As part of activity to mark Pride 2025, Dr Leila Frodsham (Consultant Gynaecologist and Psychosexual Service Lead at Guy’s and St Thomas’ NHS Foundation Trust) discusses the need for a greater understanding of the complexities of menopause for LGBTQ+ people.
Are LGBTQ+ people satisfied with their experiences of menopause care currently?
While exact figures vary across studies, research indicates that both LGBTQ+ people and cisgender women often report dissatisfaction with menopause-related care in primary healthcare settings.
There are distinct challenges that uniquely affect LGBTQ+ people. For example, the impact of hormone replacement therapy is different and not fully understood for non-binary or trans people.
Addressing these disparities requires targeted education for healthcare providers and inclusive research that considers the diverse experiences of all individuals undergoing menopause.
What are some of the specific barriers to, and gaps in, menopause care for LGBTQ+ people?
Mental health concerns are already more prevalent among bisexual and trans people — and we know that menopause itself can significantly increase the risk of mental health struggles. This intersection creates a heightened vulnerability.
For trans people experiencing genitourinary syndrome of menopause (GSM), compassionate and knowledgeable care is crucial. Around 80% of individuals in this group may suffer from genital dysphoria, making the application of hormone-based treatments — which are vital for sexual comfort, reducing UTIs, and improving smear test experiences — especially challenging.
However, treatments like topical vaginal and vulval oestrogens play a key preventative role, reducing the risk of sepsis and even mortality. Offering these therapies in a sensitive and inclusive way is essential.
Sometimes LGBTQ+ people avoid accessing healthcare altogether through fear of stigma. Cancer outcomes in the LGBTQ+ population, for example, are generally poorer. In particular, encouraging trans men to attend cervical screening appointments is essential to reduce preventable risk. This is likely to be true when choosing to access care to help treat symptoms of the menopause too.
How can healthcare workers improve the support provided?
As healthcare professionals, it is our responsibility to understand the complexities our LGBTQ+ patients face and to continually improve our knowledge, communication, and care to better serve them.
We need to do more to ensure an empathetic and inclusive healthcare experience, and encourage ongoing access to both physical and mental healthcare to improve health outcomes within the LGBTQ+ population.
It’s also vital to recognise that LGBTQ+ individuals face higher levels of social isolation and poverty, which often worsen with age. Proactively reaching out, creating specialist services, and addressing these disparities can have a profound impact.
You’ll be speaking at the RCOG World Congress 2025 on Queer Menopause. What can attendees expect from your session?
The LGBTQ+ network are delighted to host our third LGBTQ+ stream at the RCOG World Congress 2025 to raise the profile of the gynaecological health complexities and needs of the LGBTQ+ population.
I look forward to leading the session on Queer Menopause and discussing how to improve the management of healthcare for LGBTQ+ groups in an empathetic way, with practical tips on improving inclusivity for menopause support and prescribing.
LGBTQ+ people face health inequalities across the board, and the RCOG is committed to improving their access to, and experience of obstetric and gynaecological (O&G) care.
- Read more about our World Congress 2025 here.