Beyond the Cycle: How Menstruation Influences Gender Identity and Well-being in Binary and Non-binary Adults

Authors

• Rin Nguyen, University of Nebraska-LincolnFollow

First Advisor

Dena Abbott

Degree Name

Doctor of Philosophy (Ph.D.)

Committee Members

Kathryn Holland, Mun Yuk Chin, Tierney Lorenz

Department

Educational Psychology

Date of this Version

7-7-2026

Document Type

Dissertation

Citation

A dissertation presented to the faculty of the Graduate College at the University of Nebraska in partial fulfillment of requirements for the degree Doctor of Philosophy

Major: Educational Administration

Under the supervision of Professor Dena M. Abbott

Lincoln, Nebraska, May 2026

Comments

Copyright 2026, Rin Nguyen. Used by permission

Abstract

Approximately 1.8 billion people worldwide menstruate, including transgender and gender-diverse (TGD) people, yet their experiences remain underrepresented in research. Given that menstruation can affect gender alignment and psychological well-being, understanding its impact on TGD people is critical. Gender congruence, or alignment between one’s gender identity and expression, is a key factor influencing well-being, with research linking it to reduced depression and anxiety. Furthermore, emerging research on gender euphoria, the joy experienced when gender congruence is experienced, suggests it may serve as a protective factor for mental health and well-being. Gender euphoria has been associated with reduced psychological distress and increased resilience. The current study explored whether gender identity (binary and non-binary) and gender alignment (gender euphoria and gender dysphoria) moderated the relationship between gender-related menstrual distress and psychological outcomes. A total of 443 binary and non-binary adults were recruited through Prolific and Sona Systems. Participants completed a demographic questionnaire and measures of gender-related menstrual distress, gender euphoria, gender dysphoria, psychological well-being, and psychological distress. Correlational analyses indicated that gender-related menstrual distress was associated with lower psychological well-being and higher gender dysphoria and psychological distress. Gender dysphoria showed similar patterns, while gender euphoria was positively associated with psychological well-being but not with psychological distress. Moderated-moderation analyses revealed a significant three-way interaction among gender euphoria, gender identity, and gender-related menstrual distress on both psychological well-being and psychological distress. Consistent with predictions, there was a three-way interaction between gender euphoria, gender identity, and gender-related menstrual distress on psychological well-being as well as psychosocial distress. Contrary to expectations, gender euphoria strengthened these relationships rather than buffering them, particularly among binary participants. These findings contribute to emerging research on menstrual health and gender alignment in transgender and gender-diverse populations and highlight important considerations for future research and clinical practice.

Recommended Citation

Nguyen, Rin, "Beyond the Cycle: How Menstruation Influences Gender Identity and Well-being in Binary and Non-binary Adults" (2026). Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–. 513.
https://digitalcommons.unl.edu/dissunl/513