Woman sits with legs crossed, meets with therapist or counselor. Period poverty concept.

Period Poverty: A Human Rights and Public Health Issue

Woman sits with legs crossed, meets with therapist or counselor. Period poverty concept.

The euphemisms are numerous. “Aunt Flo.” “Crimson tide.” “Shark week.” “That time of the month.” In many countries, including the United States, the topic of menstruation is not only stigmatized, but outright taboo.

Despite the essential nature of menstruation, openly discussing it is off-limits, leaving menstruating individuals to navigate the expensive — and often painful — challenges of having a period in silence.

The reality of period poverty

Taboos around menstruation underlie a disturbing reality known as period poverty. This lack of access to menstrual products affects millions daily, forcing insufficient substitutions like toilet paper, cardboard, rags, paper towels, or even previously used pads. Additional costs for pain medication and clean underwear, not to mention the infrastructural necessities like toilets with running water, sinks for handwashing, and hygienic waste management, all present expensive hurdles that prove insurmountable for many.

Gender inequality feeds into period stigma as well. At least 27 states in the U.S. still tax menstrual supplies, generating approximately $88 million in annual revenue by state, all at the expense of the health and dignity of millions. Conversely, medications targeted specifically to men like Viagra and Rogaine are tax-exempt in all 50 states.

Lack of access to menstrual products has steep social costs as well. Period poverty can lead some students to miss school and after-school activities, interfering with their education, as well as their social, emotional, and psychological health. For some adults, the choice falls between providing food for their families and purchasing menstrual products, as period supplies are not eligible for coverage under food stamp programs or SNAP.

Related Courses: Women’s Health Specialty CE Courses for Nursing Professionals

Harmful alternatives

Alternatives like rags, paper towels, or previously used pads may serve an immediate need, but offer no true solution, as these alternatives heighten the risk of infections, including urinary tract and yeast infections and bacterial vaginosis.

The costs of period poverty extend beyond physical and economic, too, with numerous poor mental health outcomes tied to lack of adequate menstrual supplies, among which are heightened anxiety, low self-esteem, and depression.

Homelessness and period poverty

For the more than 210,000 homeless individuals who menstruate, periods can be catastrophic. With each monthly cycle comes the challenge of purchasing expensive sanitary products, changing those products, relieving pain, and accessing regular shower and laundry facilities. Many shelters lack the resources to provide more than a few items for each cycle.

As in every other facet of modern life, COVID-19 has strained what was already an untenable situation for many, further restricting access to menstrual products and resources that may have been available through a shelter. Social distancing measures and the closure of public restrooms limit opportunities to change pads or clothes in safety and privacy, forcing many people who menstruate and have no home to make do with soiled clothes.

Although a movement to provide free sanitary products in public places is underway, most establishments remain lacking.

Period poverty among transgender and gender non-conforming people

According to the National LBGTQ task force, transgender women and gender non-conforming people have a higher likelihood of suffering period poverty than their cisgender peers. Because issues of menstruation have been historically discussed only in terms of feminine hygiene — when they are discussed at all — trans, non-binary, and gender, non-conforming (TGNC/NB) people may face gender dysphoria, discriminiation, and other significant barriers to addressing their menstrual needs.

While some companies have begun to market menstrual products as gender-neutral (including period shorts, period underwear, and menstrual discs), many public spaces still maintain gendered divisions, reducing access to menstrual products for TGNC/NB people in male-assigned bathrooms and homeless shelters.

Related Courses: LGBTQ Competency for Healthcare Professionals and LGBTQ for Healthcare Professionals Improving Access to Care

Advocacy to mitigate period poverty

Period poverty continues to exact a heavy toll on those who menstruate, and while no single solution can resolve such a complex issue, there are significant steps we can take to resolve the inequity and restore dignity to millions. They include:

  • Adjusting the conversation around menstruation and menstrual products. These products are not a luxury; they are a right and a medical necessity.
  • Eliminating the state sales tax on menstrual products.
  • Equipping schools, universities, correctional facilities, mens’ and womens’ homeless shelters, and healthcare facilities with what they need to provide free, high-quality menstrual products.
  • Empowering healthcare professionals and administrators to advocate for free access to period products in hospitals and other healthcare organizations.
  • Increasing the availability of gender-neutral bathrooms with access to free period products.
  • Removing the taboo and stigma surrounding menstruation.
  • Providing access to free period products in all public places and offices.
  • Teaching menstrual health in schools.
  • Requiring Medicaid to cover the costs of period products.

Leading by example

Though period poverty may seem like too big of an issue to tackle all at once, some nations have begun chipping away at it, with exciting results. After a multi-year campaign, Scotland has become the first country in the world to provide period products at no cost for those who need them.

Originally introduced in Parliament in 2019 by Labour MPS Monica Lennon, the Period Products (Free Provision) (Scotland) Bill passed unanimously and requires local authorities to ensure free period products are available at schools, colleges, and designated public places.

Called a practical and progressive piece of legislation, the importance of this bill was highlighted by the effects pandemic. As Lennon says, “Periods don’t stop for pandemics, and the work to improve access to essential tampons, pads, and reusables has never been more important.”