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Sex Roles [sers] pp503-sers-374490 June 7, 2002 17:10 Style ﬁle version June 3rd, 2002
Sex Roles, Vol. 46, Nos. 1/2, January 2002 (
Menarche, Menstruation, and Gender Identity: Retrospective
Accounts From Women Who Have Undergone
Hysterectomy (the surgical removal of the uterus) precipitates the end of menstrual cycles in
premenopausal women. In this article I explore whether that premature termination of men-
strual function negatively affects women’s subjective gender identities. Using the grounded
theory research approach, I conducted in-depth interviews with 40 diverse respondents who
had undergone premenopausal hysterectomy. These women generally acknowledged that,
since the time of menarche, they had closely associated menstruation with their gender iden-
tities. However, despite some regrets, respondents’ primary reaction was almost unanimous
relief that they had ceased menstruating. This ﬁnding must be viewed in the context of over-
whelming and uncontrollable menstrual pain and bleeding that many respondents had previ-
ously experienced. Contrary to expressing remorse that they no longer identiﬁed with “nor-
mal” women, who menstruate, most respondents sought to disassociate themselves from the
normalized suffering that they perceived is endured by all menstruating women.
KEY WORDS: menstruation; hysterectomy; gender identity; gynecological surgery.
Menstruation is a “badge of femininity,” which may be
worn in misery, pain or pride, according to the attitude
of the woman.
(Greenhill, 1954, p. 155)
After that many years of bleeding I was really thankful
not to have to deal with it. And I can honestly say I
don’t miss that part of it at all, whatsoever. I don’t miss
it. I don’t feel less of a woman without it.
(Allison, a respondent)
Hysterectomy (the surgical removal of the
uterus) is the most commonly performed nonob-
An earlier version of this article was presented at the June 2001
meeting of the Society for Menstrual Cycle Research in Avon, CT.
To whom correspondence should be addressed at Department
of Sociology, University of New Hampshire, 20 College
Road, Durham, New Hampshire 03824-3586; e-mail: jelson@
stetric surgical procedure in the United States (Na-
tional Center for Health Statistics, 1996).
approximately 600,000 American women undergo
hysterectomies, a rate that is among the world’s high-
est (Farquhar & Steiner, 2002). Moreover, the over-
whelming majority of all hysterectomies performed in
the United States, approximately 75%, are performed
on women between the ages of 20 and 49 years, most of
whom are premenopausal (Rock & Thompson, 1997).
Biographical Disruption of Gender Identity
Goffman’s contention (1977, p. 315) that gender
identity involves “the deepest sense of what one is”
reﬂects an important social fact; gender identity is
one of the most fundamental means by which indi-
viduals are recognized, both by others and by them-
selves (Katz, 1979). Furthermore, gender identity may
be particularly salient for women (Deaux & Major,
Another surgical procedure performed only on women, Cae-
sarean section, is the most common of all surgical procedures.
2002 Plenum Publishing Corporation