Has menstrual activism lost sight of the bigger picture?

Over the past decade menstruation has emerged as a critical issue in global development, with funders earmarking aid money each year to provide free menstrual pads to girls. In 2014, May 28 was declared the annual Menstrual Hygiene Day.

But activists and researchers say the movement — especially in the global south, which has been the focus of menstruation-related interventions in recent years — has become misguided. They argue that it centers on some aspects of menstruation more than others and may be losing sight of the big picture.

An overemphasis on hygiene

Much of the visibility that menstruation enjoys today within global development is credited to the WASH sector.

“When WASH was building toilets, they realized that girls were benefiting even more than boys because now they had safe spaces to change their menstrual materials,” said Chris Bobel, a professor of women's, gender, and sexuality studies at the University of Massachusetts Boston.

Because WASH’s mandate relates to hygiene, that ended up getting the most attention among menstrual activists, Bobel said.

“That’s our peril as a global movement,” she said, adding that the focus is now on helping people manage their periods rather than tackling menstrual stigma.

While hygiene is important, an overemphasis can reinforce negative stereotypes, said Radha Paudel, a Nepalese menstrual activist.

“If you keep talking about hygiene, it has a negative connotation. You are imposing the idea that menstrual blood is dirty and impure,” she said.

In the absence of a holistic approach that extends beyond hygiene, menstruation is seen only as a women’s issue, said Mahbuba Kumkum, a Bangladeshi menstrual activist with the nonprofit Simavi. If it is not linked with gender equality, the human rights aspect of menstruation is lost, she added.

Menstrual products as a cure-all

Bobel said nonprofits often see menstrual products — especially pads — as a silver bullet. Distributing free pads in schools is one of the most common activities that NGOs carry out.

“They feel that ‘we've distributed pads, so the menstrual needs are met.’ But menstrual needs are not just pads; it is medicine if [the menstruator] has problems, water facilities to go privately to a toilet, a disposal facility for pads,” said Pema Lhaki, executive director of the Nepal Fertility Care Center.

Products are attractive to nonprofits because they’re tangible and salable, said Bharti Kannan, an Indian menstrual activist and the founder of social enterprise Boondh. Behavioral change, on the other hand, is intangible. The larger call to action should be for slow, transformational work that may take decades, Kannan said.

Free pads are also not a long-term solution, said Ibukun Babarinde, founder of the African initiative Mentor Missy, which is centered on menstruation and sexual education.

The focus on products is indicative of the broader attitude toward menstruation, according to Bobel. “Menstruation is a vital sign, but we don’t see it that way. We see it as a problem to be fixed: ‘What are you going to do to clean it up?’” she said, adding that more energy must be diverted to “aggressively challenging menstrual stigma.”

Like pads, young schoolgirls have become a symbol within menstrual activism. Getting pads to such girls is the top priority in the global movement, Bobel said.

This focus on female schoolchildren means that other menstruators are often left out. “There are homeless people who menstruate. There are orphans who menstruate. There are prisoners who menstruate. There are disabled people who menstruate. What do they need?” said Candice Chirwa, a menstrual activist from South Africa.

Lack of consultation

Nonprofits often promote menstrual products that are not well suited to menstruators’ lived realities, Lhaki said, citing the example of an NGO that distributed menstrual cups in Nepal.

“Menstrual cups need to be sterilized after every period. You need to boil them in a vessel. You also need access to clean water. Imagine how difficult it must have been to use it,” she said. “Also, in our side of the world, [would] any parent allow an adolescent girl to put a menstrual cup in their vagina?”

Babarinde, the Nigerian activist, recounted how one organization promoted reusable pads — but girls couldn’t wash them properly due to a water shortage. “You are trying to solve a problem but creating another problem in the process,” she said.

Rather than advocating any single product or approach, activists should offer choices and let menstruators decide, according to Lhaki. For example, if they’ve been using cloth to absorb menstrual blood, efforts can focus on demonstrating how to use it safely and effectively. “Giving them the ability to make decisions is also their journey to empowerment,” Lhaki said.

In the global south, the menstrual hygiene movement has often sought to minimize the use of traditional products such as cloth, instead favoring modern options like pads, tampons, and cups, Bobel said. But at the same time, cloth pads are making a comeback in the global north since they’re environmentally friendly.

Differences in culture and religious beliefs are important to keep in mind when replicating interventions across the world, Chirwa said, adding that a popular form of activism in the global north may have negative consequences elsewhere.

On the video platform TikTok, “Western menstrual activists are comfortable being on the toilet showing when they change their pad or change their cup,” she said. “If I were to do that in South Africa, I would receive some backlash.”

Many organizations come up with ideas that are considered progressive in the West, such as conversations on sex during menstruation, “but those are not relevant for certain communities,” Kannan said. That’s why activism must be led by people from local communities, she added.

When activists from the global north go to other parts of the world, they must first try to unlearn some of what they believe, Bobel said.

“Bracket off your assumptions [and] talk to people on the ground who are already doing the work there,” she said. “And have an incredible amount of humility.”