Conversations About Periods Must Include Trans People

"I felt like my body had betrayed me, the doctors had lied to me and I just felt hopeless."

Kenny Ethan Jones, 27, is a London-based model, activist and entrepreneur. As a trans man, his relationship with his period has always been fraught. Long before he started hormone blockers at 17, he’d felt a strong disconnect when he had his period – "It was automatically like a red alert was going off in my body," he says – but he’d believed that as he got further along in his transition, his menstrual cycle would eventually stop. And it did at first, when he started hormone blockers. But once he started testosterone, the bleeding came back.

"When I started taking testosterone, there's a period in which your body is basically adjusting," Kenny tells R29. "So I started to have a regular but temporary bleed. It probably lasted around six months, which I adjusted [to], but I think that was when I was hopeful and I was feeling happy about where I was in my transition. For me, that was the end of periods as far as I was concerned, and I was always looking forward to that."

Five years later, however, he started having full-on periods again. "Doctors don't really have an explanation why," he says, "because there's never been enough research into trans bodies." The doctors checked his testosterone levels to make sure everything was alright on that front, which it was; beyond that, they couldn’t offer an answer as to why this was happening. "So now I still have on and off periods but they're not as predictable – I wouldn't say it’s a regular monthly cycle. I'm just coming to terms [with the fact] that as long as I have my womb, that's going to be a part of my journey and my existence."

Periods are a part of life for many (but not all) people who were assigned female at birth (AFAB), a group that includes cis women, trans men, trans masc people and non-binary and genderqueer people. Yet what we are taught in school and what we can infer from the culture around us severely limits how we see menstruation and who we think experiences it. Our understanding of the menstrual cycle is limited to a monthly bleed and how it functions in the reproductive system, often eliding the messy reality and firmly establishing it as a 'women’s problem'. Meanwhile understanding and education about gender beyond a strict gender binary is still reserved for the margins of society. This all compounds to further exacerbate the shame that already surrounds periods for everyone who experiences them. And for AFAB people who aren’t women, that shame exacerbates their complicated feelings around periods.

Jamie Raines, 27, is a trans activist and content creator from Essex. Like Kenny, he says that his experiences of bleeding before transition felt completely wrong without fully understanding why. "On the one hand, people had told me that [my period] was going to happen so of course, that's what's happened," he explains. "But on the other hand, it just felt so at odds with how I felt inside. It's such an abstract concept to describe, but it just made me feel like my body was doing something wrong." While he acknowledges that no one who experiences periods likes them particularly, he found them incredibly triggering for his gender dysphoria.

"[Periods] were something that I struggled with," he adds, "and I didn't realise why until I found out I was trans, and there was this extra layer of internal difficulty I was having with accepting that this is what my body was doing." Once he was out, the difficulty shifted. "I still had all these internal things but there were all these outward messages [conflicting with my experience]. There were no [sanitary] bins in men's public toilets, all the pads smelled really flowery and they're all aimed towards women. So it felt like this extra [barrier]. Not only am I telling myself that this shouldn't be happening but I'm being told by the outside world [that] it shouldn't be happening as well."

Jamie doesn’t experience bleeding anymore but he does still experience other symptoms associated with a menstrual cycle as he hasn’t had a hysterectomy.

"I've been on testosterone for over nine years now and I still feel like I go through some kind of cycle (though not as regularly). I still experience some of the things I used to experience when I had a period in terms of cramping and things like that, and I notice with my partner we sometimes match up a little bit on our moods."

Likewise, Kenny has what he calls 'internal periods' as well as minimal bleeding. "The emotional swings, bloating, fatigue: all of those things that I was having when I had a 'regular period' pre-medication is still what's happening now." The struggle comes not just with navigating the symptoms but the fact that there is no medical understanding as to why this is happening to him, or any accessible support.

"Even when I'm explaining it to my doctor and going to trans specific clinics, they can't give you the answers because they don't know. They want to support you in the best way and they've tried putting me on [a version of] the pill that doesn't contain oestrogen which has slowed down the bleeding, but I'm still having leakage here and there."

Kenny says that this is a fact of life for trans people. There is no research into trans bodies, very limited access to medical support – the ongoing scandal of the waiting lists for access to Gender Identity Clinics in the UK, with the NHS "currently booking appointments for people who were referred to the service in October 2017", affects trans people for life, not just when they start to transition – and sparse representation of what you should expect your life to be. All you are told, says Jamie, is that taking testosterone should stop your period and if you don’t have a hysterectomy after five years, you should get a scan every two years to check for ovarian cysts.

This can coalesce into an expectation that transitioning will put a stop to your period and your menstrual cycle. "I think a lot of people go into starting testosterone thinking that they're never going to have another period again once they take their first shot of T or get their first prescription," says Jamie, "not realising that even if it does stop quite quickly for you, it's probably not going to happen within the first few months." And as in Kenny’s case, there’s no guarantee that it won’t come back in some form.

"It just feels like an area in which I thought there would be more support, because this would never be acceptable for cis bodies but it is for trans bodies," Kenny adds. "And no one wants to put the money in to actually do the research to find out."

When it comes to menstruation, we are a long way from breaking the taboos or alleviating period poverty on a societal level. In some ways, it’s no surprise that discussions around periods are so lacking for people who aren’t cis women – the discussions are fundamentally lacking for cis women, too.

But when we position periods as something integral to womanhood and something that only women experience, it does nothing to support women. It just makes life harder for everyone.

"If we were to take trans people out of the conversation and just talk about cis women experiencing periods, no cisgender woman is always going to experience a period," says Kenny. He points to pregnancy, menopause, endometriosis and eating disorders as examples of things that change or stop a person's periods – and by the 'period = woman' logic, that would stop them being a woman. But it doesn’t. This is not to dismiss people who feel that menstruation ties them intimately to their womanhood; as Kenny puts it: "If that's what feels comfortable for you and you want to align yourself with that narrative in terms of saying that a period makes you a woman, who am I to take that away from you?" It only serves to point out that trying to define womanhood as tied to periods and therefore suggest that periods can only happen to women is far too narrow a definition.

Clearly, there needs to be a change in how we talk and think about menstruation for the sake of everyone who experiences periods. That change doesn’t come by ‘erasing’ the idea that periods are experienced by cis women – it comes from broadening the conversation and showing the range of experiences.

"I think it's about creating different narratives and allowing people to choose what narrative fits well for them," says Kenny. "For me, I don't see periods as a woman's thing, I just see it as a bodily function that I happen to experience because of my gender. But I think the more stories, the more narratives that are out there, the more that people can align with the version that feels right for them, and that makes them more comfortable and that just leads to better mental health."

Part of broadening those narratives is to remove explicitly gendered language, particularly when it comes to menstrual health products. 

"A big first step that we can take is neutralising the language used in conversations around periods," says Jamie. He points to product lines like Cycle by Freda, which has completely neutralised packaging, as a great example. "I think by stripping it back, sending out something that's neutral and not specifically for a certain group of people, sends out the implicit message that periods are experienced by a broader range of people than we initially thought." Including all people who experience periods in products and advertising is part of a subtle shift in how periods are viewed. And that can positively impact everyone who feels alienated by the more delicate, floral, explicitly feminine branding of period products – from butch women to genderqueer people to trans men.

These kinds of changes are not antithetical to fighting for period justice but a part of it – by destigmatising periods for all, we can push for better access to products and help to alleviate the shame that still clouds menstruation. What's more, it will add to the pressure to put more money into researching and supporting trans bodies when on a basic level more people recognise that periods don't just affect women.

As for those who think broadening the conversation is taking up 'women’s space'? "The kind of argument I always hear is when you go neutral, it becomes about men," Kenny says. "But men are never going to be the centre in a conversation about periods, it's never going to happen, statistically. Trans people are only 1% of the population." He continues: "Opening a door to gender and accepting people for who they are... I don't know what they think is gonna happen. I just think that people will be happier."