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  • Denice Bracken

Embracing the Queerness of PCOS: The intersection of PCOS, Gender, & Identity

Updated: Sep 26, 2023


TW: Gender Identity. Gender Norms. High-demand Religions. Deconstruction. Dysphoria.


Introduction


Shame is a powerful force, insidiously woven into the fabric of modern society's identity. It creeps into our beings when the image we hold of ourselves doesn't align with societal expectations. When I first encountered the symptoms of PCOS (Polycystic Ovary Syndrome), I felt shame—for what I perceived as a profound loss of identity. An identity that was thrust upon me by a system that prescribed rigid spoken and unspoken standards for womanhood.


This condition unexpectedly led me to explore my identity, appearance, gender dysphoria, gender norms, and challenged me in the most unexpected, yet liberating ways.


PCOS affects individuals across the gender spectrum, presenting unique journeys that defy conventional narratives. PCOS is experienced in many ways by individuals and cultures all over the world. For some, PCOS is a nightmare. For others, that may not be the case. I will not attempt to speak on a lived experience that is not mine, though I would like to highlight the diversity of lived experiences when it comes to PCOS. I will speak to the lived experience that is mine in hopes that it might benefit those who felt their journey never quite resonated with the mainstream narrative around PCOS.



Breaking the Gender Binary of PCOS


Body hair. We all have it. Some wish they had more. Others wish they had less. Body hair is seen differently around the world and even throughout history. The discussion around PCOS often centers on its physical manifestations, such as facial hair growth. I myself have made many self-deprecating jokes about my 'beard' and becoming a 'man.' With womanhood being so closely associated with physical attributes and biology, it was hard not to feel my womanhood slipping away as my face was beginning to show signs of facial hair that would make any 13-year-old identifying boy ecstatic.


Interestingly enough, facial hair is just scratching the surface of what it means to have an identity of a woman in today’s society and how a condition like PCOS can blur the lines between the binary. This also reflects on what it means to have ‘seemingly masculinizing features’ as a woman in a world dominated by men who actively bully the feminine-seeming characteristics out of themselves. PCOS and its mainstream perspective on the condition highlights just one of the many ways our society pressures individuals to conform to gender norms. It comes down to the perception that ‘women’ shouldn’t have facial hair, they shouldn’t have masculine qualities.


Some of my favorite pieces of history are the many ancient Goddesses from cultures all over the world who don a full-face beard: Ishtar, Venus, Artemis, and Sif are just a few. We don’t often hear about these depictions today, most likely due to the taboo nature of women being perceived as masculine, or rather phobia around gender queerness or trans, but historians believe it to be a symbolic representation of their power.


These otherwise feminine deities host great powers of life and death, fertility, war, and wisdom. Now, I could go down the rabbit hole of power being masculinized, but that is for another time. Ultimately, however, what was once seen as a symbol of power in ancient context was a deep point of shame for myself and others.


Over the millennia, body and facial hair on women (rather the lack of) became a way to distinguish privilege, class, and instill the desirability of ‘youthfulness’. In the last 100 years alone, the removal of female body hair has drastically increased, and the stigma around body hair further falls into categories of disgust for many.


With a condition like PCOS that increases body hair for females, it forces us to investigate the binary gender construct and the expectations placed on those who don't fit neatly into predefined boxes. This struggle with internalized shame and guilt for being 'different' is an opportunity for self-discovery.



The Language around Hormones


We've been taught that testosterone is the 'male hormone,' and estrogen is the 'female hormone.' While this simplification isn't entirely incorrect, it can be dangerously misleading. These hormones are not exclusive to any one gender; they're produced by all sexes in varying amounts. Unfortunately, these labels have contributed to the stigma surrounding PCOS, particularly the fear of having 'too much' testosterone.


Testosterone has often been given a bad wrap when it comes to male behavior. For decades, there has been talk that elevated testosterone leads men to engage in behaviors that are violent, aggressive, or criminal. This simply isn’t true. Yet, I can’t help but conjecture if these types of narratives have spilled onto women who have elevated testosterone being labeled as more assertive, aggressive, or dominating. Labels that are not considered acceptable by society standards for women.


PCOS has several subtypes, some of which consist of elevated androgens (testosterone). These hormones, if ‘elevated’ in female individuals, can lead to increased body and facial hair growth, male pattern hair loss, acne, increased muscle mass, and even the deepening of the voice. For someone who perceives themselves as what is traditionally a female or woman-these features can be a thief to identity.


My personal journey with PCOS mirrored this struggle early on. I felt like I was constantly at war with my own body, striving to fit into the prescribed mold of femininity, yet my body was opposing those norms.


Fighting to remain in the mold was an anxiously obsessive priority. Constantly feeling for chin hairs, plucking, shaving, waxing, monitoring my hairline, women’s clothing never fitting right- yet men’s clothing not fully representing who I was. I was in a vicious cycle of loathing. It was mentally exhausting worrying about my PCOS symptom presentation and fear of being seen as ‘too masculine.’



Identity


While I was never hyper-femme in any shape or form, having grown up in a large family of brothers, I always felt I had to constantly strive to be the soft, meek, and 'feminine woman' that was expected of me-having been raised in a high-demand conservative American religion was liable for that expectation.


Once I removed myself from that system, I was free to essentially rebuild myself from the ground up. I was inspecting every nook and cranny of what made me, what I wanted to keep, what I wanted to throw out, and what needed to be rebuilt anew. Because identity trauma is the gift that keeps on giving, I got to re-evaluate my perspective around femininity/masculinity and how that interrelated with my PCOS identity.


The language used to discuss PCOS emphasized that I had 'too much male hormone,' and therefore too much masculinization- amplifying my feelings of abnormality and brokenness. My self-worth was intricately tied to these perceptions. My definition of being a woman and a female was so wrapped up in not having the things that I perceived as male. I was constantly fighting against myself and allowing others to declare that these things made me…wrong.


Identifying and putting these feelings into words, listening to others’ experiences on identity, and allowing myself to release my pathological identity to PCOS began to shift this perspective.


What if testosterone and PCOS didn’t make me wrong…but they simply made me…Me! I didn’t have to hold myself to standards that I no longer related to, nor truly ever related to. I didn’t have to hold shame for how my body was showing up in this life. I would never have said to someone else that they were wrong for who they are or how their body is. I wasn’t extending myself the grace to accept myself in all its complexity.


The characteristics and ideals of what I thought a woman should be were beginning to completely fall away. Those unnecessary expectations from my upbringing being called into question and charged for their disorderly conduct. It was a revelation that began the process of dismantling my preconceived notions of womanhood.



PCOS & Reframing


Reframing my perception of what it means to be a woman for myself, writing into my definition acceptance of my body’s facial hair and all, doing this invited me to harness a more acceptable, healthy, loving, and respectful relationship towards my body.


While I still don’t love that hair loss or excessive body hair growth are a part of PCOS- more that I am inconvenienced by it at times. There are things I have really loved about PCOS and have grown appreciation towards like muscle gains. After all, who doesn’t love a #musclemommy ;-).


As Sam Richardson explored in their article, A Saintly Curse: On Gender, Sainthood, and Polycystic Ovary Syndrome, “PCOS was a beautiful and accidental queering of the body.” For those who are non-binary or trans, PCOS may feel completely affirming. A generous alignment of person and body. A reminder that perception is everything.


Reframing my language, rewilding my identity as a woman, lifted the shame I’d felt around the ‘masculinization’ of my body. I removed the stigma that the presentations of my PCOS symptoms were bad, wrong, or abnormal. I began accepting my body as it is and as it presents; allowing my identity to be a more fluid and genuine expression of myself at any given time.


In the deconstruction of my identity after leaving a high-demand religion and having the experience of PCOS in and outside of that context. The deconstruction of gender norms and motherhood emerged.



Gender Norms, Motherhood, & PCOS


PCOS impacts female-bodied individuals of reproductive age, resulting in potential

sub-fertile conditions. This is a driving factor for many individuals when it comes to seeking medical and nutrition services, as well as support groups.


All desires and choices are valid when it comes to having children or not. Representation is important.


As I began entering the PCOS realms, online support pages, I began noticing a lot of stereotypical gender norm language around PCOS, more pointedly in regards to conception, pregnancy, and motherhood. The heartbreak of these individuals wanting children but struggling to conceive flooded these PCOS spaces. Aside from PCOS weight loss marketing, PCOS fertility marketing is the pitch that most practitioners aim for when it comes to PCOS. As someone who never really wanted children but was told that I should be wanting them- this was difficult. On one hand, I felt for their misery, on the other, I knew I’d never be able to relate completely. I felt like a 'cyster' impostor.


In college, I remember admitting out loud for the first time that I never desired to have children (I had felt that way since adolescence, I just never felt I could discuss it). This was culturally taboo. I remember to some degree feeling immense relief when I was told that I wasn’t ovulating, followed by immense shame because my whole “god-given” purpose was to be childbearing and rearing. The message being clear that my purpose and worth were tied to whether or not I was going to enter into motherhood. (Again- I’m not hating on motherhood- it never called to me like I saw it call to so many individuals).


My whole purpose (according to the religion I was raised in) was supposed to be centered around me raising children in the faith. The dissonance that was my life up to that point is honestly truly remarkable and unimaginable.


I entered PCOS spaces torn. I never wanted kids. I felt like nature had given me a twisted gift. The unfortunate reality remained- many spaces were very much “if you don’t want kids…and if you don’t want to rant endlessly about your symptoms….why are you here?...Maybe you should leave.”


I felt ‘wrong’ again, trying to fit myself into a gendered expectation that I truly didn’t resonate with. After undergoing religious deconstruction, gaining higher education, and understanding PCOS more comprehensively, I realized the need for PCOS spaces that included more diversity. Spaces that focused on individualized health, not just femininity, conception, and fertility. Spaces that acknowledged PCOS as a condition impacting metabolic health, immune health, and mental health. I realized I was wanting to build room for more of the nuances of PCOS. I was wanting a space for those who find PCOS affirming. For those who can see the complexity in it outside of the box. For those who don’t follow a traditional style. For others that were like me.



Embracing Diverse Identities


We all have unique stories and truths. Many things can be true at once, despite, by all appearances, their differences. We can exist between the traction of the opposites.


PCOS is a condition with deep-reaching impact. It can be hard to not begin to identify with the symptoms themselves. While PCOS may impact our perception of our identity, it is not to define who we are (at least not without consent).


When researching PCOS and gender identity, there were a handful of articles that attempted to find correlation between PCOS, gender, and sexual orientation. They all felt like poorly done research trying to explain why someone might be gay, or lesbian, or trans. There are also exciting ones that show PCOS can be gender-affirming for some.


Overall this can be deeply problematic for several reasons: it attempts to pathologize anyone who is not cis-gender heterosexual and weaponizes PCOS as the cause-stating that excess testosterone is driving their behavior, furthering the gendered narrative around ‘male’ hormone, furthering the story that PCOS steals feminine identity. Thus providing a pitching point for several PCOS-focused practitioners to target individuals into their programs to restore their femininity.


PCOS does not define queerness or gender or identity. That is something we find for ourselves. PCOS can play a unique part in that journey, offering us the invitation to explore and figure things out.


Each PCOS story is unique. In the end, PCOS did not 'steal’ my femininity, though that is not to say that those who feel that way don’t exist and have a valid right to their story. For me, I am the one who gets to define what my femme looks like. Not everyone with PCOS identifies as female, womxn, or even male. Expression of self goes far beyond the reach of PCOS. We get to define ourselves presently, not others, or diseases, or even past versions of ourselves.


Within and without the PCOS community, embracing diverse gender identities and presentations is crucial to the health of our communities. Life exists outside of the binary and traditional styles. Whether you are a cis-gendered lesbian trying to conceive, or a trans man or non-binary trying to conceive, or perhaps you have made the decision to be childfree, or you aren’t sure yet on anything but just want to address PCOS for your own personal benefit- all should be welcomed.


Conclusion


PCOS provides us with a unique and profound opportunity to not only explore our identities but also to challenge and reshape societal norms. It serves as a reminder that we all exist on a spectrum of identity and expression. As I’ve delved into the multifaceted intersection of PCOS and gender, it becomes clear that embracing diverse identities and experiences is a transformative journey.


By reframing our perceptions of ourselves and others, we have the power to create a more inclusive and supportive PCOS community and, in turn, a more inclusive and accepting world. We have the power to release shame. PCOS invites us to celebrate the beauty of our individuality and the richness that comes from diversity.


I extend an invitation to you, to embark on your own journey of self-discovery. If you have PCOS, take a moment to reflect on the language you use to define yourself and how it might be contributing to self-limiting narratives. Explore the stories of non-conforming individuals with PCOS, for you may find that their experiences resonate more deeply with your own than you ever imagined.


In doing so, we can collectively foster a sense of belonging and empowerment for everyone, regardless of where they fall on the gender spectrum. It's a journey worth embarking upon—one that can lead to a world where acceptance and diversity are celebrated, and where the uniqueness of each individual is cherished.



 

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References/Resources for your leisure: PCOS, LGBTQ+, Reframing Masculinity & Femininity:


PCOS and the LGBTQ+ Community | What You Need to Know https://www.gayparentstobe.com/gay-parenting-blog/pcos-and-lgbtqia/


https://www.e-flux.com/journal/107/318895/a-saintly-curse-on-gender-sainthood-and-polycystic-ovary-syndrome/ Liu M, Murthi S, Poretsky L. Polycystic Ovary Syndrome and Gender Identity. Yale J Biol Med. 2020;93(4):529-537. Published 2020 Sep 30. Gezer E, Piro B, Cantürk Z, et al. The Comparison of Gender Dysphoria, Body Image Satisfaction and Quality of Life Between Treatment-Naive Transgender Males With and Without Polycystic Ovary Syndrome. Transgend Health. 2022;7(6):514-520. Published 2022 Nov 29. doi:10.1089/trgh.2021.0061 Alan Booth, Douglas A. Granger, Allan Mazur, Katie T. Kivlighan, Testosterone and Social Behavior, Social Forces, Volume 85, Issue 1, September 2006, Pages 167–191, doi:10.1353/sof.2006.0116 O’Connor DB, Archer J, Hair WM, Wu FC. Exogenous testosterone, aggression, and mood in eugonadal and hypogonadal men. Physiol Behav. 2002;75(4):557-566. doi:10.1016/s0031-9384(02)00647-9 For the Love of Men: A New Vision for Modern Masculinity by Liz Plank https://www.brandeis.edu/writing-program/write-now/2021-2022/azevedo-ligia/index.html#:~:text=The%20removal%20of%20body%20hair,women%20regarding%20youth%20and%20femininity.



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