Introduction
Referencing to an article that had mentioned ‘people who menstruate’, JK Rowling recently took to Twitter and said, ‘‘I’m sure there used to be a word for those people. Someone help me out. Wumben? Wimpund? Woomud?,” reinforcing the perpetual myth that only cisgender women menstruate and leaving out transgender and non-binary menstruators from the conversation. While a positive shift can be seen when it comes to normalising menstruation for women, there is a lack of awareness about the period struggle that transgender and non-gender conforming people go through. For some transgender men, a period can heighten their gender dysphoria, while some trans women often use food dye similar to blood and wear sanitary napkins to experience the feeling of menstruation that is close to their gender identity.
Hormone Replacement Therapy
Many transgender people undergo hormone therapy to change their body. Women who take estrogen hormones may face symptoms that are similar to that of premenstrual syndrome or premenstrual dysphoric disorder — this includes mood swings, insomnia and cramps varying in length and intensity. The experience is similar to having a bloodless period and some trans women call this experience ‘having a period’. There is a lack of research when it comes to the side effects of hormone therapy, leading to PMS and PMDD, and the awareness among people is even less.
A person shared this experience, and took to Twitter to share their experience, “Nobody teaches trans girls about our periods. We just get these weird times where we’re moody and crampy and sad and we don’t know why. We just chalk it up to another reason why we’re not good enough in life,” highlighting the need for including the experiences of trans women. Sam Ridel, a writer, takes a similar view in their article where they describe how ASMB folk’s experience and needs are met with opposition and violence.
Little is known about menstrual hygiene management practices for trans men. Most trans men mention the fear of other people discovering their periods. From hiding menstrual management products to avoiding public men’s washrooms, there are some everyday struggles that trans men face for their safety and to preserve their gender identity.
Trans men often develop a negative attitude towards menstruation since it is largely seen as a part of women’s experience and not that of men. Hence, some people take menstrual suppression therapy where they are given testosterone, This leads to decline in vaginal tissue resilience. Testosterone intake leads to amenorrhea. This is a condition where an absence of periods can still lead to unintended pregnancies. Testosterone does not act like a contraceptive and can further lead to a heightening of gender dysphoria for trans men.
Health Barrier For Transgender People
Majority of women in India with a cervix (cis or trans) do not take the pap test — a screening test for cervical cancer to detect HPV (human papillomavirus) — despite being vulnerable. Two major reasons for health care disparity are economic vulnerability and discrimination by healthcare providers. Most often, trans individuals cannot afford hormone therapy or surgery costs, which often leads to them taking hormones without any proper medical supervision. It often includes the risk of sharing of needles, placing them at a higher risk of HIV transmission.
The social stigma often also leads to trans individuals experiencing poverty and unemployment, making it even more difficult to get adequate medical help. This discrimination is also evident in the healthcare sector where medical personnel are often insensitive and untrained to address the specific needs of transgender people.
To conclude, there is an immediate need to address and normalise the menstruation struggle of trans individuals, besides an overall focus on their sexual and reproductive health needs. The struggle can be addressed in the form of government policies to take care of their finances vulnerabilities. Medical professionals also need to be specially trained to address the needs of people who belong to different gender identities.