We need to talk about the LGBTQ+ menopause experience

Megan Sutton
·6-min read
Photo credit: Getty Images
Photo credit: Getty Images

From Good Housekeeping

Going through perimenopause and menopause can be a difficult time for many people, with debilitating symptoms and stubborn stigma attached. There’s lots to be done to improve menopause care, including making it accessible for people of all genders and sexualities. It’s vitally important as the number of people who identify as LGBTQ+ is increasing. For clarity, LGBTQ+ is shorthand for people who identify as lesbian, gay, bisexual, transgender, queer and more minority gender identities and sexualities.

Photo credit: Hearst Owned
Photo credit: Hearst Owned

The government estimates there are currently 200,000 to 500,000 trans people in the UK. In 2016, The Guardian found the number of people undertaking gender confirmation treatment had risen dramatically in recent years with some clinics experiencing case increases of several hundred per cent. More people are also identifying as lesbian, gay or bisexual, rising from 1.6% in 2014 to 2.2% in 2018. These figures suggest that in the future, there will be more people who identify as LGBTQ+ experiencing menopause.

Menopause conversations are often had in a way that’s heteronormative – assuming that being straight is default. When symptoms can directly impact relationships and intimacy, this can exclude those in same-sex relationships from receiving support that’s right for them.

Jane, 52, started experiencing a change in her periods when she was 49 and since then, has been accessing menopause treatment. Jane’s libido hasn’t changed and she and her wife have maintained a regular sex life, however, she feels that if she did need to access advice about that, she wouldn’t turn to her GP.

Photo credit: Hearst Owned
Photo credit: Hearst Owned

“[Mainstream advice] is more about penetrative sex, and obviously lesbian sex isn’t just around that at all,” she said.

“If we were having any problems with sexual stuff, I’d be more inclined to see a therapist and access my own information online. I can’t see me sitting [and talking to a GP] – and I am quite confident and assertive.”

Jane has noticed that healthcare posters and leaflets she’s accessed don’t seem to openly recognise diversity in sexuality.

“I've not had anything that’s said: ‘We appreciate all women are different’ or ‘All women will have different relationships.’ There isn't an acknowledgement. [It feels like they’re saying]: ‘You’re a woman, in her late 40s or early 50s who’s going through the menopause. Never mind sexuality or whatever, there are no variations,’” she said.

Despite menopause usually being talked about as something that only affects women, it happens to people of differing genders, including trans men, who were assigned the female gender at birth, and non-binary people, who identify as neither male nor female.

Some of these people experience a severe unease, known as dysphoria, when something – like menopause - happens to their bodies, acting as a reminder of the reproductive system they were born with and the gender they don’t identify with. They might avoid medical help altogether because it’s just too difficult to talk about.

Sam*, is a 36-year-old trans man who’s currently waiting for a hysterectomy that was delayed due to the pandemic. As well as taking testosterone, Sam receives injections to block the oestrogen production in his body. If his testosterone supply were to be paused (something that’s become a real threat due to Brexit import changes) he wouldn’t have any sex hormones and would begin experiencing menopause symptoms like hot flushes, describing this an “anxiety-inducing”.

Sam says the dysphoria he feels when accessing healthcare related to issues typically deemed ‘women’s health’ is “awful”.

“I’m forced to confront the fact that my body doesn’t naturally produce testosterone, but it does produce oestrogen. I experience a lot of dysphoria about that,” he said.

According to Tania Glyde, a psychotherapist and counsellor whose research has explored LGBTQ+ people’s experiences of menopause, a lack of training for GPs means they’re not able to deliver the right advice and support.

Photo credit: Hearst Owned
Photo credit: Hearst Owned

“People may simply avoid going to the doctor because it is not worth the bother. This means they may miss out on medical treatment and support that would greatly improve their lives,” she said.

Dr Kamilla Kamaruddin is a GP, trans woman and advocate for improved LGBTQ+ healthcare who agrees there is a lack of trans awareness and education that needs to be worked on. As a patient, Dr Kamaruddin has issues accessing healthcare herself.

“I’m a GP myself and there’s a GP I just don’t want to see… I will only call my surgery on a Thursday because there’s a GP who understands me [working that day]. Sometimes I will delay going to my GP for two to three weeks because the quality I’m comfortable with comes on Thursday. I think it’s quite unfortunate that even as a GP, I feel this way,” she said.

A way to make sure everyone feels seen and heard when discussing menopause in healthcare settings and more generally is inclusive language. This includes using correct pronouns for individuals (e.g he and him; they and them) and the word ‘people’ rather than ‘women’ when talking about the overarching group who can experience menopause.

“GPs surgeries are sometimes the first point of call for trans people and it’s very important that GPs have necessary training about trans awareness and using the right pronouns,” Dr Kamaruddin said.

Tania explained that inclusive language is about “showing the public that all people are equally prioritised rather than just the majority. By using the word 'people', we are inviting in, rather than excluding.”

When people don’t use inclusive language, it can have a damaging impact.

”It makes you feel ignored or invalidated. You think ‘I’m going through that’ or ‘I could go through that’ but I’m not a woman,’” Sam said.

“I think sometimes people think: ‘He’s saying that no one can ever say women go through the menopause’. No one’s saying that at all, of course you can refer to women going through the menopause. But if you’re taking about a group of individuals, that’s ‘people’ going through the menopause,” Sam added.

In a world in which the LGBTQ+ community is growing in visibility, thinking and speaking about menopause in a way that’s inclusive of everyone will only help more people to access the help they need at a difficult time. As open discussion around menopause continues to get louder, let’s make sure everyone’s part of the conversation.

You can find more information and support related to the LGBTQ+ menopause experience at Tania's website Queer Menopause.

*Name has been changed

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