October is World Menopause Month, a much needed challenge to the taboo and stigma which still all too often surrounds what used to be euphemistically referred to as - the change. A natural part of the life cycle for millions of people - sadly reduced to cheap jokes, harm minimisation  and dismissal. Change is happening however, and part of that is the growing recognition of the different experiences of menopause.

Notice I said people in that opening sentence, because it's important to remember that genders other than women can, and do, experience the menopause. As Tania Glyde explores in their LGBTQ+ menopause research: How can therapists and other healthcare practitioners best support and validate their queer menopausal clients?, trans men and non binary people go through menopause. Widening out into the gender and sexuality diverse communities as a whole, there can be very different narratives than the traditional heteronormative one. This can be very useful for us to remember as therapists whoever we work with. For example, not every cisgender heterosexual woman is mourning her menopause. Some queer clients talk of a liberation which comes with menopause, others fear even greater invisibility, whilst yet more find themselves having to engage with services which assume gender and sexuality in a way which is harmful.

How can we as therapists ensure we're not adding to those harms? 

The first step is the simplest and perhaps the most powerful. Do not assume that our clients will fit our expected narrative of what the menopause looks like or who might be menopausal. In creating that space, we can then go onto explore how the unique individual in front of us is approaching their own internal and external processes of change. A non binary person who was assigned female at birth may be both celebrating the end of periods which caused dysphoria, and struggling with the idea of taking female hormones as HRT to alleviate menopausal symptoms. A trans man may be wrestling with the extreme discomfort of having to attend gynecological appointments in a room full of women, and need a space to put down his anger and upset. Whilst one lesbian may be grieving the end of her childbearing years, another may feel liberated from periods which always felt useless as she had chosen to be childfree.

I hope you can see my point, the LGBTQ experience of menopause may at times be very similar to the more common cisgender heterosexual experience, and at times differ so widely that your clients may feel like they are adrift on a sea without the hope of rescue in sight. By affirming their experience and creating the space which says, your experience may not be common but this does not invalidate or erase it, we're able to walk with them into this new chapter in their lives, whatever that chapter may be. 

Views expressed in this article are the views of the writer and not necessarily the views of BACP. Publication does not imply endorsement of the writer’s views. Reasonable care has been taken to avoid errors but no liability will be accepted for any errors that may occur.