Abstract
Study Objective
To describe menstrual history, associated dysphoria, and desire for menstrual management
in transgender male and gender diverse adolescents who were assigned female at birth
Design
Retrospective chart review
Setting
Tertiary care children's hospital
Participants
All patients seen in a multidisciplinary pediatric gender program from March 2015
through December 2020 who were assigned female at birth, identified as transgender
male or gender nonbinary, and had achieved menarche
Intervention
None
Main Outcome Measures
Patient demographics, menstrual history, interest in and prior experiences with menstrual
management, parental support, and concerns about menstrual management
Results
Of the 129 included patients, 116 (90%) identified as transgender male and 13 (10%)
as gender nonbinary, with an average age of 15 (SD 1.6) years. Almost all (93%) patients
reported menstrual-related dysphoria. Most (88%) were interested in menstrual suppression.
The most common reasons for desiring suppression were achievement of amenorrhea (97%)
and improvement of menstrual-related dysphoria (63%).
Conclusions
Most gender diverse patients assigned female at birth reported dysphoria associated
with menses and desired menstrual suppression. This information can encourage physicians
to raise this topic and offer menstrual management for gender diverse patients who
experience distress related to menses, especially for those who are not ready for
or do not desire gender-affirming hormonal treatment. Future research is needed to
better understand patients’ experiences with menses and to determine the optimal menstrual
management methods. This could be an important intervention to improve outcomes for
this vulnerable population.
Key Words
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Article info
Publication history
Published online: February 02, 2022
Accepted:
January 28,
2022
Received in revised form:
December 19,
2021
Received:
October 18,
2021
Footnotes
Declaration of Competing Interest: All authors have no relevant conflicts of interest to declare.
Funding Source: This research was supported by internal funding from a Jefferson Pediatric Award for Clinical Research.
Prior Presentation: Some of these data were presented as an oral presentation and poster at the 2021 American Academy of Pediatrics National Conference in Philadelphia, PA, in October 2021.
Identification
Copyright
© 2022 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
