Periods are rarely discussed within the context of mental health and disorders.
Premenstrual dysphoric disorder (PMDD) is discussed at times, keeping the mental health conversation within the bounds of mood swings caused by hormonal fluctuations in the body. But the idea that having a period could have a severe impact on mental health, especially with regards to trans folk, is an important topic that tends to be discussed much less.
I am in agony for seven days out of every month, and not because of cramping or bloating. I don’t mind the cramps too much, actually, and I’ve gotten pretty good at managing them over the years. I’m in pain because I’m forced to feel like someone else for a week. On most days, I can forget what’s in my pants; I don’t feel anything foreign, just the penis I wish I had nestled between my legs. This changes when my period starts. It’s that small red stain that betrays me, ruins it all, reminds me that my body is alien. All week, I cringe as I feel blood and clots move through a part of my body that was formerly dormant, non-existent. My skin crawls from start to finish.
Seeing period commercials and pad packaging further antagonizes me during my period. It further enforces the otherness of my period, as I’m forced to consume products “for women.” I don’t hate the flouncy commercials and hyper-feminine packaging because they inaccurately portray the true physical pain and inconvenience of menstruating, I hate them because of how they trigger me. I feel mocked by the celebratory ads and the excited-looking packaging during my sensitive time of pain and dizzying dysphoria. I feel angry that our capitalistic society forces me to spend my hard-earned money on my stupid period, something I would rather just put away and forget about. I consider free-bleeding often, except I feel as though the visibility of all that blood would only upset me more. By the end of each cycle, I feel my discomfort within my own body lessen as I return to feeling like myself again.
I am so depressed on my period. I don’t want to go out, I don’t want to work. I feel filthy, and showering doesn’t seem to get rid of it. I feel offended, violated by this intruder in my body. I can’t rest because I have to watch it suspiciously, see how it behaves and prepare for when it acts in ways that I don’t understand. It sometimes kicks me out of my own body into such a devastating dysphoria that it’s hard to focus at work sometimes. I feel trapped.
While all the folks around me may whine about being on their period, most don’t know what I mean when I whine about it. They don’t know that my body takes me hostage every month, that there’s nothing ordinary about my menstrual struggle.
My depression and gender dysphoria are both majorly triggered during each menstrual cycle. My bleeding vagina, sitting in its moist pad, feel like a thousand pound weight as I try to move through the world as the person I truly am. I curse my body every time my period comes, feeling exasperated and overwhelmed that another month has already gone by. I try not to move around as much for fear of enhancing the sensation or pace of the blood coming from my pelvis. I cry to my partner most months about how badly I need it all to go away, to get a hysterectomy and forget about it. I joke to them about how I just wanna rip my reproductive organs out myself, but the anger I mask justifies the true seriousness of this claim.
Like with discussions about periods, chats about hysterectomies never consider the mental health of the patient. Pre-existing conditions like endometriosis and fibroid tumors are required to qualify for coverage of uterine surgical removals. I wish “born in the wrong body” or “hatred for vaginal bleeding” could count as qualifying conditions. In a study at the Cincinnati Children’s Hospital Medical Center, it was found that 30% of trans youth have attempted suicide at least once, and about 42% report a history of self-injury. With such a high percentage of trans lives being threatened by struggles like gender dysphoria and limited access to medical help, the mental health concerns of trans folk should be taken as seriously as the health of endometriosis sufferers.
If hormone replacement therapy doesn’t stop my period, I will seriously pursue a hysterectomy. But in order for that endeavor to be both accessible and affordable to me, the conversation about a period’s impact on patients’ mental health needs to be more widespread. My period negatively impacts me in a very noticeable and life-threatening way, and I’m not the only one.