The Queer Side of Menopause -

Menopause is seldom discussed in our society. There are no renowned movies, bestselling books, celebrated conferences, posh coaches, or well-known classes that focus on this life change, despite the fact that approximately 2 million Americans experience it every year.

For people with ovaries, menopause is a natural process that officially starts after a person has gone 12 months without their period. This usually takes place around the age of 51, though age varies widely among those who experience it. Symptoms often start years before menopause occurs, in a phase known as perimenopause. During this time, people may experience hot flashes, brain fog, joint and muscle pain, vaginal dryness, decreased libido, trouble sleeping, and increased irritability.

For those within the LGBTQ+ community, this change can come with added difficulties. Menopause is caused by a natural drop in estrogen, a change that impacts many nonbinary folks, cisgender women, and trans men. Across the vast spectrum of gender expression and sexuality, menopause will affect everyone differently. Surgeries and hormone use ultimately determine how each person experiences—or bypasses—menopause. For example, trans men and nonbinary folks with ovaries who take higher doses of testosterone are less likely to experience menopause.

On the flip side, trans women don’t naturally experience menopause, as there is no end of menses. However, those using hormone replacement therapy (HRT) may experience similar symptoms to menopause when adjusting estrogen levels or pausing HRT for any reason.

With so many different manifestations of menopause, finding a trusted health care provider is key to knowing what to expect in one’s own body. Unfortunately, fear of discrimination stops many LGBTQ+ folks from seeking care. According to research, one in six LGBTQ+ adults report that the possibility of discrimination kept them from pursuing the health care they need. For trans folks, that number jumps to one in four.

Even when that barrier is conquered, receiving adequate and informed care remains a struggle. The sensitive nature of menopause symptoms can make it difficult to broach the topic with health care providers. Take the most intimate of symptoms—vaginal dryness—as an example. Providers may be accustomed to asking about and treating this symptom in their cisgender heterosexual patients, but often neglect to ask cisgender patients with female partners how this symptom impacts them. Iris Romero, a professor of obstetrics and gynecology at the University of Chicago says, “Best practices with menopausal women is to ask how sex is going, but most lesbians, I suspect, aren’t even asked that question.”

The myth of “lesbian bed death” may be more from a lack of treatment than a lack of desire. Patti Geler, LCSW explains that both depression and a lack of libido can contribute to a decrease in sexual activity between partners. These are common symptoms of menopause, and in relationships where both partners experience this life change, these symptoms can impact intimacy for years. Infuriatingly, because menopause is so rarely discussed, many in the LGBTQ+ community have no idea that lesbian bed death may have physical causes that can easily be treated.

For trans and nonbinary folks, intimate dryness can lead to additional challenges. Heightened sensitivity can increase awareness of genitalia, triggering gender and body dysmorphia. In support groups and online forums, some masc-of-center folks report struggling with weight gain that affects hips and breasts—features often considered more feminine.

The prevailing treatment for menopause symptoms is HRT: estrogen and progesterone. Choosing this method of treatment, and managing the physical feminization that often accompanies it, is a personal decision best made with the input of a trusted health care provider. The possible impact of this treatment on gender expression and, therefore, mental health can’t be understated. Finding affirming mental health care during this time is critical.

In recent years, LGBTQ+ folks and the providers who serve them have begun creating new resources to meet the unique needs of LGBTQ+ people experiencing menopause. FOLX Health is a digital health care company designed by and for the LGBTQ+ community. Through their services, patients can secure HRT for menopause, join a virtual community, and seek mental health care. In London, therapist Tania Gayle and the Queer Menopause Collective maintain Queer Menopause, a site dedicated to providing resources to LGBTQ+ folks facing menopause. For providers, the deputy chief executive for Women’s Health Tasmania, Lucinda Shannon, launched Speaking of Health, a podcast to help health care providers be more inclusive.

These resources raise awareness of menopause and the specific ways in which it impacts members of the LGBTQ+ community. As this awareness grows, the hope is that care will improve, and that those experiencing menopause will have the knowledge necessary to feel confident in advocating for their health.

This article was initially published on Word Is Out.

The Queer Side of Menopause

Sondra Morris

Author(s)

Sondra Morris

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The Queer Side of Menopause

Sondra Morris

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Sondra Morris

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