Introduction
Menstruation is a natural biological process that has long been associated with cisgender women. However, it’s important to recognise that not all individuals who experience menstruation identify as women. Transmasculine individuals, including transgender men and non-binary people, may also have periods. This article aims to shed light on the experiences, challenges, and considerations surrounding menstruation in transmasculine individuals, as well as explore various medication options available to manage menstruation.
Menstruation and Gender Identity
For many transmasculine individuals, menstruation can be a challenging and dysphoric experience. It may conflict with their gender identity and cause emotional distress. It’s essential to acknowledge that a person’s gender identity is valid, regardless of their biological functions.
Dysphoria and Emotional Impact
Experiencing menstruation can trigger gender dysphoria in transmasculine individuals. Dysphoria may manifest as discomfort, anxiety, or depression related to their body’s functions. Coping with these emotions can be particularly challenging.
Medication Options
Transmasculine individuals have several medication options to manage menstruation and alleviate gender dysphoria:
Hormone Therapy: Testosterone therapy is a common choice among transmasculine individuals. It can suppress menstrual patterns, including lighter or irregular periods and, in many cases, stopping them altogether.
GnRH Agonist Blockers: Gonadotropin-releasing hormone agonist (GnRHa) blockers can be used to suppress ovarian function, leading to a halt in menstruation. This option is often recommended for individuals seeking menstrual suppression at the same time as stopping feminising development.
Intrauterine Devices (IUDs): Some transmasculine individuals opt for the Mirena intrauterine device (IUD / IUS), which releases small amounts of hormones to reduce or stop menstruation while providing contraceptive benefits.
Progesterone: While progesterone is a popular choice for menstrual suppression, it’s important to note that it is a feminising hormone which promotes breast development and fat distribution. Progesterone can be taken as a pill or injection.
Progesterone-Only Pills
Progesterone Injections
Gender-Affirming Care and Ovarian Function Suppression
For those who wish to suppress ovarian function, minimise feminising effects and promote masculine characteristics, medications like GnRH agonists and testosterone therapy are most suitable. For those who are not ready to take these steps, progesterone contraceptives can provide effective suppression of periods and ovarian cycles.
Progestogens are frequently utilised in managing menopause symptoms and supporting breast size during menopause. For individuals using them as a contraceptive method, common side effects include breast engorgement and tenderness, weight gain, and altered fat distribution, particularly around the hips.
Reflecting on this, the use of progestogens to suppress menstruation in trans masculine individuals may not fully align with their needs, particularly for those seeking to suppress estrogenic effects. This practice persists largely because healthcare providers consider progestogens a ‘safer’ option, often due to apprehensions about prescribing hormone blockers. It’s important to note that the only form of contraceptive progesterone not absorbed systemically in significant amounts is found in the intrauterine system (IUS).
While progesterone can be an alternative for individuals lacking access to comprehensive gender-affirming care, it should not be regarded as the primary treatment option for menstrual control in people seeking medical transition.
Support and Inclusivity
Healthcare providers and society at large should offer inclusive and compassionate care for transmasculine individuals who menstruate. Creating gender-neutral spaces, using inclusive language, and acknowledging the diverse experiences of menstruation can help reduce the stigma and anxiety associated with this topic.
Seeking Medical Advice
Transmasculine individuals who experience menstruation should consult with a healthcare provider knowledgeable about transgender healthcare. They can discuss available options, including hormone therapy and menstrual suppression, to align their physical experiences with their gender identity.
Conclusion
Menstruation in transmasculine individuals is a complex and personal experience. It can pose unique challenges related to gender dysphoria and body image. Recognizing and respecting an individual’s gender identity and providing them with comprehensive and inclusive healthcare options are essential steps toward promoting their overall well-being and mental health. Education and understanding surrounding this topic are crucial for creating a more inclusive and accepting society. Additionally, choosing the right medication option for menstrual suppression should be based on individual needs, goals, and medical history, with an emphasis on aligning physical experiences with one’s gender identity.