User:Homedpo/Menstruation

Activism

The Rise of Menstrual Activism

The prominent rise of menstrual activism began with the rise of feminist spiritualist menstrual activists in the late 1960s. In 1973, a "Bleed In" was held by Janice Delaney, Mary Jane Lupton, and Emily Toth, who believed that their shared menstruation experience merited discussion. The rise of early menstrual activism was prompted by rising cases of toxic shock syndrome due to unhygienic menstrual practices, which prompted responses feminists and menstrual activists alike. As such, a group of women gathered in Boston in the spring of 1969, calling themselves the Boston Women’s Health Book Collective (BWHBC). The creation of this group allowed for an honest criticism of the way that women's health is discussed. This accumulated in the publishing of a manual called "Women & Their Bodies", which has been adapted and currently sells today under the title of "Our Bodies, Ourselves". Though the manual itself rarely discussed menstruation, it opened the floodgates for an honest criticism of the way women's health is discussed. In the following decades, women's liberationists called for pushback against the status quo. A primary vehicle for these messages were through art; in 1971, Judy Chicago created "Red Flag", a photolithograph, and a year later, an interactive art installation called "Womanhouse". Artistic expression transcended into national recognition, as evidenced by figures like Emily Culpepper. Culpepper released a short film in 1972 that featured menstruation images that detailed realities of having one's period. The fame generated from this piece made Culpepper the figure of knowledge surrounding menstruation for laypeople, and initiated her nationwide involvement with the BWHBC.

The height of second-wave feminism led to landmark changes during this period, including the establishment of the Society for Menstrual Cycle Research and literature that more directly addressed the existence of menstrual stigma.

21th Century Activism

In the recent decade, the mainstream media has begun to adopt much of these new attitudes surrounding menstruation. At 16-years-old, Nadya Okamoto founded the organization, PERIOD, and wrote the book Period Power: a Manifesto for the Menstrual Movement. She played a large part in making discussions about menstruation commonplace, and was consequently a recipeint of wide recognition including Teen Vogue 21 under 21, InStyle Magazine’s Badass 50, Forbes 30 under 30, Bloomberg 50 “Ones to Watch”, Huffpost Culture Shifters 2020, People Magazine’s Women Changing the World, and Her Campus 22 under 22 Most Inspiring College Women.

Nevertheless, especially in the recent years, Okamoto has been slammed for some of her problematic behavior. Many small, grassroots menstrual activists who founded small organizations have come forward about Okamoto's attempt to dissolve their organizations and rebrand as PERIOD chapters. Many of these organization heads were people of color and serving the communities they knew well, while Okamoto was criticized for running for a city council position in an area that she had lived in for less than a year.

Increasingly in the past decade, lawmakers have taken on menstrual equity as important demands in their political stances. New York Congresswoman Grace Meng has been a longstanding advocate for menstrual equity, and proposed the Menstrual Equity for All Act of 2021 to Congress. Countless women's rights organizations have endorsed this bill, including the Alliance for Period Supplies, Plan, Girls Inc., Human Rights Watch, and I Support the Girls in addition to their various campaigns that fight for destigmatization, free menstrual products, and more.

Black women in period equity circles, such as Hate the Dot, Flocode Xo, We Are Happy Period, and Code Red co., have come together in the past year in light of the murders of Breonna Taylor, George Floyd, among many others, to highlight the contributions of Black people to this movement. Activism roles have also been taken on by young Black women like the Brown sisters, who founded the organization 601 For Period Equity in response to the "white-washed" nature of many other organizations.

Menstrual Inequity

The term menstrual inequity refers to the disparities in affordability, accessibility, destigmatization, and safety of menstrual products. Furthermore, calls for menstrual equity expand into demands for reproductive justice, which includes the subtopics of education, support systems, and healthcare. Menstruation is a highly stigmatized biological process, to the extent that most menstruators feel uncomfortable discussing their experiences. In the CBSN documentary "Period", New York Congresswoman Grace Meng discussed the complex feelings of shame that come with menstruation and how it contributes to gender inequality.

Beyond the perpetuation of gender inequality, the inclination to hide menstruation experiences contributes to the phenomenon of period poverty. Period poverty is defined as "a lack of access to menstrual products, education, hygiene facilities, waste management, or a combination of these", according to Medical News Today. In fact, 25% of people cannot purchase period products due to income limitations. Furthermore, period products cannot be purchased with government subsidies like food stamps, health spending allowances, Medicaid, or health insurance. According to a 2021 study conducted by U by Kotex®, only 4% of Americans are aware of resources where free or reduced cost period supplies are available to them. Period poverty also disproportionately affects people of color and transgender menstruators.

A CAT Scan of a uterine fibroid.

Socioeconomic Inequity

Menstruating is an expensive process, and thus difficulty in accessing period products disproportionately impacts low-income people. Especially with laws like the tampon tax and the lack of free menstrual products in most bathrooms, many are forced to miss school or work due to lack of access. One in five low-income women have reported missing work, school or similar events due to lack of access to period supplies. Missing these events is not only difficult, but has further implications for menstruators' mental and physical health.

With regards to mental health, 68.1% of women experiencing monthly period poverty expressed that they were experiencing moderate or severe depression compared to 43.4% of people who experienced no period poverty. This difference is striking, and signals the ways that menstrual health permeates into other aspects of menstruators' lives.

In 2021, 51% of students wore period products for longer than recommended. Overtime use of period products may lead to the onset of toxic shock syndrome, in addition to the chances of used pads and tampons having the ability to carry STIs. In a different study with low-income women, 64% of participants explained that they could not afford menstrual products in the previous year. Of these women, around one-third expressed that they resorted to other products like rags, toilet paper, and children's diapers.

The COVID-19 pandemic has only exacerbated these concerns, in a time when unemployment and financial insecurity has risen. In March, the CARES Act allowed for money from health savings and flexible spending accounts to be used for the purchasing of menstrual products.

Additional Barriers Faced by Incarcerated Menstruators

Main article: Incarceration of women in the United States

In 2017, the U.S. Department of Justice promised to grant every woman incarcerated in a federal prison with menstrual products free of charge. Yet countless women and transgender menstruators are not housed in a federal prison, and go without access to period products keeping them safe and hygienic. 54% of menstruators in prisons do not have access to sufficient period supplies, as they are forced to spend their 75 cent per hour wages at commissaries that charge up to 5 dollars for pads and tampons.

Racial Inequity

Like many other health-related concerns, menstruators' experiences are influenced by their race. The entire healthcare experience is affected by race, with people of color often receiving a worse standard of care than their white counterparts. A commonly experienced qualm, particularly for Black patients, is a difference in physician reponses to reported pain. Multiple studies have confirmed that doctors systematically prescribe pain medication less frequently and in lower doses to Black people. Medical racism extends to discussions of period pain as well.

A photo of Dr. James Marion Sims, who invented the speculum. Instrumental to his success was his operation on enslaved Black women without anesthesia.

Dismissal of period pain is further implicated by the history of violence against Black women, originating with slavery and continuing into its aftermath. Dr. J. Marion Sims, who is heralded as the father of obstetrics and gynecology, performed risky surgeries on enslaved women without anesthesia in order to experiment. A study performed through a series of interviews highlighted that for Black and Latina women, all the women in the study reported a normalization of pain by medical professionals. This was not surprising to the author of the study, given that women are proven to be less likely to report their pain when they are shot down in their attempts to seek out help. Women in the study expressed absurd symptoms such as forty-seven day long periods, excruciating cramps, unrelenting constipation-- and still were dismissed by medical professionals. These women, up to multiple decades later, were diagnosed with severe illnesses like pituitary tumors and polycystic ovary syndrome. The denial of pain for women of color does not stop at delayed diagnoses and daily pain, and rather has larger implications for mental health.

Negative relations and perceptions of one's uterus and uterine functions potentially may make many hesitant to call on their reproductive system in the future. Especially considering high Black maternal mortality rates, the connection between poor relationships with reproductive health and adverse consequences is glaring.

Fibroids are a particularly important condition to mention when discussing racial disparities in menstrual health. Uterine fibroids are significantly more likely to occur in Black women, with 9 out of 10 Black women being diagnosed with fibroids before the age of 50. Black women also face higher rates of adverse symptoms, like extreme pain and heavy menstrual bleeding. Impacts on Black women are further worsened by the fact that 42 percent of Black women wait four years or more before seeking out treatment for fibroids, compared to 29 percent of white women. Fibroids have immense consequences in terms of cancer risk, as Black women who have fibroids have shown to be 40 percent more likely to have some form of endometrial cancer. Analogously, it has been demonstrated that Black women are equally as likely to have endometriosis, but are significantly less likely to be diagnosed with the disease compared to white women.

All of the aforementioned health risks result in what physicians and activists alike label as "period trauma". Dr. Charis Chambers, a board certified OB/GYN, explains that "I would define period trauma as any sustained psychological, social, or emotional injury/distress related to or caused by menstruation." Almost half of Black school-attending menstruators reported that they are not able to do their best on school work because of their periods. Especially considering the additional systemic burdens faced by Black people, missing school and becoming further behind in the system worsens phenomena like the wage gap between white and Black women.

Gender Inequity

This map highlights current bathroom legislation in the United States with regards to transgender people. Red color highlights states that allow discrimination or legal action against those that don't use bathrooms of their birth sex. Meanwhile, those highlighted in green show states that allow transgender or gender dysphoric people to use the bathroom of their choosing.

Additional Barriers Faced by Transgender Menstruators

Menstruation is a phenomenon very closely linked to womanhood and femininity. However, it is not just women that menstruate. This association can be extremely harmful for transgender or intersex menstruators, who must grapple with this complex identity. Practices as mundane as bathroom use become challenging, as 66 percent of trans men feel uncomfortable or unsafe using their preferred restroom. Correspondingly, 66% of transgender men thought people felt negative or very negative about masculine-presenting people who menstruate. Menstruating on its own is difficult, when accounting for period stigma and period pain, but the added burden of gender dysphoria can be traumatizing for many. When considering commonly used period products, the assumption that pads and tampons are easily usable crumbles. Many trans men and trans masculine people feel uncomfortable with vaginal penetration, as penetration in itself is strongly associated with femininity and womanhood. Tampon use is therefore difficult or not an option for many transgender menstruators, making accessibility to preferred menstrual products an additional barrier. Even the packaging of period products can induce internal identity conflict, when period products are marketed in bright pink and purple hues that lie in grocery store aisles labeled "Women's Health".

Period poverty disproportionately affects transgender menstruators, because these populations already face poverty, unemployment, incarceration, and underemployment at much higher rates. Even when menstrual products are freely available in bathrooms, they are usually placed in women's bathrooms so that transgender men may struggle to gain access to these products despite any efforts made to place them there.

Similar to Black people's distrust in the medical system, poor health provider interactions with transgender patients contributes to lack of adequate menstrual health care. In a study conducted by Chrisler et al., 19% of transgender people were refused medical care because of their transgender identity, with a subsequent 28% of transgender people worried about disclosing their transgender identity to their healthcare providers. Beyond this fear, transgender men usually are supplemented by testosterone in their transitions, which is noted to eventually suppress menstruation. However, of those who don't refuse treatment, countless providers are unsure how to care for transgender patients, whether their inabilities are rooted in bigotry, ignorance, or lack of comprehensive medical education.

These deficiencies in care can lead to more unanswered questions about how and why these processes occur, which furthers the distrust in healthcare providers and continues the cycle of poor care. Menstruation is yet another barrier in the healthcare system that fails transgender people as a whole, and all of the other barriers must be addressed in order to properly handle the menstrual health needs of trans menstruators.