‘People want to capitalize on ageing’: a conversation about menopause

When Heather Corinna ended up in the emergency room in 2013 with a host of “mysterious” symptoms – dizziness, difficulty breathing, a burning face that felt like a sunburn – they were just a few weeks away from having health insurance.

Corinna remembers this distinctly because of the roughly $10,000 bill that followed. Corinna also remembers that despite their age (43), assigned sex (female), and quite a typical set of symptoms, not a single doctor considered this might be perimenopause, and, more specifically, likely a hot flash paired with a panic attack.

This is the first experience shared in What Fresh Hell is This? Corrina’s new book about menopause and perimenopause that will make your eyes wide with anger. In the book, Corinna – the sex education powerhouse behind Scarleteen.com (one of the longest-running sex education resources online) and S.E.X.(the most popular sex and relationships guide written for young adults in the English language) – offers a powerful argument, grounded in little-known history, about the gap between what this intense phase of life could be in a more humanistic world, and why it is so far from that ideal right now. I start by asking how medical professionals so rarely know how to help us through such an utterly common experience, while simultaneously the “menopause market” is booming with unregulated lotions, potions and devices like never before.

HC: For the people that just want to capitalize on us, [they capitalize on] aging: weight-related things, skincare, hair care. We can feel very seen by those things, if we’re not feeling seen elsewhere. Especially if we’ve gone to healthcare providers about perimenopause and received the range of responses that are still really typical. You’re too young. I don’t think that’s really happening to you. Your hormone levels look fine.

Not a lot of doctors have the appropriate education. And even among those who do, some of them haven’t refreshed in a long time. And if you feel gaslighted by your doctor, the marketing scphiel comes through and you think, oh, someone who sees me, someone who listens to me, someone who doesn’t doubt me. But unfortunately that someone wants your $50 subscription a month.

JF: The book addresses the emotional and sociocultural experience of navigating these particular waters. How it fucks with our sense of gender and sexuality, and of what it means to be a “smart person”. So much of that is happening for me. And I hadn’t really put it together until I read the book. I’m a frizzy-haired fat Jewish woman, it’s not like I ever was spectacular at conventional beauty, but I eventually found a way to make myself feel beautiful and sexy and smart that made me feel protected.

HC: You found your right armor.

JF: And now perimenopause is fucking up my armor.

HC: For me it’s my swagger. My particular kind of swagger that I had was my strength. It was the way that I could carry myself when I was boxing. I looked tough. But now I don’t have my same swagger. Maybe I‘ll have a different one on the other side. I don’t know.

JF: I’m confused most of the time right now. Who knows when my period will arrive next? Is this sudden mood a hormone shift or something else? I feel really sad and lost and incoherent a lot of the time. How did you write a book in the middle of this? How did you have clarity?

HC: I don’t really know! I had the drive to do it – I could see that a lot was missing from the canon – but I wasn’t exactly brimming with confidence, because who is at this time of life? I remember saying to my editor, ‘If I’m going to do this I need to be allowed to write it like if Hunter S Thompson went into menopause. Because I can’t do it any other way. I have to be allowed to just be a mess.’ Having that permission was really helpful.

JF: You are the first out nonbinary person to publish a book about menopause. And it shapes the book in wonderful ways. One of the things I was surprised to discover was how hormone therapy could have potentially gender affirming properties for someone like me, who is a cisgender femme woman facing down the loss of many of the typical markers of femininity.

HC: People use estrogen around menopause for all kinds of reasons. But there’s so much femme shaming in the world and the older women get, the worse that becomes. Particularly in mid life, when some women want to remain femme and feminine, it gets really teasy and shamey and gross. Instead of acknowledging in an empathetic way, oh my gosh, I’m so sorry that you’re having this painful gender crisis, what can we do to help affirm your gender identity? it becomes oh let go of that, you’ve aged out of that, or whatever.

Coming at it from a nonbinary place, the opposite can also be true, so much of menopause has only been looked at from a gender perspective. That the loss of femininity is the only way that someone could be suffering. Gender is not something I necessarily experience, period. For me there’s a certain virility I feel like I’m losing, that has nothing to do with femininity. And that doesn’t fit in any of our existing frameworks. I couldn’t talk to a doctor about it. Some people feel ungendered by menopause, but I’m like ‘god, I wish.’ Menopause has only made my body less legible to other people. I get more ma’ams, not fewer ma’ams.

JF: Decentering medical intervention is so important. So often, even the doctors who are supposed to know what they’re doing with menopause really don’t. And doctors often are a source of fear and pain and mistrust for a lot of folks, especially marginalized folks.

HC: Most people won’t have to go to the doctor for menopause. Which for a lot of people is really refreshing. If you don’t have decent healthcare access, and you’re poor the last thing you need is a bunch of healthcare bills.

Even if you have access, it’s how many days you’re taking off of work to seek care. That’s a big deal. If you’re fat, you know full well that if you go in there, nine times out of 10, you can complain about everything unrelated, menopause being no exception, and know what they’re going to tell you to go on a diet and tell you to exercise and that’s just going to be the end of that.

JF: Not to mention if you’re Black. The medical establishment has a history of minimizing women’s pain, but women of color especially are likely to be utterly dismissed, because so many of these symptoms are vague when you describe them even though they’re specific when you’re living them.

There’s an evolutionary theory that’s popular right now called the Grandmother Hypothesis, which tries to “explain” why women outlive their own fertility by saying it’s so we can help our children raise their children. Why on earth do we need to justify our existence?

HC: YES. Have you not met us? Also, some of us have never reproduced or had the ability to reproduce in the first place which does not mean that we never were useful the whole fucking time! But even if we did nothing – even if we only took out books from the fucking library and read them alone on our couch and gave nothing of apparent value to this world – we have value in this world just by existing.

JF: A friend of mine helped me with this a few years ago, when I had just missed my first period. She said to me, “I’ve always pictured you growing older into someone between Stevie Nicks and Frankie Bergstein.” Having something positive to look toward instead of just fear of losing what I have now has been so grounding to me. You write about this beautifully in the book, and I wonder if you have similar role models you would like to end up like?

HC: Ohhhh. I might be like a Patti Smith/David Bowie/Fran Lebowitz/Harvey Fierstein/Lily Tomlin mix.

JF: We’ll meet at Frankie Bergstein. I’ll bring the sourdough starter.

HC: I’ll bring the weed and I’ll laugh too loud so you have to tell me not to get in trouble with your neighbors.

JF: I relish that. I love this idea.

HC: I think it’s good. I’m so fucking tired of doing things for other people. At what point do I ‘earn’ the right that I get to exist for myself, to be of value to myself?

• This interview has been edited and condensed for clarity.