Whenever we talk about people who menstruate, we only know of women who looks traditionally female. Though this instinct isn't malicious or ill-intent, it is a sign that there is lack of exposure surrounding the issue of non-binary female or queer menstruation. This lack of exposure/care and the casual discrimination of transgender and non-binary individuals who menstruate negatively impact their livelihood in ways that interfere with their menstrual hygiene, mental health, and comfort in their own bodies.
The exposure that we talked of can refer to lack of gender-neutral products in the market and social stigma surrounding the act of menstruation itself, especially in country that lacks LGBTQ+ exposure and education like Cambodia.
Due to the lack of local resources regarding the topic at hand, we have enlisted the help of people in the LGBTQ community.
For this blog, we interviewed Bee Mike, a bassist for a band based in Cambodia. He will be providing us with insights into what it means for a transgender man to menstruate in Cambodia.
Difficulties menstruating while being trans and non-binary
"It's hard to pinpoint exactly when I knew that I was transgender, but I had always like dressing in boyish clothes since I was young," said Mike.
When asked about the difficulties that he faced growing up transgender while also menstruating, he said that he was always extremely shy whenever he has to talk about menstruating.
"I always had my mom go and buy me menstrual pads, and I never said anything to anyone either whenever I had my period. I don't really go and discuss or tell people about my monthly cycle."
Mike insisted that he doesn't have any problems with knowing how menstrual hygiene works, since he was used to maintaining menstrual hygiene even before he came out as transgender. However, Bee said that this is only his experience and cannot speak for his whole community; although, he did freak out a little when he had his first period, not knowing that it was just a natural occurrence.
He expressed with exasperation of the constant questioning of people around him regarding his appearance and gender ever since he was a young child, "I got so used to the question asking me whether I'm a boy or a girl. Even a motorcycle driver, who was a complete stranger, asked me that!"
"At first, these types of questions brought me to the brink of depression,” he said. “One, I felt that these questions were extremely discriminatory and I got them everywhere I went. They do not understand, even family members like my aunt kept asking me these questions."
Research shows that trans people face self-shame and social inequity and inadequacy when dealing with menstruation. For one thing, transmen who have assigned female sex, who possess masculine identities or have aligned themselves with traditionally masculine tendencies, might view menstruation as making them effeminate, or less of a "man". Therefore, this rejection of their menstruation may induce more discomfort with the act of menstruating itself.  This rejection is not the fault of transgender persons, but serves as evidence of the overt stigmatization of menstruation as being dirty and therefore, reduces your worth- a myth that has been around since the beginning of time and is continually perpetuated by patriarchal societies.
Being plagued with existing social barriers and discrimination, trans people have an even harder time navigating reproductive and sexual health issues. A 2011 survey found several root causes that may deter trans people from getting medical checkups: 48% said that it was due to financial-related issues, 19% due to being denied healthcare services, and 28% due to feeling worried about revealing their sexual identity (most likely this is because of the perceived negative attitude towards transgender). Trans people are three times more likely to be unemployed and twice more likely to live in poverty than the general population. 
Regarding his experience with health professionals, Mike said that he has never visited a clinic to check up on his sexual reproductive health, but he had taken his mother to one and felt like he could never subject himself to those type of examinations. However, he had experienced discomfort at regular health clinics before due to remarks made by health professionals about his appearance and gender that got him taken aback.
"Most of them (Clinic health workers) would say 'Oh you're a girl? I thought you were a boy'. They thought it was regular small talk, but it made me very upset."
Healthcare providers and society as a whole play a crucial role in eliminating this stigma against trans menstruating. Unfortunately, this is a problem point as healthcare providers are found to be lacking or biased when dealing with transgender patient. A survey in 2015 conducted amongst 141 OB-GYNS in the USA showed at 80% of them had not had any training in caring for a transgender person, and only 29% felt comfortable treating transgender persons. 
Due to fear of transphobic healthcare providers, and aversion to menstruation itself, transgender persons may fail to seek healthcare when they are dealing with menstrual disorders such as amenorrhea and endometriosis, which could be a sign of a more serious and sinister underlying cause.
Normalization of trans menstruating
So, what can we do to help?
It'd be wise to start somewhere simple, and that is by including transgender and non-binary persons in discussions surrounding menstrual hygiene. To stress that cisgender women are not the only ones who experience menstruation, and to push for solution that can provide comfort for all people who menstruate. This can mean advocating for trans-sensitive training for all healthcare providers, and installing menstrual products in both the male and female bathrooms. Most important of all is to erase the stigma surrounding menstruation. This is not easy, but it requires intense sexual reproductive health classes being implemented in schools, and that also includes LGBTQ+ education.
Gender-neutral menstrual products are being sold in some countries around the world. Products like Thinx and Always are starting to include transgender and non-binary by creating menstrual products that can be used by everyone. However, just changing how the product look won't do much if we're also not doing our best to educate the population about menstrual hygiene and the wrong perception about who can menstruate, what it means to menstruate, and why menstrual hygiene is a basic human right.
As for Mike, his hope is simple.
"Personally, I don't want a lot. I just want them to open their minds."
He continued, "Even if we have the same mechanisms and the same organs as if we were machines that were set with certain characteristics, I want them to know that we are not machines. We have feelings, a heart, and thoughts that differentiate us from each other."
To end on a positive note, Marie Stopes hopes and encourages all people of all gender and identities to seek sexual reproductive healthcare without shame and with confidence.
- Chrisler, J. C., Gorman, J. A., Manion, J., Murgo, M., Barney, A., Adams-Clark, A., … Mcgrath, M. (2016). Queer periods: attitudes toward and experiences with menstruation in the masculine of centre and transgender community. Culture, Health & Sexuality, 18(11), 1238–1250. doi: 10.1080/13691058.2016.1182645
- ACLU News & Commentary. (2019, December 17). Retrieved March 27, 2020, from https://www.aclu.org/news/lgbt-rights/menstruation-related-discrimination-is-sex-discrimination-we-dont-need-to-erase-trans-or-non-binary-people-to-make-that-point/
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