As a transgender man or non-binary person, you may find it challenging to find gender-affirming and informed healthcare as you approach menopause. But there are strategies to help.

Most people assigned female at birth were born with ovaries and are able to go through menopause. That’s a little more than half of the world population, according to population estimates.

That group of people includes trans men and many other non-binary folks.

The challenge is, menopause healthcare has been designed primarily for cisgender women. But folks assigned female at birth who do not identify as women also need menopause care that meets their needs.

Gender-affirming care is healthcare that affirms and supports a person’s gender identity when it’s different from the sex they were assigned at birth. It can include physical medical care, mental health care, and more.

Gender-affirming care saves lives and is essential to the well-being of trans and non-binary folks, studies have shown.

Nonbinary- and transgender-focused care is essential because all people deserve to feel respected and taken care of whenever they seek medical help.

Inclusive language is key

It’s important for healthcare professionals to use inclusive language. In doing so, they help trans men and non-binary people access the care they need. If healthcare language doesn’t take these individuals into account, they risk losing their access to healthcare completely, experts say.

For example, if your doctor doesn’t talk about gender in an inclusive way — taking trans people into account — it may make you feel dismissed and discourage you from seeking healthcare entirely.

If you already experience gender dysphoria, then it may feel like the last straw when a doctor uses language that makes you feel misgendered or invisible.

Some trans and non-binary people opt out of going to the doctor entirely, according to experts.

They should understand hormonal changes trans folks may go through

What is menopause, exactly? It’s the time of life when someone’s period (menstrual cycle) ceases entirely. If you’re trans or nonbinary and you haven’t had any surgeries or gender-affirming HRT, you may expect menopause to start between ages 45 and 55.

Trans men and non-binary people may have physical and hormonal differences from cisgender women.

Medical professionals should know about these differences and ideally have experience with people who have them, so that they can provide identity-affirming care.

As a trans man or nonbinary person, your choices and outcomes going on hormone therapy for menopause might be different than those of ciswomen, and you may need different kinds of support.

For example, you might choose to take testosterone instead of estrogen to help align your body with your gender. Or you might choose to go on the usual hormone therapy for menopause, taking estrogen to relieve symptoms, but you might need more emotional and mental health support.

Your healthcare team should be aware that sometimes those who have medically transitioned before the menopausal age don’t go through traditional menopause. That’s because the effects of the gender-affirming hormone therapy, which many people take for life, can affect menopause.

An informed healthcare professional should consider how the outcomes of your gender-affirming hormone therapy might affect you through menopause, as well.

For example, if you’re taking testosterone over a long time period, you may experience vaginal atrophy, pelvic pain, or both. Experienced healthcare professionals will be able to provide ways to minimize your symptoms.

When you’re looking for a healthcare professional who specializes in menopause care for trans and non-binary people, make sure that they’re LGBTQIA+-friendly, if not LGBTQIA+ themselves.

Green flags

Other green flags to look out for include:

  • specific inclusive language on the website or in their clinic
  • gender neutral restrooms in their clinic
  • being a member of World Professional Association for Transgender Health (WPATH)
  • having pronouns visible
  • having past experiences with trans patients

Healthcare professional directories and other resources

When you’re reviewing potential trans-friendly healthcare professionals, look for those who specialize in gynecology, menopause care, or both.

Visit these websites to search for trans-friendly healthcare professionals and find other resources:

Once you find a healthcare professional you think might be a good fit, you’ll want to have an initial appointment with them.

Here are some questions you may want to ask — tailoring them to your own needs and situation:

  • What can I do to improve mood changes from menopause?
  • Should I start hormone therapy for menopause?
  • What kind of menopause symptoms will hormone therapy treat for me?
  • What kind of hormones should I be taking?
  • What can I do if I’m having trouble sleeping?
  • Will it affect my sex drive?
  • What happens if I start having sexual problems? And how do I know that’s happening?
  • Will a hysterectomy cause menopause?
  • Should I get tested for specific cancers?
  • Should I take any natural supplements to treat my symptoms?
  • I haven’t had a period in years. Will I ever go through menopause?
  • Do I still need Pap tests and mammograms after menopause?
  • Could my hormones affect me in a negative way?
  • Could I have gender dysphoria? What happens if I do?

Finding comprehensive healthcare as a trans or non-binary person can be frustrating and discouraging.

But you’re not alone, and there are knowledgeable, caring healthcare professionals out there who will take you and your health seriously.

You have the right to ask for the things you need, including the medical professionals who take all of your health concerns seriously and who will affirm your gender when you’re going through menopause.