Menstrual health is the state of well-being in relation to the menstrual cycle. Given that 1.3% of adults aged 18-24 and 0.5% of all adults in the US identify as transgender and/ or gender diverse (TGD) (Herman, et al., 2022) and that 57% of TGD individuals were assigned female at birth (James et al., 2016), this categorization of menstrual and gestational health is exclusionary for approximately 741k Americans. Premenstrual syndrome (PMS) is characterized by physical and psychological symptoms regularly occurring during the second half of the menstrual cycle, often continuing into the first few days of menses. Symptoms of PMS disrupt social and economic functioning, negatively affecting relationships, work attendance, and productivity, and increasing healthcare costs and utilization (Halbreich, 2004; Rapkin & Winer, 2009).

Gender dysphoria (GD) denotes significant and persistent distress or impairment related to gender incongruence (American Psychiatric Association, APA, 2022). The current World Professional Association for Transgender Health (WPATH) guidelines note that “there is no formal research evaluating how menstrual suppression may impact gender incongruence and/or dysphoria” (Coleman et al., 2022). There is no research examining the severity of PMS among persons whose identities do not align directly with the biological process of menstruation. There is no research examining the relationship between gender dysphoria and PMS. Further, there are no data about differences in attitudes toward menstruation between binary transgender men and non-binary TGD adults.

This study describes the severity of PMS within binary transgender men and non-binary TGD adults; the relationship between gender dysphoria and PMS severity and impact of PMS on quality of life (QoL); and the association between PMS severity, gender dysphoria, and impact of PMS on QOL, and desire for/ use of menstrual suppression therapies. This is the first investigation of its kind, especially as we closely examine differences in experience between binary and non-binary TGD adults.

References

Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., De Vries, A. L. C., Deutsch, M. B., ... & Arcelus, J. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health. https://doi.org/10.1080/26895269.2022.2100644

Halbreich, U. (2004). The diagnosis of premenstrual syndromes and premenstrual dysphoric disorder-clinical procedures and research perspectives. Gynecological Endocrinology, 19(6), 320-334. https://doi.org/10.1080/0951590400018215

Herman JL, Flores AR, O’Neill KK. How many adults and youth identify as transgender in the United States? https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/. Accessed 20 November 2022.

Rapkin, A. J., & Winer, S. A. (2009). Premenstrual syndrome and premenstrual dysphoric disorder: quality of life and burden of illness. Expert Review of Pharmacoeconomics & Outcomes Research, 9(2), 157-170. https://doi.org/10.1586/erp.09.14