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How Transgender Men & Women Experience Menopause

At Elektra Health, we strive to provide inclusive menopause education, support, and care to ALL individuals with ovaries — and that includes transgender people. Because while menopause care is taboo, transgender menopause care is shrouded in even more stigma, not to mention the fact that the healthcare system is largely unfamiliar with this population’s unique health needs.

Everyone’s menopause experience is unique and deserves to be acknowledged and supported. That starts with education — on both the physical and emotional changes that occur during this transition which, without proper treatment, can impact one’s quality of life.

While Elektra does not currently provide transgender or gender-affirming hormone therapy, we are dedicated to creating a safe, welcoming environment for all individuals seeking menopause support.

A terminology refresher

  • Trans man: individual who is assigned female at birth but who lives and identifies as a man
  • Trans woman: individual who is assigned male at birth but who lives and identifies as a woman
  • Gender nonconforming: individual whose gender identity or gender expression differs from the gender norms associated with the sex they were assigned at birth
  • Gender dysphoria: discomfort or stress caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)
  • Cisgender (cis) person: individual who identifies with the sex they were assigned at birth (example: cisgender women are assigned female at birth and identify as women)
  • Non-binary people: individuals whose gender identity isn’t exclusively male or female

Note that while some transgender people choose to undergo gender-affirming surgery, not all do.

How transgender men experience menopause

While there is not a huge amount of data on how trans men experience menopause, evidence points to the hypothesis that they do. Despite the fact that testosterone is a lifetime treatment, it does not suppress all menopause symptoms. Because trans men are biologically female, there will be a menopause transition.

Also, some transgender men may be taking or have taken pre-pubertal blockers (GnRH analogues) that, as a result of ongoing treatment, cause lower oestrogen levels to prevent ovulation. The result: medically-induced menopause with the hallmark symptoms (weight changes, hot flashes, increased risk of osteoporosis, etc).

How transgender women experience menopause

According to the North American Menopause Society, an estimated 71% of transgender women use or intend to use gender-affirming hormone therapy (GAHT), with 25% beginning treatment after the age of 40 and 12% beginning after age 50.

When trans women stop hormone treatment, their bodies react the same way as those of cis women because both involve a sudden drop in estrogen levels. As such, they experience typical side effects and symptoms of menopause (hot flashes/night sweats, mood swings, sleep difficulties), even if the root cause differs.

Some transgender women choose to gradually lower their estrogen dose as they age. This can also trigger menopausal symptoms, although less severe if their body is still producing testosterone.

Additional resources on transgender menopause

  • All-Gender Peri/Menopause Support Facebook Group
    “This is a peer-to-peer mutual aid support group for all kinds of people currently going through, or who have gone through, all kinds of perimenopause and/or menopause, including as part of an aging process, due to hysterectomy or oophorectomy, or cancer treatment, discontinuation of HRT (including for trans women) and via other routes to these experiences.”
  • Provided: A Gender-Inclusive Guide To Pelvic PT
    On this podcast, two clinical experts (Dr. Uchenna, and Alex Papale, DPT) reflect on the sexuality education that has informed their treatment approaches, and a trans patient opens up about his experience navigating pelvic floor pain with providers who weren’t sufficiently informed about how to provide adequate treatment.
  • Queer / LGBTQIA+ Menopause
    This site was created by Tania Glyde, a London-based psychotherapist and counselor who works mainly with clients who identify as GSRD (Gender, Sex, and Relationship Diverse). Motivated by the lack of inclusive menopause information, Tania set out to create and promote additional resources for LGBTQIA+ people in menopause, along with education for therapists and healthcare practitioners.
  • Human Rights Campaign: Get the Facts on Gender-Affirming Care
    Answers to frequently asked questions about what gender-affirming care is, what it’s not, and why it’s life-saving.

How to find doctors trained in transgender health

Interested in learning more about hormone replacement therapy and other evidence-based interventions for menopause? Here are some helpful resources focused on inclusivity for the transgender community: