Transmasculine periods: Men bleed monthly, too

Transmasculine periods: Men bleed monthly, too

CW: Discussions of bottom dysphoria, period dysphoria, and medical transphobia 

The landscape in which we consider periods is slowly changing. The taboo that has surrounded menstruation for centuries is lifting. More period care products are widely available, commercials show red blood, and we can even say the word “period” without being side-eyed. The conversation is even opening to include all people who experience periods, with inclusive language reflecting that, like the switch towards terms such as “period care” and “people who menstruate”.

But much more can be done. There’s a lack of dialogue on how trans men and masculine-aligned nonbinary people experience periods, and even fewer resources that cater to them specifically. We deserve trans-friendly period care. 

Nick is a trans man who has been on testosterone for four years. Talking about periods makes him “pretty uncomfortable”, and experiencing them is even worse. When it comes up in conversation, “it always feels awkward if there's a group of people talking about periods and I’m edging in. They accept it, but if I tell someone I’ve got my period they’re caught off guard.” Testosterone therapy can suppress the menstrual cycle, but not all trans people choose to take hormones, and for others it is inaccessible due to a variety of barriers in the medical system. Even for those that do take testosterone, like Nick, periods can persist or return sporadically. 

Critic Te Arohi worked with UniQ to speak with four transmasculine students about their relationship with menstruation, and the ways in which they can balance it with their identities. Though it can be an extremely difficult topic and all respondents experienced some degree of gender dysphoria regarding periods, their desire to help fill in the gap for other trans folks prevailed. None of the trans individuals we spoke to had previously accessed resources on trans menstrual care. “Aside from some brands and general lingo moving to be a bit more gender neutral, I feel like there isn't much [in Aotearoa] specifically aimed at helping trans men to be recognised in the period discussion,” said Jamie, one of the men we interviewed. Nick agreed, saying “when [inclusivity] is pointed out, it's just that ‘guys and enbies [nonbinary people] have periods as well’ and then that’s it. People know about it but then… nothing,” he said. 

“I feel like just some recognition or resources to help and give tips and advice on how to manage menstruation as a trans person would be awesome,” echoed Jamie. Periods can be painful and disruptive to anyone who experiences them. When gender dysphoria is also involved, however, the burden multiplies. “It really sucks,” said Jamie, candidly. “[Menstruating as a trans man] makes me feel more isolated from cis men, and is just a monthly reminder that my body isn't what it 'should' be.” Jamie told us that “making people aware that people other than women get periods would really help – it doesn't necessarily have to be a 'masculine' thing, just not exclusively a feminine thing.” 

It’s a fact that men like Jamie and Nick can experience periods, yet those that do often have to deal with it completely alone due to a combination of stigma and dysphoria. “Periods are overwhelmingly feminised,” Nick explained. Nick usually experiences intermittent cramping and spotting in place of regular periods, but when he recently switched to a different form of testosterone he had his “first full period in a while”. He wasn’t made aware that this could happen. “It was a surprise… it was awful,” he said. “My GP personally is pretty good with trans healthcare but quite a few don’t have any experience. Beyond my GP I haven’t had anything, especially in NZ. It’s quite unfortunate. A bit isolating.” Nick expressed that he feels as though trans men are being left behind, but he’s optimistic. “I hope we get there soon.”

Tobin is a transmasculine person who has been taking testosterone for three months now. “There's the normal stuff that everyone hates like cramps and ruining your favourite pyjama pants, but [having a period] also makes me dysphoric so it's like doubly gross,” said Tobin, “I am hoping that being on T will stop my periods.” Tobin shares similar sentiments with Nick regarding trans healthcare, too. “I think that NZ is slightly behind say, the US, because I have exactly zero faith that if I go to a doctor about something period related that they will gender me correctly, or even just treat me with respect,” said Tobin. “I have even had to correct [trans specialists] on my T dosage frequency because they weren't following guidelines.” 

Trans men seeking to medically stop having periods have the same options as cisgender women, but this can come with a whole new host of problems. Hormonal contraceptives that lighten or stop menstruation are oestrogen- or progesterone-based, which can be a source of discomfort for some trans people. Jamie told us “I've had lots of people ask why I don't go on birth control or get an IUD to stop having periods at all, but I felt really uncomfortable with the idea of those treatments putting even more oestrogen into my body.” Though cisgender males also naturally produce small amounts of oestrogen and progesterone, not all transmascs are comfortable with the hormones, on top of the various reasons in which cisgender women turn down hormonal contraceptives. “It sounds kinda wack, but it makes me so dysphoric just thinking about that,” Jamie said. For trans men that do take hormonal contraceptives, lower hormone options such as the “mini-pill” (progesterone-only oral contraceptive) or hormonal IUDs (the Mirena and Jaydess release small amounts of levonorgestrel) are more popular options, though they are less known about and less likely to be recommended by GPs. 

While contraception can be accessed through a trusted GP, transmasculine people seeking care for gynaecological or reproductive issues may have to go through ‘Women’s Health’ clinics or similarly branded OBGYN wards, which can feel exclusionary. Nick recalled, “I had to go through a gynaecologist and I was like, mentally checking out… it was a hell of an experience.” He’s reluctant to go again, especially without support. 

Elio is a genderqueer, masculine-aligned person, and xe has endometriosis that requires treatment in gynaecological wards. Endometriosis is when the lining of the uterus (the endometrium) grows outside of the uterus, such as on surrounding muscles and organs, causing heavy periods and severe pain. An estimated 10% of people with uteruses have it, yet it is still largely misunderstood. For Elio, this means more balancing medical care with their dysphoria, as endometriosis is managed through contraception as well as surgery. “My gyno is kinda just giving up on me because I don’t want to have any hormonal [endometriosis] treatment,” xe said. Instead, to manage both their dysphoria and their periods, “I’d been considering a hysterectomy (removal of the uterus) for a long time, but the doctors don’t want to do it,” as doctors were concerned about their fertility, a subject that makes Elio extremely uncomfortable. Elio also wants their endometrium surgically removed, as “I’m thinking about that for dysphoria,” but “there’s a real lapse in healthcare for nonbinary people specifically.”

For transmascs that do get periods, whether they choose to or not, shopping for period products can be a distressing experience for people in an already dysphoric time. Though supermarkets are slowly moving away from labelling the period care aisle as “feminine hygiene products”, tampons and pads still come in overwhelmingly pink packaging, and seem to solely depict cisgender women. “Period products are very feminine,” Jamie told us, “it makes me feel silly for having to buy them – you end up feeling quite stuck between genders.” 

Some period brands have more neutral packaging, but standing in an overwhelmingly pink aisle can be dysphoric. “As a whole, period stuff is very feminine and I hate it,” Tobin said, “honestly, I would love just plain packaging.” Period boxers are popular among transmascs overseas, but “they’re difficult to find here. [New Zealand] doesn’t have them,” Elio told us. Nick said “online resources would be good” to help transmascs find gender-affirming period products in NZ, but currently there’s “nothing”. Though Nick’s a self-described “feminine guy” and doesn’t mind pink, he’s empathetic about how stigmatising it can be for transmascs and others. “I feel like kinda degendering periods would be helpful for more masculine women too. Everyone, honestly. Half the population has periods at some point.” 

Disposing of those period products presents another issue. “I’d also like to see more [sanitary] bins in men's bathrooms,” said Nick. “Generally, if you go into the disabled men’s bathroom on campus there are bins, but not in the smaller cubicles,” he continued. Critic reported on this last year, as the Uni added more sanitary bins to campus but left out the individual men’s cubicles. Not all able-bodied trans men are comfortable using the disabled cubicle when another could need it more, or it could draw unwanted attention. Elio is also concerned about “how few non-gendered bathrooms there are on campus”. The accessible bathrooms usually double as gender neutral ones, again catering to two separate groups. “Sometimes I do use the disabled bathroom, even though some people would criticise me,” Elio said, “because I don’t ‘look’ disabled. It’s another anxiety-inducing thing.” 

Property Services Division Director Dean Macaulay said that “there are currently 781 sanitary units across our main University campus (which does not include those in colleges).
The sanitary units are in female toilets, all access toilets, and in accessible toilets that are inside male toilet areas.” Also, Campus Development Division Director Tanya Syddall said that “our University’s independent accessibility consultant has advised us that all access toilets are for everyone – people with disabilities, able bodied people, and people of all genders.” And finally, the University created a Gender Neutral Toilet Strategy and Plan, which has three phases. They’re going to roll out new signage, create an all-gender facility inside each existing building (as a minimum) and when that’s done, finish by increasing the number of facilities in each building “so people need to go only one floor at most to reach an all-gender facility”.

“Even though people are being more open about periods, trans and nonbinary people are still left out,” Elio said, “it’s hard cos we’re still tryna figure it out ourselves anyway.” Periods are slowly being destigmatised, but they need to be degendered too. “The ‘girlbossification’ of destigmatising periods is unrealistic and not great for cis women either. We’re still very far away,” Elio said, “reproductive issues need to be talked about in a trans frame” and xe stressed the need for more trans research and more trans resources. People other than women have periods, and need to be part of the period conversation. Despite this, our interviewees had a lot of wisdom to pass on to other transmascs dealing with periods. “You’re not alone,” Jamie said, “and you’re not the only one going through this.” 

Period tips for transmascs, by transmascs 

“Period” was preferred by our respondents, but if it makes you uncomfortable feel free to call it whatever you need. “I kinda will talk about it like, graphically. I’ll just say I’m currently bleeding out. It’s gore,” said one respondent. Another told us, “I just say stomach cramps, because that’s the main issue for me.” Some guys use some creative euphemisms instead, such as lycanthropy, “moon sickness”, organ failure, shark week or even man-stration. You get to control the language around it. 

Managing physically:
Responses varied widely, from “I use tampons - out of sight, out of mind,” to “Pads, because I do not fuck with tampons.” For both tampons and pads, budget brands tend to have more neutral packaging, as do organic eco-friendly ones. The brands Libra, Oi and U by Kotex were mentioned. Reusable cloth pads circumvent packaging altogether, and can be DIYed or purchased. It can be difficult to fit pads with wings into some men’s underwear, but briefs can work, or with cloth pads alterations can be made. Menstrual cups are another option if you’re comfortable with inserted products, as they need to be changed far less than tampons or pads and so are low maintenance. Period boxers for men are hard to find in NZ, but period underwear in boy-short cuts is more readily available. NZ brand Awwa stocks period boxer briefs, and even Kmart has a period shorts option. 

Managing mentally:
Lastly, Critic asked our respondents if they had any tips on coping with period dysphoria. 

“I just generally blank it out, distract myself with other things. It comes and goes.”

“Some people I know talk about periods graphically or as almost a separate entity. If you need to think about it as a separate person that’s okay.”

“I don’t have a huge amount of tips as I struggle too, but I try to be a bit more gentle with myself during that time, especially with studying.”

“I think using a method like tampons or cups helps keep it out of your mind, and trying to reframe it in your mind that this is primarily a function of your body.” 

“Oestrogen is actually at its lowest point in your hormone cycle during your period, so thinking about that helps at least.” 

“Sometimes I think of it as just another gross bodily function. My organs are deep cleaning themselves. Gross. It’s easier.”

“You’re not alone and you’re not the only one going through this.”

This article first appeared in Issue 12, 2022.
Posted 5:19pm Saturday 21st May 2022 by Lotto Ramsay.