Progress toward menstrual equity in the United States is still slow; however, a few recent developments indicate that attitudes toward menstruation seem to be shifting.

The issue of equal access to products for managing menstruation has gained traction at all levels thanks to people like U.S. Rep. Grace Meng (D-N.Y.). Meng recently introduced the Menstrual Equity For All Act of 2019, which proposed making menstrual hygiene products available for free for students, inmates, employees, visitors to federal buildings and homeless people. The act would also make menstrual products reimbursable via health spending accounts and cover them under Medicaid.

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Lawmakers in 22 states also introduced bills to repeal taxes on menstrual products in 2019. Several states, including Florida, Illinois, and Nevada have abolished the tax altogether.

Also, women are talking publicly about their periods and the issue of menstrual equality is being pushed on a global scale. The film "Period. End of Sentence." took home the Academy Award for "Best Documentary (Short subject) in February 2019 and celebrities like Amy Schumer, Demi Lovato, and Chrissy Teigen, among others, are destigmatizing public discussion of menstruation.

Science is also exploring ways to make menstruation easier. A study published in the Lancet Public Health Journal in July 2019 noted that menstrual cups are just as effective as pads and tampons, broadening the availability of potential products for controlling menstruation. Highly absorbent underwear for use during the menstrual cycle is offered by companies such as Wuka, Thinx, and RubyLove, among others.

These recent moves are promising, because for much of the last century, having a healthy, convenient period, in the United States and many other countries, has been a luxury.

According to sexuality educator Ashley Haymond, even when pads and tampons first became available to consumers in the 1920s and '30s, they were typically only affordable for more well-off women. Haymond said there was a steep learning curve and many women used rags (leading to the coining of the phrase "on the rag") and other makeshift products.

"With everything, there are class differences, and learning curves, and haves and have nots," Haymond said.

Unfortunately, this discrepancy remains in place today.

According to Rewire, U.S. women spend a total of $2 billion on menstrual products annually. More than 16 million women live in poverty and women are more likely to live in poverty than men. A study in Obstetrics & Gynecology noted that most low-income women without access to feminine hygiene products make do with rags, tissue and even children's diapers.

The use of improper products like these can lead to the development of bacteria and infections for women, which, without proper access to healthcare can quickly lead to serious health problems.

Adding to the lack of accessibility is the fact that regular state sales taxes apply to sanitary products. Nicole Kaeding, a former vice president of federal and special projects at The Tax Foundation, has argued that these sales taxes are necessary and don't single out feminine products.

"Traditionally, we don't discuss sales tax as being a tax on a specific item, as it is misleading ... states should also be hesitant to exempt items such as feminine hygiene products from their sales tax base because they continue to erode the revenue productivity of these taxes. As the sales tax base gets smaller, states must raise tax rates on the remaining items to generate the same amount of revenue," Kaeding wrote for the Tax Foundation in 2017.

"Sales tax on menstrual hygiene products adds up to a significant amount of money over an individual's lifetime, but loss of this revenue would not be a big hit to state and local sales tax revenue," Haymond said.

Marcy Karin, a professor of law at the University of the District of Columbia, argues that although this tax is no different than the sales tax applied to other store-bought items, it's a barrier that shouldn't exist for people who menstruate.

"There's no other way to describe it but gender-based discrimination. ... Menstruating individuals don't really have a choice but to purchase these types of products, in whatever form they might be or be able to access," Karin said.

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Karin is the director of UDC's legislation clinic, which has worked with a non-profit called Bringing Resources to Aid Women's Shelters (BRAWS) for three years.

The collaboration between BRAWS and UDC helped lead to the repeal of the tampon tax in Washington and efforts to have the tax repealed in Virginia. BRAWS also testified before Congress alongside UDC law students, school-aged students, former inmates and leaders of homeless and domestic violence shelters for "Voices of Women and Girls on Menstruation, Dignity, and the Issue of Access" in late 2017.

The hearing and subsequent 2018 Periods and Policy report from BRAWS and UDC, shed light on the domino effect of stigma and lack of access to menstrual products. BRAWS and UDC also stressed how menstruators from school age to adulthood suffer varying forms of indignity because of a regular biological function.

Period poverty in schools

The Periods and Policy Report detailed the impact of lack of access to menstrual products in schools and how it impacts female and gender nonconforming students who don't have easy access to necessary supplies. In one story, 12-year-old Nicole Hertzog shared how she had to ask for a "turtle" or "penguin" instead of a tampon or pad in class.

"These and other types of social stigmas attached to menstruation have led girls to feel embarrassed and ashamed of a perfectly natural process," the report said.

According to a University of Richmond School of Law study, less than half (42.13%) of all surveyed females attended a high school that provided menstrual hygiene products. Many of the schools that did provide products also made students pay for them. This restricted access had a variety of consequences, from lateness, absences and decreased learning ability, to health problems.

Period poverty is believed to contribute to instances of truancy in students who don't have a way to manage their periods. So for four years, according to NPR, BRAWS has provided menstrual products to local schools with high truancy rates.

Holly Seibold, the BRAWS founder, and executive director believes period poverty in schools contributes directly to economic poverty because it prevents students from fully participating and taking advantage of educational opportunities.

"If you have your period and you have no way to manage it, are you going to sign up for track? No," Seibold said. "Those ... who cannot afford products ... are not receiving the same opportunities as those who (can) afford it, and therefore they will never be able to pull themselves out of poverty," Seibold says.

Seibold wants to make menstrual products available in school bathrooms, so students don't have to go to their nurse's office. According to Seibold, providing access in schools to all menstruators would cost Fairfax County Public Schools $750,000 of its $3 billion budget. However, Seibold says the school board insisted to her that the change would cost too much for installation and personnel costs.

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"I'll continue arguing until the day I die that if it was boys who were menstruating that they would get them," Seibold said.

Poverty leads to further shame and trauma

Other stories at the hearing from former inmates and shelter leaders shed light on how a lack of menstrual products led to indignity for girls and women, as well as transgender and nonbinary people who menstruate, all of whom may be dealing with difficult situations like domestic violence or homelessness.

According to a report by the U.S. Department of Housing and Urban Development, 40% of all homeless people are women, while 21% are children. The report also noted that 55% of all people living in transitional housing are women and the National Center for Transgender Equality notes that one in five transgender people has experienced homelessness. Unfortunately, the Periods and Policy Report noted that increased demands on shelters mean every shelter can't afford to provide hygiene products to all of its menstruating residents.

During the congressional hearing, Meng noted that some shelters "can't afford them or in some cases weren't even allowed to use their grants to get them."

"Being homeless, I could never afford what I wanted in hygiene supplies. I would use whatever I could get," an anonymous BRAWS client said.

According to the report, the average menstruator experiences more than 2,200 days of menstruation (roughly six years) throughout her lifetime and uses four tampons per day. At nearly $7 per box, this adds up to a lifetime total of $1,773.33.

Haymond mentioned that states need to devote more resources to education and raising awareness about different options for period management.

"States do play a role in public health, letting their citizens know that these things are available ... they can encourage businesses ... to provide tampons and pads just as they would other products," Haymond said.

When it comes to the economics and financial impact of menstrual equity, Seibold stresses the ability for menstruators to remain in school and have the tools to educate themselves and escape poverty, while Karin argues that menstruators can use the money they save from paying for feminine products to contribute to society.

"Not only is it about that money that might go back into the community but if people have access to the products they need ... then you have the people going back to school," Karin said. "So you have people being able to fully participate in their communities and all of that really matters when we're talking about gender equality or gender justice."

Distributed by Tribune Content Agency, LLC.

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