'Dignity for all who bleed': Trans, non-binary Kenyans face menstruation stigma

• Period poverty is widespread across Kenya
• Trans, non-binary Kenyans face additional stigma
• Fear of mockery reduces access to sanitary pad

NAIROBI - When 26-year-old Alex from Mathare, one of Nairobi's most densely populated informal settlements, gets his period, he disappears from public view.

A transgender man, Alex avoids shops, clinics and communal toilets during this time. He doesn't buy sanitary pads for fear of ridicule and instead resorts to cutting strips of cloth from old blankets.

"It's not that there are no shops selling pads," he said. "It's the humiliation I face just trying to buy them. People stare. Some laugh. The last time I tried, the shopkeeper looked me in the eye and said, 'Pads are for women. Are you confused?' Then he refused to sell them to me."

This kind of reaction is also why Alex, and other LGBTQ+ people interviewed for this story, chose to use pseudonyms to protect their identities.

Across Kenya, period poverty — the lack of access to safe, affordable menstrual products — remains a major challenge.

But transgender men and non-binary individuals, also face stigma, and menstruation comes with shame, misgendering and sometimes ridicule.

Fear of insults, mockery

Trans and non-binary Kenyans who menstruate are often excluded from mainstream public health messaging around menstrual hygiene and overlooked in many LGBTQ+ advocacy spaces that fail to recognise the complexity of their needs.

"Stigma is the number one barrier," said Grace Moraa, a community health volunteer in Kisii County in western Kenya.

"Even when people can afford menstrual products, they may still avoid buying them because of the fear of being insulted, mocked or outed."

In a deeply conservative society where gender roles are rigid, anyone who breaks these norms can become a target, Moraa said. Human rights organisations have documented numerous cases of discrimination, harassment and targeted violence against gender-diverse people in urban and rural communities.

Chris, a 24-year-old non-binary university student living in Homa Bay town in western Kenya, said they stay in their room with their phone off during their period.

"Even the cramps are easier to bear than the stares and comments. I once went to a health clinic and was asked, 'Are you a woman or a man? Because this isn't normal.'"

Health risks

Given the obstacles, many trans or non-binary people improvise, using rags, cotton wool, newspapers or plastic bags instead of sanitary pads, or wearing several pairs of underwear.

But this behaviour can be risky.

"Improvised methods can cause infections, skin rashes or even toxic shock syndrome in extreme cases," says Lilian Kamau, a Nairobi-based gynecologist.

"But for many gender-diverse individuals, the fear of discrimination outweighs the risk to their health."

For many transgender men, menstruation can intensify gender dysphoria, the psychological distress that results from a mismatch between one's gender identity and assigned sex at birth.

When periods are managed in secrecy, they can trigger anxiety, depression and even suicidal ideation.

"In the slums and rural areas, there is zero visibility for trans people who menstruate," says Jane Mwikali, a social worker who supports LGBTQ+ youth in the Kibera informal settlement in Nairobi.

"There are no safe clinics, no inclusive schools, no pads in male toilets. They are completely invisible. And invisibility is dangerous."

This year, World Menstrual Hygiene Day on May 28 focused on inclusion, calling for all who menstruate to be allowed to do so with dignity and support, regardless of gender identity.

"Menstrual health is not just a women's issue," said Frankie Kibagendi, programmes lead at Jinsiangu, a Kenyan sexual and reproductive health rights organisation campaigning to include transgender, non-binary, and intersex individuals in menstrual health programming.

"It's a human rights issue. We are fighting for visibility and dignity for all who bleed — including trans men, intersex persons, and non-binary people."

Forced to leave

In conservative places like Homa Bay, Kisii and central Meru, menstruation is still a taboo subject and considered shameful and impure. People who are menstruating are often excluded from daily activities like cooking or attending religious events.

These traditional beliefs also affect trans people.

"People assume only women bleed. If you're a man and you buy pads, they say you're possessed or cursed," says Awink Owino, a transgender activist based in Homa Bay town.

"In some cases, people are forced to leave home or drop out of school when their identity and menstruation intersect."

But change is happening. Young people in the Kibera Pride Initiative are pushing for more inclusive healthcare, including gender-neutral waiting areas in clinics and the installation of sanitary pad dispensers in women's and men's bathrooms.

A pilot programme run by volunteer nurses and parents of gender-diverse children in western Kenya is training midwives to use inclusive language and care for gender-diverse patients.

"We have to change the system from the ground up," says Morris Odhiambo, an independent trainer who works with the programme. "Menstrual health is a basic right. And that includes all people who bleed."

For Chris, the most important thing is recognition.

"Just say it out loud. Trans men can have periods. Non-binary people can have periods. If we're not acknowledged, we're not supported. And if we're not supported, we suffer."

Alex dreams of a future where he can walk into a shop and buy menstrual pads without fear.

"I'm not ashamed that I bleed," he says. "I'm ashamed of how society treats me because of it."

(Reporting by Peter Ongera; Editing by Ayla Jean Yackley.)