Menstrual Dysphoria and Preferences for Menstrual Suppression in Transgender and Gender-Diverse Youth

Menstruation can present a significant challenge for transgender and gender-diverse (TGD) individuals. While menstrual suppression can help alleviate this experience, research on the topic remains scarce. This study aimed to assess menstruation-related discomfort experienced by TGD individuals and to identify their preferences for menstrual suppression methods.

This cross-sectional study was conducted between December 2021 and September 2023 with a sample of TGD individuals (n = 21) aged 12-24, experiencing menstrual dysphoria. Participants completed an initial questionnaire assessing menstruation-related discomfort, followed by counseling on menstrual suppression options, including combined oral contraceptives (COCs), progestin-only pills, depot medroxyprogesterone acetate injection, levonorgestrel-releasing intrauterine device, and the etonogestrel implant. A second questionnaire evaluated factors influencing method preferences and documented the chosen suppression method. Descriptive statistical analyses were performed, with continuous variables presented as mean ± standard deviation and ordinal variables as numbers and percentages.

The conditions most frequently associated with severe discomfort related to menstruation were gender incongruence (81%), the carrying and use of menstrual products (95.2%), and the purchase of menstrual products (85.7%). The most popular method of menstrual suppression was COCs (63.1%). Several factors were identified as influencing the choice of method, including the estrogen content, frequency of use, and the necessity of a gynecological examination or visiting a different health facility.

The study underscores the considerable distress that menstruation can cause in TGD youth. Moreover, the importance of personalized, patient-centered counseling is emphasized, with the objective of empowering individuals to make decisions based on their specific needs.