A Movement Dawns, and Finally Gets Brighter

In April 2016, Newsweek ran a feature on menstrual activism. The cover featured an unwrapped tampon against a deep red background. The words, large, bold and in contrasting white, read: “There Will Be Blood. Get Over It. Period Stigma is hurting the economy, schools and the environment. But the crimson tide is turning.” When a mainstream, high-circulation news organization ran a feature like this, it signaled that something had shifted in the urgency around menstrual culture. Despite what many assume, menstrual activism is not new. It has been eating at the edges of body-based shame and stigma for decades. According to Bobel (2007, 2010), “feminist spiritualist menstrual activists” broke ground in the late 1960s with their reframing of menstruation as a source of power and sisterhood. They refused the taken-for-granted assumption that menstruation was merely a nuisance, a “curse,” and offered a conceptual reframing through art, including filmmaking, music, poetry, and ritual. They built upon a second wave cultural feminist sensibility that embraced rather than obscured sexual differences.

Concurrently, the women’s health movement emerged, cultivating a robust resistance to the androcentric and often patronizing medical establishment. These activists spurred a healthy scrutiny of many tacit practices, especially those around reproductive health care, which led to attention to menstrual and menopausal health care. Animated by a need for bodily sovereignty and the tools and resources to make informed choices regarding providers, diagnoses and treatments, these activists joined consumer rights advocates when thousands of women developed Toxic Shock Syndrome (TSS) (and 38 died) as a result of a new super absorbent, fully synthetic tampon call Rely (“It Even Absorbs the Worry” was its tagline). Rely’s makers, Procter & Gamble, pulled the tampon from the shelves because it was an aggressive incubator for the potentially lethal bacterial strain staphylococcus aureus. This tragedy led activists to work with the US government to better regulate the industry, leading to mandated TSS warnings in tampon packages and standardized absorbency ratings to help consumers choose the appropriate tampon to meet their needs.

Some environmentalists also became menstrual activists, adding to the critique of conventional care by bringing to light the polluting effects of single use menstrual care products and promoting greener alternatives such as organic tampons and pads, reusable cloth pads, cups, and sponges. Further, as third-wave feminism took shape, it found alignment with Punk and anarchism’s anti-capitalism and Do It Yourself ethos (Leblanc 1999; Marcus and McKay 2010). This intersection became a site for the emergence of what Bobel terms the “radical menstruation” wing of the movement (Bobel 2010). Alternative products were championed, as well as free bleeding, as were zine making, early blogging and menstrual health education. Creative actions such as tampon art and tampon “send backs,” in which activists return menstrual products to their manufacturers, defined menstrual activism through the turn of the century.

Another hallmark of the radical menstruation activist approach was its disinterest in structural reform. While earlier activists worked tirelessly with both government and industry to protect consumers, radical menstruation activists took a more cultural approach, instigating attitudinal change through visual art, performance, and humor. While feminist spiritualists promoted personal transformation through a celebration of menstruation, radical menstruation focused on building a more inclusive movement and “undoing gender,” in the words of theorist Judith Butler (1990). Some began to use the word ‘menstruator,’ a term that embraced anybody that menstruated, heretofore assumed to be women. This linguistic move splits the biological (menstruation) from the socio sociocultural (the social construction of gender).

Today’s menstrual activism is difficult to categorize, revealing its dynamism and its responsiveness to an ever-globalizing world where boundaries around identities are shifting. Accordingly, scholarship on menstrual activism is emerging and complicating definitions and categorizations (see Barkardóttir 2016; Fahs 2016; Kafai 2019; Tarzibachi 2017). Persdotter (2013), for example, situating her inquiry in western Europe, refers not to menstrual activism, but instead to the “menstrual Countermovement”: “the mass of actions, and agents that purposefully work towards challenging the repressive mainstream menstrual discourse of shame and silence” (13). She argues for a more nuanced and diverse categorization that makes room for consumer-oriented change makers, such as those who produce and sell alternative menstrual products, ritualists, and others whose work is at once activist and income generating. With this historical overview in mind, we turn now to selected activist actions, moving between past and present. Our aim is to illustrate both important continuities with and key departures from menstrual activism’s little known history.

Laughing While Bleeding: Using Humor to Break the Silence

In 1978, Gloria Steinem penned her now-iconic satire “If Men Could Menstruate.” The essay, what she dubbed “a political fantasy,” first appeared in Ms. and has been widely and regularly republished and excerpted since. Cleverly using satiric humor, Steinem guides the reader through a thought experiment led by the question: “So what would happen if suddenly, magically, men could menstruate and women could not?” She goes on: “Clearly, menstruation would become an enviable, worthy, masculine event. Men would brag about how long and how much. Young boys would talk about it as the envied beginning of manhood. Gifts, religious ceremonies, family dinners, and stag parties would mark the day” (Steinem 1978). A few years later, “If Men Could Menstruate” was republished in a collection of feminist humor titled “Pulling Our Own Strings” (Kaufman and Blakely 1980), which included several menstrual-themed pieces in the book’s lead section titled “Periodic Hysteria.” The book opens with an introduction explaining what makes humor feminist: at once an acknowledgment of sexist oppression and a vision of change. The book includes an argument for feminist menstrual humor in which “the attitude is that menses is not to be hidden (as shameful) but to be joked about (as normal) or even celebrated (as naturally female) . . . the expression of such humor attacks the unhealthy and oppressing idea cultivated for thousands of years that women’s bodies are foul” (Kaufman 1980, 14).

This claim similarly animates contemporary menstrual activist humor. The Crimson Wave is a stand-up comedy duo of Natalie Norman and Jess Beaulieu from Toronto, Canada that describes their feminist podcast as being “about periods/vaginas/Beyonce’s vagina where guests tell hilarious stories, anecdotes, and theories about their lovely menses.” In this same vein, UK-based solo comedian, educator and activist Chella Quint performs her gender-inclusive show aimed at menstrual stigma through playful deconstruction of vintage menstrual product ads. In her shows, she introduces her tongue-in-cheek “product”: Stains.™ The use of the bright red stain—as earrings, as cufflinks, as felt stains ready to be pinned to any part of the body—deploys the visual to challenge menstrual invisibility. The use of the visual has been a mainstay of menstrual activists since the dawn of the movement.

The Visual Is Political: Menstrual Art as Change Agent

In 1971, Judy Chicago, feminist art pathbreaker, created a shocking photolithograph: a self-portrait of Chicago, legs spread, withdrawing a tampon from her vagina. Titled “Red Flag,” the piece, reports Chicago, represented something so profoundly absent from our visual landscape that many people assumed the object was a penis.

The following year, Chicago further explored menstrual realities when she created “Menstruation Bathroom” in her multiroom installation collaboration with Judith Schapiro, “Womanhouse.” In Menstruation Bathroom, numerous tampons and pads (both single use and reusable cloth), used and unused, are strewn throughout the room. They sit on shelves, piled in the trash bin, on the floor and hanging on the clothesline. Here, one encounters the scope and scale of menstrual care across many cycles, even years. Interestingly, the blood in this piece is relatively contained—only a few splatters appear on the floor. The lid to the toilet is closed.

Some forty years later, self-described ‘menstrual designer’ Jen Lewis and collaborator and photographer Rob Lewis lifted the lid in their work and began showing portraits of menstrual blood moving through water. As a menstrual cup user, Lewis grew fascinated by the designs she observed as she emptied her menstrual cup in the toilet. Her work has been featured in mainstream and fringe media and widely circulated across social media. In 2015, she curated the largest art show featuring menstrual art: Widening the Cycle: A Menstrual Cycle and Reproductive Art Show. Framing menstrual art as part of the reproductive justice movement, the show displayed the work of 38 artists from 10 countries “to disrupt the current cultural narrative and replace it with one that reflects the real thoughts, emotions and experiences of menstruators” (http://www.wideningthecycle.com/). Soon after, “Our Bodies Our Blood,” “an art project about creating a safe space to express thoughts on menstruation, cultural shame and our stories,” went on view in Nova Scotia. In 2017, there were two menstrually focused group art shows—“Period” in Miami, Florida (http://rojasrubensteenprojects.com/new-page/) and “The Crimson Wave: Art About and With Menstrual Blood” in Bangalore, India (http://www.boondh.co/the-crimson-wave.html). These shows are evidence that menstrual artists form a crucial part of the battle to make menstruation visible and culturally relevant.

2015 was the same year Cosmopolitan dubbed “the year the period went public” evinced by an illustrated timeline cataloging “The 8 Greatest Menstrual Moments of 2015.” The 12-month history included Instagram’s much-maligned decision to twice remove a photo of artist and New York Times bestselling poet Rupi Kaur lying in bed wearing period-stained pants. The photo quickly went viral. Cosmo’s timeline also included a reference to Kiran Gandhi’s decision to free bleed while running the London Marathon. Initially, Gandhi chose to go without menstrual absorbent for ease and comfort, but as she ran, she began to consider the political implications of her act, transforming her personal decision into a moving protest, a type of circumstantial performance piece (Gandhi 2015). Gandhi has continued her menstrual activism, with a focus on menstrual product access (https://madamegandhi.blog/hi/) and legislative action. Her turn to legislative action represents a return to the roots of menstrual activism, when collaborations between feminist health and consumer rights advocates pressured the government to provide more careful oversight of the industry. While menstrual activists of the late twentieth and early twenty-first centuries showed disinterest, springing from distrust of lawmakers and corporate players, the newer crop of social change has doubled down on making change through legal reform.

Menstrual Activists (Go Back) to Washington

In some menstrual products there are trace amounts of dioxins, which are potentially carcinogenic. Recent studies have found phthalates and furanes as well (Gloaguen 2017), but the contents of menstrual products, classified in the US as a class of medical device, are not made available to the public. Since 1997, Congresswoman Carolyn B. Maloney has brought a bill before Congress nine times, and each time it languished in committee; she called the bill the Tampon Safety and Research Act. Her most recent version is the Robin Danielson Feminine Hygiene Product Safety Act of 2015, named after a woman who died in 1988 of Toxic Shock Syndrome. Maloney proposes the National Institute of Health fund research on the synthetics and chemicals used in menstrual products and test for reproductive problems as well as common health conditions “to close this research gap” (O’Hara 2015). In addition, the FDA would check manufacturers’ data and make this information available to the public (O’Hara 2015). Maloney’s bill is now joined by US Rep. Grace Meng’s introduction of the Accurate Labeling of Menstrual Products Act of 2016, which calls for menstrual product companies to disclose the ingredients of their products.

As menstrual activism gains force, some legislators are linking issues of safety to broader issues of access and affordability. In New York City, Mayor Bill de Blasio signed legislation to provide public school grades 6–12, homeless shelters, and correctional facilities with free pads and tampons. US Rep. Grace Meng proposed a second menstrual-related bill: the five-part Menstrual Equity Act of 2017, the product of a recent spate of interest and energy around the cost of menstrual products. The fact that many cities, states, and countries tax menstrual products, commonly referred to as the “tampon tax,” has become a lightning rod for those frustrated by gender inequality. Considering that items such as men’s shaving cream, Viagra, candy, and soda do not carry this added tax, it is easy to regard the extra cost as a form of discrimination against females qua females. For menstruators, menstrual supplies are as essential as toilet paper.

No doubt, the reach of social media and an evolving public attitude toward menstruation facilitated high profile efforts such as Jennifer Weiss-Wolf’s joint campaign with Cosmopolitan magazine; “Stop Taxing our Periods! Period.” To date, it has garnered over 68,000 signatures. Weiss-Wolf coined the phrase ‘menstrual equity,’ to frame “what it means to consider the ability to manage menstruation in the context of full democratic and civic participation” (Jones 2016a). Menstruation, she claims “transcends all the other things about women’s bodies that make us targets for the right, and this one doesn’t” (Arriaga 2017). This may explain bipartisan support for removing the ‘tampon tax’ in a climate where other reproductive issues garner little Republican support.

Access and Affordability: Today’s Menstrual Activism’s Rallying Cry

In a marked departure from their predecessors who, for the most part, had not yet taken stock of the particular realities of various populations, today’s activists are keen to address the menstrual needs of the marginalized. For low-income, homeless, and incarcerated menstruators, removing a tax or testing for potential health risks is less a priority than gaining access to menstrual products. A 2011 Feeding America Survey places menstrual products among the top eight basic essentials; however, they are not covered by food stamps. Many low-income menstruators cannot afford the products they need—even without taxes in certain places. The cost is estimated at approximately $2500 over the course of a lifetime (Meng 2017).

Homeless menstruators face not only a lack of access to menstrual products but also to clean spaces in which to care for their menstruating bodies. A handful of campaigns and organizations are distributing menstrual care products to low-income and homeless menstruators. #Happy Period and Period: the Menstrual Movement are two such organizations, both newcomers to the movement. Many of the new activists are under 30. Their age may explain a growing sensitivity to the needs of menstruators in schools, including not only the cost of products but also access to supplies in school bathrooms.

Universities have also provided free menstrual products to students so that all students can focus on their education despite their income or level of preparedness–or gender identity. For example, a student-led initiative at Brown University put free pads and tampons in women’s, men’s and gender-inclusive bathrooms around campus. Other schools—such as Emory, University of Arizona, Reed College, University of Minnesota-Twin Cities, and the University of Wisconsin at Madison—have followed suit with similar programs.

Another profoundly marginalized population—incarcerated menstruators—has become a focus of some activists. In prisons and jails, menstrual products are often rationed, restricted, traded, or used by guards in power games. The lack of menstrual supplies among inmates affects not only their hygiene but also their self-esteem. Chandra Bozelko, a former inmate, said, “To ask a macho guard for a tampon is humiliating. But it’s more than that: it’s an acknowledgement of the fact that, ultimately, the prison controls your cleanliness, your health and your feelings of self-esteem” (Ronan 2015). Not only is there a dearth of materials, but also the ones provided are small, poor quality and lack adhesive. Some incarcerated menstruators are forced to wear these for multiple days, which can cause bacterial or fungal infections, or lead to bleeding through clothes.

In April 2017, Colorado passed an amendment agreeing to spend $40,000 to provide tampons for female inmates. Senators Elizabeth Warren and Cory Booker introduced the Dignity for Incarcerated Women Act on July 11, 2017; the legislation proposes distributing free quality pads and tampons to inmates. Soon thereafter, and ostensibly to avoid a legislative mandate, the US Department of Justice issued an Operations Memorandum in August 2017 that “ensures that female inmates have access to a range of feminine hygiene products related to menstruation” (https://www.bop.gov/policy/om/001_2017.pdf). Because the mandate does not apply to state and municipal facilities, the fight continues. As Bozelko (2017) forcefully writes:

Talking openly about menstruation can’t be restricted to hygiene, as important as it is. The appeal to public health sidles up to the issue by making it seem like it’s everyone’s problem. That just gets us halfway there. The truth is that it shouldn’t be anyone’s problem because your period really isn’t a predicament. It’s proof of life.

Bozelko’s observation resonates. While early menstrual activism of the past did attend to products, the focus was safety and promoting alternative, more environmentally friendly cups and cloth pads in a context of creative resistance to menstrual invisibility. Today, the product focus dominates the activist landscape, one centered on product access and affordability. While these are worthy projects indeed, they are narrowly focused on what Sharra Vostral (2011) calls “technologies of passing,” that enable menstruators to “pass” as non-menstruators in order to comply with the cultural norms—keep it hidden, keep it quiet. As such, products serve merely to accommodate rather than resist the menstrual mandate of shame, silence, and secrecy. In this way, contemporary menstrual activism has dulled its radical edge through a neoliberal engagement with menstrual management. When menstrual activism’s main focus devolves to a preoccupation with “something to bleed on,” it betrays its feminist roots of challenging the misogynist framing of the polluted and disgusting menstrual body.

Identity Politics

Menstrual activism is uniquely positioned to push feminists and other critically minded scholars and activists toward thinking about the complexities of gender and the body. That said, the hazards of doing justice to the menstrual experience—particularly with regard to gender identity—have been particularly messy in recent years. Menstruation is, at once, deeply gendered and coded as women’s experience and also expansive and transgressive in its gender politics. Many women menstruate but not all women menstruate. Some women, such as women who have gone through menopause, those who have had hysterectomies, pregnant women, young women, women with severe eating disorders, women suppressing their periods, women on certain kinds of birth control, and some competitive athletes do not menstruate; this then complicates simplistic notions that all women menstruate.

Similarly, some men do menstruate. Trans men often still menstruate, particularly if they are not on testosterone hormone therapies. Further, trans men who menstruate often report distress and body dysmorphia during their menstrual periods, while other trans men associate menstruation more positively (Fahs 2016; Reading 2014). Holly Devor (1999) found that trans men reported intensely negative emotions about menstruation, with 51% saying they felt emotional discomfort. Trans men and transmasculine people’s menstrual experiences are under-researched, in part because menstrual bleeding is not typically associated with cultural ideals about masculinity. This can lead not only to trans men feeling distress about their periods but also, as one recent study found, avoiding restrooms and working toward menstrual suppression (Chrisler et al. 2016).

Endometriosis— where tissue that normally lines the uterus grows outside of the uterus and causes pain—also complicates the ‘who menstruates?’ question. Cara Jones (2016b) has argued that not all bodies with endometriosis are female and that endometriosis has been found in infants, postmenopausal bodies, post-hysterectomy bodies, trans men, and cisgender men. At the same time, trans women and transfeminine people’s experiences who undergo hormone replacement therapy often report “menstrual” symptoms and pain such as soreness, swelling, nausea, cramping, dizziness, migraines, muscle fatigue, joint pain, bloating, depression, and mood changes on a cyclical basis; researchers have largely ignored this (Riedel 2016).

The move to recognize the breadth of the menstrual experience has appeared more vividly in recent years. While little research has examined non-binary gender identity and menstruation, some activist and “artivist” work has started to make room for these experiences; for example, Cass Clemmer (https://www.tonithetampon.com/) developed the character “Toni the Tampon” for a coloring book about menstruation in order to broaden cultural ideas about who menstruates. In July 2017, Clemmer posted a photo on Facebook that showed Clemmer with obvious menstrual blood on their pants; the photo went viral and inspired a series of news articles and commentaries (Dupere 2017).

The move from gendered language to non-gendered language creates a conversation that, on the one hand, expands notions of “who menstruates” and, on the other hand, erases some of the ways menstruation is coded as a cisgender female experience. Some menstrual activists argue that non-gendered language of “menstruators” should be used in tandem with “women” and “girls” as a way to both broaden the language of menstruation while still marking menstruation as feminized and menstrual negativity as grounded in misogyny (Przybylo and Fahs 2018). How to best challenge the frank sexism of much menstrual discourse remains an open question that menstrual activists are continuing to take up. Expanding the existing circle of menstruators better represents the wide swath of people affected by menstrual cycle changes. Thus, “Menstrual bleeding in this sense is complex: it is both highly gendered and not attached as a material reality to only one gender” (Przybylo and Fahs 2018).

Additionally, menstrual activism has also grown savvier in recent years in its approach to race and class diversity, particularly as menstrual activists recognize that different groups of menstruators have different needs. There has been a major push toward thinking about menstrual health as more of a global issue rather than a solely Western issue; this means that menstrual activists may simultaneously work within the contexts of the US and the Western world and in the Global South. In the last several years, a development subsector referred to as “Menstrual Hygiene Management,” has rapidly proliferated. Using human rights (Boosey and Wilson 2014; WASH United and Human Rights Watch 2017; Winkler and Roaf 2014) and public health frames (Sommer et al. 2015), MHM advocates seek to challenge menstrual shame, silence, and stigma through initiatives that provide girls and women access to menstrual care products, improved infrastructure (access to toilets, water, and soap) and puberty education.

Policy efforts are sometimes engaged as well, such as persuading governments to provide menstrual care resources—including menstrual products and menstrual health education—in government schools (Bobel 2015). For example, Menstrual Hygiene Day now has a global platform with 350 events in 54 countries as of 2017, including educational events in schools, community rallies, concerts to raise awareness about menstrual health needs, advocacy workshops with governments, and product donations. India was the most active of all nations with 67 separate events. Online media coverage has been abundant, with pieces in Huffington Post, The Guardian, El Pais, Metro, and Glamour, just as digital campaigning has been abundant and successful. All key development partners working in the field of menstrual health management participated in menstrual hygiene day (for example, UNICEF, WaterAid, WSSCC, Global Citizen, USAID, PLAN International, and PATH). These efforts are part of a larger global trend of centering development efforts on girls, a move that has garnered some feminist critique as overly instrumentalist and only superficially focused on girls’ most acute needs (Hayhurst 2011; Koffman and Gill 2013).

As discussed earlier, social class issues have also been foregrounded in the recent policy work of menstrual activists, particularly as menstrual activists recognize the importance of addressing underserved populations like homeless and incarcerated menstruators. Initiatives to give homeless menstruators access to menstrual products have begun, as have policies to make high-quality tampons and pads available to those in prison. Beyond this, the push toward reusable products as a class-based issue has also occurred; rather than framing reusable products only as an environmentally friendly choice, menstrual activists have encouraged women and other menstruators to see these products as ways to cut ties with corporate control over periods and save money while doing so (Edwards 2015; Mok 2004).

Corporate and Media Appropriation

As with any resistance movement, one of the dangers of pushing for progressive social change is that the work is often swiftly appropriated, distorted, and/or used for unintended purposes. For example, for years, menstrual activists critiqued the use of ‘blue liquid’ to signify menstrual blood, noting that it distorted the ordinariness of the menstrual experience by erasing blood. This has recently been taken up in an advertisement for Kotex that makes fun of the blue liquid commercials in order to sell disposable tampons and pads (https://www.youtube.com/watch?v=lpypeLL1dAs).

Similarly, activists’ efforts to promote the empowerment of women have been distorted by corporate and media entities as “girl power” packaged to sell products, particularly in menstrual advertisements. Products that purport to “empower” women, like tampon subscription services, often end up merely recreating menstrual shaming and taboo; for example, Club Monthly advertises, “Feminine products at your door, without the shame of the store” (Davis 2014). Many menstrual products have “better and better” technologies that serve to better hide or mask menstruation. Tampon companies inject scented perfumes into tampons to “deodorize” the vagina, just as disposable pad companies design products to be better absorbent and “leak proof.” The language of appropriation used to sell tampons and disposable pads exemplifies one of the hazards of menstrual activist work and serves as a reminder of why menstrual activists must always remain one step ahead of such corporate and media appropriation.

Hostilities and Trivialization

Menstrual activists have also faced hostilities from right-wing internet trolls, bloggers, and journalists for the work they do, resulting in painful clashes about the value of making menstruation more public. Given that menstrual activist work is often in the public eye, such hostilities have intensified in recent years. The hostile climate of the Trump presidency and his policies and practices of xenophobia, racism, sexism, and classism have only worsened these attacks. Clemmer grappled with a host of negative reactions to their work on gender-inclusive menstrual education and their “Toni the Tampon” character (Clemmer 2017). Their work has been met with harsh criticisms and hateful, vitriolic rhetoric from some conservatives (we avoid replicating that here in order to not further and reproduce hate speech) and even some doctors. We, too, have dealt with such hostilities. Breanne Fahs’s recent book cover for Out for Blood—which features a realistic depiction of menstrual blood running down a woman’s leg—started a tweetstorm online in early 2017 after some right-wing bloggers found it “disgusting”; later in 2017, Fahs also watched conservative internet trolls move freely from mocking and trivializing her work on fatness narratives to mocking and trivializing her work on menstruation.

Menstrual activists also face numerous other obstacles related to the trivialization of their work, particularly as many activists work to get policies changed, funding secured, or research published. Those working within the academy face critiques that their work is not on a “serious” subject, or that it is of little academic value (Fahs et al. 2018). The taboo of menstruation, or beliefs that people should not discuss menstruation publicly, have negatively impacted public conversations about governmental policy initiatives and media coverage for menstrual activist work (Bobel 2007, 2010). Recent debates concerning menstrual leave in the workplace reveal the enduring perception of menstruation as a minor matter that should be quietly managed. This view often stems from a liberal feminist ideology that fails to engage the complexity of menstrual experience as at once biological and sociocultural. As long as menstruation is portrayed as trivial, silly, gross, or unimportant, much of the important work on menstruation continues to get sidelined (Fig. 71.1).

Fig. 71.1

Day 5 of “Sloughing,” a 28-day performance by Raegan Truax. Pictured: Thao P. Nguyen (performing) and Raegan Truax (artist) at Royal NoneSuch Gallery in Oakland, CA. www.raegantruax.com/sloughing (Credit: Jeremiah Barber 2017)