Social Support Related to Menses in Gender-Diverse Adolescents: A Qualitative Study.

Abstract

Study objective: Menses in transgender or gender-diverse people can cause dysphoria, which has been linked to various comorbid conditions including depression, anxiety, and suicidal ideation. Although social support is thought to be beneficial for adolescents in general, little is known about its effects on gender-diverse adolescents (GDAs) receiving care. Thus, this study sought to document the effects of social support on the menses management experiences for GDAs and highlight how such support influences their access to and satisfaction with gender-affirming care.

Methods: Participants were recruited from a tertiary care children's hospital to participate in semi-structured phone interviews. Eligibility included adolescents who were 12-20 years of age and had undergone menarche. Interviewers asked respondents about the impact of menses on their mental health, relationships, daily activities, and experiences with menses management and suppression.

Results: A total of 36 individuals participated, with a mean age of 16.82 (SD 2.02) years. Six major themes were identified related to social support: Types of Support, Support Persons within the Social Network, School Environment, Medical Providers as a Social Support, Resources, and Advice for Others.

Conclusion: This study highlights the vital role of social support as GDAs navigate gender-affirming care and menses management. The exploration of various sources of support-such as family, peers, and health care providers-emphasizes the importance of safe, affirming environments for GDAs. Clinicians as perceived support have a unique opportunity to foster shared decision-making and health advocacy by using preferred pronouns, recognizing dysphoria triggers, and considering GDAs' perspectives when developing care plans.