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Reproductive Health

How to Debunk Menstrual Health Stigmas in the Age of Consumerism

A conversation with Chris Bobel

Dr. Bobel is Associate Professor of Women’s, Gender, and Sexuality Studies at the University of Massachusetts, and is also President of The Society for Menstrual Cycle Research. She just published a book, The Managed Body, where she explores developing girls and menstrual health in the global south.

I spoke with Dr. Bobel about how misinformation spreads about menstruation, how myths and taboos persist, as well as her thoughts on why consumer products are not the answer.

Here is an excerpt of our conversation, edited for clarity:

Ava: What misinformation about menstruation do you see spreading in the global south?

Dr. Bobel: There’s misinformation being spread by some of the NGOs and social businesses that are addressing menstrual health. There is a tendency for organizations—understandably motivated by timetables, competitive funding, competition, and a dearth of resources—that many organizations are not fact checking things like, “one out of 10 African girls misses school when she’s on her period” or that the lack of menstrual pads is making girls sick.

Those are the two claims that are often made by very well-meaning organizations to advance the cause of menstrual health, to attract attention and resources to justify their intervention. But the truth is neither of them are suitably supported by the available evidence. When it comes to the menstrual health space, we’re kind of building the house while we’re were living in it. So we’re making assumptions that we have yet to prove.

So the research just doesn’t line up yet to prove that there’s a clear relationship between access to menstrual materials and school attendance. And there’s not clear evidence that when using cloth for instance—or something else that’s not a commercial single-use menstrual pad—that people will get sick. And yet those claims are often made.

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Ava: Are they myths?

Dr. Bobel: I wouldn’t call them myths per se, I would just call them assumptions or claims that are made. They hold up because they repeat what somebody else has said, or they think they heard it from UNICEF or they think they read it in a UNESCO report, or maybe they read a report on a piece of research that was done in a small population in Sierra Leone, but then they extrapolate that to a site in India.

It’s bad politics of citation, right? So people don’t get to the bottom. They don’t go to the source and actually read the study, or they don’t find out that there is no study it’s just one NGO was quoting one news article that quoted a different NGO that’s quoting a different news article and you get to the bottom and you realize there’s nothing there.

Ava: Are there other examples?

Dr. Bobel: There’s another example of this under-reliance on the evidence and over-reliance on what are called spectacles. In the absence of good science, what people often do is tell the most heart-wrenching story about the young woman who died because she wore a cloth as a menstrual absorbent and there was a rusty hook in it and she contracted tetanus and died.

These are real stories, but to position them as the norm to justify intervention, I find this problematic. It is intended to create awareness and empathy, but I think it actually serves to create distance between other people, different people. Right? So that we then sort of see the brown and black people of the global south as the savage, as ignorant, as not knowing better. I don’t think that’s actually a way to challenge inequality and improve the lives of people globally.

Ava: What role do you think consumer products do or don’t play in changing stigmas around menstruation?

Dr. Bobel: I recognize that language of menstruation, particularly in the west and increasingly in the global south, is a language of products. We equate menstruation with a mess. We equate menstruation with something that needs to be cleaned up. That’s why I titled my book “The Managed Body” because of this idea that, that the menstruating body is one in need of management. We don’t construct it as a vital sign. We don’t construct it as something neutral, normal, or healthy. We construct it as a problem that needs to be solved. And the menstrual care industry has been brilliant at delivering the “solution” and the solution comes in a box or bag.

I don’t want to eclipse menstrual discomfort, pain, or disorders. Those are a reality. But for most people, menstruation is a normal event, but it gets socially constructed. It could be constructed as a nuisance, as something you have to hate, and we just want to make it go away. And that’s the work of stigma. There are complex reasons why that has to do with gender and embodiment and in some, in some cases, race as well as class. And so, of course, people will do whatever they can to keep it quiet, keep it hidden. And this is true in consumer culture more generally—your body grows hair, but you then need to make it go away.

So the personal care products are very effective at showing up very quickly and saying, oh, we’ve got the solution for you. But they also helped to construct the problem, right? It’s shameful that you leak, the leak is a social crisis. Or, you don’t want anybody to know that that’s a tampon, so we’re going to wrap it in neon bright wrappings or make it small enough that it fits in your hand so that you can discreetly walk from the classroom to the bathroom. Or the scented products, particularly scented tampons, which are absolutely unnecessary because there is no menstrual odor if you’re wearing a product internally.

And so, of course, we want to smell like a flower. We don’t want to smell like a woman, a human woman. So that’s my worry about this emphasis on product. It’s nice to have options. I think it’s great. I’m not against options and innovation, but I think it’s a false belief that if you give people more options, that’s going to fight stigma. That doesn’t fight stigma—that accommodates stigma.

Ava: What else needs to be done to fight these taboos? Is it education to flip the script girls have internally about their menstruation?

Dr. Bobel: Yes. I think we do need to change the script, but it needs to be for more than girls. It needs to be for boys, parents, religious leaders, teachers, coaches, doctors, nurses. I did a workshop with school nurses—they were so hungry for information. They know that they have an opportunity to talk with kids about their bodies in ways that are body positive and to promote menstrual literacy. But guess what? Many of them felt constrained because they didn’t feel supported by the administration.

It wasn’t okay to talk honestly about bodies, it wasn’t okay to talk about menstruation. And we need to. We need a massive educational overhaul, where menstrual health and more generally puberty and reproductive health are wheeled not just into health class but show up in lots of places: history, political science—it can be a really productive lens to think about a lot of things.

And it will normalize it because it’s just part of the conversation. But right now we marginalize. It’s so acutely that we have some schools—even to this day—it’s one day of education about menstruation. And the boys and the girls are separated. Sometimes the boys get to play basketball and the girls see a video, right? And then no wonder kids are clueless and no wonder they weaponize menstruation because they don’t understand it and it makes them uncomfortable.

It’s weird when you think about it—blood comes out of your body, but you’re not dying. What strange thing; You need to unpack it. We really need to invest in education and I’ve talked to lots of tech innovators and startup people and I don’t think I’ve talked to anyone that’s innovating and education. They’re all innovating in product and I would really like to see some innovation in the direction of education and awareness campaign.

I would really like to see a really serious effort to teach menstrual literacy in the context of body positivity. And I don’t mean everybody has to love their period. I think that’s exchanging one tyranny—hating your period—for another one, loving your period. I don’t want to assume anybody’s relationship to their body, especially for people that are gender nonconforming or trans.

But if you don’t have good information, you can’t make informed decisions about how to care for your body. You’re operating in the dark. We have to turn the lights on and literacy training in a variety of settings—not only schools and not only for girls but for everybody—is the way to do that. I think we should do that at least as much as we do the product innovation.

Ava: What else could we be doing?

Dr. Bobel: Menstrual health is a gateway to all kinds of conversations about sexuality, about sexual violence, about healthcare decision making across the lifespan beyond the menstrual cycle. For me, this is why this issue is so fascinating—you open your mouth and start talking about menstruation and pretty soon you’re talking about 10 different issues. But how can you draw in more people into more of these conversations? How can people leverage body literacy to think critically about lots of dimensions of their life? Because it’s not only fertility that people need to learn about.

The only way forward for the mental health movement is if we build linkages with other movements. Otherwise, we’re going to languish on the margins as some kind of weird fringy cause. People say why are you talking about periods when there’s sex trafficking and there’s massive mass incarceration, and there are school shootings. But it’s the beginning of the body hatred that puts into motion an entire lifetime of disregard for staying in tune with the body—and that is powerful. And if we do it right, early, then I think we can change the script. It’s never too late. It’s not too late for somebody that’s 30 or 40 or 50 or 60 or for boys or for parents. And I think we’ve got a great opportunity there.

Lindsay Meisel

Lindsay Meisel is the Head of Content at Ava. She has over a decade of experience writing about science, technology, and health, with a focus on women's health and the menstrual cycle. Her work has been featured on The Fertility Hour, The Birth Hour, The Breakthrough Journal, and The Rumpus.

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