Menopause comes with its share of anxiety, especially when you’re dealing with unfamiliar—and sometimes worrying—symptoms. For lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) people, menopause comes with extra nuance and different healthcare risks.

When queer and transgender people need menopause-related healthcare, our identities have to be part of the conversation. Having a doctor, friends, and family who understand that and offer inclusive support means that everyone gets the best possible care (including cisgender, heterosexual women). It helps LGBTQIA+ people feel safer reaching out and reduces healthcare risks—including the most common ones everyone faces during and after menopause.

What Are the Risks for LGBTQIA+ People?

As your body changes during menopause, so does the way you take care of it. Your risk of certain diseases and chronic conditions goes up, including:

  • Heart disease
  • Osteoporosis
  • Diabetes
  • Thyroid problems
  • Oral health issues

Let’s be real: Plenty of cisgender, heterosexual women have been brushed off by their doctors. But when you’re queer or transgender, your identity, body, and appearance might not fit what even doctors expect for someone going through menopause.

Systemic struggles with poverty, discrimination, isolation, and healthcare bias alone raise healthcare risks. Not only do they increase stress, but they also make it harder for LGBTQIA+ people to access healthcare at all, never mind gender-affirming care for menopause.

When LGBTQIA+ people already have a higher rate of chronic conditions and disability than cisgender and heterosexual people, that factors into menopause care. Without acknowledging the already increased risk of these conditions, the risk of developing them after menopause can go up even further. Plus, when a provider doesn’t understand your identity, it can mean their advice does more harm than good.

Are LGBTQIA+ Menopause Healthcare Needs Actually Different?

Menopause looks and feels different for everyone, no matter your gender or sexual identity. Still, providers should remember that many LGBTQIA+ people may have or have had:

  • Sex that isn’t penis-in-vagina (PIV)
  • Varied partner dynamics
  • Gender dysphoria
  • Intersex anatomy
  • Hormone replacement therapy (HRT) or gender-affirming surgery
  • Difficulty accessing healthcare resources

Each of these factors can affect LGBTQIA+ healthcare needs. A woman who has sex with women may have questions about vaginal dryness and sex during menopause that can’t be answered with PIV information. If you have a partner going through menopause at the same time as you, they’ll need to know how to communicate about that differently than you would with a cisgender husband. An intersex person may have physical anatomy that looks and functions differently than a cisgender woman’s.

Not to mention, the lack of studies on menopause in transgender men or nonbinary people makes accessing information about how other trans people deal with menopause harder. It can make trans and nonbinary people who are going through it feel more alone. It makes it all the more important to communicate about menopause across the gender and sexuality spectrum.

How Can Healthcare Spaces Welcome Everyone?

Reducing menopause-related healthcare risks involves making both small and systemic changes to how we approach support for menopause. You can make some of them in your daily life or medical practice right away, and even those can make queer and transgender people going through menopause feel safe and welcome.

Use the Correct Names and Pronoun

Many transgender and nonbinary people use names and pronouns other than the ones they were assigned at birth. When you make it common practice to ask each patient’s name and pronouns—yes, even your cisgender patients—it makes us feel more comfortable talking with you about our health.

Include an optional field on medical forms for people to fill in their gender identity and sexuality. That gives people space to decide if they’re comfortable sharing that information, and it shows that you are an LGBTQIA+ ally.

Remember that not all transgender and nonbinary people medically or surgically transition. Not everyone has the resources to make those changes, even if they do want them, and others simply don’t want to. Respecting their identity can be life-saving and reduce the burden of stress and the health risks that come with it.

Listen, Communicate, and Educate

Because there are so few resources on the queer and transgender menopause experience, it’s up to providers and loved ones to listen to the people living it. As a doctor or therapist, it can inform your practice. As a friend, partner, or family member, it helps you offer personal support.

Make sure you do your own research, too. Look at studies on queer menopause, join forums where people talk about their experiences, and seek out resources like Queer Menopause, which shares studies, books, podcasts, videos, and more about LGBTQIA+ menopause. When you actively work to understand diverse menopause experiences, you break down the barriers to care that many LGBTQIA+ people face.

Create Access to Affirming Healthcare

Making healthcare accessible and inclusive isn’t something we can do overnight. It takes collective effort through education, information, and sharing resources. That can mean:

  • Providers getting more formal education about LGBTQIA+ menopause experiences
  • Doing more scientific research and studies on LGBTQIA+ menopause
  • Changing health messaging to reflect LGBTQIA+ identities
  • Offering more personalized care plans for everyone (not just queer and trans people)
  • Creating accessible, affordable healthcare resources for marginalized people
  • Framing menopause as a natural body process—not a marker of womanhood

Gender-affirming menopause care is out there, but we need more of it. The LGBTQ+ Healthcare Directory has a network of providers who understand your experience and provide safe care.

How Can You Support LGBTQIA+ People Going Through Menopause?

Reducing healthcare risks happens outside the doctor’s office, too. Healthcare risks go down just by having an environment where we feel safe, comfortable, and cared about.

Even respecting our identities, using our correct names and pronouns, and listening to our menopause experiences make a huge difference. Here are a few other ways you can show you’re an ally and make healthcare safer for your queer and transgender loved ones:

  • Stand up for them when someone misgenders them
  • Go with them to appointments, if asked
  • Include them in conversations about menopause and sexual and reproductive health
  • Use inclusive language about menopause in your personal spaces

Reducing Risk Means Making Changes

Including queer and transgender people in menopause care isn’t about getting rid of the care already available to many cisgender, heterosexual women. It’s about expanding that care and the messaging around it so LGBTQIA+ people can get their needs met, too. Creating more personalized, inclusive care reduces healthcare risks for people of all genders and sexualities. Finding these gaps makes you think, too—what are we missing in everyone’s menopause experience?

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