The Bloody Truth: Period Poverty Around the World

Out of the 800 million people worldwide who menstruate daily, more than 500 million of them struggle with menstrual health management, or period poverty: the inability to access safe and hygienic menstrual products, sanitary toilets, and proper waste management facilities (Sanchez and Rodrigues, “Month After Month”). The words “period poverty” tend to paint the picture of a dirty and rundown area; one with no running water or modern bathrooms. In fact, in a study conducted by Flo, a period tracker app used by 152 million people worldwide, 34% of respondents from a pool of 300,000 people thought that period poverty was only an issue in developing countries (Thorpe). But this is untrue; in the United Kingdom, 10% of people who menstruate cannot afford period products (“1 in 10”). Even in the economic superpower of the world, the United States, 42 million impoverished menstruators are unable to care for themselves during their periods (“The State of Period Poverty”). For instance, 20% of low-income people with periods in St. Louis, Missouri cannot afford period products on a monthly basis (Sebert and Peters). And keep in mind that, when discussing period poverty, it is crucial to remember that not all menstruators are women and not all women menstruate (Rapp and Kilpatrick).

One of the leading causes of period poverty is lack of income; when some families must choose between buying a box of tampons or feeding their children, the choice is simple. According to Paper, “Soap and toilet paper are also available as a public commodity because there is a civically expected level of hygiene” (Sharma). While these are considered necessities, pads and tampons are considered luxury goods and “exempt from the basic hygiene category” and taxed as such, even though hundreds of millions of people require them daily (Sharma). Without the proper products and facilities to manage periods, people can suffer lasting negative consequences. People with periods may have to reuse pads or wear tampons for prolonged periods of time, and in some parts of the world, menstruators may be forced to manage their periods with dirty rags, tree bark, or even sands (Volkova). This results in a heightened risk for urinary tract infections, toxic shock syndrome, skin irritation, vaginal itching, and more. Not only can people’s physical health be compromised, but also the emotional toll that accompanies a lack of access to period products can heighten anxiety, depression, and distress (Rapp and Kilpatrick). Many of those who cannot afford period products would rather stay home than deal with the embarrassment. The inadequate menstrual management can prevent people from going to job interviews, or even attending school, making this issue a vicious cycle: if people cannot get the proper education or job, they cannot afford period products. Ultimately, this demonstrates that period products are as essential as soap and toilet paper and therefore should at least be tax-free and affordable, if not free.

Some countries have already taken action to make period products more accessible to those who need it. In 2004, Kenya was the first nation to eliminate a national sales tax on menstrual products, followed by Australia and Ireland (Rafanelli and Volkova). Scotland also took action in 2018 when it became the first nation to make pads and tampons completely free in all educational institutions (Volkova). Similarly, the United States’ legislature attempted to alleviate this issue with the Menstrual Equity For All Act of 2019, which is a bill that would make menstrual products available for free in schools, shelters, and other public facilities (Tully-McManus). Skeptics are often critical about the expenses of offering free menstrual products and may wonder where the funding comes from. This is understandable because the average school district would require about $8,000 to cover a sufficient amount of tampons and dispensers. However, this is an expense that “local governments could easily cough up given that items like band-aids, condoms, sunscreen, and even viagra are within state budgets” (Sharma). Offering free period products is definitely a step towards ending period poverty, and for some of those who cannot afford pads and tampons, this can be a lifesaver. But it is not enough. According to The Conversation, free products “can manage short-term issues, but they will not solve what is a complex socio-economic issue” (Barrington et al.).

There is little evidence that free period products alone can solve the major issues that stem from period poverty. One of these important issues is that, for girls, menstruation is the top reason they skip school (Rosa). For instance, in Uganda, people may steer away from using pads even if they have them because there is misinformation that pads cause infections and cancer. Additionally, it is hard to properly manage reusable pads because schools do not have the proper washing facilities, and wearing them for long periods of time is uncomfortable (Barrington et al.). As for disposable pads, there often is not a place to discard them. In countries around the world, people who menstruate worry that pads and tampons are ineffective and will cause leaks onto their underwear and pants (Barrington et al.). Treating period products as a necessity and not as a luxury is just the first step to battling period poverty. This all goes to show that, despite having access to free period products, there is a multitude of reasons why someone may still feel uncomfortable attending school. But what is the cause of this? The short answer is menstruation stigmatization.

In other words, periods are so stigmatized around the world that people who menstruate are effectively silenced, and cannot learn enough about periods to properly use period products. We cannot leave stigma out of the conversation when addressing solutions to period poverty. Society teaches that periods are solely a women’s issue, and gender roles have been so ingrained into our society that the physical discomfort of periods is laughed off. And “for trans and non-binary people, non-inclusive gender language can be even more marginalizing than what they face on a daily basis” (Sharma). However, even though the world can never seem to agree on much, having a period has historically been a source of stigma worldwide, and is still seen in the present day. In Tanzania, people believe that if someone else sees their pads, they will be cursed (“Period Stigma Around the World”). In Bangladesh, when someone is on their period, they cannot leave the house for fear of being cursed by evil spirits (“Period Stigma Around the World”). In rural Ghana, a menstruating person cannot enter a room with a man in it (“Period Stigma Around the World”). In Nepal, people on their periods are banished from their homes and forced to sleep in poorly constructed “menstruation huts” because they are seen as “dirty” while on their periods (Vaughn). Even in the United States, people ask for pads like they are asking for illicit drugs, and hide pads in their pockets or up their sleeves until they reach the bathroom. Most people do not even feel comfortable calling it a period; instead, they use euphemisms like “It’s just my time of the month” or “Auntie Flo is here!” By contrast, in the Cherokee Nation, menstruating women are considered “sacred” and “powerful,” but this positive outlook is a rare one (“Menstruation Around the World”).

Even so, many countries are taking steps to achieve a period positive environment such as this one. For example, a department store that sells menstrual supplies in Japan provided employees badges that indicated if they were on their period in an attempt to create an environment where conversations surrounding periods are encouraged (“Period Stigma Around the World”). However, there was an ambiguous response to the initiative. Some responded positively and experienced its intended effect. Conversely, most believed that the badge invited harassment. Regardless, this solution is an example of good intentions gone wrong, but it is important to acknowledge that they were aware of the issue and tried to alleviate it. Another example of an attempted solution gone wrong is when countries such as Japan, Taiwan, Indonesia, South Korea, and Zambia began offering paid menstrual leave (“Period Stigma Around the World’’). Even though this seems like a generous benefit to offer, there are hidden consequences. For instance, designating leave specifically for periods may encourage hiring discrimination against women, regardless if they get periods or not. It also seems to imply that getting periods is a handicap that results in people not being able to do their jobs, which is definitely untrue (“Period Stigma Around the World’’). However, I am not saying that people with dysmenorrhea, endometriosis, or similar conditions should not receive paid sick leave. Rather, a blanket policy perhaps is not the most effective solution to combating period poverty, and open discussion is not enough to act as a silver bullet to solve period poverty.

Despite all of this, there are many countries that are successfully implementing various policies to support those experiencing period poverty. In 2019, the countries of the United Kingdom formed the United Kingdom Period Poverty Task Force, and its goal is to tackle the issue of period poverty and stigma around periods in the UK (“United Kingdom: Period Poverty”). One member of the task force emphasized that “tackling the societal challenge of period poverty and related issues in a holistic way is critical to supporting girls’ confidence and wellbeing” (“United Kingdom: Period Poverty”). In order to do this, they are working with experts to build on existing initiatives that will reduce the stigma around periods, and they are focusing specifically on “knowledge, awareness, and education” (“United Kingdom: Period Poverty”). More specifically, in London, Plan International UK is calling for a new Relationships and Sex Education curriculum that will help students learn how to properly manage their periods, and encourage open discussion around the topic (Astrup). Another country that is experiencing success in its attempts to fight against period poverty in the United States. Specifically, PERIOD The Menstrual Movement is an organization based in the United States that is “fighting to end period poverty and stigma through service, education, and advocacy” (“Period Stigma Around the World”). In October 2019, PERIOD The Menstrual Movement celebrated the first National Period Day and even made history with 60 rallies in all 50 states (“Period Stigma Around the World”). Contrasting the failed attempts by Japan and other countries, these countries and organizations are not only facilitating open discussions of periods, but also adding period education into the equation in order to have well-informed discussions which I believe is the best solution to period poverty. Although the steps taken by the UK and the United States are just the beginning to solving the widespread issue of period poverty, they show that period education and encouraging open conversations surrounding periods have been successful and are necessary to a period positive world.

Taking a look at the bigger picture, one paradox I feel the need to address is that, at least in the United States, most men seem to be comfortable talking about abortions, but not periods, even though they are both experiences typically associated with the female body. But why is this true? Perhaps it is because the archetypal masculine human is powerful, assertive, independent, but most prominently, in control. And the existence of an uncontrollable bodily process that is exclusively associated with females threatens this notion. But with abortions, they can take back an element of control by arguing that abortions are about a fetus’s life, effectively removing female body autonomy from the conversation. I can imagine why some may believe that this is extreme reasoning, but that does not change the fact that internalized misogyny exists in males and females alike, and contributes to period stigma. This is seen when even women and others with periods feel uncomfortable talking about periods because of the ingrained association of periods with smell, mess, and disgust, most likely arising from negative comments from their male counterparts. But it could also be their moms telling them to keep their periods hidden for fear of making the boys in their class uncomfortable. Either way, the rhetoric paints periods to be a shameful bodily process and plays into menstruation stigmatization.

The issue of period poverty has much more to it than just the affordability of period products. Not only does period poverty result in physical and mental health issues, but it also prevents people with periods from bleeding with dignity. Consequently, low-income menstruators miss school and job interviews, playing into the cycle of period poverty. Even though offering free pads and tampons will provide short-term relief to the issue, it does not address the stigma that prevents people from properly managing their periods. Efforts of period education and facilitating honest conversations on periods are necessary in order to fully acknowledge the scope of the issue. The actions of places such as the United States or the United Kingdom and movements from nonprofit organizations show that we are working towards a more period positive world. Perhaps one day, people around the world will no longer have to ask for a tampon in hushed tones, and everyone with periods will be able to bleed with pride.

Works Cited

“1 In 10 Girls Have Been Unable to Afford Sanitary Wear.” Plan International UK, 13 Oct. 2017, https://plan-uk.org/media-centre/1-in-10-girls-have-been-unable-to-afford-sanitary-wear-survey-finds.

Astrup, Juliette. “PERIOD POVERTY Tackling the Taboo: The Journal of the Health Visitors’ Association.” Community Practitioner, vol. 90, no. 12, 2018, pp. 40–42. ProQuest, http://libproxy.usc.edu/login?url=https://www-proquest-com.libproxy2.usc.edu/docview/1987646421?accountid=14749.

Barrington, Dani, et al. “It Will Take a Lot More than Free Menstrual Pads to End Period Poverty.” The Conversation, 6 Apr. 2020, www.theconversation.com/it-will-take-a-lot-more-than-free-menstrual-pads-to-end-period-poverty-120189.

“Menstruation Around the World.” Your Period, 2019, www.yourperiod.ca/normal-periods/menstruation-around-the-world/.

“Month After Month: Period Poverty.” Figo, 22 Feb. 2019, www.figo.org/news/month-after-month-period-poverty.

“Period Stigma Around the World and What to Do About It.” Kindara, Prima-Temp, 6 Mar.2020, www.kindara.com/blog/period-stigma-around-the-world-and-what-to-do-about-it.

Rafanelli, Amarica. “Rags Instead of Tampons. Here’s What Period Poverty Looks Like in the U.S.” Direct Relief, Direct Relief, 24 Oct. 2019, www.directrelief.org/2019/10/rags-instead-of-tampons-heres-what-period-poverty-looks-like-in-the-u-s/.

Rapp, Ashley, and Sidonie Kilpatrick. “Changing the Cycle: Period Poverty as a Public Health Crisis.” University of Michigan School of Public Health, 4 Feb. 2020, sph.umich.edu/pursuit/2020posts/period-poverty.html.

Rosa, Shawna De La. “Report Finds ‘Period Poverty’ a Top Reason Girls Miss School.” Education Dive, 21 Oct. 2019, www.educationdive.com/news/report-finds-period-poverty-a-top-reason-girls-miss-school/565424/.

Sanchez, Erica, and Leah Rodriguez. “Period Poverty: Everything You Need to Know.” Global Citizen, Global Citizen, 5 Feb. 2019, www.globalcitizen.org/en/content/period-poverty-everything-you-need-to-know/.

Sebert, Anne Kuhlmann, and Eleanor Bergquist Peters. “Unmet Menstrual Hygiene Needs Among Low-Income Women: Obstetrics & Gynecology.” The American College of Obstetricians and Gynecologists, Feb. 2019, journals.lww.com/greenjournal/fulltext/2019/02000/unmet_menstrual_hygiene_needs_among_low_income.2.aspx.

Sharma, Jeena. “The State of Period Poverty in the United States.” PAPER, PAPER, 15 June 2020, www.papermag.com/period-poverty-tampon-tax-united-states-2631311601.html?rebelltitem=9.

“The State of Period Poverty in the U.S.” Center for Global Women’s Health Penn Nursing, 2019, www.nursing.upenn.edu/live/news/1545-the-state-of-period-poverty-in-the-us.

Thorpe, JR. “Period Poverty In The U.S. Stats Show It’s A Complicated Issue.” Bustle, Bustle, 18 Oct. 2019, www.bustle.com/p/period-poverty-in-the-us-stats-show-its-a-complicated-issue-19220019.

Tully-McManus, Katherine. “This Democrat Wants Free Tampons and Pads Available in All Federal Buildings.” Roll Call, 2019, www.rollcall.com/2019/03/26/this-democrat-wants-free-tampons-and-pads-available-in-all-federal-buildings/.

“United Kingdom: Period Poverty Task Force Meets for the First Time.” Asia News Monitor, Jul 25, 2019. ProQuest, http://libproxy.usc.edu/login?url=https://www-proquest-com.libproxy2.usc.edu/docview/2262802005?accountid=14749.

Vaughn, Emily. “Menstrual Huts Are Illegal In Nepal. So Why Are Women Still Dying In Them?” NPR, NPR, 17 Dec. 2019, www.npr.org/sections/goatsandsoda/2019/12/17/787808530/menstrual-huts-are-illegal-in-nepal-so-why-are-women-still-dying-in-them.

Volkova, Maria. “The Global Implications of Period Poverty and What You Can Do to Help.” Blood & Milk, 30 May 2019, www.bloodandmilk.com/the-global-implications-of-period-poverty-and-what-you-can-do-to-help/.