Women have historically been side-lined from medical attention at a greater degree than men and there is little known about the premenstrual syndrome (PMS), as it is not validated as a legitimate condition even though it often requires treatment. Over 90% of women and trans men report experiencing premenstrual symptoms, such as bloating, moodiness, cramps or fatigue. PMS could be defined as ‘a series of symptoms arising the week prior to menstruation and ending the first day of menses.’ However, most women and trans men have little knowledge of the direct causes of the issue or specific treatments. So why is this gender bias still persistent in medical research in the twenty-first century?
Some trans men still have a period every month, if they have not undergone gender assignment surgery or do not take hormones. Yet, for trans men who suffer from various symptoms before they have their periods, menstrual blood could be viewed as more than a shameful bodily fluid; the blood may function as a reminder of part of themselves that they do not identify with.
The research that has been carried out for PMS so far remains largely inconclusive. Women’s and trans men’s bodies are viewed as abnormal even iniquitous, therefore their sexual subjectivities are excluded from critical health care. The medical treatment provided to them most of the time is sporadic and insufficient, so they continue to experience physical pain and discomfort. They are often excluded because their symptoms are viewed as illegitimate, portraying women and trans men as hysteric. In many situations, women and trans men are told -“it’s all in your head”.
Even though menstruation is a biological reality, it is formulated as a social construct. Society affects one’s experience of having a period and how one deals with it. In most patriarchal cultures, the experience of menstruation is permeated by feelings of shame and secrecy, as menstruation is considered as something unclean. The double standard of constructing men’s bodies as “clean” but women’s bodies as “dirty” should be challenged. Unfortunately, the negative perception of menstruation can lead to ‘body shame, self-objectification, and lack of agency in sexual decision-making.’
In order to combat the gender bias in medical research, the distinction among sex and gender is crucial. Gender needs to be viewed as a fluid category instead of as an essential one. Women used to be viewed as the weaker sex due to their closeness to nature, therefore when they were menstruating they were viewed as monstrous as they were unable to “control” their bodies. In the same vein, trans men were viewed as occupying monstrous bodies due to their “unnaturalness”. However, who defines what is “natural”? There is no straightforward answer to this, as the norm is a social construct. Thus, it is important to bring attention to the interconnectedness between sex, gender, body and sexual orientation. As Annandale and Clark suggest:
‘We artificially, and inappropriately, divide people into two camps…we build a series of other characteristics on top of gender i.e. […] women are irrational, men are rational and so on…real life experience is not like this; attributes and experiences like acting rationally or being healthy cross-cut gender and are not the province of men or women as a group’.
The fear towards those who do not conform to the sex and gender order is still pervasive today. De-gendering menstruation is vital in order to be able to deal with the taboos surrounding PMS in a gender-inclusive way. Therefore, it is necessary to acknowledge the multiplicity of menstrual realities that different bodies experience.
In conclusion, the lack of adequate medical research around PMS is a cultural construct. There is a major gap in studying menstruation because patriarchal culture silences the discourse of women and subsequently trans men who are viewed as marginal entities. Their bodies are asserted yet at the same time negated from popular culture. What is being silenced and absent in discourse is constantly spoken of. It is necessary for trans men’s experiences to be contextualized in order to alleviate their sense of isolation and to de-stigmatize menstruation.