Why it's high time we ended period-related stigma and discrimination

Menstrual hygiene remains a pressing issue in India

38-Women-take-part-in-a-menstrual-health-and-hygiene Taking on taboos: Women take part in a menstrual health and hygiene workshop jointly organised by Sheffield Hallam University and The Sidhast Foundation near Ranikhet, Uttarakhand | Madhumita Pandey

I was nearly 12 when I first got my period. My mother had recently relocated to Mohali for work and at the time it was just my father, older brother, grandparents and I in Delhi. I remember seeing bloodstains on the bed sheet and running straight to the bathroom. My father must have seen the stains, too, as a few minutes later my grandmother knocked on the bathroom door and told me to throw my clothes in for washing and take a shower. I do not remember being scared, just uncomfortable. Very uncomfortable. When I came out of the shower, my father handed me a sanitary pad and told me that I would have to use it for a couple of days. He showed me how to open it and where it goes and then I was off to give it a go. The next morning while getting me ready for school, he said, “You might feel eager to tell your friends but please do not tell everyone that you are wearing a pad.” He must have known me pretty well as the first thing I did once I got to school was telling my closest friends that I had gotten my period!

A recent study by the Population Research Centre, Patna University, found that about 40 per cent of rural female adolescents in Bihar use cloth instead of sanitary napkins, and that even among the girls who use the latter, 90 per cent had not received any government-supplied napkins in recent years.

Years later, my mother would tell me what had transpired while I was in the shower. My father rang my mother and told her that I had got my period. She instructed him to go to the pharmacy and get some sanitary pads. In the meantime, he told my grandmother to help me get cleaned up. When my mother came home the next weekend, she made sure I got to spend enough time with her to get all my doubts cleared, including how I thought a sanitary pad was just an adult diaper for women who went to work (and who can blame me, haven’t we all seen the sanitary pad commercials with the blue liquid!).

This has remained a key positive memory of my life. But as I grew older, I realised that not everyone’s memory of how they got their first period was a pleasant one.

Every month, 1.8 billion people across the world menstruate. Millions of these girls, women, transgender men, and non-binary persons are unable to manage their menstrual cycle in a dignified or healthy way. In India, there are more than 35.5 crore menstruating women and girls, and many of them, especially those living in rural areas, face several challenges because of their menstruation, which restricts their autonomy and agency.

Menstrual hygiene remains a pressing issue in India, and a pervasive lack of awareness compounds it. For instance, research has indicated that anywhere between 29 per cent and 71 per cent of girls in India have no prior knowledge of menstruation before experiencing their first period. Cultural taboos and social stigma continue to negatively impact the menstruation experience. A national survey found that 70 per cent of girls in India perceive menstruation as “dirty”, while over 30 per cent experience fear and anxiety because of societal taboos associated with menstruation. Lastly, access to affordable and hygienic menstrual products remains a significant barrier. According to the National Family Health Survey (NFHS-4), only about 58 per cent of women in India aged 15 to 24 use hygienic methods of menstrual protection. Many girls drop out of school and several others are excluded from participating in everyday spheres of life.

It is important to look at menstrual health and hygiene as a basic human right. In fact, there are existing human rights that include obligations related to menstrual health and hygiene. For instance, the right to equality and non-discrimination, gender equality or the right to health, education, water and sanitation. Furthermore, there is a greater emphasis on the interconnectedness of these issues under the umbrella of climate change and sustainable development as outlined by the UN Sustainable Development Goals. We know that women and men experience climate change differently. Based on the findings of the Intergovernmental Panel on Climate Change, it is clear that people who are already among the most vulnerable and marginalised will experience the greatest impacts of climate change.

Srimathi Jayaprakash Srimathi Jayaprakash

With that in mind, I undertook a project on menstrual health in Uttarakhand from an intersectional gender and climate justice lens. It was a collaborative effort that was supported by Sheffield Hallam University of the UK; The Sidhast Foundation, a local NGO; Pink Leaf, a sanitary company started by two young men; the Almora chief medical officer's office; and the local panchayat. Participants were local village women and girls, as well as two government self-help groups. The workshop, led by two young female doctors from the local hospital, was aimed at creating awareness about the importance of menstrual and reproductive health and hygiene. After the lunch break, we moved on to the focus groups.

I truly believe something powerful happens when a group of women sits together and shares stories. And that is exactly what happened when we began the focus group. Everyone jogged their memories to remember their first period, which instantly opened a portal to deep and meaningful experience-sharing. The accounts of challenges made me reflect on my own Kumaoni identity and how different my experiences were growing up in a city. Women recalled not receiving proper information about periods, not having access to sanitary products, being denied access to the kitchen, and not sleeping in the same bed as their husbands. However, these were not lamenting narratives and were often balanced with a lot of laughter and giggles. But that was not surprising given the history of resilience shown by pahadi women in fighting the harsh elements of nature, resisting many unsustainable practices of modernisation as well as battling alcoholism among the men. We were lucky to hear narratives of women from across three generations of a family. While the grandmother recalled facing stigma around menstruation, the daughter recalled resisting many such unfounded taboos. Finally, the granddaughter shared how she does not feel restricted during her period and is able to actively engage in all her day-to-day activities. Many women also recalled segregation being common practice during periods and how they want to ensure their daughters and daughters-in-law do not have to go through similar unjust and discriminatory practices. It was interesting how many women shared that their husbands also condemned these ideas.

It was clear that things were slowly changing. Many women were still using cloth pads but were open to switching to reasonably priced, good-quality sanitary products. They were aware of the government-provided sanitary pads through anganwadis but felt that the quality was not good enough to make the switch. As the women and girls of the region are historically known to have sustainable practices, an important conversation about waste management also emerged. The need for biodegradable products and an effective way of disposing them seemed imperative. Another key point was focusing on efforts towards educating boys and men about menstrual health and barriers to gender equality.

The aim of the International Women’s Day 2024 #InspireInclusion campaign is to collectively forge a more inclusive world for women. But this world cannot be forged without support from men, who need to be reminded that they are equal stakeholders in this mission. A gender-equal world benefits all. UN agencies have stressed that if gender quality is not achieved, the implementation of all other goals would be compromised.

On March 8, 2020, Shashi Tharoor, MP, had started a conversation on menstrual health when he tweeted a petition advocating for menstrual leave for women in public and private workplaces. In March last year, Kerala MPs T.N. Prathapan, Benny Behanan and Rajmohan Unnithan posed questions in the Lok Sabha on whether the government had considered making provision for paid menstrual leave mandatory for all workplaces. More recently, Union Minister Smriti Irani came under fire when she made a statement in Parliament on how menstruation is not a handicap, and that the government is not coming up with any policy for mandatory paid period leave.

While all these debates contribute towards a healthy discourse on menstrual health, perhaps the priority needs to be directed towards the grassroots level. For instance, a recent study conducted by the Population Research Centre, Patna University, found that about 40 per cent of rural female adolescents in Bihar use cloth instead of sanitary napkins, and that even among the girls who use the latter, 90 per cent had not received any government-supplied napkins in recent years. And let us not forget this is a state that introduced menstrual leave of two days all the way back in the 1990s. The study also revealed that at least 5 per cent of the girls were not allowed to take bath during their menstruation.

PAD ISN'T BAD: A national survey found that 70 per cent of girls in India perceive menstruation as “dirty”, while over 30 per cent experience fear and anxiety because of societal taboos associated with menstruation

In India, there are various policies and schemes aimed at promoting accessibility to menstrual products and sanitation infrastructure. Among these are the National Menstrual Hygiene Scheme, Menstrual Hygiene Management Guidelines and the Swachh Bharat Mission.

However, more concerted efforts need to be made in educational and awareness-centred campaigns keeping regional complexities in mind. This is not only the responsibility of the Union and state governments, but also every one of us. So, this International Women’s Day, I call to action boys and girls, men and women to be agents of change and promote inclusion by ending period-related stigma and discrimination.

Dr Madhumita Pandey is senior lecturer in criminology and the Gender-Justice Hub lead at the department of law and criminology, Sheffield Hallam University. She works in the area of sexual offence, sex offenders and violence against women, particularly focusing on rape, in the global south.