Menstrual health refers to a “state of complete physical, mental and social well-being in relation to the menstrual cycle”. Despite being a bodily physiological function, menstruation is still widely perceived as shameful and remains a neglected component of global health. Menstrual disorders such as dysmenorrhea, pelvic pain and heavy menstrual bleeding may negatively impact the quality of life of individuals who menstruate, and repeated episodes of period and pelvic pain may lead to central sensitization and a higher risk of chronic pain syndromes in adulthood. Transgender and gender diverse (hereafter trans) adolescents have a gender identity distinct from their biological sex assigned at birth. This population is particularly vulnerable, facing persistent disparities in accessing healthcare and experiencing poorer health outcomes. Evidence demonstrates that the provision of gender-affirming care significantly improves mental health and quality of life for trans adolescents, a practice supported by most professional societies. Gender affirmation in trans adolescents assigned female at birth may involve various interventions, including menstrual suppression, which refers to the use of hormonal medications to reduce or stop menstruation. While indications for menstrual suppression in trans adolescents can include menstrual disorders, as in the general population, it also plays a critical role in alleviating gender dysphoria associated with menstruation. Nevertheless, research on menstrual health in trans adolescents remains limited. Little is known about their experiences with menstruation, as well as prevalence and management of menstrual disorders within this population. This thesis seeks to improve the understanding of pelvic pain development and management, and to investigate the effects of menstrual suppression in trans adolescents. It explores critical gaps in current knowledge and identifies areas for improvement to inform strategies enhancing menstrual health access for trans adolescents.