Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, New Hyde Park, New York, USA; Donald and Barbara Zucker, School of Medicine at Hofstra / Northwell, Hempstead, New York, USA.
Curr Probl Pediatr Adolesc Health Care. 2022 Aug;52(8):101239. doi: 10.1016/j.cppeds.2022.101239. Epub 2022 Aug 8.
Menstruation is a female normative process. Physiologically, it indicates that the hypothalamic-pituitary-ovarian axis is functioning appropriately, and all the correct female end-organs are intact. Menarche also heralds a girl's arrival into womanhood, which culturally is often celebrated. It is a sign of the possibility of fertility, pregnancy and motherhood. However, menstruation for transgender males, and other gender diverse individuals assigned female at birth, may be anything but celebratory. For these adolescents, menstruation is an indication that one's body is not functioning appropriately and that one does not have the correct organs congruent to their gender identity. Menstruation or the anticipation of menarche for many transgender males is often met with worsening of dysphoria, anxiety, depression and suicidal ideation. Therefore, to meet the physiologic and psychologic needs of transgender males, one needs to be aware of issues that may be present in relation to menstruation and be knowledgeable on how to medically proceed with sensitivity and respect toward one's gender identity. Research on menstruation, both from a physical and psychologic perspective, has been historically based on women and cannot be simply extrapolated to be the same for transgender males. Although there is a paucity of literature on the subject, over the past decade there has begun to be a great interest in the care of transgender individuals. This article focuses on concerns related to menstruation among transgender adolescent males and gender diverse individuals assigned female at birth, including suppression of menses, fertility, contraception, and pregnancy.
月经是女性的正常生理过程。从生理上讲，它表明下丘脑-垂体-卵巢轴功能正常，所有正确的女性终末器官都完好无损。初潮也标志着女孩进入成年期，在文化上通常会庆祝这一时刻。它是生育、怀孕和成为母亲的可能性的标志。然而，对于跨性别男性和其他在出生时被指定为女性的性别多样化个体来说，月经可能并非如此。对于这些青少年来说，月经表明他们的身体功能不正常，他们没有与自己的性别认同相符的正确器官。对于许多跨性别男性来说，月经或初潮的预期常常伴随着更严重的性别焦虑、焦虑、抑郁和自杀意念。因此，为了满足跨性别男性的生理和心理需求，人们需要了解与月经相关的问题，并了解如何以敏感和尊重的态度对待他们的性别认同，以医学方式进行处理。从生理和心理角度对月经的研究历史上一直基于女性，不能简单地推断对跨性别男性也是如此。尽管关于这个主题的文献很少，但在过去十年中，人们对跨性别者的护理产生了极大的兴趣。本文重点关注跨性别青春期男性和在出生时被指定为女性的性别多样化个体的月经相关问题，包括月经抑制、生育能力、避孕和怀孕。
