Improving menstrual equity in the USA: perspectives from trans and non-binary people assigned female at birth and health care providers

Abstract

Menstruation research has largely focused on addressing menstrual management barriers facing cisgender women and girls in low and middle-income countries. Scant literature has assessed the menstrual management needs of trans and non-binary people assigned female at birth. To better understand these frequently invisibilised menstruation-related needs, we conducted a multimethod qualitative study in New York City which included: 17 indepth interviews across trans and non-binary people (n ¼ 10) and health care providers who serve them (n ¼ 7); and seven anonymous post-interview participatory writing responses with trans and non-binary participants to further elucidate their lived experiences with menstrual management. Lack of health care provider transgender competency, public toilet design (i.e. gaps in cubicle doors and lack of in-cubicle menstrual product disposal bins), and the social dynamics of public toilets (i.e. work and school) were identified as significant barriers to managing menstruation safely and accessibly for trans and non-binary people. These findings have important implications for healthcare policy, public toilet legislation and advancing menstrual equity in the USA.

Characteristics of Menstrual Suppression and Its Association With Mental Health in Transgender Adolescents

“…We were not able to determine the reasons behind this distress, but studies in TGD adults have shown that the use of menstrual products, experiencing menstrual symptoms such as dysmenorrhea or breast tenderness, and using male public restrooms in the absence of appropriate sanitary item disposal facilities can cause dysphoria. 6,19,20 In our study, 24.7% of adolescents were on menstrual suppression at their initial visit to our gender service. In a retrospective study of 133 TGD adolescents, Schwartz et al 10 reported that 14% were on menstrual suppression at their initial visit to their gender clinic, a rate that is similar to the 14.4% that we previously observed at our institution during the initial introduction of FASST.…”

What can Australian schools do better? Supporting students during menstruation

“…No gender diverse individuals reportedly participated in this study, although the perspectives of transgender students are important. More research is required on the experience and needs of this group who may experience a range of menstruation-related stressors at school not experienced by cisgender female-identifying students (Lane et al, 2021).…”

Use and perceptions on reusable and non-reusable menstrual products in Spain: A mixed-methods study

“…The use of toilet paper and not using products to manage menstruation was significantly more common among trans people and non-binary people, compared to cis participants and those identifying their gender as women. Acknowledging the needs and preferences of trans, intersex and non-binary people who menstruate is crucial [ 25 , 26 ]. Besides, distress among non-binary, intersex and trans people who menstruate resulting from packaging and advertising of menstrual products portraying menstruation as to represent “hegemonic femininity”, and the fact that many menstrual products need to be inserted in the vagina has already been discussed [ 27 – 29 ].…”