29/05/25

Perimenopause and Gender Dysphoria

Gender dysphoria is the distress experienced by a person whose gender does not align with the sex they were assigned with at birth. For transgender and non-binary people, gender dysphoria feels like you aren’t living in your own skin due to your gender identity, gender expression or behaviour not conforming to the sex that you were born with.

Transgender men and non-binary people assigned female at birth (AFAB) often experience gender dysphoria during perimenopause due to the sociocultural associations with ‘womanhood’ and ‘femininity’. Many gender diverse people often dread menopause because of bodily changes such as weight gain, breast tenderness, vaginal dryness and hot flushes which intensifies gender dysphoria.

Those who identify as trans and non-binary experience gender dysphoria at the clinical level often due to being misgendered, dead-named and discriminated against because of their provider’s lack of education and personal bias. This means that members of the gender diverse community avoid and ignore seeking care for perimenopausal symptoms due to perceived clinician and cultural incompetency, and a lack of LGBTQIA+ allied healthcare access.

Studies have shown that non-binary people in particular delay seeking healthcare due to an experienced or perceived fear of discrimination and mistreatment from their providers. They are less likely to get regular cervical screenings due to gender dysphoria, and report higher rates of not only depression during perimenopause which greatly impacts a person’s mood, but higher rates of cervical cancer due to healthcare avoidance.

Cultural narratives often express menopause as an aging milestone and time for bonding between women, leading non-binary and trans men to feel isolated and excluded from conversations about their changing bodies. Gender diverse people also report that the overarching ‘women’s care’ focus invalidates diverse identities, as those situated outside of the gender binary are made to feel invisible and unwelcome, with some folks reporting they misgender themselves to get equal access and treatment.

Better training in gender and sexuality and the way menopause is experienced by diverse people needs to be adopted at the tertiary level. More inclusive language and avoiding overtly feminine styling in campaigns and educational resources from clinicians and support groups would be a start to including more gender diverse groups into conversations around perimenopause and menopause.

References

Frank, S.E. (2020), Queering menstruation: trans and non-binary identity and body politics. Sociol Inq, 90: 371-404. https://doi.org/10.1111/soin.12355

Glyde, T. (2022). LGBTQIA+ menopause: room for improvement. The Lancet, 400(10363), 1578-1579. https://doi.org/10.1016/S0140-6736(22)01935-3

Queer Menopause. (2021). What is the non-binary experience of menopause? https://www.queermenopause.com/blog/2021/10/9/what-is-the-non-binary-experience-of-menopause

Sobel, T., Derakshani, D., Vencill, J.A. (2024). Menopause experiences in sexual minority women and non-binary people. Maturitas, (185). https://doi.org/10.1016/j.maturitas.2024.108007

Thomas, C., Dwyer, A., Batchelor, J., Van Niekerk, L. (2024). A qualitative exploration of gynaecological healthcare experiences of lesbian, gay, bisexual, transgender, queer people assigned female at birth. Aust N Z J Obstet Gynaecol. 64(1):55-62. doi: 10.1111/ajo.13741