On December 4, 2014, the American Civil Liberties Union Of Michigan filed a federal suit against Muskegon County on behalf of eight inmates at its county jail, launching a case that garnered headlines and is still pending today. The women contended that the inhumane and degrading policies at the dirty, overpopulated jail violated their constitutional rights.

Among their primary concerns? A lack of access to clean underwear and adequate feminine hygiene products like tampons, sanitary pads, underwear, and toilet paper.

One of the women involved in the suit, Londora Kitchens, declared: “For example, on July 13, 2014, I was menstruating and was out of sanitary napkins. During this period, Officer Grieves told me that I was ‘shit out of luck,’ and I better not ‘bleed on the floor.’”

The case helped shed light on an issue that has been gaining increasing attention in recent years. This year, the ACLU published a seminal report on reproductive health in prisons that dove deep into issues of menstrual care for inmates, and the issue was also addressed in an Orange is the New Black storyline. More importantly, politicians and lawmakers are starting to take notice; also this year, New York City passed a first-of-its-kind law to improve inmate access to menstrual sanitation products.

This exposure, and the progress it’s engendered, are crucial; women currently comprise the fastest growing population of inmates in the U.S. (with most of them being black and Hispanic), and a lack of appropriate access exposes all inmates who menstruate not only to shame, but to serious health risks.

Two years after that harrowing suit was filed, could we finally be on the cusp of real change?

Rikers Island, New York City’s massive prison complex, is notorious for its abuses against inmates. So it should come as no surprise that female inmates there have complained of being regularly denied access to menstrual products.

At times, this has been because of a limited supply of available products. But inmates have also talked about guards and staff denying access to assert their power.“It’s insulting and there’s no reason for it, except to be punishing,” says Stephanie Covington, Ph.D., L.C.S.W., co- director of the Center For Gender and Justice. In my interview with Covington, she spoke of instances where menstrual hygiene products were actually readily available in the prison facilities, but were willfully withheld by officers tasked with distributing them.

In a report by the Correctional Association Of New York, the vast majority of women interviewed reported that the sanitary napkins given to them were not sufficient enough for their needs. In order to receive additional pads, a special permit had to be to be obtained from the medical department. This practice is not only unjustified, it’s unreasonable, as the reason why many women need more sanitary napkins is not because of some underlying medical condition like anaemia, but because they weren’t given enough in the first place. The poor quality of the state-distributed sanitary products further exacerbates the situation. The report cites an inmate complaining: “My period lasts seven days. . . . Sometimes I have to wear four at a time because they are so thin.”

In a statement included in the ACLU report from this year, a woman incarcerated in California noted:

“Pads are not dispensed as they are supposed to be. We are forced to reuse them, we are forced to beg for what we need, and if an officer is in a bad mood, they are allowed to take what we have and say we are hoarding.”

She further went on to state that women in her jail who were in solitary confinement had it worse. These women were not given any sanitary products at all, and were forced to bleed on the floors that were already soiled with pee and excrement.

In an account of her six-plus years spent at the York Correctional Institution in Niantic, Connecticut, Chandra Bozelko describes seeing pads fly out of fellow inmates’ pants because the adhesives on them failed to stick after several days of wearing a single pad. The only way she escaped having her pads slither down her legs was by layering and quilting together about six at a time. This was “so I could wear a homemade diaper that was too big to slide down my pants. I had enough supplies to do so because I bought my pads from the commissary,” she recounts. But she sometimes couldn’t get the pads, as the commissary only kept them in short supply and kept running out. All female inmates can buy these products like Chandra did, but considering the fact that 72% of them were living in poverty prior to being incarcerated, that often isn’t feasible.

Why are women so routinely being denied this access? Nicholas Turner, president of the Vera Institute of Justice, says the answer lies in a mix of systemic issues at jails and standard-issue misogyny:

“Jail is a ‘man’s world’ in that men make up the majority and women’s needs aren’t on the radar. They are chaotic places, not organized or run to be responsive to needs of people.

This culture tolerates treatment of people as something other than people — in a degrading way. I think the combination of these factors, along with plain old sexism, explains it.”

Stigmas against inmates have also made it difficult for women to find justice on this issue. Indeed, some have argued that it’s wrong to raise alarm about the lack of access to menstrual sanitation because, after all, why should we pamper criminals?

But this line of thinking is problematic on several levels.

A report by the Vera Institute of Justice clarifies that:

“Jails are county or municipality run confinement facilities that primarily hold people who are charged with committing a criminal offence and awaiting the resolution of their cases — and are therefore legally presumed innocent. In 2014, nearly two-thirds of those in jail were unconvicted.”

Some of the inmates are impoverished women who couldn’t pay fines or who were accused of violating their terms of parole/probation. Beyond that, even convicted perpetrators of crimes have an important qualification — a large number of women convicted of assault on a man were abused by the very same men.

In any case, the reason for incarceration is irrelevant; Article 5 of the Universal Declaration Of Human Rights enshrines the inalienable right to dignity, stating: “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.”

Depriving women of sanitary pads and clean underwear not only humiliates them, it exposes them to a number of health risks. Poor menstrual hygiene management practices can cause bacterial vaginosis and significantly increase risks of reproductive and urinary tract infections. Leaving in tampons for long periods of time has also been linked to the potentially fatal condition of Toxic Shock Syndrome. What’s worse, 30% of women who’ve had TSS once will get it again.

It’s even more distressing to realize that female inmates actually need these products more than women on the outside do. Findings of a report published in the Internet Journal Of Criminology revealed that female prisoners experienced a higher degree of menstrual irregularity and symptom distress compared to women in regular communities.

“Officials at every level of government must take steps to ensure that women have adequate access to free‎ feminine hygiene products and health care while incarcerated, whether through federal guidelines, state legislation, or local policies and procedures,” says Elizabeth Swavola, co-author of the Vera Institute of Justice report. “More importantly, government stakeholders must invest in their communities to make treatment and services, including housing and employment, more readily available to women, and their families, to prevent them from becoming involved with the justice system in the first place.”

In July of this year, New York City mayor Bill de Blasio signed into law a measure that would give women in prisons, public schools, and homeless shelters access to feminine hygiene products for free. This followed months of advocacy by council member Julissa Ferreras-Copeland. Under the law, inmates will be given these products immediately upon requesting them. “These laws recognize that feminine hygiene products are a necessity―not a luxury,” said Mayor Blasio in a release.

Though NYC is the first jurisdiction to pass such a law, it’s not the first place to make positive strides on this issue. Last year, Dane County, Wisconsin, passed a resolution that would make menstrual products available in coin-free dispensers in all its public buildings, including its correctional facility. But efforts by Wisconsin State representative Melissa Sargent to introduce a statewide law that would make these products freely available in publicly funded buildings (including both public prisons and private ones receiving funds from the state) failed.

“Women in prisons have become much more of a focal point recently,” Covington, who has provided technical assistance and consulting services to the Federal Bureau of Prisons and many state/local jurisdictions, says. “It’s good people are talking about it, because for many many years, people haven’t paid attention to them. ”

Everyone deserves the right to health and dignity, and as such, access to crucial menstrual hygiene care. How long until our nation’s prison system acknowledges that?