A Pride Month special blog! 🌈

This blog post mentions gender dysphoria and suicide which might be triggering.

There is a lot more to being a male or female or any other gender than the sex assigned at birth. Anyone’s biological or assigned sex does not always tell your complete story.

People often get confused between the terms sex, and gender. But they are actually all different things.

• Sex is a label — that you’re assigned by a doctor at birth based on the genitals you’re born with. It goes on your birth certificate.
• Gender is much more complex. Gender or gender identity is a social construct and how society has distributed roles for the particular gender. Gender identity is defined as an internal sense of being male, female, neither of these, both, or another gender(s).

Not all women menstruate and not everybody who menstruates is a woman.

Some cis-gender women (assigned female at birth) don’t have periods due to menopause, stress, disease, hysterectomy or any other conditions. They may have never started menstruating due to a variety of medical conditions. At the same time, there are people who menstruate who aren’t cis-women. They might be trans men, intersex, genderqueer or nonbinary.

Periods have always been thought of as a feminine phenomenon, and are often seen as a symbol of femininity. Yet there are many around us who do not identify as female, and yet menstruate monthly. The period care products sold across the world are termed as feminine hygiene products instead of menstrual hygiene products which excludes people from trans and non binary communities who experience menstruation but do not identify themselves as women.

Trans men (those who are men and have female genitalia at birth) and non-binary or genderfluid individuals (those who do no conform to an exclusively male or female gender) also experience periods! Trans women on the other hand, do not undergo menstruation but they can experience premenstrual syndrome due to hormone therapy that they may be undertaking.

This Pride Month, we at Project Baala want to address menstruation as a biological process and not as a “woman thing” — a dialogue around gender-neutral menstruation. Menstruation is a biological function and as an experience, it can be highly variable and mean different things to different people.

We must demystify and destigmatize menstruation without shutting anyone out. It can be incredibly empowering to exchange ideas, experiences and information about how trans individuals and nonbinary people experience periods.

This Pride Month, we want to make periods more inclusive for all menstruators!

Experiences

Transmen, some intersex, genderqueer and nonbinary people undergo periods in the same way that cis women do, but in some cases their experience can often be difficult and traumatic.

As menstruation is often seen as a feminine occurrence, those who undergo gender reaffirmation surgery to transit from sex assigned at birth to the gender they identify with they may often experience gender dysphoria due to their periods. Gender dysphoria is defined as “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.”

Some commentators have said their dysphoria gets amplified during their periods, and in the same article, one respondent said they face suicidal ideations during this time due to the effects of the dysphoria.

An article in Forbes magazine cites a survey which says about 27% of trans people surveyed said that their periods cause mental health issues such as anxiety and stress.

Even though transitioning itself has been reported to induce many positive effects, including better mental health, optimistic outlook to life, etc, this may not always be the case.

In addition to gender dysphoria, transpeople and nonbinary people often face discrimination with families and societies and this can amplify psychological pain and difficulty. If a menstruator has pre-existing conditions like PCOS, this can add considerable physical and psychological difficulties.

The Way Forward

While transmen and nonbinary people may undergo varying difficulties during periods, there are some steps that can be taken to alleviate a portion of the pain.

The first and most simple way would be to educate. Trans-menstruators feel the same pain and discomfort during menstruation, but often find it difficult to speak about it with family, friends and doctors, due to societal non-acceptance of their identity. Therefore providing emotional support and being an ally can go a long way.

Building a more inclusive medical support and hygiene infrastructure. Medical professionals should be taught gender in a non-binary fashion. In order for transgender people to feel comfortable accessing health care in India, there needs to be an overhaul at all levels of the system — as discrimination exists at all of those levels. It’s a combination of problems — no acceptance of trans bodies because there is no knowledge of trans bodies, no education. Therefore, there is no infrastructure that supports transgender people.

In a country like India, where menstruation is still considered a taboo and transitioning is far from being accepted in society, the role of support, gender sensitivity and education becomes even more imperative.

Marketing also plays a great role in normalizing transpeople’s experiences. In the United States, many menstrual product companies have now changed their marketing to make them more gender inclusive. For example, popular sanitary pad brand Always decided to remove the “female symbol” (♀) from their packaging to make it more inclusive. In India, there are a lot of brands such as Boondh and Rio working towards inclusive dialogue towards menstruation.

Last but not the least, use gender inclusive language and refer to an individual with the pronouns they would like to be referred to by, as this may also have a positive impact.

About the Author — Drupad is an intern with Project Baala. When he isn’t working, you will probably find him cooking, reading a book or petting his neighbour’s cat.

Khushali (Strategic Alliance & Partnership Lead) — Khushali is an engineer with a rich experience in working with communities, non-profit and brings experience of working in various women health startups. She has experience across fundraising, partnerships and brand building.