Short Abstract:

This study examines strategies for improving menstrual equity in the UK, utilising the Capability Approach to assess and compare UK period poverty frameworks with dignity-centered initiatives in India, Nepal, and Pakistan. The study highlights the need for a multidisciplinary approach infused with dignity to advance menstrual equity.

Long Abstract:

In 2015, menstruation became a pivotal concern within the UK, propelled by the taxation of tampons, censorship of menstrual blood in the media, and the potential toxicity of menstrual products (Gharib, 2015; Sommer et al., 2015). The term, 'period poverty', initially coined by the media as the "inaccessibility to safe and hygienic menstrual products due to financial constraints", quickly became synonymous with all menstrual-related issues (Geng, 2021). Igniting a social movement led by activists, corporations, and politicians in an effort to raise awareness and instigate change. However, nearly a decade on and despite legislative advancements, including the landmark Period Products (Free Provision) (Scotland) Act 2021, menstruation continues to be a source of shame for many. According to a study by Always, 58% of UK citizens feel uncomfortable discussing menstruation, and 2 in 5 young people have faced ridicule due to menstruation (2023).

As an ongoing PhD research endeavour, this paper seeks to explore practical strategies for reducing menstrual stigma and enhancing menstrual health outcomes within the UK. Menstrual health plays a vital role in advancing gender equality across various domains, including education, health, well-being, and societal engagement (Bobel, 2019). Despite its importance, the fundamental right for all menstruators to be able to manage their menses with dignity and safety remains unfulfilled globally and in the UK (Karki and Espinosa, 2018; Plan International, 2018). This research situates itself within the broader global discourse on gender inequalities, and the cross-cutting themes are a lack of dignity, shame, and taboo.

Drawing upon the capability approach, developed by Sen (1999) and expanded upon by Nussbaum (2000), the study transcends traditional economic metrics, focusing instead on 'capabilities' (the freedoms and opportunities people have to be and do the things they value) and 'functionings' (the actual achievements and states of being realised through those capabilities). Dignity is a core concept, encompassing notions of being valued, societal respect, and a life free from shame and discrimination (Alkire, 2007; Sennette, 2003; Hojman & Miranda, 2018). In the context of menstrual health, dignity means having the freedom, resources, and societal support to manage menstruation without experiencing stigma or humiliation, the bodily autonomy to make menstrual choices, and the broader recognition of menstruation as a normal biological function.

The purpose of this project is to (i) evaluate the effectiveness of theoretical frameworks underpinning current UK efforts to address period poverty, (ii) analyse the distinctions between dignity-centred menstrual health initiatives in India, Nepal, and Pakistan, and (iii) develop a multidisciplinary strategy for the UK context that incorporates principles of the dignity approach.

To achieve these aims, the project employs a mixed-methods approach across four phases. Phase 1 includes a thematic analysis of UK policies and media discourse to evaluate the effectiveness of current approaches. Phase 2 involves observations of dignity-centered initiatives in the Global South to identify adaptable strategies for the UK. Phase 3 utilises a survey to capture UK menstrual experiences. Finally, Phase 4 employs art-based focus groups to explore the lived experiences of menstruation.

This paper will focus on the first two completed phases.

Phase one involved a thematic analysis of 5 existing UK policies and 173 articles published by major news media outlets from January 2021 to December 2022. Content analysis and the use of NVivo software were employed to uncover dominant narratives and gaps in the dialogue and action. The analysis identified the following four main themes regarding the discussion on period poverty. Firstly, the issue mainly revolves around the accessibility, availability, and sustainability of menstrual products. Secondly, it is portrayed as affecting schoolgirls disproportionately. Thirdly, it is considered a women's health issue that raises important questions about the role of gender in addressing menstruation. Finally, the discourse reinforces contradictory ideas of concealment, secrecy, and confinement, which can hinder progress towards menstrual liberation.

The second phase included a 1-month field trip for observations and 11 months of remote interactions with organisations affiliated with the Global South Coalition for Dignified Menstruation in India, Nepal, and Pakistan. With a decolonial perspective, the study examined the methods these organisations employ to encourage positive menstrual health practices and counteract stigma. Analysis revealed that the initiatives often adopted an asset-based approach to empower communities to examine their behaviours and attitudes towards menstruation. Moreover, the organisations extensively utilised creative mediums such as singing, arts, and poetry as tools to broach the often-stigmatised topic of menstruation.

This paper underscores the persistent challenges in menstrual health within the UK despite legislative progress. It emphasises the need for a multidisciplinary approach that marries dignity and creative engagement to combat menstrual stigma and enhance equity. Key capabilities highlighted include shifting societal narratives to dismantle stigma and promoting menstrual equity as a core aspect of gender equality and human dignity, urging further action and research in this vital area.

Alkire, S. et al. (2020) ‘Multidimensional Poverty and COVID-19 Risk Factors: A Rapid Overview of Interlinked Deprivations across 5.7 Billion People’.

Always (2023) Breaking Period Stigma with New Report from Always®. Available at: https://www.always.co.uk/en-gb/breaking-period-stigma/

Bobel, C. (2019) The Managed Body. Switzerland: Palgrave Macmillan.

Geng, C. (2021) What to know about period poverty, Medical News Today. Available at: https://www.medicalnewstoday.com/articles/period-poverty

Gharib, M. (2015) Why 2015 Was the Year of the Period, and We Don't Mean Punctuation. Available at: https://works.bepress.com/chris_bobel/31/.

Hojman, D.A. and Miranda, Á. (2018) ‘Agency, Human Dignity, and Subjective Well-being’, World Development, 101, pp. 1–15.

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Sen, A. (1999) Development as Freedom. Oxford: Oxford University Press.

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