What clinicians can do to help with period poverty

Period poverty isn’t just an issue in third-world countries or among low-income women. Across the United States, women of all ages still struggle to afford menstrual products—which are too-often viewed by commercial markets and governments as a luxury item rather than a basic necessity for personal hygiene.

For teens and young women, a lack of access to menstrual supplies can have far-reaching effects, even detracting from things like time in the classroom.

Menstrual equity movements have gained traction in recent years, but the COVID-19 pandemic highlighted the fact that there is still much work to be done.

According to a survey commissioned by Thinx and PERIOD, nearly a quarter of all school-aged students struggle to afford period products, and 16% have had to make the choice between purchasing menstrual products of food and clothing. While this is a problem that is faced across the spectrum of socioeconomic groups, the report indicates that Latinx, low-come, rural, and college-age students are most impacted.1

Schools have long been a resource for many students who struggle to get access to menstruation products, but the COVID-19 pandemic made that more difficult. Nearly a third of students in the survey reported that going back to school after COVID-19 lockdowns was a relief in terms of menstrual support, but 3 in 5 students say free hygiene products are still rarely available in their school bathrooms.1

It isn’t just anxiety and shame that can develop from period poverty, though. Roughly half of the students surveyed reported wearing menstrual products for longer than recommended due to lack of resources, and 1 in 10 students globally are believed to miss school during their periods because of a lack of access to hygiene items.2

There are a lot of issues that contribute to the problem of period poverty, but about three-quarters of the students surveyed want more education and advocacy when it comes to menstrual health and access to hygiene products. This is where pediatricians can help.

Pediatricians often ask families and patients about access to all sorts of basic needs like housing and food, but period products might not often make the cut.1

Elise Joy, executive director and co-founder of the New Jersey-based non-profit Girls Helping Girls Period, says pediatricians should keep in mind that several forms of poverty often go hand-in-hand. Joy and her daughters formed Girls Helping Girls Period after volunteering at a local food bank and realizing that nutrition wasn’t the only thing visitors to the resource center were lacking.

“Where there is period poverty there is, most likely, food insecurity. I recommend anyone who is struggling begin visiting a food pantry. While they are not created equal, more and more are seeing the need to supply menstrual products,” Joy says. “They can be in short supply at food pantries, too, but in many states, like our state of NJ, the state food banks have started to make period products available.”

Organizations like Girls Helping Girls Period raise funds and awareness to help secure hygiene products for food banks so that they can be distributed to those in need. Joy says the need has been there a long time, but increased reliance on food banks during the COVID-19 pandemic really highlighted the problem.

Pediatricians should direct patients and families who report or are suspected to have food or housing insecurity to additional resources that can help them with all their needs, including period products.

Advocacy is another important area where pediatricians can have a strong voice about period poverty. There are numerous state and federal laws either recently passed or in consideration that aim to reduce period poverty and biased pricing on gender-based hygiene products. Some states have repealed or banned so-called “pink taxes” or “tampon taxes” that add a luxury tax to basic period products, but 35 states still have these laws on the books.3

“Slowly states are realizing that providing basic period products is part of their responsibility in publicly educating students,” Joy says. “There has been a huge groundswell of advocacy across the nation from students and families demanding that pads and tampons be offered, free of charge, to students for use in school.”

Pediatricians shouldn’t limit their advocacy efforts to the legislature, either. Check your state laws and make sure that they are being enforced in your local schools, she says.

“There are many places that have these mandates on the books but they have not been implemented well. If your state law says there should be free products in school and your child does not find them, help make a change. Write a letter to the principal. Make a presentation to the school board. Get other parents involved, too,” Joy says. “Can you imagine having to make this much of a fuss to get toilet paper in bathrooms? Of course not. Students tell us not having pads or tampons in bathrooms sends a strong message that they are not a priority, and that their education is not as important to educators as that of their peers who do not menstruate.”

Pediatricians can also help parents and their children have open discussions about menstruation, period products, and other personal hygiene methods to help reduce the stigma and fears around these topics.

“It doesn't have to be dinner table discussion, but there is no way we will normalize periods if we all don't help break the taboos. It is primarily because we don't talk about them openly that this problem of period poverty exists,” Joy adds. “Until we all play a role in making change, we can expect things to stay the same. Students today are fantastic about talking about tough subjects—they need to teach their parents to do the same. I think pediatricians can really help in normalizing the conversation simply in their approach to talking to patients and families. If they are open and matter-of-fact in the doctor's office, it will go a long way toward letting a patient and their family know it's ok to talk about it, ask for help, ask questions about their own bodies.”

The national non-profit Alliance for Period Products also offers national support for menstrual supplies in partnership with the National Diaper Bank Network. The Alliance for Period Products works with a network of 120 community-based organizations that can be found here.

Program Director Jennifer Gaines offers the follow advice to pediatricians whose have patients facing period poverty.

• Take a basic needs-informed approach with the patient and ask direct questions:
  1. Do you know how to use menstrual products?
  2. Do you have access to the period supplies you need to manage your period?
  3. Do you and/or your family struggle to afford the period supplies you need to manage your period?
  4. Do you know resources in your area that can help supply free period products?
• Organize or identify educational workshops for both parents and children about periods and using products.
• Consider keeping period supplies in stock in the office and providing the patient with enough products to manage a full cycle.
• Identify and build community partnerships with local basic needs organizations.
  1. To find out if an agency in your area provides period supplies to individuals in need, please contact the local service directory in your area by calling 2-1-1 or going online to 211.org.
  2. Ask about or search for period supplies or basic needs.
  3. Also check the listings under women, girls, families, or transgender individuals.
  4. If you still can’t find a resource, try local faith-based organizations and food pantries.

Resources:

1. Period.org. (2019.) State of the period: The widespread impact of period poverty on U.S. students.
2. UNESCO.org. (2014.) 2013/4 Education for All Global Monitoring Report.
3. Period.org. (2021.) State of the period 2021: The widespread impact of period poverty on U.S. students.

This article was originally published by our sister publication Contemporary Pediatrics.