Hormone Therapy

A review of menopause in transgender and gender diverse individuals.

TL;DR

Research on menopause in transgender and gender diverse individuals is lacking and without guidelines, but providers can draw on shared principles of cisgender menopausal hormone therapy and gender-affirming hormone therapy to support this population using shared decision-making and culturally competent care.

Key Findings

Research on menopause in transgender and gender diverse (TGD) individuals is lacking, with no clinical management guidelines currently available.

  • This is described as 'the first review of its type' to summarize the impact of the menopausal transition on TGD individuals.
  • No existing guidelines are identified to support clinical management of menopause in TGD people.
  • The review highlights 'the intersection of gender identity, hormone treatment, and age-related changes' as a key gap in the literature.

The menopausal transition presents specific challenges and health considerations unique to transgender and gender diverse individuals.

  • The review summarizes the described impact of the menopausal transition on TGD individuals.
  • The experiences of TGD people 'do not necessarily conform to stereotypically ciswoman experiences.'
  • The review addresses the intersection of gender identity, hormone treatment, and age-related changes as compounding factors.

Gender-affirming hormone therapy (GAHT) is associated with potential long-term risks that intersect with aging and the menopausal transition.

  • The review examines 'the potential long-term risks associated with both gender-affirming hormone therapy and the intersectionality with aging.'
  • These risks are identified as having the potential to impact hormone management and overall comprehensive care.
  • The review draws on shared principles between cisgender menopausal hormone therapy and GAHT to address these risks.

Providers are recommended to use shared decision-making, culturally competent care, and a strong understanding of TGD biological, personal, and social experiences when managing menopause in this population.

  • The authors recommend 'using shared decision-making, culturally competent care, and a strong understanding of the biological, personal, and social experiences of TGD people.'
  • Providers are described as 'well positioned to apply their expertise to support the TGD population during menopause' by drawing on existing knowledge of both menopausal hormone therapy and GAHT.
  • The recommendation explicitly acknowledges that TGD experiences 'do not necessarily conform to stereotypically ciswoman experiences.'

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Citation

Kelley C, Ariel D. (2025). A review of menopause in transgender and gender diverse individuals.. Current opinion in obstetrics & gynecology. https://doi.org/10.1097/GCO.0000000000001013