The Period Project: Period Poverty and the Fight for Menstrual Equity

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During her time in prison, Kimberly Haven lacked access to sufficient menstrual products. Like many of her fellow inmates, she resorted to using “homemade” products rather than enduring the degrading and dehumanizing experience of begging for more from prison staff. As a result of this unfortunate yet all-too-common reality for incarcerated women, she suffered toxic shock syndrome and required an emergency hysterectomy after her release from prison. As it turns out, her story is not unusual, nor are the severe and often invisible health risks involved. Haven, like many others, paid for her crime not just with time in prison, but also with her health.

Caroline Dillon, a teenager from New Hampshire, knows classmates who miss school because they lack access to menstrual products or who resort to reusing products or using socks, newspapers or other unsanitary items to control their menstruation, greatly increasing their risk of dangerous infections. Dillon’s classmates are not alone: More than one in five teenagers have struggled to afford menstrual products, according to one study, and more than four in five have either missed class or know a classmate who missed class because they did not have access to menstrual products.

These and other examples illustrate the concept of period poverty, which undergirds the movement for menstrual equity—or “the affordability, accessibility and safety of menstrual products.” It also includes education, reproductive care, ensuring individuals have accessible and affordable options for how they want to care for their menstrual health, and ending the stigma around menstruation.

These realities, while shocking, are not rare. For this reason, Ms. magazine, the California Women’s Law Center (CWLC) and the Center for Biotechnology and Global Health Policy (CBGHP) at the University of California, Irvine, are collaborating to bring these issues to the forefront. This article is the first in a three-part series introducing the Period Project, which examines the scope and consequences of period poverty and assesses state progress toward achieving menstrual equity through legislation.

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The Period Project reflects more than a year of research looking at each state, and its efforts to bring about menstrual equity. (Art by Brandi Phipps)

As part of the Period Project, we conducted original research and are developing “Period Project Report Cards,” which will assign each state and the District of Columbia a grade on an A–F scale to evaluate their progress toward menstrual equity. Composite scores for each state, awardi a maximum score of 3.0. One point will be earned for each of the following:

  • Full passage of a law repealing a state sales tax on menstrual products.
  • Full passage of a law mandating free menstrual products in prisons.
  • Full passage of a law mandating free menstrual products in public schools.

The grading also takes into account failed and pending state efforts to enact menstrual equity legislation. Bills that were introduced but ultimately died are awarded 0.2 points; bills that were stalled (i.e., introduced but neither died officially nor progressed) were awarded 0.4 points; bills that were active but had not yet passed in their chamber of origination were awarded 0.6 points; and bills that passed their chamber of origination and were currently active in the other chamber were awarded 0.8 points. Using the states’ composite scores, we will assign each state a letter grade of A, B, C, D, or F. The Report Cards will be published this fall.

We launched this project, because accessible and affordable menstrual products remain a persistent issue for those who menstruate. Globally, at least 500 million people suffer from insufficient access to affordable menstrual products. Tragically, the barriers to adequate access to menstrual products pervade communities with limited political and socioeconomic power due to deeply entrenched histories of racism, sexism, classism, and other forms of discrimination. The consequences are particularly pernicious for the incarcerated. According to Haven, menstrual products in prisons are “weaponized. They are withheld in order to get certain behavior, and they are doled out in whatever amounts and at the convenience of correctional staff (when they are distributed at all).”

Troublingly, period poverty is an open secret—but rather than helping menstruating people, many states engage in punishing behavior by applying “luxury” taxes to menstrual products or restricting poor people from using government aid to purchase tampons and sanitary pads.

For example, despite their vital importance to health and well-being, federal food stamps—i.e. the Supplemental Nutrition Assistance Program (SNAP)—have not historically covered “hygiene products,” which include menstrual products. Statistics vary, but the lifetime cost of pads and tampons likely adds up to at least $6,000, an amount which does not include the cost of other menstruation-related products, such as pain relievers, heating pads and hot water bottles, ruined underwear, birth control and medical care due to infections or other complications.

The good news is that states like Illinois have taken an important step in pursuit of menstrual equity by passing laws to allow the purchase of menstrual products with SNAP benefits.

That said, another glaring problem contributing to the cost of menstrual products is that many states continue to impose a sales tax, or “luxury tax,” on menstrual products. These policies contribute to the cost of menstrual products and demonstrate how periods are regarded as a superficial burden that people should be able to carry on their own. Products to ease that burden are therefore viewed as a “luxury,” not a necessity. 

For example, Richard Pickett, a Republican state representative from Maine, said that the incarcerated population should not receive free menstrual products because “the correctional system was never meant to be a country club.” Joey Hensley, a Republican state senator from Tennessee, similarly expressed concerns that a sales tax “holiday” on menstrual products in his state might lead to out-of-control tampon buying. Other politicians fear a “slippery slope,” asking whether schools would also be required to provide other items such as toothbrushes, shampoo, deodorant and razors.

Such rhetoric ignores the fact that menstruation is a biological reality. And despite the controversy, menstrual products are essential items for health, hygiene and overall well-being. Health risks associated with unsafe and unhygienic menstrual hygiene practices include reproductive tract infections, infertility and even death.

A primary driver of period poverty in the United States is inadequate access to menstrual products due to economic hardship, compounded by geographic factors that exacerbate lack of access and affordability and lost productivity or time off from work.

For example, grocery stores and pharmacies are vital resources of menstrual products. However, far too many Americans—roughly 40.5 million—live in “grocery/food deserts” or “pharmacy deserts,” making it difficult to acquire these essential products. Approximately one in three neighborhoods in large cities like Los Angeles, Chicago, Houston and Memphis are considered pharmacy deserts, affecting around 15 million people. People of color are more likely to live in pharmacy deserts, with disparities most notable in Los Angeles, Chicago, Albuquerque, Memphis, Boston, Milwaukee, Baltimore and Philadelphia. For some populations, such as the incarcerated, menstrual products may be completely out of reach.            

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Roughly 40.5 million Americans live in “grocery/food deserts” or “pharmacy deserts,” making it difficult to acquire menstrual products. (GoodRx)

Yet, there is some reason for optimism: As a result of advocacy and increasing awareness of period poverty, some states are starting to take action by eliminating sales taxes on menstrual products, providing free menstrual products in prisons, and/or providing free menstrual products in public schools.

The next two articles in this series—released Thursday, Feb. 24 and Friday, Feb. 25, respectively—will introduce the Period Project and take a closer look at menstrual equity in schools and the carceral setting.

 Michele Goodwin contributed to this report.

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About and

Allison M. Whelan is a scholar, bioethicist and attorney whose work focuses on constitutional law and reproductive health, rights and justice. She is currently a Sharswood fellow at the University of Pennsylvania Law School and an associate fellow at the University of Pennsylvania's Leonard Davis Institute of Health Economics.
Emily Spears is an intern at the California Women’s Law Center and is currently studying sociology, gender studies and philosophy at UCLA.