By Elfrida Adeleye
When we talk about menstrual health, many people only think of female persons. But not everyone who menstruates is a female person. Some intersex people also menstruate. Their needs are often ignored in health programmes and public conversations. Even schools, which should be institutions of learning, rarely include intersex persons in their curriculum.
Intersex people are born with bodies that do not fit the typical definitions of male or female. This can include genitalia, but also chromosomes and hormones. Some intersex people have a uterus and experience periods. Others do not. But for those who do, it is important that they have access to correct information, support and safe products.
For intersex people who menstruate, many of them face shame, confusion or silence when their periods start. For intersex people who menstruate, the onset of periods is often accompanied by shame, confusion and silence. This is not just from a lack of information, but from systemic erasure. In many communities, menstruation is framed strictly as a “female issue,” leaving no room for the experiences of intersex people whose bodies may not conform to binary expectations. As a result, in the situation where an intersex person begin menstruating, they are often met with disbelief, ridicule or outright denial of their bodily autonomy. Some are pressured to hide their experiences to protect their families from perceived social shame, while others are told that their bodies are “wrong” or in need of medical correction. These cause fear, stress and mental health issues.
Some Intersex men who experience symptoms linked to menstruation, such as cramping, spotting or bleeding may feel a deep discomfort with their body. This is called dysphoria. It is the feeling that your body is not matching who you know yourself to be. It can be painful, especially when health workers dismiss their symptoms and/or belittle them. They are left feeling alone and confused.
Most health workers are not trained to care for intersex people. Some do not even know what intersex means. In our report on Medical Practices and Experiences Surrounding Intersex Births in Nigerian Hospitals, we found that 74% of healthcare professionals indicated that their hospitals had no specific approach to managing intersex cases.
This leads to misinformed treatment or harmful advice. For example, telling someone to take hormonal medicine to stop their bleeding without checking their full health background to understand the root cause or even asking the person if they even want that. Another is by using language that makes them feel ashamed, such as calling them a mystery insisting on them being “fixed”.
Menstrual health education must include intersex people. Just as teaching boys about menstruation helps reduce stigma, incorporating the experiences of intersex individuals creates greater understanding and inclusivity. In Kenya, initiatives like Jinsiangu’s InclusiFit are leading the way by addressing menstrual hygiene needs specific to intersex persons.
Safe toilets, pain relief and access to pads are not gender issues. They are health needs. Intersex people must be included in menstrual health programmes. For example, a school toilet should be safe for both a boy who menstruates and a girl who menstruates. This can be done by making restrooms gender neutral or by making disposal bins available in all toilet stalls to make disposal of sanitary items easy. It should not be based on gender, but on need.
Also, language matters. Saying “women and girls” all the time can leave others out. A better term is “people who menstruate.” This helps include everyone without confusion.
If we say menstrual health is for all, then we must mean it. Intersex people are part of that “all.” Their needs are not extra. They are basic. This world menstrual health hygiene day and beyond, we must all work towards including intersex persons in menstrual healthcare.
