Can Transgender Women Menstruate?

While technically, the answer is no… new research shows that they experience menstrual-like symptoms that are worth learning about!

This article is brought to you in partnership with (and written by) Lauren C. Houghton Asher Baron from Columbia University's Mailman School of Public Health, and Inga Winkler from PERIODS ERC: Human Rights in the Menstrual Movement.

In our culture, menstruation is… complicated. It is associated with womanhood, of course, yet not all women menstruate and not all people who menstruate are women! It is somehow seen as both beautiful and “natural,” while also being stigmatized as unclean or embarrassing. As menstruation researchers and activists, we have authored a study that examines the experiences of transgender men and nonbinary people who menstruate, but none have examined the intersections of menstruation and transgender women’s biology and sense of self.

So when we heard trans women describing menstruation-like symptoms (cramps, tenderness in breast tissue, and specific food cravings), we were intrigued. Trans women don’t menstruate, so how can they experience the ebbs and flows of a menstrual cycle? We started asking questions to learn more and then decided to create a study to delve into their experiences. We wanted to understand the physiological experiences of our study subjects and how they interpret these symptoms in relation to their gender identity.

What We Did

In cisgender women, the menstrual cycle consists of the follicular and luteal phases, separated by ovulation. During these phases, ovaries produce hormones that result in various physical, emotional, and cognitive symptoms: menstrual cycle symptoms. These symptoms (mood changes, bloating, and breast tenderness) occur most often during the late luteal phase.

We spoke with 20 trans women to ask them whether they had noticed physical symptoms that mirrored those of menstruation in cis women. 19 of them also tracked these symptoms over time using the Clue menstrual cycle tracking app. Finally, we collected (and analyzed) urine samples from 14 of them to look for correlations between their lived experiences and their hormone levels. 

What We Found

Our study participants reported a wide range of emotional, cognitive, and physical symptoms, including those typically associated with the luteal (low hormone) phase in cisgender women—such as cramps, tender breasts, and cravings. Overall, these symptoms tended to match up with times when estradiol levels were lower than participants’ personal averages, although patterns varied by individual.

Many participants shared that they do feel these physical and emotional symptoms on a cyclical basis. One woman noted, “I get everything but the period, all of it…sensitivity, tears, I get more emo…wild emotional changes…and GI issues.” Another woman said that she experiences breast tenderness, acne, mood swings, cravings, and cramps. Several women labeled their experience as a cycle or a period, with one individual stating explicitly, “It’s as simple as my period, I have my period.”

What This Means

By looking at hormone levels, symptom data, and interviews together, we found that some transgender women do have hormonal cycles that impact their moods and physical experiences… similar to cisgender women. 

Some of our participants viewed these ebbs and flows as “cycles,” in a way that contributed to gender euphoria—affirming their womanhood. This is really helpful information, as therapists and medical providers can support trans patients who may be seeking ways to affirm their identity as women. Others were ambivalent or dismissive of this narrative, reminding us that no community is a monolith: even when some experiences are common, other experiences are equally valid. What matters in how we define and perceive our (gender) identity is personal to each of us.

In Short…

Our findings challenge cisnormative definitions of menstrual cycles, which typically focus on ovulation and menstruation rather than the entire cycle. By documenting the presence of cyclical experiences among transgender women (and their interpretations of them), we hope we’ve expanded understanding of menstrual and hormonal health and embodiment. Our work demonstrates a real need for more inclusive frameworks that recognize gender-diverse experiences of hormonal cycles and identity.

Check out the full study here!

Baron, A., Prochazka, S., Schipper, K., Shea, A., Goldsmith, J., Winkler, I. T., & Houghton, L. C. (2026). A bloodless menstrual cycle? The perceived and hormonal menstrual cycle-like experiences of transgender women in the United States. International Journal of Transgender Health, 1–14. https://doi.org/10.1080/26895269.2026.2636663