If you had asked "before 2015 can men menstruate" in a doctor’s office or a university lecture hall, the answer you got would depend entirely on who you were talking to and what, exactly, you meant by "man."
Biology is messy.
Medical history doesn't always move in a straight line. Long before the mid-2010s, when cultural conversations around gender identity and biological sex became a staple of the evening news and social media feeds, the medical community was already grappling with the reality that the human body doesn't always fit into two neat boxes. To understand the landscape of that era, you have to look at three very different things: transgender healthcare, intersex conditions, and rare medical anomalies.
It's complicated.
Back in the early 2000s, the "Standards of Care" published by the World Professional Association for Transgender Health (WPATH)—specifically version 6 (2001) and version 7 (2011)—were the blueprints for how doctors treated trans people. These documents recognized that transgender men existed. These are people who were assigned female at birth but identify as men. For these individuals, menstruation was a lived reality. It wasn't a "new" phenomenon that started in 2015; it was a clinical fact that had been managed by endocrinologists and therapists for decades.
The Reality for Transgender Men Pre-2015
For a trans man living in 1995 or 2010, the "monthly cycle" was often a source of significant distress, commonly referred to as gender dysphoria. But it happened. Unless a person underwent a hysterectomy or used high doses of testosterone to suppress the uterine lining, the biological process continued.
Testosterone therapy isn't a magic "off" switch for everyone.
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Even before 2015, medical journals like The Journal of Clinical Endocrinology & Metabolism were publishing studies on how hormone replacement therapy (HRT) affected the reproductive systems of transmasculine individuals. While testosterone usually stops ovulation and menstruation within a few months, it doesn't always work perfectly. Some men experienced "breakthrough bleeding." This created a unique medical scenario where someone who lived, worked, and was legally recognized as a man was still dealing with a menstrual cycle.
It's honestly a bit of a misconception that this is a "modern" debate. The 1960s and 70s saw the establishment of gender identity clinics at major institutions like Johns Hopkins University. The doctors there weren't confused by the idea of a man menstruating; they were busy trying to figure out how to stop it to help their patients feel more comfortable.
Persistent Müllerian Duct Syndrome (PMDS)
Then there is the purely "cisgender" male perspective—meaning people born with XY chromosomes who develop as males. Can they menstruate? Generally, no. But biology loves an exception.
Take Persistent Müllerian Duct Syndrome (PMDS). This is a rare intersex condition. In a typical male fetus, the body produces a hormone called Anti-Müllerian Hormone (AMH) which causes the "female" reproductive tracks to wither away. In people with PMDS, this doesn't happen.
The result? A person who looks entirely male on the outside—has a penis, testes, and secondary male characteristics—but also possesses a uterus and fallopian tubes on the inside.
Before 2015, there were dozens of documented cases of PMDS in medical literature. Most were discovered accidentally during surgeries for hernias or undescended testes. In some extremely rare instances, if the uterus was connected to the urinary tract, these men could experience "hematuria," which is blood in the urine. While not technically "menstruation" in the sense of a cycle intended for pregnancy, it was the shedding of uterine lining in a person who identifies and appears as a man.
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Hematuria and the "Male Period" Misnomer
We also have to talk about how people used the word "menstruate" colloquially before the 2010s. Sometimes, people use the term to describe any cyclical pain or bleeding.
There is a parasitic infection called Schistosomiasis. It’s caused by fluke worms. In parts of Africa where the infection is endemic, it causes chronic bladder inflammation and bloody urine. In the mid-20th century, some anthropologists noted that in certain communities, this was so common among young men that it was jokingly or culturally referred to as a "male period." It was seen as a rite of passage into puberty, even though it was actually a sign of a debilitating disease.
It’s a grim example, sure. But it shows that the concept of a "bleeding man" has existed in various cultural and medical contexts for a long time.
The 2011 Shift in Medical Documentation
If you're looking for a "turning point" before 2015, look at 2011. That was the year WPATH released Version 7 of its Standards of Care. This document was massive. It moved away from the idea that being transgender was a "disorder" and focused on "gender incongruence."
This shift was huge for healthcare providers. It meant that a man walking into a clinic and asking for help with menstrual cramps wasn't treated as a biological impossibility, but as a patient with a specific, manageable need. Doctors were already being trained on this.
The Endocrine Society also released clinical practice guidelines in 2009 regarding the treatment of transsexual persons. These guidelines explicitly discussed the management of the menstrual cycle in trans men. So, if you were a medical professional reading the peer-reviewed literature in 2010, the answer to "can men menstruate" was a nuanced "Yes, in specific circumstances involving transgender or intersex health."
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Why the Question "Before 2015" Matters
Why is 2015 the cutoff in so many people's minds? Probably because that's when the "Mainstream Transition" happened. This was the era of the "transgender tipping point," as Time magazine famously put it.
Before 2015, these discussions were mostly confined to:
- Academic medical journals.
- Small, tight-knit LGBTQ+ communities.
- Intersex advocacy groups like the Intersex Society of North America (ISNA).
Most people didn't think about it because they didn't have to. The visibility wasn't there. But the science was.
The reality is that "man" is a social and legal category, while "menstruation" is a biological process. Usually, they don't overlap. But "usually" isn't "always." In medicine, the exceptions are often where we learn the most. Whether it was a trans man in 1990 navigating a world without legal protections, or a man with PMDS in 2005 discovering he had a uterus during a routine hernia repair, the phenomenon has always been part of the human experience.
What to Take Away
The history of this topic is less about a change in biology and more about a change in what we choose to acknowledge.
If you're researching this for historical or medical reasons, the evidence is clear:
- Transgender men have existed and menstruated throughout history, with medical protocols for managing this dating back decades.
- Intersex conditions like PMDS have historically resulted in individuals with male phenotypes possessing uterine tissue.
- Medical literature prior to 2015, particularly from the Endocrine Society and WPATH, provide the clinical framework for these realities.
The next step for anyone interested in this intersection of history and biology is to look at the "hidden" medical records of the 20th century. Dig into the archives of the Harry Benjamin International Gender Dysphoria Association (the precursor to WPATH). You’ll find that the "modern" debate is actually decades old. Understanding that biology is a spectrum rather than a binary isn't a new-age invention; it's the result of looking closely at the data we've had all along.