By Jessica Milne, MPH
Growing up, I was very concerned about periods because I didn’t start menstruating until I was 15. In the years leading up to menarche, I experienced a lot of anxiety about when it would start, why it was taking so long, and what was wrong with me for being such a late bloomer?
Eventually, it came, and in late 2018, I came out as non-binary and began using they/them pronouns. At this point, I had already been menstruating for about 7 years. Still, menstruation is widely considered as an indicator of womanhood, resulting in some complicated feelings about menstruation and my gender identity. I felt bothered by my period for the first time, like it was a reminder of my assigned sex. This required some self-affirmation to work through. A career in sexual & LGBTQ health research has eased these complexities somewhat, as well as being surrounded by (and building) an affirming community.
I felt bothered by my period for the first time, like it was a reminder of my assigned sex.
People's problems with periods
Menstrual stigma has real health implications — physical and mental — for people who menstruate all around the world. From a young age, we are taught to hide or conceal evidence of menstruation at all costs. This has consequences for the way that young menstruators feel about themselves/their own bodies, as well as how other people view menstruators.
A 2002 study tested for menstrual stigma by setting up an experiment in which a cis female researcher (pretending to be a participant) “accidentally” dropped either a hair clip or a tampon from her purse in front of the real study participants. Not only was the researcher rated as less competent and less likable by participants when she dropped the tampon, but participants tended to sit further away from someone who they thought was menstruating.
Not only was the researcher rated as less competent and less likable by participants when she dropped the tampon, but participants tended to sit further away from someone who they thought was menstruating.
Menstruating while trans
So while cisgender (meaning sex assigned at birth aligns with gender identity) women who menstruate are negatively impacted by this stigma, the effects may be amplified for trans and gender non-conforming (GNC) menstruators due to the increased pressure to conceal evidence of menstruation for both identity and safety reasons. The threat of violence is real for this population, and one study surveying masculine of center people about menstruation reported 66% of menstruators who use men’s restrooms felt unsafe, and that some (13.4%) even avoid public restrooms to conceal evidence of menstruation.
The [negative] effects may be amplified for trans and gender non-conforming (GNC) menstruators due to the increased pressure to conceal evidence of menstruation for both identity and safety reasons.
Despite the harmful yet common framing of menstruation as a women’s experience, it’s important to understand two main points: not all women menstruate, and (2) not everyone who menstruates is a woman. While referring to periods as a woman-only experience is harmful to trans and GNC communities, trans and GNC people should not have to feel bad about their menstrual cycles. Of course, many people in this community experience significant gender dysphoria (distress related to a mismatch between a person’s assigned sex at birth and their gender identity) during menstruation.
Not all women menstruate, and not everyone who menstruates is a woman.
A friend of mine who is a trans guy (and agreed to have his story shared) described the impact of gender dysphoria combined with physical symptoms of menstruation: “I definitely think [being trans] made it more difficult for me compared to cis people — just the added dysphoria on top of the physical symptoms could be paralyzing for me.”
The added dysphoria on top of the physical symptoms could be paralyzing for me.
Coping with your period when you're not a woman
He also mentioned the need to alter his routine by staying home, taking a lot of pain medication, or changing his eating habits while menstruating. In the past, he avoided menstruating by using hormonal birth control (a practice called menstrual suppression) including the pill and an IUD. He emphasized the ability to ignore his period as a key practice to ease gender dysphoria — either through menstrual suppression, or using a menstrual cup (as they can stay in place for 12 hours without being emptied, and can be “forgotten about” for longer).
We need a societal shift in the way menstruation is portrayed to ease the gender dysphoria and stigma surrounding menstruation. For starters: a greater representation of trans and GNC menstruators is necessary in media (e.g., tampon/pad/menstrual cup commercials that feature menstruators of all genders, movies/tv that addresses these issues), as well as more training for healthcare providers on diverse gender identities. One example of non-binary menstruation representation in music that comes to mind is from folk-punk musician Mary Wander, whose song Person Who Menstruates includes the lyric, “I feel my strongest and most like me when I bleed.” Some examples of menstrual activists to follow on social media include The Period Prince, and Toni the Tampon.
“I feel my strongest and most like me when I bleed.”
Embracing your period, regardless of gender
During my undergraduate career, I joined a research lab focused on reproductive and sexual health where I had the opportunity to learn about the aforementioned research on menstrual attitudes and emotions. Growing up, I didn’t necessarily feel embarrassed about periods—perhaps because I was the last of all my friends to get mine. The attitude my mom had toward periods was basically, “It’s going to happen to you someday, and it sucks, but here’s how you manage it.”
It didn’t seem very stigmatizing, but it wasn’t positive either. Learning about this idea of “period positivity” at the research lab, for instance, menstruation as an “example of the rhythmicity which pervades all of life” was eye-opening for me. Granted, this approach may not be immediately helpful for people who experience severe physical pain, negative psychological effects, and/or gender dysphoria during their period, but I hope to work toward a future where positive attitudes toward our bodies and their functions are the norm.
Viewing menstruation in a positive light has allowed me to become more in touch with my body, which in turn has guided me toward accepting my periods and viewing them as a health indicator—meaning that a regular period can be a potential sign of good health. Using period tracking apps have helped me notice patterns that impact my health (For example, whenever I’m stressed my period is usually late).
[Thinking positively about periods] has guided me toward accepting my periods and viewing them as a health indicator — meaning that a regular period can be a potential sign of good health.
I’ve used period tracking apps for as long as I’ve had a smartphone, but I recently purchased a copy of the Cycles Journal, which is a resource combining self-care and period/fertility tracking with more spiritual spaces including herbal wisdom, lunar phases, and astrology, which may be useful for menstruators of any gender trying to become more in touch with their body through mindful tracking practices.
Some advice for allies, health professionals, and parents
Avoid assumptions. This goes for gender, assigned sex at birth, menstrual status, fertility status, etc.
Be mindful about using non-gendered language when speaking about menstruation and other sexual health topics
Normalize diverse menstruation experiences while being open to talking about abnormal symptoms
Some folks begin menstruating at age 10 and some begin at age 15 like me. But if your child tells you their period is causing debilitating pain, it may be time to visit the doctor.
When talking about menstruation, including your own cycle, avoid the use of language that perpetuates stereotypes or menstrual stigma (e.g., “I’m being a bitch today because I’m PMSing”)
Menstrual positivity is one form of body positivity, so take some time to learn about Health At Every Size (HAES) Frameworks too.
Interested in learning more?
Read about The Price of Periods in Prison
Jessie is a public health researcher passionate about studying health disparities along the lines of race, class, and gender. Much of their work has involved sexual health and LGBTQ populations. Jessie hopes to bridge the gap between community based public health research and horizontally run networks of mutual aid and care.