A qualitative inquiry into the lived experiences of menstrual health and hygiene among transgender and non-binary populations in urban India

Menstrual health and hygiene (MHH) research has mainly focused on women and girls, with limited evidence on how transgender and non-binary (TNB) individuals manage their menstruation. This study aims to document the lived experiences of MHH among TNB people in urban India.

Using a qualitative approach, we conducted 13 semi-structured telephonic interviews with TNB adults aged 19-40 years in three major Indian metropolitan cities. Eleven participants identified as transmale, one as non-binary, and one as male/intersex. The interviews covered various aspects of life, such as home, school, workplace, and other public spaces. The researchers recorded, transcribed, and de-identified the interviews before conducting thematic analysis.

We identified three major themes: gendering of menstruation, navigating physical aspects of menstruation, and challenges beyond bleeding. The gendering of menstruation shaped the overall experiences of MHH among participants. Many participants reported having no knowledge about menstruation before menarche, which left them in a state of confusion, shame, and dysphoria. Managing dysphoria was a significant challenge of managing periods. Navigating physical aspects of menstruation was less challenging in familiar, private surroundings. However, accessing public spaces remained a major challenge and stressor. Despite participants undergoing hormonal replacement therapy (HRT) to suppress menstruation, they continued to experience menstrual symptoms, which continued dysphoria. Participants reported facing challenges beyond bleeding, including the burden of multiple diseases, accessing gendered healthcare services, and lack of social support.

Documenting the lived experiences of MHH among TNB people is a crucial step towards "de-gendering" menstruation and enhance their overall well-being.