England’s official menopause guidance to include trans and non-binary people for the first time

Two people are holding placards in support of trans people, during the demonstration for better transgender health care organized in Amsterdam

Trans and non-binary people will be included for the first time in NICE guidance on the menopause, the public body has announced.

The National Institute for Health and Care Excellence (NICE) provides evidence-based recommendations for healthcare in England, and its current menopause guidance, last updated in 2019, is aimed at “women in menopause, and their families and carers”, and “healthcare professionals who care for women in menopause”.

Of course not all people who go through the menopause are women but, as with many highly-gendered areas of healthcare like pregnancy services, gynaecological care and prostate cancer screening, trans and non-binary folk had been left out of the conversation – until now.

On Friday (27 May), NICE published the scope of its updated guidelines, to be finalised next year, which will explicitly include trans and non-binary people, alongside cisgender women, over the age of 40 who are affected by menopause, perimenopause and postmenopause.

The new guidance is aimed at “women, non-binary and trans people with menopause, their families or carers, and the public”, and “healthcare professionals who care for women, non-binary and trans people with menopause”.

The guidance will reassess the health outcomes of hormone replacement therapy (HRT) during menopause, will look at the effectiveness of of cognitive behavioural therapy (CBT) in managing menopause symptoms, and will also include advice on “managing menopause-like symptoms in trans and non-binary people who are taking cross-sex hormones for treatment of gender dysphoria, including those who are medically transitioning”.

During scoping, NICE carried out an equality impact assessment, it said, and noted that “it is important to consider intersectionality, that an individual may experience several marginalised identities” which impact their experience of menopause.

Dr Gail Allsopp, NICE interim chief medical officer, told the i: “We recognise the profound impact, both physically and psychologically that menopause can have and the need for updated guidance. We are working at pace on this guideline update to ensure that its impact can be realised as soon as possible.”

Gaele Lalahy, COO of leading menopause support app Balance, told PinkNews: “The news that the National Institute for Health and Care Excellence are expanding their menopause guidelines to be more inclusive is very welcome.

“It’s important that accurate and evidence-based information about the perimenopause and menopause is provided for all that need it; this includes anyone and all genders. It’s important that we all continue to work towards providing tailored content for trans and non-binary people, recognising the specific needs that are not currently addressed in mainstream menopause spaces.”