Period Stigma Is More Than an Inconvenience—It’s a Global Health Crisis

Amanda Pell

Photo by Valentin Salja @ Unsplash

This summer, after “Tampongate”— a controversy caused when Democratic Rep. Sean Maloney of New York was denied $37.16 in funds to buy menstrual products for his staffers—roiled Capitol Hill, I found myself on the beach with my (baby boomer) aunt. And she had questions.

“You’re a feminist,” she said. “What’s the deal with this push for free tampons in Capitol Hill buildings? Don’t those politicians make enough money to pay for their own hygiene items?”

She had a point. The average salary for congresspeople is $174,000 annually, more than enough to cover basic hygiene. But congressional staffers, interns, and volunteers make a lot less than that; and besides, (I went on to explain) the incident was more about menstrual products still being largely viewed as nonessential in our society. That harmful perception leads to not only Congressional budget cuts, but vital health products being taxed as luxuries in places where an inability to afford or access them can be life-altering.

Globally, menstruation is a chronically under-discussed topic. Menstrual shame is nearly universal and stretches more or less to the beginning of time. Medieval women were denied pain relief since cramps were a “reminder of Eve’s Original Sin” while a traditional Nepali practice of literally banishing menstruating women to a shed was only just criminalized in August of 2018 after the deaths of two teenage girls in a year.

And so we find ourselves facing the modern health crisis that is menstrual inequity … because the patriarchy is grossed out by periods.

No one even thinks about it

“It’s all about the stigma,” says Chelsea VonChaz, founder of Happy Period, a nonprofit dedicated to giving menstrual hygiene kits to those who can’t access or afford them. “We don’t really think about our periods or we think about them negatively,” she says.

VonChaz founded Happy Period after a chance encounter with a homeless girl who had a period stain on her pants made VonChaz think about “what it’s like to go without basic necessities for your period because you simply don’t have the means financially.”

Several states require some access to menstrual products in public facilities like schools and shelters. But many shelters don’t have enough supply to meet the demand, particularly charity-based facilities that rely heavily on donations. Menstrual products are one of the least-donated items shelters receive. “People aren’t thinking about periods, so they’re more likely to get donations of toothbrushes and toothpaste, even razor blades for men to shave with, than pads and tampons,” VonChaz says.

But it’s not just homeless and extremely low-income people who find menstrual supplies to be cost-prohibitive. “This happens across the board,” VonChaz says. HuffPost estimates a lifetime of menstruation costs up to $18,171. It’s a financial burden for any person working to make ends meet—one made worse by the fact that 36 states still treat menstrual hygiene products as luxury items, an imposing sales tax commonly known as a the “tampon tax.” (Outside of the U.S., it can be even costlier. Across most European countries, sales taxes range from a whopping 19 to 27 percent.)

Few, if any, available government assistance programs offer period-related financial assistance. Medicaid excludes menstrual products, despite being classified by the Food and Drug Administration as medical products. Nor can they be bought with federal safety net programs like the Supplemental Nutrition Assistance Program, which only covers food. The Temporary Assistance for Needy Families program does cover the both menstrual products and much needed Midol, but only families with children qualify.

Without access to donated products or governmental assistance, homeless and low-income menstruators must often choose between purchasing other essentials—like food for themselves and their families—and purchasing menstrual products. “They’re having to make these decisions between their baby’s diapers and their pads and tampons,” says VonChaz. In developing countries, young girls have been known to offer sex in exchange for money just to buy menstrual products—a practice they call “sex for pads.”

Shame, blame, and toxic shock

Those struggling financially also make do with the few resources they have on hand, an option that can lead to infection or disease. “They may use socks because socks are donated more than pads and tampons,” says VonChaz. “They may use potato chip bags or just layer up as much clothing as they can find or use old rags and other materials they should not be using.” When they do have access to supplies, it’s usually limited, meaning they often leave tampons in for longer than recommended in an effort to make them last—a practice that can result in Toxic Shock Syndrome.

Without resources to manage their period, they’re left with one semi-hygienic option: free bleeding, or menstruating without using products to absorb flow. Instances of voluntary free bleeding have occurred somewhat frequently since the 1970s, intended to draw attention to the code of silence governing reproductive health. But when free bleeding occurs unintentionally because someone lacks basic supplies, it can have damaging consequences. A Georgia woman claimed she was fired for leaking menstrual blood at work, and many people take unpaid time off to deal with painful cramps or because they can’t afford not to free bleed. Among the school-aged, menstruation contributes to a global phenomenon of absenteeism. Thirty percent of girls in Nepal and Afghanistan report having missed school due to their period, while over 20 percent of girls in India drop out completely once they reach puberty. Industrialized nations are impacted, too—new research by Always indicates that 1 in 5 girls in America and 1 in 7 girls in Canada have left early or skipped school because they didn’t have a period product.

In other words, an inability to access period products causes menstruators to suffer at work and at school—the two tools they most need to escape the cycle of poverty.

Among transgender and nonbinary people, menstrual inequity isn’t just damaging — it’s downright dangerous. Having one’s period can publicly expose one as trans. “Being ‘outed’ this way can happen through leakage, or because you’re spotted disposing of a bloodied tampon in the men’s restroom waste bin,” says Sam Dylan Finch, editor and creator of Let’s Queer Things Up!, in an email. “Your status as transgender is now known, and anyone who is hostile towards trans people now knows it, too.” According to the National Transgender Discrimination Survey, people who are “visually non-conforming,” report markedly higher rates of harassment, discrimination, and assault.

“If you are homeless and transgender (which is common in trans populations, as homelessness disproportionately impacts us), you are relying almost exclusively on public restrooms, which means you are repeatedly taking these risks throughout your day,” says Finch. The same discrimination survey found that 1 in 5 transgender individuals have experienced homelessness at some point in their lives. Of those, 55 percent reported being harassed by shelter staff or residents, 29 percent were turned away altogether, and 22 percent were sexually assaulted by residents or staff.

Want to help? Start the conversation

The good news is, while menstrual inequity is an undeniably serious issue, it also has some of the most accessible solutions–and everyone can make an impact. “Advocate for gender-neutral restrooms that include menstrual products, support organizations pushing back on the ‘tampon tax,’ and support businesses that use gender-neutral language when selling or providing menstrual products,” suggests Finch.

Just talking about menstruation and menstrual equity can also help. “The stigma is the problem. That’s really the core of the issue,” says VonChaz. Shelters lack menstrual products largely because people forget about periods when they’re making donations, while men’s rooms lack them because we perpetuate the stereotype that periods are a “women’s issue.”

The most direct way to help equalize the period playing field is to contribute supplies where you know they’re needed. “If you’re at the store and you’re buying a box for yourself, get an extra box and donate it to a local shelter,” says VonChaz. “Or ship it,” she adds, noting that a great place to send period supplies is to natural disaster victims like those impacted by Hurricane Michael. You can also donate cash directly to Happy Period and similar trans-inclusive menstrual charities like or PERIOD or Aunt Flow, an organic tampon company that accepts cash donations to put toward sending menstrual products to those in need.

The bottom line on menstrual equity is simply to refuse to stop talking about it. Remind people at church, at school, in community groups, and among friends and family to include period products in their holiday donations. Insist on modern, trans-inclusive reproductive education for your kids at school. And never be ashamed to talk about your own periods—good, bad, or ugly.