On Menstrual Justice

By Prof. Marcy Karin

Professor Marcy Karin shares her remarks from the GENDER.ED-IASH event on Reproductive Justice to mark International Women’s Day in 2023. We don’t talk about menstrual injustice enough, she writes. On the rare occasions we do talk about menstruation in public, we view it as something dirty and don’t consider the varied lived experiences of menstruating bodies.  

Image: Prof. Marcy Karin

Usually, I start by saying that my big idea for normative change is to have people say the word period in more spaces.  And the moment I say menstruation for the first time – I get to watch the awkward and uncomfortable reactions of the audience.  Today, it is such a pleasure to be the second period dignity speaker. 

Thanks to GENDER.ED and IASH for both putting on this important panel to expand the conversation about reproductive justice and for sponsoring my time at the University to engage in a comparative examination of the role of law and policy in supporting menstruation through menopause at work and school in Scotland (and the United Kingdom more broadly).

My goal is to introduce you to what Margaret Johnson calls menstrual justice, articulate why menstrual justice should be included in the broader reproductive justice conversation, and share a glimmer of optimism despite what feels like an otherwise bleak moment.

Professor Johnson describes menstrual injustice as the oppression of menstruators—so some women, girls, transgender men and boys, nonbinary and intersex persons—simply because they menstruate. Moments of menstrual injustice occur every day across the globe because existing societal structures fail to acknowledge, anticipate, or accommodate the menstrual cycle—and when they do acknowledge it, it is often done in a way that causes harm — to the dignity, bodily autonomy, education, or economic security of current and former menstruators.

Here’s the heart of it:  the biological process does not stop at school, work or other public places.  Nor does it stop during a pandemic, during a disaster, during a test or a workplace presentation.  There also is no one universal menstrual experience – either across people or across one’s lifespan from menarche through menopause.  Cycles change.  People may unexpectedly bleed or bleed differently.  And environmental and social factors impact cycles.

Yet, our institutions are not designed to recognize this or to support needs related to periods, perimenopause, menopause or related conditions like dysmenorrhea, endometriosis, fibroids, or PCOS.  These menstrual-related needs fall into two buckets:

  • Menstrual accommodations: These include access to free menstrual products, private and sanitary spaces to dispose of menstrual discharge and the products that absorb them, break time away from work or class to use the toilet, and ventilation to mitigate hot flushes.
  • Ability to operate in spaces free from indignities, discrimination, and harassment because of menstruation.

Historically, these are topics hidden from public discourse. When mentioned, it is viewed as dirty and shameful—as something other than normal.  And when lived experiences with menstruation are mentioned, it tends to be from privileged cis white women—and not from those who may experience menstruation differently because of disability, religion, housing immigration or class status, or racial national or gendered identities.  Those voices are often missing altogether.

Bleeding also is a bodily expression, and menstruators rarely are indifferent to the process, even when conditioned not to discuss it.

This reality and the corresponding shame, lack of menstrual education, and power dynamics of most of our structures causes indignity and harm.

Take Alisha Coleman, a perimenopausal phone operator who was terminated after menstrual blood twice leaked on company property. She was fired because she “lacked high standards of cleanliness.”

Or Joyce Flores, who worked as a dental hygienist in a correctional facility.  She was fired after being flagged for “suspicion of contraband” because her body scan images “looked different” when she forgot to take products with her to work and was scanned at different times with tampons and toilet paper to absorb menstrual discharge.

And this is not just an American problem—my research project here involves building and analysing a database of dozens of cases under the UK Equality Act involving menstrual and menopausal discrimination.

I also could have used examples of workers in Norway who were required to wear red bracelets or factory workers in Spain who had to wear a red sign with the word “toilet” on it “in a bid to humiliate [workers] into taking less breaks.”  Or department store workers in Japan who were asked if they wanted to voluntarily wear a “Miss Period” badge when menstruating to receive better treatment.  Or when a grocery store spied on staff to monitor menstrual cycles “to prevent shoplifting.”

But for menstruation these harms would not have occurred.  That is menstrual injustice.  And we don’t talk about it—or at least not enough.

We talk about pregnancy, termination of pregnancy, breastfeeding, the need for sex education and their corresponding impact on economic security and bodily autonomy.  But the entire continuum of reproductive health and reproduction must be included to challenge patriarchal structures that control our bodies.  And we need better menstrual literacy and understanding of gendered disadvantages stemming from all reproductive harms.

In the last decade, there has been a global push for menstrual justice—both accommodations and antidiscrimination protections.  But there is only one law that explicitly covers the menstrual cycle or offers support to current or former menstruators in the US or Scotland:  Scotland’s Period Products Act, which now requires responsible bodies to supply a range of menstrual products to people who need them.

Nothing else specifically addresses these needs or lived experiences on a national level–and while a recent UK policy consultation could have led to menopause protections at work in Scotland, efforts are now stalled after Westminster declined to move forward with needed reforms.

So we keep going.  And I hope we do so in a way that extends beyond supporting the norm of the ideal person being one who does not menstruate and menstrual concealment as the only solution to the “problem” of menstruation.  People may choose to hide menstruation to be the ideal student or ideal worker. And especially until we do better about educating people about menstruation and destigmatize it – products are needed.  But one item and “solution” is not enough.  We need more options and policy supports to address the range of menstrual needs and experiences.

But before my glimmer of optimism, the problematic caveat to my statement that most are not talking about menstruation as reproductive justice. Post Dobbs, people are talking about the connection between menstruation and the reproductive justice in the States with respect to one thing: menstrual surveillance and tracking.  Because a lack of menstruation in a particular cycle can be used to determine if someone is pregnant, having access to data related to whether (and when) someone is (or recently was) menstruating may be evidence of a pregnancy being terminated.

Data from menstrual tracking—which is a useful practice for health and understanding one’s body—as well as conversations from social media DMs, chats—where people seek information about options including from trained and trusted professionals—may be shared with law enforcement in a way that could provide supporting evidence that someone has or is trying to receive reproductive care related to terminating a pregnancy.

Or aiding or helping someone in getting such care—which is also illegal in some states now. This is fertile ground—an attempt to legally prevent menstrual data from being shared with law enforcement just failed in the Virginia state legislature.

Change is possible in this space.  Scotland is leading on product access; England enacted menstrual literacy requirements in 2021, and the UK’s Equality Act sometimes applies to the menopausal worker. Further, governments around the globe—Australia, India, Japan, Kenya, Spain and beyond—have laws and are experimenting with others to shift attitudes and behaviours to combat stigma and otherwise address menstruators’ needs.

And I’m cautiously optimistic that more is coming when I look at how rapidly things have changed since I first testified about menstrual accommodations in 2016 and co-hosted the first Congressional briefing on menstrual justice in 2017. Students like Lauren and Vivi Lin (a student here who advocates for menstrual justice in Taiwan) and their colleagues, local activists, academics, and some legislators and executives around the world are talking, creatively collaborating across boundaries, and inching us closer to full reproductive justice. We will soon have additional, enforceable public policy interventions to minimize menstrual injustices, including by respecting all forms of bodily autonomy, enhancing dignity, and offering menstrual modifications and antidiscrimination protections.  And then—and only then—will we fully acknowledge that menstruation and menopause matter, including access to products and beyond, and have any chance at obtaining true, intersectional safe and dignified lived experiences.

Thank you.

Author Bio

Marcy Karin is the Jack and Lovel Olender Professor of Law at the University of the District of Columbia School of Law.  She teaches courses in gender, disability, and employment law, directs the Legislation and Civil Rights Clinic and supervises student representation on systemic reform projects for community group clientsShe is housed at the Institute for Advanced Studies in the Humanities though June as the 2023 Fulbright Distinguished Scholar.