Normalization of Menstruation – what & how can it be done?
Addressing social and gender norms surrounding menstruation is an essential milestone in the journey of empowering women and girls. The silence and taboo surrounding menstruation have caused a lot of setbacks for women and have deprived them of multiple growth and development opportunities. There is no dearth of data to show how adolescent girls drop out of education, miss important lessons, loose interest in class participation, emotion loss including self-esteem, confidence, thus missing the bus for next milestones. Similarly for women menstruation has led to avoiding going out for work, essentially missing workdays every month and feeling ashamed and facing tons of other stigmatizing remarks. The problem or challenges surrounding menstruation is way more than what has been mentioned here and is quite evidentially known to all.
The question is – how do we make menstruation “normal” as part of our daily living and language?
Any natural or biological process is normal. We are born, we grow, age and die out. This is a natural and normal progression for life on earth. Anything that does not conform to this progression is identified as unnatural or problematic.
Similarly, menstruation is a regular biological process that starts with adolescence and all women go through this process. Not having menstruation (post puberty) in a regular cyclic manner is a problem. Such a condition calls for medical attention. Thus, that is not normal.
Economic conditions, rural-urban divide, infrastructural provisions, and education are the main factors that cause inequalities and inequities or period poverty for women and adolescent girls. From an enabling opportunities’ perspective, various institutional actions have been taken like making workplaces friendly for women to practice safe and hygienic menstruation. 5Ps1 of period hygiene is essential to make workspaces period-friendly (Palm, Product, Proper disposal, Pain and Period care). Especially in urban workspaces, provision of water, disposable sanitary napkins, toilet rolls and garbage-bins in the toilet are now common.
Boosting Business research project in India and Bangladesh showed evidently the increased return of investment (RoI) and other business benefits when there is an improvement in WASH facilities for women at workspaces. It encouraged women practicing hygienic management of menstruation through changing their sanitary materials within or less than 6 hours’ time period (84% during endline to 53.7% at baseline). 98% of women responded to be feeling comfortable and overall lowered health risks due to the period friendly toilets at factories and other workplaces. Although in urban low resource residential settings (slums), poor urban planning women and girls are disproportionately affected due to inadequate sanitation infrastructure, and limited access to water2 . Women and girls have limited to access to safe and private spaces and disposal mechanisms. Availability of different types of sanitary materials have also provided an opportunity for women and girls to choose product as per their need in their context. There are now one-time usable, reusable menstrual pads, cups and tampons available as per different size and price and other features. Looming climate change with increased heat and decreasing water availability, loss of livelihoods and wealth will further have an additional bearing on women’s reproductive health and choices.
Few offices in urban spaces have started provided period leave for women to be able to rest. However, supreme court has denied taking up the PIL calling it a policy matter. Spain, Japan, Indonesia, Philippines, Taiwan, South Korea, Zambia, South Korea and Vietnam are few countries which have policies for period leave. Zomato in India announced 10 days paid period leaves for its workers, in 2020. Bihar has a policy of 2 days period leave every month for all its employees since 1992. Kerela has recently announced period leaves for female students in higher education institutions.
Project Concern International (PCI India), through its Umang project3 is making the mothers as champions to enable daughters to practice menstrual hygiene at home and school. Mothers as members of women’s collectives (Self-Help Groups – SHG) are coming together to ensure no girl is missing her school due to period poverty. The increased bonding between mothers and daughters is enabling more quality conversation and sharing of correct information from mothers to daughters. This enables de-mystifying the myths and de-stigmatize the conversation and the natural process. To ensure norms are shifting, the inter-generational conversation and demonstration of behaviour is crucial (social cognitive theory).
However, in all these its essential for all to understand and accept that MENSTRUATION/PERIOD IS NORMAL . We need to get to the route of behaviour and norm shifting to enable and empower people to absolutely accept the natural process as normal without any discrimination or disrespect. It is very essential in our efforts towards reducing gender gap and improve access to equal opportunities between women & girls and men & boys. Normalization of menstruation across the strata of communities, societies and larger socio-eco-system is essential to enable women and girls, enjoy their full potential without any fear of threat or violence or discrimination.
According to American sociologist Diane Vaughan, normalization of deviance is a process where the deviance from a certain behaviour becomes culturally appropriate. As per various behavior and perception change theories, the process of normalization must focus on changing the perception of individuals i.e., women & girls who menstruate and all individuals irrespective of their sex and gender identities, who perceive this as shameful. Creation of a new norm of menstruation as natural, we need to follow a sequence, as suggested by Cristina Bicchieri, needs to follow 5 stage process 4 :
– Change in factual and normative personal belief
– Collective decision to change
– Introduction of sanctions for non-compliance
– Creation of normative expectations
– Creation of empirical expectations
Referring to different behavioral and normative theories, following are the essential actions to bring a change in perception and behaviour towards menstruation.
1. Awareness generation about female reproductive system and menstruation is the first step in the process of normalization. Demystifying and removing the misconceptions around female body and reproductive organs and the system is possible only by bringing in men and boys in the conversation. Traditionally they have been out of these conversations and have very limited access to sex education. Because it was left to women and girls only to learn and deal with, it has turned into a very secretive issue of them and thus, many wrong perceptions have got crystalized. Awareness generation is essential bring the factual information to people and allowing them to question and mould their personal beliefs.
2. Sensitization on and de-stigmatizing menstruation as dirty or act of shame. While awareness generation will allow men and boys to learn and become knowledgeable about the process, however, its needed to enable them to become compassionate about women and girls, especially around periods. Its essential with knowledge men and boys to understand and recognize the hormonal, behavioral and other physical changes that women and girls go through. Its essential to understand the roles and responsibilities and behaviors they are expected to exhibit towards the women and girls in their families and workspaces. They need to de-stigmatize the periods and create an enabling/supportive environment for women and girls to gain or continue to enjoy her enhanced confidence, self-esteem, space and voice like another time in the society and in the relationship.
Generating conversations beyond education contexts is essential to enable boys and girls to map out and practice their behaviours in general societal spaces and relations. Although men may feel it to be an alien topic; however, they also need help to identify their roles, actions and behaviours towards their female relatives, friends, partners, colleagues etc.… in their lives. This allows people to generate a collective conversations with full understanding and take a decision about their behaviour and sanctions. The people themselves can become a reference network for each other to establish the new normative behaviour.
3. Joint media advocacy to promote menstruation as normal process. Media has a bigger role in influencing people’s behaviours, perceptions and values. As per agenda setting theory, media has the power to set the agenda for larger public conversations. Thus, its essential for men and women, boys and girls to jointly advocate with media for redefined messages regarding menstruation. Women and men, girls and boys together should create the normative and empirical expectations, that can be amplified via different social and mass media channels. Media houses/channels can strategize to establish the sanction and the new reference network to normalize menstruation.
4. Wider and deeper community-based conversations. For a sustained change in the process of shifting of perceptions and behaviours, its essential to cover a critical mass in a widespread geography. Conversations should include individuals across generations and genders. As per the social cognitive theory humans learn behaviors by observing others and choosing which behaviors to imitate. Hence, its essential for older and younger generations, each gender to enable each other to shift and continue a changed behaviour and perception. They need to be facilitated to establish sanctions for conforming and non-conforming to the new decided behaviour around normalizing menstruation. Collectives need to come up with descriptive norms and facilitate a progressive injunctive normative behaviour in their communities. A holistic change in same direction across all layers of the socio-eco-system is essential. This can be residential, workspaces, urban-rural, public spaces… all sorts of communities and societal setups need to be involved with these new normal conversations around menstruation.
A combined efforts of all stakeholders at community and system level is essential to generate an honest conversation around menstruation, remove the associated stigma, to enjoy menstruation has a natural and normal process.
‘maahvari aurat ki prakritik takat hain; raaste ki rukawat nahi!’
‘Menstruation is one of the natural strengths of women, not an obstruction.’
Author: Sushmita Mukherjee – Director Gender and Adolescent Girls, PCI India
4 https://bit.ly/45ml1Li (A Handbook for Social Change: Bicchieri’s Norms in the Wild)