Menstrual Stigma Across Cultures (Episode 337)

Full Transcript: Episode 337

Lisa: Welcome to the Fertility Friday podcast, your source for information about the fertility awareness method and all things fertility. I’m your host Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Charting Journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I know, I’m a busy girl, but I managed to fit it all in. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health, and I’m so excited that you’re here with us today.

Lisa: Today I’m sharing my interview with Ila Mostafa all about menstrual taboos, and I’m really excited to share this episode because it really gets into some of the conversations around how our culture looks at periods. There is a history in each culture, in each world religion, that of course is controversial, but that really does make mention of periods, and often we see periods mentioned in a negative way. It can be interpreted differently, so there’s a lot of perspective shifts around what the meaning of the words are if you’re looking at biblical texts or something like that, but there are certainly nods in a variety of religious texts to menstruation being dirty or unclean or requiring a time of separation, and that can be interpreted in a negative way and lend itself to this idea that menstruation is bad or dirty or unclean, and something we need to hide or feel ashamed about. There are certain cultural aspects of menstruation taken down from certain religious teachings, even the sense that women were the bearers of original sin, and that painful childbirth was the punishment for that. So there’s certainly this religious overtone that has permeated, because even to this day, one of the topics I talk about quite a bit is period pain, and I’m often surprised by how many of the women I work with are resolved to experience period pain. They feel that it’s just normal, and some women feel like it’s just our lot in life as women to have these horrible, painful periods. I’m not saying that in every case it’s coming directly from this, but if there are thousands of years old teachings that painful childbirth was related to this concept of original sin, it’s not much of a stretch to think that concept could contribute in part to this idea that it’s just our lot in life to have tough periods, because that’s kind of how our culture looks at it. Often I am the first person for some, not all, who is saying out loud, “Look, it’s common, sure, but it’s not normal. We shouldn’t have to be in pain and there are other ways to handle it.” For many women, that’s not something they’ve even been told by their healthcare professionals. So I’m always interested in learning about the historical context, and I’m often thinking about how these teachings affect us day to day, and also how they could affect women around the world in different economic and cultural settings. So I will leave it at that without further ado. I came upon Ila’s research paper entitled The Real Period Stain: Menstrual Stigma and Its Pressures in South Asia, and I thought it presented a really interesting and important viewpoint so we could open the conversation about menstrual stigma, and even dive into how religious teachings can interplay with culture and impact menstrual taboos. So without further ado, welcome to the show.

Ila: Hi, thank you so much for having me. Yeah, so I am currently in my senior year at Augustana College in Rock Island, Illinois, and I did this project on menstrual stigma in South Asia because it’s something I grew very interested in. Initially the project had a very different direction, but as I discovered more about menstrual stigma and thought about my personal experiences with it, I realized that’s really what I wanted to study and dig into.

Lisa: I feel like a really nice opener to this conversation might be your own experience with menstruation, because I won’t give away what you were sharing with me, but I feel like that’s a great place to start. Would you mind sharing a bit about your own experience with menstruation and how it differed based on where you were living and the cultural experience, even within the same culture?

Ila: Yeah, so I was telling you earlier that menstrual experiences in the US and in Bangladesh, where I’m originally from, are very, very different. About three years ago I went back to Bangladesh to visit family, and that’s also when I conducted most of the research for this paper. When I got my period, I had to wrap up my used pad in the packaging it came in, then wrap that in newspaper, then hide it underneath my shirt and walk to the balcony really quickly to put it under a rag in a bucket just to hide it — whereas in the US, there are receptacles in every bathroom stall for used period products, and even at home I can just throw it in the trash can and that’s it. So the extensive process I went through in Bangladesh really showed me the extent to which menstrual stigma is battered into the mindset there, and that’s what opened my eyes to the idea that menstrual stigma is very different cross-culturally.

Lisa: Could you share what your definition is — how would you define menstrual stigma, and what kind of impact does it actually have on our lives?

Ila: To define stigma, we go back to the definition that sociologist Goffman established, saying it was a stain or mark that sets people apart from others — this quality of “othering” that really defines menstrual stigma, in this case othering people who experience menstrual periods. It’s this taboo, this disgust surrounding the idea of menstruation and oftentimes menstrual blood itself. In a lot of texts, scholars have associated menstrual blood with an abomination of the body, something that keeps women from being pure and clean.

Lisa: This is all very controversial waters, so for everyone listening, Ila and I are going to do our best to explore these ideas. The goal isn’t to vilify any particular group, it’s just to have a conversation around it. One observation I’ve made is that if you search the academic literature about menstrual taboos, you’ll find countless examples from specific religious texts, and what’s interesting is that an academic perspective may interpret a section of text without the context to mean a certain thing, and use that to describe why it’s dirty and unclean — but if you speak to someone who is actually part of that religion or culture, they’ll look at the same text and say it’s not within the context of what it means, and it’s not how it actually works culturally. In your research and experience, could you talk about that, and how it’s not always practiced exactly how it’s laid out either?

Ila: In this project I focused on South Asia, so the two big religions I looked at were Hinduism and Islam. As a practicing Muslim myself, I looked at Islam first — in the Quran, menstruation is referred to as hayd, and during menstruation a woman is considered unclean and can’t pray. The verse, in Surah al-Baqarah, refers to women as pollution during their period, and later says that Allah loves those who are pure and clean, so it’s almost suggesting that during this time a woman is unclean and unpure and that Allah will not accept her — which is a problematic way to think, because it denies that menstruation is a very natural process, and it also gives people leeway to mistreat women who are on their period or who may be vulnerable during it. I think there are so many facets within a religion that it’s hard to simply say this is wrong or this is right, because for some people that line is blurred, and for some people they don’t know whether to go along with what’s in the Quran or with something they believe more socially — which is something I experienced too. When I was younger I understood that I couldn’t pray because I wasn’t clean, but as I got older, and especially as I got into this research, I felt that a natural process in my body shouldn’t define my faith, and yet it seems that’s what Islam was telling me to do. On the other hand, with Hinduism, the big thing I noticed was that women were also not allowed to pray, and in some parts of India women aren’t allowed to enter certain parts of the house or cook, and many women are put into a separate hut or house near their own home when menstruating, to banish the evil spirits that come with menstruation. There was one specific case I looked at in Tamil Nadu, South India, where a girl was separated from her house and put in a hut, and a cyclone hit the town, and she died because she couldn’t get out. There’s natural disaster and lack of accessibility involved, but for the most part, menstrual stigma endangered her life. If she’d been in the house with her family, maybe she would have been safer — it’s hard to say, but menstrual stigma definitely played a role.

Lisa: This is all very contentious territory, because what is written somewhere doesn’t necessarily match a lot of women’s experiences. You touched on how your experience of menstruation was different in one region versus another. For the woman listening who says she’s never felt that way at all, who actually likes having some time to herself during her cycle and has never felt like anyone told her she was dirty or unclean, and who’s heard that these texts are being taken out of context because there are places in religious texts that show love for everybody — how do you reconcile some of those different viewpoints, and how does it filter into your own experience?

Ila: The big thing that comes to mind is that to each their own — everyone has their own individual experiences, and there’s no way one person can speak for another. To the woman who’s never felt stigma, or who appreciates the time by herself, or who accepts the teachings of her religion in terms of menstrual stigma, that’s her prerogative. A lot of people don’t necessarily have the privilege to not feel the stigma. A lot of people, especially young women, may not understand the tenets of their religion when it comes to restricting their activities, and we also have to remember that when we talk about women we can’t just talk about women in the US or urban areas — we have to talk about women in rural villages, uneducated women, women who may have abusive families, women who don’t have the same access to resources. And another thing that often gets brushed over is gender non-conforming people who still experience periods, which I think solidifies the idea that a period is a natural bodily function, and gender and identity is something you define for yourself. When people associate something you’re supposed to define for yourself with a natural process already deemed dirty and unclean, it creates a tension that’s very hard to navigate. But I think the best thing to do is understand that everybody has their own experience, while taking a second to consider that someone else may feel differently.

Lisa: It’s interesting because everyone experiences this so differently. I was brought up Christian, so that’s my religious framework, though I wouldn’t say I identify with all of it — it’s more the framework I was brought up in. What I find interesting from that objective perspective is that when you look at religious texts from a variety of world religions, similarities appear in many of them. And from that journalist-observer perspective, what’s interesting isn’t necessarily how strictly it’s followed — because even if a text says something, it doesn’t mean your relationship or life is strictly based on what the book says — but that we might think ancient stigmas don’t affect us today, when I think they still do. An example I often use is that in my perfect world, menstrual products would be free and available in every public bathroom, because we’d acknowledge it’s a normal bodily function, the same way toilet paper is just there. Even the absence of that, and the absence of discussion, and the presence of shame — even though your experience was different, it’s still something we’re not really broadcasting here either.

Ila: I think menstrual stigma is present for all people who have periods, all across the world. I think a lot about young girls who’ve just reached menarche, or who are having a period for the first time — it’s easy to feel embarrassed and nervous, and there are a lot of odd rumors going around about it. Even when I was a teenager I would hide my pad in my pants or shirt and rush to the bathroom so no one could tell I was on my period, and when someone did find out I was so embarrassed and nervous that others would find out. So menstrual stigma is very rampant, and women feel it in different ways, and I think how it manifests in culture and religion varies from place to place, but it’s still a dangerous, harmful thing that affects women, and it’s something people don’t really think about. You mentioned the cost of menstrual products — that’s another big thing, especially in South Asia. When I was in Bangladesh, touring pharmacies, I found that pads were kept on the very top shelf, and when I asked the man at the counter if I could see them, he took one down, dusted it off, and gave it to me, because women don’t feel comfortable buying pads themselves. One woman I interviewed told me her husband goes and buys her pads for her. And when I bought a pack of pads in Bangladesh, the man behind the counter wrapped them in newspaper and put them in a plastic bag so no one would know I was buying pads. The idea that we have to hide something so natural for the sake of others, so they don’t feel embarrassed, is really frustrating, and it gets at the innate inequality that exists between men and women. It’s about gender inequality, religious aspects, and cultural aspects, but at the very bottom it’s about the inequality we feel.

Lisa: It’s fascinating that on the most basic level, every human being is on earth because their mother had a menstrual cycle. If women didn’t menstruate, there would be no next generation. It’s interesting and necessary to ponder those questions — where does this come from — and anyone wondering that is eventually going to stumble across religious texts, and see that menstruation is often used and interpreted differently and passed down and acted out within different cultures, but the actual text, out of context, paints a pretty unequal, negative perspective, saying women are ritually unclean because of this. You raised an important point about disparity — it’s different for urban, educated, middle to upper class women who have the money and agency to access products and negotiate what they want, versus women who don’t have that same degree of agency. Correct me if I’m wrong, but share with us what it looks like for women in impoverished areas who don’t have the ability to purchase hygienic menstrual products.

Ila: In my project I interviewed women in both an urban area and a rural village, very different socioeconomic statuses. The big thing I found was that women in the more urban area all used pads or some modern menstrual product, whereas almost all the women in the village used cloth. That’s partly because they were a bit older, but mostly because cloth was a cheaper alternative — but unfortunately it’s not hygienic, because it’s something they’d wash and reuse, and they’d try to dry it somewhere men couldn’t see it, so it would stay damp and they’d still use it again, which causes health problems including reproductive tract infections. Not having access to safe, hygienic products is really hard on women’s health, and it’s all because of the cost difference. Why is it so expensive to maintain a lifestyle that’s natural? Why is something that happens to me naturally so hard to take care of? Why are women forced to adjust to other people when it’s their own bodies and experiences? It’s almost as if every aspect, even down to this natural system, is adjusted for the sake of somebody else, as if we exist for somebody else — and that goes back not only to the disparity between urban women and women in villages, but also between men and women, and how women are constantly told to redefine and reform themselves for others.

Lisa: That’s such a good point, and it’s something I’ve addressed on the podcast in different ways — the concept of reusable products, becoming less dependent on the system, and young girls in certain places not being able to attend school because of their periods. Even reusable pads not being able to be hung out to dry properly increases the risk of urinary tract infections. When you’re sitting pretty in a nation living a middle to upper class urban life, it’s easy to think this doesn’t affect you, but I’ve made an observation that a lot of women think it’s totally normal to have painful periods and raging PMS, and we accept it as normal because periods “suck” — it’s almost like a curse, and being brought up in a Christian background myself, there’s that idea we were cursed after being thrown out of the garden. I can choose to accept or ignore that part of the story, but at the same time, so many women — whether or not they resonate with everything we’ve talked about — do identify with the concept that this is a curse, that it’s their plight as a woman to experience this pain, and if that isn’t related to historical stigma, then what is?

Ila: That’s absolutely right. When I was interviewing women, I asked how they feel when they’re on their period, and they said they don’t feel good at all, they’re in a lot of pain, they just want to lie down — and I’d ask, well then what do you do? And a lot of women said, “How can I not work, how can I not do what I have to do?” It’s almost like this isn’t a viable excuse, because it’s something everyone has to do, and if she can do it, you can do it. But that’s not the case — period cramps, PMS, and a lot of other symptoms come with the menstrual cycle, and when we glaze over that as a curse or “women’s business,” we’re denying equality between genders, and denying women the same pursuit of life that we give men, where if a man is sick, he can take a day off, but when you’re on your period, even though it’s a health condition, something difficult to deal with, we ignore the female experience and what it means to be equal.

Lisa: It feels in many ways that the world was based on men’s experience. If we look through a solely male perspective, it’s almost like they had to explain away the situation by pretending it didn’t exist. One of the questions I wanted to get to is, where do we go from here?

Ila: My first order of business, menstrual products need to be in every bathroom. Some people worry that they’d just be stolen or played with, but even if that happened for a couple of days, eventually it would just become normal — do you see people hoarding water because it’s available from the tap? No, you don’t. Given the research and experiences you’ve had over these past few years, what have you come up with — how can we make this better for everyone who has periods?

Lisa: I do agree that menstrual products should be free, because menstruation doesn’t take a break — it comes every month whether or not you have money that month. If you can’t take care of it, it’s not something you can hide. So making menstrual products free and accessible is one way to push back against the stigma. On top of that, companies, schools, and workplaces need to understand that menstruation is a difficult time for many people — some women feel extreme pain, some feel nauseous, some can’t get out of bed — and it’s important to have men understand that this is not “women’s business,” and for women to understand it’s not something they have to hide, it’s natural, it’s a part of the body, and once men and women understand and accept that, it’ll be a little easier to navigate, especially for men who consider it women’s business. It’s never going to be easy, and there’s a long way to go, but it starts with communication.

Ila: I couldn’t agree more, and shout out to the men who are already there — because a lot of men share households with women, whether a mother, sister, daughter, wife, partner, cousin, or friend, so at the end of the day you can’t escape it. It’s interesting, I had a conversation with Lara Owen who introduced me to the concept of reproductive labor, which felt really relevant here — women have been left to bear the brunt of that burden. Even though the average woman today has fewer children than a century ago, she’s still having periods cyclically, whether or not she’s using some method of birth control, and the burden of that, financially and otherwise, is placed solely on us.

Lisa: I’d add a layer to that, because I feel that the stigma around menstruation being necessarily this horrible, painful, and difficult thing prevents the conversation from getting to what it means to have a normal cycle. A big part of what I do is share the idea that the menstrual cycle is a vital sign, and we need to have a conversation about what’s normal versus what’s common — pain in any other context isn’t normal, so why would it be normal here? Severe mood changes aren’t normal in any other context, so why would they be here? If we looked at the cycle as a sign of health, as your body’s way of saying something’s out of balance, there’s so much research and so many women who’ve improved their periods over the years by not accepting that framing. Not talking about it prevents us from even having that conversation about improving our experience of our period.

Ila: I think the “culture of silence” that surrounds menstruation is a phrase I came upon a lot in my research, and it’s very dangerous for women. I appreciate that in the US, more people are coming to talk about menstruation and women’s health in general — podcasts like yours, OB-GYNs and doctors going on TV or radio, books about it — and I think that start of conversation is so important, though it still has a long way to go. In Bangladesh, and a lot of South Asia, it’s still necessary — women feel a little odd talking about it, but when I was interviewing women, especially in the village, other women gathered to listen, which shows women are interested in knowing what this research and topic is about. So finding ways to talk about it is going to be the most important thing, but you have to get past this idea of propriety, which I find really dangerous, because this obsession with propriety keeps men from talking about menstruation and keeps women from telling others about it.

Lisa: What do you mean when you say propriety?

Ila: In South Asia, when it comes to culture and tradition, the idea is that women must be “proper,” and proper always means being quiet, sitting up straight, talking politely, and only talking about certain subjects in public. These guidelines for a woman’s existence really limit the conversations they can have and the openness possible around menstruation.

Lisa: That’s more overt than what we have here, but we have something similar, even if it’s not as overt — for example, so many women have had the experience of going to their healthcare practitioner and being dismissed, told a symptom couldn’t be that bad, or even condescended to. The culturally accepted response to that is to shrink and not challenge it, and it’s one of the hardest things to actually challenge that authority. So even in our culture, it’s not as overt, but those same ideas are still there.

Ila: Definitely, and this idea of being dismissed and not believed extends into a lot of aspects of a woman’s life, and it’s very prevalent especially among women of color, immigrant women, and women who may not have finished higher education, which introduces issues of class and elitism, which underlies this idea of inequality between men and women — women considered not only weaker, but not as intelligent. But no one understands my body better than I do, because I’m the person living in it, and I think that goes for menstruation too. Every woman menstruates, but every woman menstruates differently, and these are the symptoms I’m feeling, and they’re valid because I’m feeling them.

Lisa: Even if you intuitively know it on some level, I feel there’s a cultural idea that we shouldn’t pay attention to that — it’s a theme that comes up in my work time and again, because for many women, actually paying attention to their cycles and tracking is one of their entry points into finally trusting their intuition, because it’s right there all along. As we draw toward a close, one of the things that jarred me into reality was thinking about what it would be like for homeless women who experience menstruation. Even as deep as I am in this work, that wasn’t something I’d really thought of until the last several years. I think about safety for homeless women a lot, and about the fact that there isn’t always access to menstrual products.

Ila: That’s why I agree there should be free menstrual products — there are women who can purchase them, and women who can’t. And it’s not just about getting menstrual products, it’s about getting good ones, because there are pads and tampons you’ll bleed through immediately. When I needed a pad in high school and went to the nurse’s office, it was the worst pad ever. So when you don’t give homeless women or imprisoned women the same access to good menstrual products, you’re telling them it’s not worth it to give it to them — you’re degrading them by denying them something they need for a natural process. Menstruation doesn’t go easy on you because you’re rich or smart, so it’s important that we accommodate all women who experience menstruation equally, because that’s what they deserve as human beings. And that’s where I get into the tampon tax — it reiterates that inequality between men and women, saying if you want to live as a woman, you have to make up for your existence by paying more, and I think that’s ridiculous, because I shouldn’t have to pay more for something I need when a man doesn’t have to pay more for something he wants.

Lisa: If men menstruated, it would be free, and there’d be this whole big celebrated competitive thing about it. Ila, this has been such an important conversation — I really appreciate you having it with me. I could see your passion, and I understand why, because it’s ridiculous that we even have to have this conversation, as if we were sitting here talking about needing toilet paper in bathrooms. I do believe it will eventually happen, in terms of the practical piece, though when it comes to equality we still have a long way to go. But as long as we keep having conversations like this one, and acknowledging how stigma can play a role across class, society, and religious lines — even within the same culture, experiences can be so different, and we can’t assume everyone is having the same experience as we are. Given all that, what’s the one thing you’d want to leave our listeners with today?

Ila: I want to say there’s no such thing as a weak woman — I’ve never met a weak woman, every woman I know is so incredibly strong, and I think that strength is something all women have, not only to get through something as difficult as menstruation, but to fight for the rights we want at the same time. I want to leave you with hope — in the UK there’s a woman called Amika George who started the Free Periods movement, and legislation in the UK has allowed free menstrual products in all schools for girls. So there are changes being made, and there’s hope.

Lisa: I love that, thank you for helping us end on that note. I see different movements here in Canada too — I interviewed Jana Girdauskas, who started a movement here in Toronto called The Period Purse, providing menstrual products to homeless women and women in low-resource settings. This is why it’s important to talk about it, so we can spread these ideas. Thank you so much for being here.

Ila: Thank you for having me.

Lisa: Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/337. I really enjoyed this conversation and think it’s important to get in there and talk about some of the societal taboos around menstruation, because there are so many women affected by this, whether we’re aware of it or not. Part of my training did involve learning about different religious views on periods and how that can impact the method itself and its effectiveness — for example, if a period of no contact around bleeding required by certain religious practices happens to fall into the fertile window, that matters if you’re trying to conceive. So it’s important to know that there are different practices, different interpretations, different texts that mention menstruation, and different cultural practices — and even within a certain culture or religion, this can be practiced in wildly different ways. Hopefully this episode raised awareness that some women do struggle, some do have to hide their bleeding, and that it can be a bit of a challenge, because if you’re a woman of reproductive age who’s relatively healthy, you’re going to have a regular menstrual cycle — it’s a sign of health — and it’s challenging when that perfectly normal bodily function is looked at in a negative light in some cases, something you have to hide or feel shame around. So it’s good to talk about these issues, with the hope that one day women can just freely menstruate without feeling any kind of way about it — that it’s simply considered a normal, healthy bodily function, and we look at it as just a part of living in a female body. That’s my hope. I feel like periods have certainly come out in the last decade, much more openly discussed in our culture, but even with this newfound openness, the average woman still faces some degree of challenge and taboo around it, in one form or another. With that said, I hope you have a wonderful week, and as always, until next time, be well and happy charting.