ve been in transition or living out as trans for more than five minutes.
Try to be confident and clear. Some preparation prior to the appointment can help, but if you feel that you have been discriminated against, you can report it to your local Health Complaints organisation, the Australian Human Rights Commission, your state’s Anti-Discrimination Board or local community legal centre (particularly the Inner City Legal Centre if you are in NSW).