2. Towards a Trans–Intersex Coalition
The oppression faced by intersex and trans individuals within a binary, heteronormative framework has been discussed by many. Often, intersex and trans individuals are forcefully placed in a bigenderist framework that aims to “correct” them through surgical and cultural means, so that they will be recognized as intelligible human beings (
Long 2019, p. 123). Generally, there has been a tendency to position intersex and trans individuals strictly outside the binary, both within activism and academia. However, as
Bettcher (
2015, p. 414) points out, such a ‘beyond-the-binary’ model can oppress those intersex and trans individuals who want to be identified within the binary. Usually, intersex and trans communities are perceived as having more differences than commonalities, with various factors contributing to this conundrum. Some trans individuals claim that they are ‘brain intersex’ (
Costello 2016, p. 105) due to a congenital condition that leads to the differentiation between their brain sex and genital sex, consequently leading to a disparity between their identified gender and sex assigned at birth. This argument is often evoked to seek the medical care, especially free gender transition services, that they need. At the same time, several other intersex individuals vehemently oppose such an argument because it justifies the unwanted and intrusive surgeries and hormonal interventions performed on intersex bodies. This disparity often leads to tensions between the two communities. Nevertheless, there are more similarities than differences between these seemingly distinct communities—both are oppressed by a binary framework influenced by heteronormativity and cisgenderism. In recent times, many scholars and activists have highlighted the need to think of intersex and trans issues collectively, as they challenge not only binary thinking, but also our ontological and epistemological categories about sex and gender themselves (
Horlacher 2016, p. 2). Intersex and trans studies highlight the need for a coalition between the two communities, with a special emphasis on intersectionality, so that the issues they face can be addressed effectively, and the oppressive system that aims to harm them and erase their existence can be questioned and subverted. The publication of
The Intersex Issue by
TSQ in 2022, a pioneering journal in trans studies, is one such example.
In the novel, menstruation becomes the bodily reality that initiates varied concerns and confusions about Ash’s sex and gender, often leading to the negation of his bodily autonomy and self-determination of gender. Several studies have focused on menstruation from various perspectives, including how it is connected with sex and gender identities (
Bobel 2010), access to healthcare and the stigmatization of queer individuals in public spaces such as binary-gendered bathrooms (
Chrisler et al. 2016), the legitimization of trans menstruation (
Rydström 2020), photography as a potent tool in menstrual activism (
Kafai 2019), and the ‘aggressive gendering’ of menstruation products as feminine hygiene products (
Frank 2020, p. 386). These studies connote the need to contest the cisgendering of menstruation. Degendering menstruation is essential to legitimize menstruating non-normative bodies and identities, especially those of intersex individuals. However, studies that solely focus on the menstrual experiences of intersex individuals remain scarce. Here, the young adult (YA) fiction
Just Ash is relevant as it not only engages with a significant albeit underexplored issue, the menstrual experience of intersex children and individuals, but also its status as popular fiction ensures a broader audience, thereby raising more awareness on the issue under discussion. What Emily Corbett discusses in the context of trans YA fiction is relevant here too.
Corbett (
2024, p. 14) contends that trans YA fiction is often subsumed under the LGBTQ+ category, which predominantly emphasizes gay and lesbian narratives. The life experiences of different communities are so diverse that they cannot be contained within a single acronym. Similarly, intersex YA fiction also receives limited recognition, as there have not been many studies on it. Through this study, the present article underscores the need to critically engage with intersex YA fiction, which can ultimately contribute to intersex activism. Thus,
Just Ash becomes a significant social product, addressing a pertinent issue faced by intersex individuals.
3. Menstrunormativity in Just Ash
The emergence of menstruation activism in the late twentieth century as part of the feminist movement, along with the development of critical menstruation studies, problematizes existing notions regarding menstruation and highlights the necessity to understand it from an all-inclusive (inclusive of various sex and gender identities) perspective. Influenced by androcentrism, the ‘leaky, liquid, flowing menstruation…is constructed as a shameful form of pollution that must be contained… (it) is constituted as a problem in need of a solution’ (
Bobel 2010, p. 31). Often in patriarchal societies, menstruation is regarded as a demerit, a flaw, ‘a contagion and disorder’ (
Frank 2020, p. 374), perceived as a limitation of the female body. Similarly,
Grosz (
1994) discusses how viscous and cloudy fluids, such as menstrual blood, have been culturally perceived as impure and polluting. In all these contexts, menstruation is commonly considered as a bodily difference between males and females, reinforcing binary notions. Such a mainstream approach to menstruation reinforces the link between gender expectations and certain body features. Many trans, non-binary, and intersex individuals also undergo similar ordeals. For instance, in the graphic memoir
Gender Queer (2019), Maia Kobabe, who identifies as a non-binary person, discusses the unsettling experiences em
2 faced during eir menarche. Since menstruation and everything associated with it are generally perceived as a feminine experience, Kobabe found menstruation to be a disconcerting, nightmarish bodily experience that contested eir gender identity as a non-binary person (
Kobabe 2019, pp. 30–38). Similarly, every intersex individual, like Ash, who menstruates and does not identify as a woman, also challenges the prevailing notions about menstruation, often resulting in oppressive situations.
The menarche of Ash is the pivotal moment in
Just Ash, illustrating how a bodily function is gendered to maintain the binary paradigm within a society. Ash’s “normal” life is disrupted when he begins to menstruate during one of his soccer practice sessions on the field, which is a male-dominated space in the novel. This event makes him acutely aware that his body is not conforming to the expectations of a male body. Those around him, including his family, remind him of the “anomalous” behavior of his body, evident in the bullying by his peers at school and the imposition of female sex and feminine gender by his family. The trouble that ensues for Ash can be analyzed through the concept of menstrunormativity, which highlights how a narrow definition of menstruation will deem certain individuals and their bodies as ‘wrong/ unhealthy/abnormal, or monstrous’ (
Persdotter 2020, p. 358) and in need of medical intervention. This is perpetuated by societal and cultural notions, as well as by the medical discourse. Particularly within the framework of medical normality, any deviation of menstruation and the menstruating body from the norm is treated as an “illness.” Usually, menstruation is associated with the female embodiment, and the experience is defined and regulated by menstrunormativity. It encompasses the following:
sets of menstrual standards and conventions that seek to order and stratify menstrual life; creating hierarchies of existence; menstrual insiders and outsiders, menstrual “normals” and “abnormals,” regulating what menstrual worlds come into being, what menstrualities become possible or impossible; which menstrualities become uncomplicated, effortless and easy and which become difficult, burdensome, and painful.
It shows why Ash’s menstruating body was perceived as an “anomaly” requiring medical care and why he was expected to conform to a feminine identity and alter his body accordingly.
Ash was born with an intersex variation known as congenital adrenal hyperplasia (CAH), which affects the adrenal glands of the body. Thus, he has a small penis; the genitalia, which is unconventional for a guy. CAH also results in a condition called “salt wasting”, because of which his body cannot retain sodium. His menstruation indicates the presence of functioning ovary(ies) and a uterus, which cause immense mental distress as his body’s behavior contradicts conventional notions about the male anatomy. Due to his menstruating corporeality, his parents and society perceive him as a girl and subsequently as a transgender person because he was assigned a male sex and, consequently, a masculine gender at birth, but is now forced to present himself as a girl. According to
Bettcher (
2014a), the term “transgender” refers to people who ‘”do not conform to prevailing expectations about gender” by presenting and living genders that were not assigned to them at birth or by presenting and living genders in ways that may not be readily intelligible in terms of more traditional conceptions of gender.’ In this regard, Ash is not a transgender person because he identifies with the birth-assigned sex and gender (male/man), which makes him a cisgender person. The misgendering by his parents and others reveals the society’s lack of awareness regarding intersex and trans individuals and how, at times, both can benefit from each other. The challenges he faces stem from the society’s rigid conceptions about sex and gender, and the violence he experiences is underscored by transphobia.
Ash’s menstruating body subjects him to intense scrutiny from everyone around him, including the medical discourse, because he deviates from the normative ideal of a “menstrunormate.” A menstrunormate is defined as the ideal menstruator
3—‘a ciswoman with a regular 28-day cycle, who obscures all evidence of menstruation’ (
Persdotter 2020, p. 361). Since he is not an ideal menstruator, the existing discourses immediately render him a ‘menstrual monster.’ The interplay of multiple and contradictory normativities culminates in the creation of the menstrual monster, which refers to individuals who are outside the norms of ideal menstruation, including those who do not menstruate at all (
Persdotter 2020, p. 362). A menstrual monster can also identify oneself as other than a cis woman, encompassing trans or intersex people. The menstrual monster is also characterized by having “the wrong body.” ‘Its vagina is too small, too large, it smells too much, it is too moist and too dry, it is too deep and too shallow; it is allergic to cotton, and silicone, and rubber; and it doesn’t have a vulva, vagina, or a uterus’ (
Persdotter 2020, p. 364). It immediately demonizes trans and intersex individuals who menstruate, which explains the negative societal reactions to Ash’s menstruating corporeality, as elaborated below.
Ash struggles at school to hide his menstruating body to avert bullying and physical atrocities. Derogatory remarks such as ‘you’re a dyke’ and ‘he’s got both’ (p. 16) exemplify the social censure that Ash experiences in his school. Despite his best efforts, he was brutally assaulted by his peers who perceive him as a “dyke” due to his menstruating body. The aforementioned instances also expose the underlying transphobia inherent in such attacks and remarks. Although Ash is not a trans individual, the concept of ‘identity invalidation’ (
Bettcher 2015, p. 420), which addresses the intersections of trans, intersex, and sexist oppressions, is pertinent here.
Bettcher (
2015) posits that trans and intersex individuals frequently encounter threats to their identity, which will be questioned and negated by those around them. The self-determination of gender by the individuals concerned becomes irrelevant if their gender “performance” does not align with prevailing social and cultural codes. It becomes an instance of ‘reality enforcement,’ (
Bettcher 2014b, p. 392) particularly when the public gender presentation and private genitalia are perceived as misaligned. For others, Ash’s masculine presentation is evidently at odds with his menstruating body. Such “enforcements” often result in violent attacks towards gender- and sex-variant individuals, as demonstrated by the assault Ash endures from his peers. Other aspects of the reality enforcement, such as ‘the appearance-reality contrast, the deceiver-pretender double bind, and genital verification’ (
Bettcher 2014b, p. 392) are also applicable to Ash. When the aspect of menstruation becomes public knowledge, Ash’s self-determination of gender as a boy and masculine gender presentation are invalidated by others because menstruation is usually associated with a female body and feminine gender identity. The alleged appearance–reality incongruence renders him a “deceiver–pretender,” evident in how many react to his menstruating body. For instance, Ash’s ex-girlfriend, Louisa Carmichael, lashes out at him for “deceiving” her, asserting that he is really a girl, a ‘dyke,’ merely pretending to be a boy during their relationship (p. 16). Such instances are reminiscent of what happens in the intimate lives of many intersex and trans individuals—the fear of being exposed as a deceiver if they were able to “pass” as a sexually dimorphic, cisgender person, only “pretending” to be what they were presenting. The crude comment ‘show us your pussy’ (p. 17) by Ash’s peers and the scrutiny he endured at the doctor’s office illustrate how others feel entitled to verify his genital status, given his deviation from the normative binary due to his menstruating body.
In contemporary discourse, menstruators are often compelled to hide their leaky bodies at all costs to pass as non-menstruators. Secrecy is at the center of the dominant, mainstream menstrual discourses, which are associated with attributes like chastity, purity, and shame. Such mainstream discourses try to “help” a menstruator pass as a ‘modest non-bleeder’ (
Kafai 2019, p. 63). That is why Ash feels compelled to hide his menstruating body at all costs. Furthermore, since mainstream discourses essentialize menstruation as a female experience, everything around menstruation is also associated with femininity. Thus, when a non-menstrunormate like Ash has to use menstrual products that are overtly advertised as feminine products (
Frank 2020, p. 386;
Martin and Narushima 2024, p. 8), it is a constant reminder that ‘a biological aspect of their bodies is deeply tied to social norms and expectations of femininity and womanhood’ (
Frank 2020, p. 387). Thus, Ash feels confused and repulsed by the ‘small, square, plastic package’ (p. 4), a sanitary napkin offered by his mother. For him, it is a negation of his identity as a boy (p. 4), which makes him feel lost, and he throws away the napkin as a result. Even the mere act of disposing of a plastic wrapper in a male restroom warrants censure from others around Ash, evidenced by his schoolmate Evan Carmichael’s comment, ‘shouldn’t you be using the girls’ room now?’ (p. 25). Ash’s experience is emblematic of the challenges faced by countless trans and non-binary menstruators in heavily gendered public restrooms, particularly male restrooms. Such spaces often become sites of surveillance and gender policing under the gaze of other users, where any menstruator outside the binary gender norms fears being exposed as “pretenders,” often resulting in physical harm (
Chrisler et al. 2016;
Frank 2020). The simple act of throwing away a used napkin or the anxiety that the sound of a sanitary napkin might be overheard by others can trigger dysphoria in many individuals.
Ash’s confusion regarding his menstruating body is indicative of the lack of proper awareness about menstruation among intersex individuals. Michelle, Ash’s friend and later girlfriend, has to remind him that menstruation is ‘kind of a monthly thing’ (p. 26) when he curiously asks how she knew that he was on his period. Ash’s experience is representative of the menstrual experience of many intersex individuals. The study conducted by
Berger et al. (
2023) reveals that the existing sex education system is inadequate to address the needs and concerns of intersex children and adults. Intersex individuals receive poor sexual health information through school sex education. In particular, they receive no awareness about menstruation from such curricula and healthcare professionals. Most individuals have to learn about menstruation through trial-and-error and from peer groups (
Berger et al. 2023, p. 8). Ash was unable to find the necessary information about menstruation from the sex education provided by his school, his parents, or even from a healthcare professional like Dr. Tran, who has been his doctor since his infancy. Michelle became his sole source of information.
Since the majority of information about menstruation, both scientific and colloquial, is underscored by cisnormativity
4, repronormativity
5, and transnormativity
6 (
Lowik 2021), Ash finds it challenging to conceptualize a menstruating corporeality beyond the female/feminine embodiment, resulting in dysphoric attitudes towards his own intersex body and gender identity as a boy. Often, due to the negative perceptions and stigma associated with menstruation, trans individuals seek menstrual suppression through medical interventions to affirm their gender identity (
Chrisler et al. 2016, p. 1244). Similarly, Ash also seeks menstrual suppression so that he can be a “normal” guy. The gendering of menstruation as a feminine experience underlies both Ash’s own and others’ adverse reactions to his menstruating body. His desire to stop menstruation was fulfilled with the assistance of Michelle, who helped him obtain birth control pills. The societal response to a boy acquiring birth control pills for himself is evident in the momentary, yet significant, reaction of shock exhibited by the receptionist at Planned Parenthood, a state-sponsored service. The relief he experiences about being “normal” again because of his non-menstruating body is problematic. On the whole, everyone, including Ash himself, views menstruation as a female experience that often leads to delays in receiving the necessary care. It also points to the need to reconceptualize menstruation beyond the existing framework, even as a masculine experience (
Lowik 2021, p. 8) to legitimize the existence of non-binary menstruating corporealities.
How the medical discourse considers certain types of menstruation as an “illness” and in need of medical attention is exemplified by the medicalization of Ash’s menstruating body. This approach reflects a complete disregard for the needs and wants of the intersex individual and highlights the extreme medicalization by the medical discourse. Consequently, Ash undergoes, what could be termed ‘curative violence’ (
Orr 2022, p. 3), which aims to uphold the traditional sex binary and compulsory dyadism and is influenced by notions of able-bodiness. Curative violence arises when cure is what frames a particular bodily reality, such as menstruation, as a disorder and disease and ends up causing disastrous effects for the individual concerned.
The discomfort experienced by Ash at the hands of a medical professional reveals the ‘trans-intersex nexus,’ ‘the mechanism that consolidates the medical authority, which ultimately wields power over trans and intersex bodies’ (
Wang 2022, p. 177). Furthermore, influenced by heteronormativity, cisgenderism, and binary notions regarding sex, the “trans–intersex nexus” aims ‘to consolidate medical authority to determine gender’ (
Wang 2022, p. 173). During a hospital visit following his menarche, despite Ash’s repeated assertion that he is a guy, Dr. Tran misgenders him by using female pronouns and decides that the appropriate course of action is for Ash to become a girl, despite the potential distress this may cause him. The doctor perceives menstruation as indicative of the embedded femininity of Ash’s body, prioritizing reproduction over Ash’s gender identity and preferences. Emphasis is placed on Ash’s ‘functioning ovary’ and the possibility to ‘reproduce vaginally’ (p. 11) over his well-being. Evidently, heteronormativity and sexual dimorphism, ‘compulsory dyadism’ (
Orr 2022, p. 19) itself, dominate Dr. Tran’s decision-making process. According to
Orr (
2022), compulsory dyadism is ‘an ongoing exorcising process and structure of pathologization, curative violence, erasure, trauma, and oppression,’ ‘the instituted cultural mandate that people cannot violate the sex dyad, have intersex traits or house “the spectre of intersex”’ (p. 19). Consequently, Dr. Tran finds it inconceivable to conceptualize and accept a masculine embodiment that menstruates. For her, the supposed “expert,” the logical explanation is that Ash must be a girl, irrespective of how Ash identifies himself.
Medical paternalism is explicit when the doctor rejects Ash’s perspective on his own body and gender and asserts that ‘you might change your mind about that later’ (p. 11). According to
Dreger (
2000), medical paternalism is one of the characteristic features of intersex medicalization. Here, the doctor has hegemony over the patient’s knowledge and care, positioning themselves as “experts” who determine the best options for the patient. To Ash’s dismay, Dr. Tran asserts that ‘Most girls with CAH experience irregular periods. Sometimes menarche arrives late, or it never arrives at all’ (p. 10). Although Dr. Tran rejects Ash’s request for a gonadectomy because he is too young to have such an ‘invasive surgery’ (p. 11), she authoritatively prescribes surgical intervention to impose a female body and feminine gender identity on Ash, when she says
Ashley’s blood cells have low amounts of FSH, which means she may be able to reproduce when she comes of age. A vaginoplasty would have to be performed to widen the birth canal. With androgen blockers and a full penectomy, she would be virtually indistinguishable from a non-intersex female.
(p. 20)
This scenario reveals the double standards of medical practitioners towards intersex bodies. The doctor is negligent of the fact that such non-consensual, intrusive surgeries may result in long-lasting body–mind disabilities for Ash. It also highlights the general tendency in intersex medicalization to impose a female sex and feminine gender identity to preserve feminine reproductive capabilities, if present, regardless of the appearance of the genitalia and the self-determination of gender by the intersex individual (
Dreger 2000, p. 182). Ash’s repeated assertions that he is a guy are disregarded by Dr. Tran and subsequently by his father, who violently suggests, ‘couldn’t we just cut out the testicle’ (p. 111), thereby imposing the decision to conduct a sex change surgery on Ash. However, he runs away from the hospital to join his sister in Boston. Prior to this, he was forced by his mother to present himself as a girl, which she deemed appropriate based on his menstruating body. As a result, he briefly attended another school where he presented himself as a girl, but found the experience to be a constant invalidation of his masculine gender identity.
The underlying trauma and violence in Ash’s experiences emphasize the need to degender menstruation, thereby fostering discourses that are inclusive of diverse sex and gender identities. The process of degendering begins as Ash becomes more at ease with his body and realizes that society’s unfair expectations make guys having periods and girls not having periods abnormalities (p. 139). He says, ‘when I got my period, when I started feminizing, I lost my say over how I was perceived. From then on, I had to look and behave a certain way’ (p. 200). His life in Boston under the care of his sister Evie, who identifies as a lesbian, enables Ash to perceive menstruation beyond the confines of cisnormative and repronormative frameworks. The intersex support group, InterPersonal, helps him realize that intersexuality is an umbrella term that encompasses a wide variety of bodily and gender diversities. One’s sense of gender cannot be challenged even if one’s body does not align with the self-determined gender. The resources and services available to him in metropolitan Boston further illustrate the potential for an intersex–trans coalition. For instance, in Boston, he buys a binder to flatten his chest, a practice commonly adopted by many trans men and non-binary individuals. In addition, he met many intersex individuals, some of whom are also trans. The love and acceptance offered by his girlfriend Michelle also help Ash to be comfortable with his body, indicating the role family and peers can play in legitimizing non-binary menstruating corporealities.