Nobody Knows Shit.

On navigating transmasc perimenopause in a sea of estrogen pushers

Adding to the detritus of the weekly New York Times articles about perimenopause, I am throwing my hat into the ring based off of my isolation to find any resources about experiences of transmasc menopause and early menopause. Not only have I had TERF doctors, but I’ve been to primary care doctors who didn’t believe I was going through perimenopause at my age, and then gender affirming care not knowing how to proceed with someone going through perimenopause already. I have been met with conflicting advice and complete misunderstandings of gender dysphoria while oftentimes being given an ultimatum of estrogen and a look of disbelief when I aggressively refuse. It has been beyond frustrating and isolating. Blogs from femmes or women writing about perimenopause haven’t been soothing as there is oftentimes still the underlying appreciations of their AFAB bodies that haven’t been contending with the shame and pain of gender dysphoria since childhood.

I have been androgynous and masc of center since high school. In college, I used the word genderqueer but there often wasn’t language available yet to encompass my gender identity and presentation. I only told myself that it was possible to get gender affirming care and live fully in my body later in life. Finally got surgery at 39 without being on T. Unbeknownst to me, perimenopause symptoms aggressively hit me in the face the year before, but no one fully believed what I was experiencing and so I diligently starting tracking my symptoms to try to get a better sense of what was happening to me and why my body and brain felt out of my control. Looking back the symptoms had been there even earlier. At 33 I had an intense depressive episode consume me out of nowhere. At 36 I was diagnosed with bipolar 2 from mood swings that were not recognized as being correlated with my cycles. All of this was most likely the start of perimenopause. Looking back at emails from 2016 to friends, I wrote about being really fatigued and feeling feverish but never having a fever. I was having hot flashes and didn’t know it since I didn’t know this could happen in your early thirties. Even when my hot flashes overtook my body and covered me in sweat at 38, I was still told I was too young and they weren’t hot flashes. Even at 41 when having a cycle of over 70 days with no consistent sleep, hourly hot flashes and cold flashes, and then bleeding for 23 days straight, I was still told by doctors that I was too young. That this couldn’t be perimenopause, and it had to be a much more dire health concern warranting biopsies and tests with wands and sanctioned body torture. Because nobody knows shit.

The menopause specialist was the first person to say that I was clearly in perimenopause and in the late stages even, nearing the end. That was over a year ago and I am screaming for the coach to put me in menopause. It has been an exhausting and isolating mass of years for my body and mind and I am fucking over it. The menopause specialist was the first doctor not to push estrogen on me and offer testosterone to support my muscles, brain and bones from prolonged decay from hitting menopause at an earlier age. But even she said wait until you hit menopause because the testosterone may make my symptoms sweats worse.

The nurses at Planned Parenthood said they wouldn’t know what T would do and that it could work to lessen the dysphoria, but that it could also make my hot flashes worse. They said we don’t know; we have seen people start T before and after menopause, but never during. They said we will just have to figure it out from you.

And that’s what all this has been: trying and failing. Nothing working. It’s been over 4 years since I started getting life interfering hot flashes that stop me in my tracks but still having to pretend like everything is ok while working and carrying on with life surrounding me while I feel at war with my body. Sleeping on a torso sized ice pack, still having night sweats interrupt sleep like clockwork, and eventually cursing the day. Finding some relief by leaning on my longtime friend from the same suburb who is also going through perimenopause early. We text angry notes about our bodies and minds; feeling misunderstood by our friends from how exhausting this has all been; how hard it is to be present in public and to feel like a human being. We joke about the water from our town being tainted and that’s why we both got it early, but we questioned the water source of our suburbs for years after counting the amount of peers who ended up dead or with major mental health crises. And getting it earlier means that it is more intense and often longer of a process, and so our teeth grind down even harder, forcefully trying to swallow our bitter reality.

How little is known about perimenopause in general that has had me seeking answers from people on the internet. Four years ago, I was reaching out to get zines about perimenopause as some of the only content I could find. Even as I am writing this, perimenopause is underlined in red, not being recognized as a correctly spelled word in the auto correct dictionary, giving the suggestion to change the spelling to “menopause”. Now there’s increased dialogue and awareness about it in the media, recognizing how much this experience has been neglected to remain a mysterious or downplayed transition in the medical field over the years. But I’ve found next to nothing on trying to navigate this while presenting as masculine and contending with the dysphoria this all brings.

This transition is difficult for anyone. I wouldn’t wish this for anyone; the exhaustion, the anger, the sadness, the burning, the disconnection, the misanthropy, the dampness, the futility, the seemingly never-ending new afflictions to both body and mind. And then the dysphoria layered on top of it, not wanting to write about something that has been causing me so much distress for years because I don’t want others to attach me with those body parts or associate me with “womanhood”. But I haven’t seen anything out there talking about how to navigate this as a transmasc non-binary person with dysphoria that doesn’t want celebrate their body or connect it to its purpose as a caregiver or parent. I have pretended much of these parts don’t exist, given them generic names such as “area”, avoided an OB/GYN until 33, wore pads and period underpants until I stopped bleeding since tampons were painful and dysphoric. I really wish that I had transitioned before I ever had to deal with perimenopause.

But I figured it out later in life, or just was able to imagine the possibilities of another lifetime. And even though I would like to just forget all the mental and physical pain perimenopause has caused/ is causing, I would like to put this out there in hopes of anyone else who is trans masculine and having to go through this sometime in their life to not feel so isolated in their experience, and having to realize that they don’t have to endure the estrogen pushers breathing down their necks because that’s all many doctors know and nobody knows shit. And nobody knows shit about what to do with us. This is just my experience. It doesn’t mean that it will be your experience, or the same experience for every transmasc going through perimenopause, or even the same solutions they opt to take because this is just how I’ve had to try to manage, and I’m just like everybody else. Because I don’t know shit either.