Yes, Men Can Have Periods and We Need to Talk About Them

I haven’t menstruated in three years. I’m fortunate to be one of the trans guys whose periods stopped when I started taking testosterone.

This is by no means a universal experience even among trans people taking testosterone, and many of my peers have either continued menstruating or have endless spotting. Many others don’t take testosterone, either because it isn’t right for them, or because the health care system has kept them waiting.

Recently, the corner of Twitter interested in feminism and gender diversity had a row over transgender inclusion. This has been an issue in feminist circles for many years, as people negotiate who is inside and who is outside the sphere of feminists’ concern. On Twitter these kind of boundary disputes have been a perennial issue.

In this case, the trigger was the trending hashtag #ifmenhadperiods. Meant to highlight the ways that sexism plays out around the topic of menstruation—such as through a lack of medical progress or material support—it was roundly criticized for being both inaccurate and oppressive. Why? For starters, some men do have periods—and many women don’t.

Planned Parenthood got involved in the discussion, using the term “menstruators.” Some disliked this term, arguing that sanitary products are a women’s issue, and that it is dehumanizing to refer to women as “menstruators.”

This is an understandable objection to an inelegant term, if one accepts the premise that sanitary products are only for women. However, the term is an attempt to find language that’s inclusive.

We do not need to hypothesize what the world would be like if men had periods. Some men do have periods, as do some non-binary people.

Once in awhile, I hear stories of people whose periods started again after many years on testosterone. I dread it happening to me. It’s not clear why this happens, but it’s typically a sign that one’s hormone replacement therapy (HRT) needs changing.

Contrary to some contributions to that unfortunate hashtag, menstruating when trans is, on average, pretty terrible—for a number of reasons.

We pay the same luxury taxes as everyone else—even though we make less money.

One argument made in #ifmenhadperiods is that the luxury tax on sanitary goods would not exist if men had periods—after all, razors are usually taxed as essentials, despite being arguably less essential than the “luxury” of keeping clean during your period.

Unfortunately, trans people pay the same luxury goods taxes as everyone else, but they’re statistically less likely to be able to afford it—in the US, 15 percent of trans people (16 percent of trans men) earn less than $10k a year, compared to four percent of the general population.

Trans “menstruators” are more likely to be homeless.

Even if sales taxes on sanitary products were lifted, it would only make a small dent in the impact that menstruation has on the lives of people in severe poverty. There has, thankfully, been more discussion lately about how hard it is to have a period when you live on the street. Some organizations have started helping homeless people with period supplies, such as Conscious Period in California and The Homeless Period in the UK.

With trans people twice as likely to be homeless than the general population, they struggle more to afford sanitary items. They are also less likely to have access to a private space to change pads or tampons, or to empty a menstrual cup.

If advocacy for people who menstruate aims to help the most vulnerable, then it must include people who are dealing with their period in these very difficult circumstances, including not just homeless cis women, but homeless trans people.

Support comes at the cost of denying who you are.

I remember being congratulated when my period started, because “it meant I was becoming a woman.” This felt like cold comfort when I was in physical agony and psychological distress because the entire experience seemed like it was fundamentally wrong. It wasn’t until later that I made sense of that “fundamentally wrong” feeling as part the pervasive gender dysphoria that would not change until I transitioned. The idea that my period “made me a woman” was echoed every time I sought support for debilitating period pain.

Having my gender incorrectly guessed is a fairly common occurrence, but it does make me less likely to ask for help if my period should strike. For trans men who keep their trans status private, the problem is even worse. Asking for help would require explaining things about themselves that they might rather keep private.

The health system ignores us when we need help.

The thought of having a period again terrifies me not just because of the dysphoria and unbearable physical pain I used to experience when menstruating, but because I believe the medical system would do little to help me.

Let’s face it: the health system is woefully inadequate when it comes to dealing with any kind of problematic menstruation, no matter the gender identity of the person experiencing it. Dysmenorrhea (painful periods) is poorly understood because research into the problem does not receive the funding it needs. Nobody is certain why it happens, and methods for best treating it are not always communicated well.

Before I transitioned, it took almost 10 years of painful periods before I received pain management that worked more than half of time. My experience is far from rare, with huge numbers of people having to put their lives on hold simply because they’re menstruating. Endometriosis and reproductive cancers often go undetected and untreated because reproductive and menstrual pain simply aren’t taken seriously.

Compounding that problem, trans people face huge barriers to getting good health care. These include problems arising from insurance companies and state health systems that make it difficult or impossible for a man to receive anatomy-appropriate sexual health care if he has a womb and cervix. American health insurance companies have a bad record for this historically, though in recent years new regulations have slowly changed things. Under the NHS in the UK, trans men are not automatically invited for cervical cancer screenings, and instead must persuade their doctors to provide them.

This is a difficult prospect, since trans people also very commonly experience harassment, unfair treatment, and even assault from intolerant doctors—most of whom have not received any trans-specific training. One in five trans men in the US has been refused care due to their identity, and half have postponed doctor’s visits due to discrimination. At least one has died due to a reproductive cancer that doctors refused to treat because of his trans status.

Frequently, we end up educating our own doctors about our bodies, and not all doctors are particularly enthusiastic about receiving biology lessons from an untrained member of the public.

This reality is treated as politically inconvenient.

Trans people who want to talk about menstruation and reproduction without giving up their identities have become a bit of a political scapegoat in certain strands of feminist discourse.

When the general needs of people who menstruate are of concern, it is vital to talk about people who menstruate, rather than shut out people who need support simply because they are not women. Solidarity between women who menstruate is vital, but there also need to be initiatives that aim at meeting the needs of all people who menstruate.