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A Systematic Review on Menstrual Health and Hygiene Experiences of Transgender and Nonbinary Populations: A Global Perspective
Journal article

A Systematic Review on Menstrual Health and Hygiene Experiences of Transgender and Nonbinary Populations: A Global Perspective

Priyanka Dubey, Shannon Lea Watkins, Muthusamy Sivakami, Kelly K. Baker, William T. Story, Libby Fry, Abinaya Ilavarasan and Rima A. Afifi
Annals of LGBTQ Public and Population Health
05/11/2026
DOI: 10.1891/LGBTQ-2025-0010

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Abstract

The social marginalization of transgender and nonbinary (TNB) individuals can impede their access to menstrual health and hygiene (MHH) resources. This study aimed to synthesize global literature on MHH for TNB populations and identify future research needs. We systematically reviewed studies on the lived experiences of TNB individuals regarding MHH. Searches of six databases for peer-reviewed articles published in English until April 2022 yielded 3,651 records. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, two independent reviewers screened titles, abstracts, and full texts, extracting and synthesizing findings through narrative synthesis for quantitative studies and thematic synthesis for qualitative studies. Twenty-one unique studies met the inclusion criteria. Quantitative studies examined the effectiveness of contraception and hormonal therapy options in achieving amenorrhea, while qualitative studies explored the physical, emotional, and environmental aspects of MHH. Most studies were based in the Global North. Three overarching themes emerged: (a) perceptions about cisnormative menstruation in a binary society, (b) managing menstrual flow and related aspects, and (c) accessing healthcare. Studies highlighted the “othering” of the TNB population in MHH, focusing on menstruation linked to women, public bathroom accessibility, and menstrual product availability. Three intervention areas emerged to support TNB individuals in managing menstruation and improving overall health: (a) creating inclusive and safe public spaces, (b) improving menstrual and sexual and reproductive healthcare, and (c) degendering menstruation. This review underscored the unique challenges and needs of TNB populations regarding MHH, highlighting an urgent need for further research to inform intervention and program development.

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