“I thought I was bleeding to death”: Growing up intersex and unprepared for menstruation

Image Description: Two cracked restroom symbols—one male and one female—mounted on a wall, each split diagonally as if broken. Between them hangs a blank white plaque with a single drop of blood at its center.

When 18-year-old Roberto first experienced menstruation, she was terrified. Born intersex and raised as a boy, she had never been taught about periods, let alone how to manage one.

Before that terrifying day, Roberto had spent her entire life in a quiet village in Kisii County. Her parents never disclosed anything about her intersex identity, partly because they did not fully understand it themselves, and partly due to the stigma surrounding differences in sex development.

Roberto grew up playing football with boys, dressing like them, and following all the expectations of male childhood. Yet, as she entered adolescence, she began noticing subtle changes in her body that did not match those of her peers.

She occasionally experienced discomfort, mood shifts, and physical traits she could not explain. With no information about intersex bodies or reproductive health, she simply brushed these feelings aside. Conversations about menstruation were reserved for girls, leaving Roberto completely unprepared for what was coming.

“I thought I was bleeding to death, but I could not tell anyone, not even my mother,” she recalls. “I used an old T-shirt and hid it under my mattress.”

It was only years later, after meeting a community health volunteer who worked with intersex and gender-diverse youth, that Roberto finally shared her experience. The volunteer explained what it meant to be intersex, helped her understand her body, and connected her to a safe support group.

Through these conversations, Roberto slowly began embracing an identity that felt more aligned with who she truly was. She chose to use she/her pronouns because it was the first time she felt seen, understood, and comfortable in her own skin.

“It felt like breathing freely for the first time,” she says. “Like I could finally be myself without fear.”

The hidden reality of intersex menstruators

Roberto’s experience reveals a little-known truth: intersex individuals who menstruate are often invisible in menstrual health policies, education, and aid programmes. 

While Kenya, and Africa more broadly, has made progress in addressing period poverty among girls and women, intersex people are left behind, navigating their cycles in silence and shame.

When 23-year-old John first experienced menstruation, it was not a typical “coming-of-age” moment. Instead, it became a confusing and isolating chapter defined by stigma and secrecy. 

Growing up in South Nyanza, John lived in a household and a wider community that neither understood nor accepted their identity, let alone their menstrual health needs.

“I bled in silence for years, and yet I could not talk to anyone,” they recount. “My mother kept asking why I was not ‘normal’, but I was too scared to explain something I did not even fully understand myself.”

Intersex persons like Roberto and John are often excluded from the conversation about menstruation. 

“This is despite the fact that they suffer in silence,” says Margret Mogaka, a reproductive health advocate at the Kisii Teaching and Referral Hospital (KTRH).

Although the Kenyan government launched the Menstrual Hygiene Management Policy in 2019 to promote menstrual equity, intersex individuals are not included. 

“Menstruation is still framed as a female-only issue,” says Mogaka. “This excludes not only trans men but also intersex people, many of whom menstruate and need the same support.”

She adds that many public schools, clinics, and community programmes assume only girls need menstrual products or information. 

“This makes it nearly impossible for intersex menstruators to access sanitary pads or counseling without facing ridicule.” 

In 2022, Kenya released a distinct policy, this time related to Sexual and Reproductive Health more broadly. It calls for universal access to reproductive health and explicitly commits to protecting the rights of intersex persons, including prohibiting discrimination and inhumane treatment. 

Nonetheless, the guidelines are rife with problematic framing, positioning intersex identity as something to be “diagnosed” and “rehabilitated.”

The policy describes being intersex as “a disabling developmental state presenting with ambiguous genitalia at birth,” and gestures toward a “definitive” sexual identity that must ultimately be achieved.

Dennis Anyoka, an advocate of the High Court of Kenya, believes legislative recognition must be followed by tangible protections.

“The constitution acknowledges intersex persons, but we need policy documents that explicitly include their SRHR needs,” he says, “Without that, healthcare workers and schools remain blind to our existence.”

Kibagendi stresses that breaking the silence around intersex identity and menstruation requires more than statistics.

“It demands empathy, policy reform, and inclusive education,” he says, “Because no one, regardless of their sex characteristics, should suffer for bleeding.”

In Kenya, 44% of intersex persons born with a functioning uterus, ovaries, and vagina experience menstrual cycles, according to a report by Jinsiangu and Amka Africa.  

Within this demographic, menstrual health access is unevenly distributed, with 57% using pads, 9% tampons, 9% cloth, 4% cotton, tissue, or menstrual cups, and 13% not using pads or tampons at all. 

Kenya’s 2019 census officially recorded 1,524 intersex individuals, but human rights groups estimate the number is far higher due to underreporting and stigma.

Despite legal recognition, intersex persons still face a healthcare system ill-equipped to support their sexual and reproductive health. Public hospitals rarely have professionals trained to handle intersex-specific needs, especially those related to menstruation.

Potential Solutions

In many rural Kenyan communities, taboos around menstruation are amplified when it comes to intersex persons.

“There is a lot of shame and parents do not talk about it. Some hide their intersex children entirely,” says Joyce Kemuma, a community health worker in Nyamira County. “So, when an intersex child starts menstruating, it is traumatic for both the child and the family.”

Kemuma recalls attending to a 15-year-old intersex teen who had been menstruating for months without telling anyone, using dirty rags and newspapers. 

“She was afraid people would brand her a curse,” she explains.

Many intersex youths face confusion or denial of their biological realities. Some are subjected to harmful corrective surgeries or denied access to sanitary pads because they do not fit society’s stereotypical image of a menstruator.

KTRH’s Head of Clinical Services, Joyce Daniel, notes that medical curricula often overlook intersex health entirely.

“We are trained with a binary mindset of male or female, and this leaves a gap in both understanding and empathy,” she says. 

Even well-intended government programmes, such as the free pad distribution in public schools, do not reach intersex youth, many of whom drop out due to bullying or trauma linked to identity.

Despite these challenges, organisations such as Jinsiangu and the Intersex Persons Society of Kenya (IPSK) are amplifying intersex voices. They offer safe spaces, psychosocial support, inclusive menstrual kits, and advocacy for gender-sensitive health policies.

“Menstrual health is a human right,” says Njeri Wanjiru, a programme officer at Jinsiangu. “We are pushing for curricula reform, inclusive public health messages, and non-discriminatory access to sanitary products, because intersex people bleed too.”

In Nairobi, a pilot programme, InclusiFit, led by a community organisation is testing anonymous sanitary pad dispensers in informal settlements. These allow intersex individuals who may not feel safe buying pads publicly to access them discreetly. 

It is the first menstrual hygiene product in Kenya designed specifically for intersex individuals. It has undergone rigorous testing and trademark processes to ensure its effectiveness and accessibility.

InclusiFit is backed by a group of local activists and organisations, including community advocate Frankie Robert Kibagendi. 

“Being intersex is not just about the body. It is about unique anatomical realities that vary widely,” Kibagendi explains. “So far, no existing product has been designed to fit those realities. That is why we stepped in.”

Working closely with intersex persons themselves, the team developed a prototype tailored to different anatomical needs. The design process was consultative, with community members helping determine materials, comfort, and usability. Feedback is regularly collected to improve the product, ensuring it evolves with user experience.

Yet, innovation comes with a cost.

“We are still in the early stages,” Kibagendi says. “We have the concept and the design, but full-scale production is expensive.”

Understandably, with no major company or government agency taking up the project, access remains limited. Stigma persists, often rooted in myths and misinformation.

“The most common misconception is that intersex people are a curse,” Kibagendi says. “There is also a widespread belief that only people with vaginas menstruate, which is not always true. Some intersex individuals who were raised as boys can and do experience periods, but society rarely acknowledges this.”

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Edited/Reviewed by Samuel Banjoko, Caleb Okereke, PK Cross, Awom Kenneth, and Uzoma Ihejirika.

Illustrated by Rex Opara.