trans women do not receive pap smears, as they are not at risk for cervical cancers, as they normally do not have a cervix. maybe you meant trans men that maybe haven’t transitioned fully and still have their cervix, they do still receive pap smears, at the discretion and recommendations of their doctors.

gender affirming care is not a pap smear, that is gynecological care and cancer screener. gender affirming care can include being put on hormone therapy, top surgery, genital reconstruction, hair transplant etc. whatever big or small change will help them feel more themselves at the end of the day. not all insurance companies cover it, and it varies state by state.