The following is a summary of “Menstrual Management Choices in Transgender and Gender Diverse Adolescents,” published in the February 2023 issue of the Adolescent Health by Schwartz et al.

Patients who are transgender or gender nonconforming and have been assigned female at birth may request menstruation management to help with the associated emotional distress. This research aims to provide a comprehensive account of transgender and gender-variant teenage beginnings and progression into menstrual management methods (MMMs). From March 2015 to December 2020, individuals in a multidisciplinary pediatric gender program who were assigned female at birth, identified as transgender or gender diverse, and had reached menarche were included in a retrospective chart analysis. 

A statistical analysis of a descriptive kind was run. Among a total of 133 patients, 119 (90% of the total) identified as trans men, 11 (8%) as gender nonbinary, and 3 (2%) as having an additional gender identification. The median age was 15 (SD = 1.6) years old. Only 12 patients (9%) reported ever having sexual relations. During the study, 48 participants (36%) used testosterone to help them feel more comfortable with their gender. There were 114 non-MMM users (86%) on the first visit. About 3% of the 80 patients who started a new MMM opted for COCs, 65% used norethindrone acetate (NETA), and 11% planned to put in a levonorgestrel intrauterine contraceptive device (IUD).

Among the 56 patients using NETA for an entire year, 20 also had an IUD. Findings from this research provide information on the MMM preferences of transgender and gender-variant teenagers who use these methods nearly solely for menstruation management and not for contraception. Most patients offered the chance to begin using an MMM did so, even though only a minority of patients were already doing so at baseline. Regarding contraception, NETA and the levonorgestrel IUD were the most popular choices.

Source: sciencedirect.com/science/article/abs/pii/S1054139X22006930