From Period Poverty to Period Parity

Period poverty refers to the lack of access to essential menstrual products, hygiene facilities, waste management and/or education. It is concerned with the social, economic, political and cultural barriers to safe menstruation, education and sanitation. Although it affects over 27% of the menstruating population, adding up to 500 million people worldwide,  the lack of awareness and research around this issue is alarming. 

Period poverty is a threefold problem of the lack of education, acceptance, and access, increasingly worsening in many parts of the world, including India. This is a result of the global gender inequality that manifests itself in the form of high prices of sanitary products, lack of awareness about their usage, normalisation of stigmas around menstruation and the perpetuation of cultural ignorance as it is a “women’s problem.” 

One of the most significant causes of period poverty is the ubiquity of taboos and myths surrounding menstruation and its “impurity” that are passed through generations. The shame around periods prevents people from having open dialogues regarding access to menstrual products, the chemical substances they comprise of, and their health implications. According to a 2014 report conducted by Dasra on menstrual health and hygiene in India, 70% of mothers consider menstruation to be “dirty,” eternising a culture of shame and ignorance. Although period poverty is a global health crisis, this outlook on it results in large concerns remaining unaddressed.  Additionally, the report also discovered that 71% of girls in India had no knowledge of menstruation before their first period. This unpreparedness leads to shock, fear and anxiety, often resulting in school dropouts. 

The inequality is further compounded with the disavowal of transgender people as menstruators. Many people still consider periods a women-only experience. Not only does this completely disregard other menstruators such as non-binary or trans people, but it also implies that all women menstruate. Many people who are not women menstruate, and not all women do. A number of infertile women or women suffering from certain medical conditions are unable to menstruate. This discussion about period poverty needs to be handled gently and with a correct, inclusive outlook. This includes our language. Otherwise, it creates additional challenges for non-women menstruators. Given that inclusiveness is not yet widely practised, many studies, including the ones referred to in this article, solely focus on women who menstruate. This can create gaps in the representation of the menstruating population. 

Poor hygiene standards further aggravate the problem. For large groups of people, especially in rural areas, menstrual hygiene is almost non-existent. The scarcity of water and lack of toilets — let alone menstrual products — demonstrates how distressing the current situation is. According to official data from the Unified District Information System for Education, of the 10.83 lakh government schools in India, over 15,000 have no toilets. The study also concluded that 63 million adolescent girls lived in homes without toilet facilities, magnifying the struggle for many young menstruators. 
The consequent effect of period poverty is extensive and universal. The first implication is on physical health and hygiene. Lack of access to menstrual products forces menstruators to resort to unhygienic alternatives that put individuals at a higher risk of various urogenital infections. Some people have no choice but to use menstrual products for longer than intended to save money. Leaving a tampon in for too long can increase a person’s risk of toxic shock syndrome, a rare but dangerous infection. “Sanitary Protection: Every Woman’s Health Right, “ a study by AC Nielsen revealed that only 12% of India’s 355 million women use sanitary napkins. Around 70% of women in India say their family can’t afford to buy them of which 88% resort to harmful alternatives like un-sanitized cloth, ashes and husk sand. Incidents of Reproductive Tract Infection are 70% more common among these women. 

The implications on mental health and well-being cannot be overlooked either. Being unable to manage your period with the appropriate products can lead to feelings of distress, discomfort and anxiety. A study conducted by BMC Women’s Health in January 2021 found a link between period poverty and mental health. Among the women who reported experiencing period poverty every month, 68.1% reported symptoms of moderate to severe depression, compared to the 43.4% of women who had never experienced poverty. Although this study had several limitations, it did present a relationship between the two variables. A comparison between countries is harder to draw since higher rates of depression are also linked with high-income inequality. Therefore, it can be difficult to conclude whether period poverty directly causes depression.

Finally, education and careers are both disrupted by this issue. Focusing on schoolwork can be extremely difficult if one is uncomfortable, distracted or unable to actively participate due to menstrual leakage or odour. This can have long term consequences by impacting attendance, self-esteem, skill development, grades and future earning potential. It has been estimated that 1 out of 5 girls drop out of school after they start menstruating. Similar effects are seen in the workforce where people are unable to participate to their full potential and consequently face significant economic implications. According to the Dasra study, 31% of women in India miss an average of 2.2 days of work per month when they menstruate. Especially for daily wage workers, this can create a dent in their financial stability, trapping them in a cycle where they once again cannot afford menstrual products. 

Period poverty must be dealt with immediately. The first step is to increase education and share knowledge. Normalising menstruation and destroying taboos around this natural process within our organisations, communities, and schools is crucial. Initiating a conversation is crucial as it accelerates further research about menstruation that can help us learn how to address it better.  National advocacy is an essential course of action. Menstruators need the support of the government, private firms and charitable programs to provide adequate infrastructure and access to affordable menstrual products. Finally, governments need to establish protective legislation that can ensure national access to proper facilities and hygiene products. Many governments, including India’s, have made a major breakthrough by removing the tax off of menstrual products, making them more affordable.

Period poverty is a global crisis that does not have an overnight solution. The objective is to reach a state of menstrual equity. A position where we can ensure people have the means, support, and choices to decide how they want to take care of their menstrual health. Where healthcare providers, educators and individuals ensure that menstrual health is a priority. Where sanitary products are affordable, accessible and safe. 

Article by Parnika Gupta and Sia Aggarwal from the REDefine Team

Featured Artwork by Saanve Jatia

“What Is Period Poverty?” Medical News Today, MediLexicon International, https://www.medicalnewstoday.com/articles/period-poverty

Roy, Shriya. “What Is Period Poverty?” Feminism In India, 27 July 2021, https://feminisminindia.com/2021/07/28/what-is-period-poverty/.  

Almeida, Desirée Viteri, and Follow meDesirée Viteri AlmeidaPh.D.(c) Law & Political Science [Criminal Law & Criminal Sciences: Violence Against Women. “Period Poverty and Stigmatization.” The Organization for World Peace, 7 Sept. 2021, https://theowp.org/reports/period-poverty-and-stigmatization/

“Period Poverty: Everything You Need to Know.” Global Citizen, https://www.globalcitizen.org/en/content/period-poverty-everything-you-need-to-know/

“How Period Poverty Finally Became a Political Scandal.” Politics.co.uk, 19 Dec. 2017, https://www.politics.co.uk/blog/2017/12/19/how-period-poverty-finally-became-a-political-scandal/.

“Spot On – Improving Menstrual Management in India.” Dasra, https://www.dasra.org/resource/improving-menstrual-health-and-hygiene

Cardoso, Lauren F., et al. “Period Poverty and Mental Health Implications among College-Aged Women in the United States – BMC Women’s Health.” BioMed Central, BioMed Central, 6 Jan. 2021, https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-020-01149-5

A Tax on Tampons is a Tax on Menstruators

Menstruation is not a choice. Proper hygiene is every menstruator’s right. Across the world, 1.8 billion menstruate monthly. Yet millions of these girls, women, transgender men, and non-binary people face a lack of basic menstrual services, stemming from both poverty and the stigma around menstruation.

Although ensuring that everyone has access to menstrual products should be a matter of public health, many people are forced to resort to unsafe and unhygienic methods of managing their periods. Periods are one of the primary reasons why girls drop out of school in India. Many others are forced to stay at home solely because they do not have the means to handle menstruation hygienically. Some women have no choice but to use cloth or rags which, if not clean, can increase the risk of infections. It is every menstruator’s inherent right to have access to clean and safe products. Therefore, it is unreasonable to tax them on such goods. 

The tampon tax is an indirect tax imposed on menstrual products. This is often regarded as a sexist tax since other necessities and health items like prescriptions and over-the-counter drugs are tax exempt. In fact, there are places around the world where admissions to rodeos and college athletic events are untaxed, while tampons are not. It is argued to rightfully declare menstrual products as an essential commodity, abolish the tax on them, and introduce a price ceiling to ensure that they are accessible to low-income households. However, not all minds are on the same page about this notion.

For several countries, exempting menstrual products from being taxed results in reduced public revenue collection. Hungary and Sweden impose the maximum tax — at 27% and 25% respectively — on sanitary products, making them expensive for most consumers. In many US states cutting the tampon tax is estimated to eliminate anywhere from 10-60 million dollars in revenue per year. Eliminating this tax would result in having to increase tax rates on other products to balance out that loss. In retrospect, however, states like Alabama and Texas allow you to buy a Snickers bar tax-free from a vending machine but deem menstrual products as unessential. 

India, on the other hand, is one of the few countries that, as of 2018, has scrapped its tampon tax. India has a population of more than 355 million menstruating people, 88% of whom use unsafe sanitary products to manage their periods due to a lack of awareness and financial instability. The 12% tax had made products even more inaccessible in a country where most menstruators already do not have access to items like sanitary pads. Before 2018, under the GST, sanitary pads were not considered a tax-free essential item, making them unaffordable to over 70% of menstruators. After a year of campaigning and lobbying against the levy, India altered its tax system to classify menstrual products as “essential” and made them entirely tax-free. Other countries like Kenya, Canada, Australia, and Nigeria have done the same.

Making sanitary products more accessible goes beyond tax cuts. Scotland recently became the first country in the world to ensure that tampons and pads are free for all those who need them. Nepal began distributing free menstrual products in schools across the country in 2017. This was part of their attempt to reduce school absenteeism caused by the inability to manage periods. 

Making menstrual products affordable is a part of the fight for gender equality as it pushes people to recognise menstruation as a biological process that does not need to be stigmatised and should not hinder someone’s education, career, or future. 

Globally, more women than men live in poverty as a result of sexism across society limiting them in employment opportunities, caregiving support, education, etc. The gender wage gap, the gender wealth gap, occupation segregation into low paying jobs, domestic violence, and inadequate public support all factor into this. There is an unfair financial burden on women who get paid less than men in comparable positions. Women and girls already struggle to access the resources to manage their periods and the tampon tax further hardens this challenge. It forces menstruators to either resort to less safe and less hygienic means of managing their menstruation or forces them to live at a constant financial disadvantage. In Kenya, for example, a study conducted by FSG concluded that relatively poorer girls and women may turn to prostitution to afford pads.

Providing affordable menstrual hygiene products is a step in the right direction, but not enough to end period poverty. In order to truly achieve this aim, there has to be a widespread advocation of education, increased availability of adequate water and sanitation facilities, and addressal of harmful gender norms. It is all our responsibilities to make our voices heard and ensure that lawmakers acknowledge menstrual products as essential items. This will bring us one step closer to bridging the gap between the opportunities received by the different genders.

Organisations all around the world are consistently fighting to make products more affordable. The organisation Period Equity launched the Tax-Free Period campaign to urge US states to eliminate the tampon tax as soon as possible. Companies like Aakar Innovations and the Muruganantham Jayshree Industries have devised ways to reduce the production costs of these products and extend these products to Self Help Groups (SHGs). These groups enable menstruators to purchase their own pad making machine, establish a warrant, and continue to produce affordable pads.

A tax imposed on menstrual products is not just a tax on a product. It is essentially a tax on people solely because of their biological need to menstruate.

Article by Parnika Gupta from the REDefine Team

Featured Artwork by Prathna Anand

“Home.” Tax-Free. Period., https://www.taxfreeperiod.com/home

“The Tampon Tax: Everything You Need to Know.” Global Citizen, https://www.globalcitizen.org/en/content/tampon-tax-explained-definition-facts-statistics/.

Catarina de Albuquerque, Magdalena Sepúlveda. “Women’s Equality Starts With Ending the Tampon Tax.” The Daily Beast, The Daily Beast Company, 29 May 2021, https://www.thedailybeast.com/womens-equality-starts-with-ending-the-tampon-tax#:~:text= 

“Op-Ed: Taxing Tampons Isn’t Just Unfair, It’s Unconstitutional.” Los Angeles Times, Los Angeles Times, 11 July 2019, https://www.latimes.com/opinion/op-ed/la-oe-chemerinsky-weiss-wolf-tampons-tax-20190711-story.html.

“India Scraps Tampon Tax after Campaign.” BBC News, BBC, 21 July 2018, https://www.bbc.com/news/world-asia-india-44912742.

Russon, Mary-Ann. “Activists Cheer as ‘Sexist’ Tampon Tax Is Scrapped.” BBC News, BBC, 1 Jan. 2021, https://www.bbc.com/news/business-55502252.

Morales, Christina. “U.K. Eliminates Tax on Tampons and Other Sanitary Products.” The New York Times, The New York Times, 1 Jan. 2021, https://www.nytimes.com/2021/01/01/world/europe/tampon-tax-uk.html.

https://www.globalcitizen.org/en/content/tampon-tax-explained-definition-facts-statistics/

Menstrualhygieneday.org. 2022. FSG-Menstrual-Health-Landscape_Kenya. [online] Available at: <https://menstrualhygieneday.org/wp-content/uploads/2016/04/FSG-Menstrual-Health-Landscape_Kenya.pdf&gt; [Accessed 10 January 2022].  

Our Session at Ashray

Our first pan-India venture and our second online talk.

An individual-group photo.

With the blessings of an online platform and stable connectivity, our session with the children from Ashray stretched over two days. We were met with an initially hesitant crowd who grew more comfortable as our session progressed: we started with icebreakers, but they didn’t quite break the ice as well as our next segment of discussing personal stories. We altered our usual talk as per the request of the organisation, and focused more on the physical changes of puberty rather than the science, and more on menstrual hygiene than sexual hygiene. We added three new segments to our talk as well; the first, on how to measure bra sizes and the different types of bras; the second on personal hygiene; and the third on attraction.

We started with our typical walk-through of puberty following our short story-sharing session. We saw the students grow more comfortable as they related to the experiences we were describing, which luckily made getting into more tricky and embarrassing topics less awkward. We had challenges in accurately describing the reproductive organs and their roles to the students. Luckily, Ms Vrinda Jatia, the founder of Ashray, made these topics easier for the children to understand as she was familiar with them and well-versed with their learning style.

Explaining fertilisation was also a challenge, one we managed with the founder’s help. Subsequent explanations of the menstrual cycle helped the children put the role of sex into perspective, and also the role of hormones. Though we managed to condense the role of hormones to make it easier to understand, we do understand that there will be some barriers that cannot be overcome in a two-day online session. The children eased into the conversation once again when we began talking about PMS and its symptoms, a phenomenon that can unite menstruators across all backgrounds. 

We had our new segment on bras next, where we demonstrated what and where to measure for a bra size, make the correct calculations, and determine the right size to buy. We discussed the different types of bras one may find comfortable, as well. We had to repeat the segment as it was a new concept to the children, and with the help of the founder, we could explain it thoroughly. Here is an area we will look at for improvement: our skills in communicating demonstrative knowledge over theoretical knowledge, and sequent consolidation.

We went over how to wear a pad and what different menstrual products are available, something we did in our talk for Dribble Academy as well. We were concerned over how this would work online, but the students were already familiar with pads and menstrual hygiene, reciting to us what we were going to explain to them in the next part of the talk. 

We expanded our conversation regarding personal hygiene into taking care of skin and hair as well as taking care of oneself during menstruation. The children had many questions regarding what products to use, and we further discussed the need to use different products depending on how someone’s skin or hair is. The fact that the children found it so easy to accept that they should buy products based on their needs also drove in the point that everyone’s bodies are different and grow differently, hence may need to be treated differently, as well. 

In the end, we talked about attraction. This was also new to us, as it was outside the realm of menstrual and sexual health and hygiene. We did feel awkward at first, to talk about our own experiences with romance and attraction, however, the children seemed comfortable enough with us that we were able to extend the same comfort to ourselves. We spoke about these topics in a familiar manner with them. Having that connection over shared experiences, despite living in different cities and being on opposite ends of the spectrum of privilege is what makes the entire talk worth the extra hours. Seeing them understand, seeing them learn, feeling like we’ve made a difference — that is what drives REDefine. Ashray was our first pan-India venture, an opportunity which arose due to the pandemic. As this session was a success, we look forward to having more communication with wider audiences.

For more information on Ashray: https://ashray-ngo.org

Until next time,

Samara from the REDefine Team.

Separating Your Societal Ideals from Your Personal Beliefs

As the puberty series comes to an end, we hope that we’ve been able to provide some comfort to you and your child during this confusing phase. Before concluding, there is one more topic that needs to be addressed. As your child begins their journey through puberty, they will be bombarded with a colossal amount of information from various external sources. We believe it is important for them to know how to ignore erroneous information. 

First and foremost, let’s discuss the definition of societal ideals and personal beliefs. Societal ideals are the expectations that society and/or our communities enforce on us. On the other hand, our personal beliefs include, but are not limited to, our morals and cultural practices. The purpose of this article is to help you integrate the idea that personal beliefs take precedence over the norms of society into your talk.

Our society influences the way people think about menstruation and puberty. In India, people who menstruate are compelled to be ashamed of their cycle and all which is associated with it. We scarcely find people talking about this topic in public, and during the rare occasion that it is discussed, it is riddled with taboos and stigma. Menstruation is still used, by our society, as an opportunity to isolate those who menstruate. For instance, in India, 23,000,000 people leave school when they start their period. This can be due to the lack of access to sanitary products, or discouragement from family members. Which, in turn, prevents them from completing their education, hence hindering their ability to get good jobs in the future. Although this is more evident in rural India, it certainly isn’t absent in urban areas. Most shops still pack sanitary pads in black bags so that they can remain “hidden.” Similarly, most of us have experienced the embarrassment of taking a pad out in class. The reason that this is included in the series is to prevent your child from incorporating inaccurate information. Help them understand that menstruating isn’t a limitation and they shouldn’t give into information that says otherwise. 

However, it isn’t just society that dictates our outlook on puberty and menstruation. Adolescents are exposed to a variety of other sources of information. The most obvious and arguably the most influential is social media. Although I agree that social media is a great platform to spread awareness, it is also a breeding ground for false information. Social media encourages the creation of unrealistic standards. I remember watching a video where a person discussed how productive and positive they are during their period. It made me feel guilty for sometimes being tired, moody, and unproductive on my period. I couldn’t watch that person’s videos without feeling this way and it made me feel even more guilty because I knew that my ambivalence and lethargy is completely normal. Moreover, adolescents tend to get a vast amount of information from magazines like Cosmopolitan. Although these magazines are great for entertainment, they shouldn’t be your child’s primary source of information. It is because these magazines often publish articles like “How to keep your Boyfriends Happy in a Relationship,” which may encourage harmful ideas about relationships and sex.

To prevent your child from internalising misleading ideas, it is vital to prepare them to filter information. In a day and age like today, it is impossible (and impractical) to completely isolate your child from the internet. A more practical approach is for you to encourage your child to speak to you during a period of crisis (which I assure you will happen often enough), or inform them of more accurate sources like Healthline or books like Just for Girls/ Just for Boys if they are younger. 

Before we end the series, I would like to remind you that every child is different. Each one will handle these complicated situations the best way they know how to. Give them time to adjust to these changes and their new perspective on life.

We hope you enjoy reading the articles as much as we loved writing them!

Signing off,

Tihara from the REDefine Team

Featured artwork by Sanvee Jatia

Vaginal Hygiene

With sex and its subsequent concepts out of the way, there is still a topic of importance to be addressed when it comes to puberty: hygiene. In people who menstruate, periods are a messy and unpredictable time, but a compromise should never be made in maintaining cleanliness. Since—  and especially because — ill-hygiene can lead to ill-health, it is necessary to discuss vaginal hygiene.

Vaginitis is a broad term used to describe the numerous illnesses that can cause infection or inflammation of the vagina. Common symptoms include a change in vaginal discharge, itching in and around the vagina, and burning sensations during urination. It is crucial that these discussions are not made taboo, so that your children may confide in you if they may  face such symptoms. Some symptoms may overlap with those of other illnesses or could present as a combination of one disorder and another. It is best not to try and diagnose these illnesses by yourself and consult a medical professional if they arise.

Vaginal discharge is a normal and observed occurrence. Each individual’s discharge differs, and it can change consistency and colour depending on the day of the menstrual cycle. Discharge changes around ovulation and before the period starts — during ovulation it may present as stickier than usual, and during the end of the cycle as creamier than usual. These changes are absolutely normal, as is the absence of vaginal discharge. Sometimes, discharge may change or differ due to tight clothes or a particular food eaten. Though it may seem trivial to discuss, it is a new and scary concept for your child. For their own comfort, even these small things should be discussed. After all, vaginal discharge begins before periods do.

There are a few types of vaginal discharge that can indicate different disorders. One that is fairly common is an odourless, thick, white discharge, described to have the consistency of “cottage cheese,” which is an indication of a yeast infection. There is a naturally present fungus in the vagina which may have been upset due to an imbalance in the environment of the vagina, causing overgrowth and subsequent infection. This is accompanied by possible burning and itching sensations. Yeast infections can occur for many reasons, such as a disturbance in pH levels (possibly a result of trying new soaps or body products) or a hormonal imbalance. Yeast infections are treatable with medicine.

Another common abnormal discharge is one that is foul-smelling (referred to as a “fishy” odour) and thin, and milky in consistency. It is an indication of bacterial vaginosis, a condition where an upsetting of pH levels in the environment of the vagina causes the overgrowth of naturally present bacteria. There can be many factors interfering with the pH levels, so do be mindful of changes in soaps, and avoid douching the vagina.

The vagina is a self-cleaning organ, and discharge is a method by which the vagina rids itself of harmful bacteria. Special soaps need not be used to clean the vagina nor douching, unless medically prescribed. Ensure that your child is informed of this, and do not feel insecure of any changes that they may observe in their bodies.

During menstruation, the requirement for vaginal hygiene cannot be disregarded. We have a set of tips that are helpful to follow during this time. No other special measures need to be taken apart from them unless your child has a pre-existing condition that may require them. (This image in an aide we use during our talks!)

Another situation when vaginal hygiene needs to be maintained is before, during, and after sexual intercourse. This is, understandably, difficult to bring up, albeit necessary. Your child should know that it is important to practice safe sex, and know the contraceptives that they can use. In case they feel discomfort or pain during or after sexual intercourse, it is possible that they have an illness that needs to be examined. Do not hesitate to inform them of such instances, for leaving this in the dark may only make it worse. It lies on your shoulders to create an environment where such discussions can be held without shame.

Until next time,

Yuvana from the REDefine Team

Featured Artwork by Prathna Anand

References:

Cleveland Clinic. “Vaginitis: Causes, Symptoms, Treatments & Prevention.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/9131-vaginitis. Accessed 11 July 2021.

Mayo Clinic Staff. “Bacterial Vaginosis – Symptoms and Causes.” Mayo Clinic, 1998–2021 Mayo Foundation for Medical Education and Research (MFMER), 1 May 2019, http://www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/symptoms-causes/syc-20352279.

Shkodzik, Kate, MD. “All Types of Vaginal Discharge: What Do They Really Indicate?” Flo, 2021 Flo Health, 24 May 2021, flo.health/menstrual-cycle/health/vaginal-discharge/all-types-of-vaginal-discharge-what-do-they-really-indicate.

Wahlgren, Kara, and Carolyn Twersky. “Everything You Need to Know About Vaginal Discharge.” Seventeen, 2021 Hearst Magazine Media, Inc., 3 Dec. 2018, http://www.seventeen.com/health/sex-health/a46186/there-are-9-types-of-vaginal-discharge-heres-what-they-mean.