Every one of us has been affected differently since the beginning of this pandemic. Some people have their plans canceled for the summer; others no longer have the chance to celebrate graduation as they anticipated. But there is a group of people who’ve been hit differently by this pandemic: Females in poverty who have limited access to menstrual supplies.

Unfortunately, it has long been established by erroneous societal norms that “periods talks” are taboo. But I am going to have that talk with you because we can no longer ignore this critical discussion; this is a human rights matter that requires as much attention as any other global issues, especially now.

Background

Period poverty is “the lack of access to sanitary products, menstrual hygiene education, toilets and showers, hand-washing facilities, and waste management.” (Global Citizens). Although period poverty also covers the minimal access to safe and sanitary spaces, this article mostly focuses on the increased shortage in menstrual supplies due to COVID-19. Additionally, since period poverty also affects transgenders, it is critical to address the rising concept of Menstrual Equality, which I will be covered in future posts.  

The lack of access to menstrual products affects those females who are living with low-income, are homeless, or are incarcerated. (Free to Bleed). Because of the high cost of menstrual supplies, women who are unable to care for their menstrual health will seek whatever materials available to make their own supplies, usually unsafe ones such as rags, clothing, newspapers, paper towels, and in desperate cases even cardboard. (Id.) This practice leads females to face many serious health problems, including “skin infections, urinary tract and bladder infections, and toxic shock syndrome.” (Id.). Risker health problems also arise that can haunt women for the rest of their lives. For example, in India, a young teen had to undergo a hysterectomy after using a rag infested with lizard eggs as a menstrual pad because she lacked access to appropriate supplies. In addition to health risks, females are also forced to miss days of work and school, as well as other opportunities for success. (Free to Bleed) Accordingly, females are forced to make tough choices – food or pads? school supplies or tampons? (Id.) The critical problem is that because of the stigma surrounding the discussions of periods, females end up suffering in silence, afraid to seek help from a society that does not recognize their needs as essential and only impose humiliation on them.

Currently, in the United States, there is no legislation supporting menstruation, and most states impose sales taxes on menstrual products (Id.). Women, especially those living in poverty or are homeless, report infections caused by using supplies for a long period of time or for using unsafe materials mentioned above. (Profitable Menstruation) The incarcerated, on the other hand, often have to beg and bargain with officers to care for their menstrual health. (Id.)

The menstrual products in the United States face sale taxes in forty states, unlike other essential hygiene products. (Id.) The inconsistent tax on the products made tampons and pads excluded from the Health Savings or Flexible Spending Account Allowances. (Id.) Menstrual products are also unavailable in public bathrooms and school or workplace bathrooms, unlike soap and toilet papers that are always offered complementarily. (Id.) They are also not covered by any nutritional benefits program or food stamps and are not categorized as budgetary expenses for publicly funded shelters and centers. (Id.) All of these restrictions make it hard, if not impossible, for females to care for their menstrual health.

In the United States, the average cost of a thirty-six tampon box is seven dollars. (The Unconstitutional Tampon Tax). Taking into account the days of the menstrual cycle and the average years in which women experience menstrual cycles, the average individual cost for tampons only, not including state and sales taxes nor other products such as pads, cups, or wipes, is $1,946. (Profitable Menstruation) When accounting average state and sales taxes imposed on these products in different jurisdictions, the cost is calculated between $2,037.46 and $2,140.60 per woman. (Id.) These are a high and noticeable cost that many women in the United States simply cannot afford. (Id.)

Fortunately, since 2016, four states and the District of Columbia abolished their sales tax on menstrual products. (The Unconstitutional Tampon Tax). Because many advocates argued that the tax is both discriminatory and unnecessary, many states are considering the change in future ballots. Women around the nation have also brought class action suits in four states asking courts to declare state tampon tax unconstitutional while requesting refunds from prior taxes paid. (The Unconstitutional Tampon Tax).

The recognition of the essential nature of menstrual products is reflected in the language of many agencies and departments whose task is to protect the health, welfare, and safety of all citizens. For example, the Food and Drug Administration labeled menstrual products as Class II “medical device,” assigning them the same importance level as contact lenses, condoms, and pregnancy tests. (FDA) The FDA stated that “the only affirmative obligations required of manufacturers are that they provide basic instructional labeling on the packaging, and keep records of adverse events caused by their products. Transparency in testing results is not required, nor is labeling or detailed disclosure about product ingredients on the packaging.” (Id.)

Other federal agencies, such as the Internal Revenue Service code, did not recognize tampons as essential until very recently. This means the IRS did not reimburse tampons, pads, or similar products under the Flexible Spending Accounts until the CARES Act of March 2020 was passed in response to the coronavirus pandemic. (The CARES Act) Before the pandemic, the FSA stated that tampons and pads “do not play a role in alleviating or aiding in the treatment plan of a specific illness, [thus] they are not covered under any circumstances with consumer spending accounts.” (Id.)

Moreover, even though the U.S. Department of Labor and the Occupational Safety and Health Administration (OSHA) requires all employers to provide their workers with “safe, sanitary toilet facilities as well as products required for washing and drying,” menstrual products are “conspicuously excluded from that list of hygiene necessities, though addressed in meticulous detail in disposal protocols facilities.” (U.S. Policymaking to Address Menstruation: Advancing an Equity Agenda) (See also OSHA Frequently Asked Questions)

Luckily, lawmakers around the nation advocated for a change and immediate action to treat menstrual products as essentials. Many introduced bills advocating for restaurants and businesses to have free supplies to women the same way they have complimentary soup and toilet papers. Others introduced bills excluding menstrual products from sales tax, and others focused on addressing equality in prisons. For example, in 2018, legislatures in Virginia introduced House Bill 83 (HB 83) that required prisons in the Commonwealth of Virginia to provide free menstrual products to inmates. The bill was successfully passed.

The Effects of COVID-19 on Period Poverty

The pre-existing inequalities women face to care for their menstrual health have been exacerbated by this pandemic. On May 28, the Menstrual Hygiene Day, experts emphasized the increase of period poverty during the pandemic that is affecting women and girls, not only in the United States, but around the world. (Plan International) The pandemic left women and girls facing a shortage of supplies, a sharp increase in prices of supplies, and a lack of access to resources and basic services for menstrual care. (Id.) Experts and health professionals in 30 countries (not including the United States) were surveyed, and the results were as follow:

  • 81% were concerned people who menstruate would not be supported to meet their menstrual hygiene management (MHM) needs.
  • 75% said COVID-19 might pose increased health risks for people who menstruate, as resources, such as water, are diverted to other need
  • 73% stated that limited access to menstrual products through shortages or disrupted supply chains is a significant issue.
  • 68% pointed to restricted access to facilities to change, clean, and dispose of period products during the crisis has been a fundamental problem.
  • 58% said an increase in the price of products is exacerbating period poverty during the lockdown.

The United States is no exception to these findings. By March 2020, Amazon and other major sellers run out of nearly every brand and variety of tampons and pads. (Business Insider). This shortage hit women who live paycheck to paycheck the hardest. While many people rushed to hoard all kinds of foods and supplies as the lockdown took place, the poorest were left with empty shelves, and women in poverty were left with little to no menstrual supplies. (Id.) As Dana Marlow, the owner of I Support the Girls, stated, “Periods don’t stop for pandemics […], and in times of disasters, like global pandemics, it’s easy to overlook the basic essentials folks need for their dignity.” (NY Times)

Fortunately, as we see many states opening up and the lockdown slowly reduced, the shortage in supplies has decreased, and the shelves are restocked. What remains unchanged, however, is the high prices of menstrual products, the taxes imposed by many states, and the lack of recognition of the essential nature of menstrual supplies. These inequalities that women and girls face in the United States remain a fundamental problem, with or without a pandemic.

Students will go back to school eventually, but many girls will have to miss school days due to a lack of access to tampons or pads. Employers will open back their doors to workers, but many women will not have access to free menstrual products in bathrooms as they do with soup and toilet papers. The homeless, the incarcerated, and the low-income will continue their daily struggles of trying to afford a box of supplies that helps them care for their health without risks.

Such change is long overdue and must be the topic of discussion in many states. Without laws and policies addressing the minimal access and the high costs of hygiene products, women and girls around the nation will continue suffering silently, and their hope for justice will continue to diminish. In the meantime, however, here is a list of organizations that distribute free menstrual supplies in the United States:

  1. The Salvation Army
  2. I Support The Girls
  3. Period
  4. The Period Project
  5. Tampon Tuesday
  6. Girls Helping Girls Period
Chrissy packing up period products at the I Support The Girls warehouse in Maryland

You can also help by donating menstrual products and money to those organizations so they can keep helping women and girls in need.

Feel free to drop links and names of other initiatives working for this cause in the comments below.