Menopause experiences in sexual minority women and non-binary people

Abstract

Sexual minority women (lesbian/gay, bisexual, and queer-identified cisgender women) as well as non-binary people have unique experiences in menopause but remain underrepresented in the scientific literature as compared with cisgender, heterosexual women. This review provides an overview of their experiences with menopause, including menstrual cessation, menopause symptoms, experiences with healthcare systems, and sexual health. The end of menstruation comes with mixed emotions for many sexual minority women, including sadness, grief, relief, and a sense of freedom. Sexual and gender minority individuals often experience discrimination and bias in healthcare encounters. So, too, do sexual minority women and non-binary people report negative experiences with the healthcare system while navigating menopause. In particular, this includes challenges locating inclusive menopause resources and culturally competent clinicians who create safe, trusting healthcare environments. In contrast to heterosexual women, sexual minority women have more open communication with partners regarding sexual function during menopause, and often have greater sexual satisfaction due to more expansive definitions of sex and pleasure. Non-binary individuals can experience distress, isolation, and gender dysphoria during the menopause transition, though research on their experiences remains extremely limited. To better care for sexual and gender minorities, more inclusive menopause education resources and healthcare environments are sorely needed, as are culturally competent healthcare clinicians. Increasing representation of sexual and gender minorities in the scientific literature on menopause is also crucial to improve understanding and clinical care.