Polycystic Ovarian Syndrome (PCOS):
A gender-affirming guide
Why a gender-affirming & gender neutral approach?
At Progressive Therapeutic Collective, we recognize the unique needs of individuals across the gender spectrum who are affected by Polycystic Ovary Syndrome (PCOS).
Our new gender-affirming guide to PCOS is designed to provide comprehensive and sensitive support that respects and acknowledges all gender identities.
This guide covers both the medical and emotional aspects of PCOS, offering introductory information and resources to help people navigate their healthcare journey with confidence and understanding.
Polycystic Ovary Syndrome (PCOS) is a common hormonal condition that can affect individuals of any gender who have ovaries. It is characterised by a range of symptoms including irregular menstrual cycles, excessive hair growth, acne, and difficulties with fertility.
PCOS is also associated with metabolic issues such as insulin resistance, which can increase the risk of developing type 2 diabetes and cardiovascular disease.
The condition can significantly impact physical, emotional, and mental health, making comprehensive and affirming care essential.
Why is PCOS a Misnomer
The term "Polycystic Ovary Syndrome" is a misnomer because it implies that the presence of multiple ovarian cysts is necessary for diagnosis, which is not always the case. In reality, the name does not fully capture the complexity of the condition, as PCOS can occur without the presence of ovarian cysts and involves a broader spectrum of hormonal imbalances and metabolic issues. This mislabeling can lead to misunderstandings and misdiagnoses, underscoring the need for greater awareness and more accurate terminology that reflects the diverse presentations of PCOS.
Challenges with Diagnosis and Treatment
Diagnosing and treating PCOS presents several challenges, particularly for gender-diverse individuals. Symptoms of PCOS can overlap with those of other conditions, and there is no single test for diagnosis, often requiring a combination of medical history, physical examination, and blood tests. Gender-diverse individuals may face additional barriers, such as lack of access to gender-affirming healthcare and the potential for bias in medical settings. These challenges can lead to delayed diagnosis and treatment, exacerbating symptoms and negatively impacting quality of life.
Current Approaches and Path Forward
Current approaches to managing PCOS focus on addressing individual symptoms and improving overall health. This includes lifestyle modifications like diet and exercise, medications to regulate menstrual cycles and manage symptoms, and sometimes fertility treatments.
For gender-diverse individuals, it is crucial that healthcare providers offer affirming and inclusive care that respects their identity and unique experiences. Moving forward, increased research, education, and awareness are needed to develop more comprehensive and tailored approaches to PCOS management, ensuring that all individuals receive the support and treatment they need.
Jess 36
“Living with PCOS has been tough, especially managing symptoms like irregular periods and excessive hair growth, not to mention the emotional toll. But finding a gender-affirming GP has made a huge difference. My GP really listens to me, respects my gender identity, and offers care that addresses both my physical and mental health. This supportive relationship has made me feel understood and validated, helping me handle PCOS with more confidence and optimism.”
DIAGNOSIS
Medical History
A detailed medical history is crucial in diagnosing PCOS. Healthcare providers will ask about menstrual cycle irregularities, symptoms such as excessive hair growth, acne, and weight changes, as well as family history of similar conditions. For gender-diverse individuals, it is important to discuss any hormonal therapies or surgeries that might impact symptoms.
Physical Examination
A physical examination can help identify signs of PCOS. This may include checking for excess hair growth (hirsutism), acne, and other skin conditions. Body mass index (BMI) and blood pressure may also be assessed. A gender-affirming approach ensures that the examination is conducted with sensitivity and respect for the individual's gender identity.
Blood Tests
Blood tests are used to measure hormone levels, which can indicate PCOS. These tests may check levels of androgens (male hormones), such as testosterone, as well as other hormones like insulin, glucose, and lipid levels. It's important to tailor these tests to the individual's unique hormonal profile, especially for those undergoing gender-affirming hormone therapy.
Ultrasound
An ultrasound scan of the ovaries can help diagnose PCOS by checking for the presence of multiple small cysts and assessing the thickness of the ovarian walls. However, it's crucial to note that not all individuals with PCOS will have these cysts, and their absence does not rule out the condition. A gender-affirming approach involves explaining the procedure and ensuring the individual's comfort throughout the process.
Diagnostic Criteria
The diagnosis of PCOS is often based on the Rotterdam criteria, which require at least two of the following three features:
Irregular or absent menstrual cycles
High levels of androgens (detected through blood tests or physical symptoms like hirsutism)
Polycystic ovaries observed on ultrasound
Healthcare providers should use these criteria flexibly and consider the individual's entire clinical picture, ensuring a respectful and affirming diagnostic process.
Misconceptions of PCOS
Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder that affects many individuals worldwide, yet misconceptions about the condition persist. These misunderstandings can lead to confusion, misdiagnosis, and inadequate treatment. Let's explore some of the most common misconceptions about PCOS and set the record straight.
Misconception 1: PCOS Only Affects Women
One of the most prevalent misconceptions is that PCOS only affects women. In reality, PCOS can impact anyone with ovaries, regardless of their gender identity. This includes transgender men, non-binary individuals, and gender-diverse people. Recognizing this is crucial for providing inclusive and affirming healthcare.
Misconception 2: You Must Have Ovarian Cysts to Have PCOS
The name "Polycystic Ovary Syndrome" is misleading because it suggests that having ovarian cysts is necessary for diagnosis. However, not all individuals with PCOS have cysts on their ovaries. The condition is characterized by a range of symptoms, including hormonal imbalances and metabolic issues, which can occur even in the absence of cysts. This misconception can lead to underdiagnosis or misdiagnosis, particularly when healthcare providers rely solely on ultrasound findings.
Misconception 3: PCOS Is Always Linked to Obesity
While many individuals with PCOS may struggle with weight management, the condition affects people of all body types. Lean PCOS is a term used to describe individuals who have PCOS without being overweight or obese. Weight alone should not be used as a diagnostic criterion, and it's important to consider the full spectrum of symptoms and signs.
Misconception 4: PCOS Is Just a Reproductive Issue
PCOS is often thought of solely as a reproductive disorder because it can cause irregular menstrual cycles and fertility challenges. However, PCOS is also a metabolic condition that can have wide-ranging effects on overall health. It can increase the risk of developing type 2 diabetes, cardiovascular disease, and other metabolic disorders. Addressing PCOS requires a holistic approach that goes beyond reproductive health.
Misconception 5: There Is a One-Size-Fits-All Treatment
PCOS manifests differently in each individual, meaning there is no single treatment that works for everyone. Treatment plans should be personalized, taking into account the specific symptoms and needs of the individual. This can include lifestyle modifications, medications to regulate menstrual cycles and manage symptoms, and mental health support. A gender-affirming and inclusive approach is essential to provide effective care.
Misconception 6: PCOS Symptoms Are the Same for Everyone
The symptoms of PCOS can vary widely from person to person. Some may experience severe acne and hair growth, while others might struggle more with weight gain and menstrual irregularities. This variability can make it challenging to diagnose and treat PCOS, emphasizing the need for individualized care plans that address each person's unique experience.
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We don’t receive any government assistance, nor private funding. All of our work is funded solely through our therapeutic activities.
We have chosen to provide a two-tier payment option for individual counselling, in recognition of the cost of therapeutic support.
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Pay the Rent & Mutual Aid
The Pay the Rent movement calls for non-Indigenous individuals and businesses to regularly contribute financially to Indigenous organisations as part of reparations and restorative justice. This movement aims to provide tangible support to Indigenous communities, addressing historical and ongoing injustices while fostering a sense of accountability and solidarity.
At Progressive Therapeutic Collective (PTC), we've been paying the rent since our inception four years ago.
Each year, we allocate 1% of our annual profit to The Westerman Jilya Institute for Indigenous Mental Health and another 1% to Decolonise Sex Work Australia, a Blak mutual aid fund for sex workers. As a white-owned business, we believe it’s crucial to acknowledge and address systemic injustices against Indigenous communities. Our commitment to mutual aid is about taking concrete actions to bring aboug meaningful and genuine social change.
