Exploring the impact of gynaecological conditions on well-being across the lifespan and gender spectrum

Hughes, Chloe and Bourne, Katy (2025) Exploring the impact of gynaecological conditions on well-being across the lifespan and gender spectrum. PhD thesis, Lancaster University.

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Abstract

The thesis begins with a literature review exploring the association between premenstrual syndrome (PMS) and/or premenstrual dysphoric disorder (PMDD) and the experience of symptoms during the menopausal transition. The review included 24 studies that were identified via systematic searches on four databases with a focus on health research. The data were synthesised through a narrative approach, and findings propose a link between historical PMS/PMDD symptoms and a more negative symptomatic experience in menopause. The underlying mechanisms for this link are yet to be fully understood, however, the data suggests a link that reaches beyond biology and suggests psychosocial determinants to be influential. The empirical paper explored narratives from transgender and gender diverse (TGD) people who were assigned female at birth (AFAB) and who have lived experience of gynaecological and/or menstrual conditions/difficulties. Ten participants (two trans men, six non-binary and two non-binary/agender people) were interviewed, and data were analysed using Foucauldian Informed Narrative Analysis. Three narrative chapters emerged that were understood through the interaction with wider societal narratives, such as misogyny and cisnormativity. These chapters detail a journey of being dismissed and having symptoms normalised, resulting in long struggles with dysphoria and having to access gendered healthcare. The final chapter details the common struggle between cisgender and TGD individuals fighting against an inherently misogynistic healthcare system. The final paper is the critical appraisal, which focuses on key reflections from the author on the research process and addresses positionality.