Menopause Beyond the Binary- Supporting The LGBTQ+ Community

We can be better allies to the LGBTQ+ community by creating inclusive spaces that centre listening, learning, and standing beside those whose experiences differ from our own. Small actions, like using correct pronouns and challenging outdated assumptions, help make menopause support truly inclusive for everyone.

June is Pride Awareness Month, a time to celebrate, honour, and uplift the LGBTQ+ community. At Menopause Unmasked, inclusivity is at the heart of everything I do, and that includes recognising that menopause doesn’t look the same for everyone.

It’s vital that support reflects the diverse experiences of all people, including those who are trans, non-binary, and gender-diverse. Whether you’re experiencing hormone changes yourself, supporting someone who is, or simply wanting to learn more, this month I’m sharing insights and tools to help everyone feel seen, respected, and empowered.

Most menopause advertising, research, and marketing are still centred on white, cisgender women, yet even within that group, the frustration around lack of support is significant. For minority communities, including LGBTQ+ individuals, the visibility, understanding, and access to care is even more limited. This needs to change and fast.

Anyone with a female reproductive system who hasn’t had surgical intervention will experience menopause eventually. Around 75% will have symptoms significant enough to notice. But how those symptoms present and how they’re managed, varies greatly depending on each person’s biology, hormone history, and identity.

Transmasculine people can experience menopause, and like anyone else, their journey is unique. For those with ovaries, menopause may occur naturally with age, be triggered by testosterone therapy, or happen after surgical removal of the ovaries. While testosterone often stops menstruation, ovulation can still happen, even without a cycle, so contraception is still important if pregnancy is not desired.

Trans women don’t go through menopause in the traditional sense, as they don’t have ovaries or a uterus. However, they can still experience menopause-like symptoms, often related to fluctuating oestrogen levels from gender-affirming hormone therapy (GAHT) especially when doses change or are stopped for any reason. Importantly, it’s no longer considered risky for most trans women to take oestrogen long-term, so menopause doesn’t need to be medically induced.

Testosterone therapy can also cause menopause-like symptoms in transmasculine people, such as hot flushes, hair thinning, vaginal or front-hole dryness, and mood shifts, due to a drop in oestrogen.

As with all things menopause, an individualised, multidisciplinary approach is best, one that centres your health and respects your identity.

Tips for Navigating Menopause as a Trans or Non-Binary Person

Your body deserves to be heard. If you’re experiencing new symptoms or discomfort, it’s a sign to pay attention, there’s often something that can be done.

Talking about menopause can feel overwhelming or dysphoric, especially in medical settings. Here are a few ways to feel more in control during appointments:

• Decide ahead of time what language feels right for you (e.g., “front hole” instead of “vagina”) and let your healthcare provider know.

• Write down your symptoms or questions in advance or even hand them over to be read if speaking feels too hard.

• Bring a trusted friend or partner to advocate with you and offer support.

You’re not alone, and you deserve care that acknowledges your whole self.