What do you call your private parts, to yourself, to your doctor, in polite company? There are plenty of slang words for the female genitalia—some cute, some raunchy, some silly, some banal—but none of them, not even the scientific-sounding vagina, is quite right.

The term vagina refers to the canal that connects the inner, non-visible organs—cervix, uterus, ovaries—to the visible, outer part, which is the vulva. Often, when we refer to our pussy, hoo-haw, cooter, or vagina, we’re actually talking about is our vulva. Given that “vagina” isn’t —arguably— the prettiest or most exciting word out there, why is that our collective, patriarchal culture insists on using it?

Swedish artist Liv Strömquist wants women to reclaim the word vulva. Or, more specifically, she wants us to—finally—claim it. The illustrator, whose book of graphic nonfiction, Fruit of Knowledge: The Vulva vs the Patriarchy, was released in English last month, aims to destigmatize the female body, especially the vulva, the orgasm, and menstruation.

The 40-year-old feminist activist felt a lot of shame about her body growing up, especially when it came to menstruation. As an adult, she decided to start looking into the taboos associated with the female body. She started asking pointed questions, like, “Where does the taboo around the vulva come from? Has it always looked the same throughout history? How does the taboo around the vulva affect us women psychologically?” she told me via email in early October. “All these things were very interesting for me. I wanted to investigate why there is so much shame surrounding women’s bodies—and in particular the genital parts—in order to change it.”

And then, in 2012, she started turning what she had discovered into Fruit of Knowledge (originally published in Swedish in 2014 as Kunskapens frukt), a cultural history that explores—in edgy, satirical tones and comic-book form—the pathologies, politics, and oft horrifying punishments that female and trans bodies have suffered at the hands of religion, science, and men.    

The meticulously researched Fruit of Knowledge chronicles—toggling between dead serious and drop-dead funny tones—the female body’s mistreatment and mishandling, starting with Eve and winding through history, medicine, pop culture, sex ed, contemporary advertisements, and more.

As graphic nonfiction gains more of a foothold in the literary world, we see more and more serious subjects conveyed in comics form. Here it brings awesome power to a misunderstood and hushed-up topic.

Where does the taboo around the vulva come from? Has it always looked the same throughout history?
Click To Tweet

“So much is communicated with a well-drawn side-eye, angry eyebrows, etc.,” translator Melissa Bowers told me via email. “The first time I read [Fruit of Knowledge] I was either giggling, cringing, or both. I was so charmed by Liv’s simple, expressive drawing style.” Charmed is a surprisingly accurate response to the way Strömquist conveys information. When asked why she chose the comics form to write about such thorny material, she said, “I’ve always really liked comics, since I was a child. If you see a comic in a magazine you immediately want to read it—and this is why I really like this art form. It’s very appealing, not difficult or pretentious. It’s folksy. Articles about feminism and left-wing politics often tend to be very heavy, academic and serious, so I like to make my work fun to read.”

Fruit of Knowledge certainly achieves that artistic intention, turning a gallery of “Men Who Have Been Too Interested in the Female Genitalia” into an informative yet humorous hall of shame, and, in “Blood Mountain,” poking fun at the superstitions around menstruation, while also digging into ancient times, when it “appears that menstruation was MORE holy and LESS icky.”

For thousands of years and across cultures, Strömquist relays, the vulva and menstruation had been integral parts of the sacred landscape—vulvas made their appearance in Greek myth, Egyptian lore, European fables, and notably, monasteries, churches, and village gates in Celtic culture. It was once believed that the female orgasm was necessary (and thus highly valued) for procreation. Sounds a bit different than the way we treat the female body today, doesn’t it?

Strömquist explains the disparity this way: “The very overt hatred and fixation that the monotheistic religions have with the female body and sexuality [arose because religions]—in their early stage—were in competition with fertility cults.”

During the Enlightenment, and with the rise of medical science (and male doctors), those in power had to come up with new theories for female inferiority.

For thousands of years and across cultures, Strömquist relays, the vulva and menstruation had been integral parts of the sacred landscape.
Click To Tweet

Strömquist continued explaining that:

“Science had to try to find explanations as to why women were different from men and couldn’t have the same access to power and money in society. Before they could say, ‘Women have no power in society because that’s what god wants’—but later they had to come up with scientific reasons. That’s when medical science started to obsess on things like the uterus, menstruation and so on.

“In the debate over if women could enter university in the end of the 1800s, there was a doctor who wrote a book that argued that women couldn’t enter university because of their menstruation. If they studied, their brain would use the blood they needed for menstruation, and become infertile. So if women started to study in the university, it would be the end of the human race.”

This might sound extreme to us now, but considering the contemporary struggle to simply close the gender pay gap or support working mothers—how far have we really come? Society continues to use the female body—and its natural functions—against women.

While much of what Strömquist covers in her work relates to the biologically female body, she also fixes her searing gaze on the binary two-gender system, criticizing the surgeries that intersex babies undergo, often in the first weeks of their life, which only serve to “categorize genitals” and “remove sensitive tissues that the person might miss later in life.”

In “Blood Mountain,” the chapter which covers menstruation, Strömquist explores the fallacy of PMS being linked to a particular gender, illustrating her point with a male figure skater lifting a leg to expose bloody panties, accompanied by the captioned thought that if we didn’t live in a binary two-gender society, “I could have drawn the first page of this chapter like this → Or in some completely different way!! Which I am too socially conditioned to even think of!!!”

Social conditioning plays a strong role throughout Strömquist’s work, and she’s keen to exploit that awareness, not allowing how we culturally perceive biology and gender to dominate her art.  

In all areas of her work, Strömquist explores “provocative” subject matter. Last year, her art came under fire last year when Stockholm’s metro commuters found her subway illustrations of women menstruating “disgusting,” while others insisted it was awkward explaining the red stains to their children.

“There was a big debate over my pictures when they were displayed in the Stockholm Metro-station,” Strömquist says.

“They were vandalized twice so they had to be replaced with new prints. There was a political debate, where the populist right-wing party in Sweden wrote an article criticizing the use of tax money to support this kind of art and promised that if they got in power they would replace this kind of art with pre-modern oil painting. People still have quite strong feelings about [menstruation], which I find interesting.”

Despite the controversy over her artwork, she also “received a lot of support and positive reactions” for depicting menstruation—something that happens to millions of bodies every day—in a celebratory public forum.

Strömquist currently lives in Malmö, where she works for a youth radio station and hosts a political podcast. She has two new books in the works. One, a comic titled “Rise and Fall,” covers “climate change and problems of world capitalism.” The other is “a book about the social construction of romantic love,” which she hopes to see published in English as well.

In her chapter, “Upside Down Rooster Comb,” where she quotes Sartre and The Latin Kings, Strömquist also cites psychologist Harriet Lerner, who has been writing about the consequences of mislabeling the vulva as the vagina for decades. Lerner “likens this misuse of language to ‘psychic genital mutilation.’”

Whereas the vagina is often described in terms of absence, “a ‘hole’ waiting to be filled with a cock,” the vulva is very rarely mentioned—in conversation, and even in biology textbooks.

We are literally discouraged from properly naming the vulva. “If we don’t have the words,” Stromquist says, “we cannot understand what the organ is or how it looks and works. Words are really important. In many languages there isn’t even a proper word for the [female] sexual organ—one that isn’t an insult.”

Imagine being encouraged to call your arm your hand, or being told your entire life that your toes are your leg. This kind of senseless mislabeling encourages confusion, avoidance, and embarrassment, all of which prevent many people from treating the vulva with the respect and veneration it deserves.

If we don’t have the words we cannot understand what the vulva is or how it looks and works.
Click To Tweet

Given the current political climate in the United States, Strömquist’s vibrant, excoriating work is more necessary than ever. Fruit of Knowledge is the kind of self-care Western culture needs—accessible, intelligent, and engaging renderings of culture and history—that provide the encouragement to help us finally name and reclaim the female body.

I want to clarify that “middle school” is not a topic that I willingly return to. For me, middle school was a time of bubblegum caught in braces, hormone-charged crushes, and embarrassing growths of every variety. It was also a time when my school first began tackling that universally blush-worthy topic: the human body. I recently spoke to a few of my male friends about their middle school sex education. And honestly, what the hell were they learning?

At my school, the boys were segregated from the girls when the time came to broach the puberty talk. I asked my male friends about sex education because I wanted to know what went on in their separate room. In the “girls room,” we talked about menstruation and were given little period packs filled with tampons and illustrated pamphlets. According to them, the boys had discussed puberty, sexual feelings, and morning erections. The school tailored the talks to the students’ anatomy. In the same way that I didn’t learn about penises and what happens to them in the morning, the boys didn’t learn about vaginas and what happens to them every month.

There were other differences, too. In the room I was in, unlike in the “boys room,” we didn’t talk about the normalization of sexuality, as if the absence of erections cancelled out the possibility of sexual feelings. I, and the girls in the room with me, didn’t talk about sex or dating in a classroom setting until three years later, when all eighth graders had to take a mandatory health class.

At the time, I didn’t think much about the gender separation, and it made sense that we were put in different rooms to discuss the issues that affected us. Like most everyone, I’d been taught from a young age that periods happen to girls and boners happen to boys—a reductive, cisnormative view that, among other issues, erases and stigmatizes the experiences of transgender children. Associating menstruation exclusively with girls can be particularly damaging to trans boys, who may already feel uncomfortable with their periods.

As I’ve grown older, I’ve come to understand other ways, too, in which this enforced segregation can have negative impacts. For instance,I was embarrassed buying tampons when my cashier was male. I didn’t like talking about my period around guys — although I would shamelessly use “period cramps” as an excuse not to participate in gym class (you could almost see my male gym teacher visibly shudder when the word “period” was mentioned). I internalized that periods didn’t just happen to girls, they were not to be acknowledged around men.

My discomfort discussing my period around men hinted at a broader question: Would I still be embarrassed if boys had been present in the room when I learned about menstruation?

I internalized that periods were not to be acknowledged around men.
Click To Tweet

I believe that the answer is no. Segregating boys and girls during sex education sessions contributes to a culture in which periods are seen as taboo to talk about with men, or indeed in public at all. During my middle school experience, the physical separation of the girls and boys created the impression that periods are a topic to be discussed solely among women. It is this physical separation which directly contributes to a culture of stigmatization around the topic of menstruation.

The concept of separation leading to stigmatization also works in reverse: Stigmatization leads to separation. In certain communities, cisgender girls and women are required to live in a hut outside of their villages while they are menstruating. In India, for instance, the Gond and Madiya ethnic groups banish menstruating women outside the boundaries of the village for the duration of their periods (Kaur, “Banished for menstruating: the Indian women isolated while they bleed”). Last year, in Nepal, an 18-year old girl died of a snakebite that she sustained while isolated in a “menstruation hut” (Bhandari and Nashar, “Shunned During Her Period, Nepali Woman Dies of Snakebite”). In India and Nepal, women are placed into dangerous situations because of menstruation’s stigmatization.

The shame associated with menstruation also plays a part in religion. In traditional Jewish and evangelical Christian communities, a woman who is on her period is untouchable. According to Chapters 15 to 18 of Leviticus, if you touch a menstruating woman, you become “tum’ah,” or “impure.” The notion that menstruation is impure highlights its stigma. The enforced, unseen boundaries of menstruating women from those around them transforms internal stigma into physical separation.

How Sex Education Fails Queer And Trans Kids
theestablishment.co

The twinned relationship between separation and stigmatization exists because of cisgender male aversion to menstruation. From a young age, boys’ lack of education about the topic leads to discomfort and even prejudice. In 1986, when Dr. J. Brooks-Gunn and Dr. Diane Ruble analyzed the reactions of college-age cisgender men and women to menstruation, they found that men, who had an inferential understanding of menstruation rather than an experiential understanding, believed that periods were more debilitating than women did. The male participants also believed that periods affected women’s “moodiness” more than the female participants. These viewpoints feed into misogynistic tropes about women: they’re moody or “hysterical;” they won’t work as hard as a man on the job because of their “debilitating” periods.

Since the 1980s, there have been a host of other studies that have confirmed that the way men and women perceive menstruation is different, and that men see periods more negatively. In 2016, three decades after the study conducted by Brooks-Gunn and Ruble, Tamara Peranovic and Brenda Bentley found that when male respondents were growing up, they saw periods as “taboo,” and shrouded in secrecy. This impacted their openness to discussing periods as adults, and led them to believe that periods were a “woman’s problem.” Similarly, Brooks-Gunn and Ruble’s study posits that the difference between how cis women and men see periods is due to information asymmetry. Interestingly, certain male respondents in the Peranovic and Bentley study were “dissatisfied with the education they received” about periods.

From a young age, boys’ lack of education about the topic of menstruation leads to discomfort and even prejudice.
Click To Tweet

From my own experience as a teenager, I gathered that periods are seen as “dirty,” and are considered a “dirty” topic to talk to men about — my gym teacher’s wince was enough to teach me that men don’t like to think about menstruation. But why should that be the case? Menstruation is a natural function that affects half of the world’s population on a regular basis.

The way that sex education is organized depends on the state. Each state decides on its own sex education policy, and bills concerning sex education have to pass the state legislature. Currently, 24 states and the District of Columbia require public schools to teach sex education, and 33 states and the District of Columbia require students to receive instruction about HIV/AIDS. Decisions on how to actually approach sex ed, however, are mostly left up to individual school districts. It’s difficult to ascertain how many schools segregate puberty talks, or whether schools are even offering puberty talks.

Despite this, parsing the psychological literature about male and female attitudes towards menstruation demonstrates that men and women usually do not receive the same information or education about menstruation. Negative male attitudes towards periods, therefore, are largely down to information asymmetry or lack of male education on the topic.

Alaska’s New Sex Ed Law Is Both Ludicrous And Harmful
theestablishment.co

It’s time to de-segregate sex education so that cis women no longer feel embarrassed about a natural, biological process. What’s more, de-segregating the sex education space should work both ways. Girls should learn about sexual feelings and male puberty in the same ways that boys do. That way, natural cis male experiences, such as voice drops during puberty, are less likely to be ridiculed by those who do not understand the biological underpinnings of the phenomenon. Demystifying the human body contributes to an open culture in which questions are encouraged and bodies are no longer seen as a source of shame or embarrassment.

Those who favor gender segregation during sex education claim children will feel more comfortable asking questions about their bodies if they’re separated from children of the opposite sex. This viewpoint, however, not only enforces the idea that one should only be comfortable talking about one’s body around those of the same gender, but excludes the experience of transgender and nonbinary students. Educating children about sexual education in the same space ensures that nobody feels misplaced or excluded.

For those who feel this is sure to cause embarrassment, there are strategies. Some schools offer an anonymous question service where students have the opportunity to write their questions on a slip of paper for teachers to answer at the end of the sex education session. Sex ed teachers can hold office hours for students to ask questions they may not feel comfortable sharing with a group. Using these strategies, nobody has to feel embarrassed asking a question, and students of all genders can hear the answers.

The conversations we have with children affect the adults they become. Periods are nothing to be embarrassed about, and if students of all genders were taught about menstruation at the same time, women might not be so uncomfortable discussing their periods in front of their male counterparts — and men might not be so uncomfortable hearing about it.

So, when teaching students about sex education, let’s tackle the body’s processes in a more inclusive way. That way, middle schoolers can focus on the truly embarrassing things in life, like pimples and parents.

‘I promise you it’s totally possible to get rid of cramps through exercise.’

Editor’s note: The following is a satirical piece designed to lambaste despicable ideas surrounding reproductive anatomy, menstruation, and gender. To that end, it utilizes some cissexist and heteronormative language. As we’ve heard from readers since the piece’s publication, some usages of this language, sans the proper editorial note(s)/overt satirical markers, are erasive to some people assigned female at birth. We apologize for any harm caused and will aim to be more inclusive in our editorial process going forward.

Well, actually, I read that there’s no such thing as PMS. What happens during, you know, that time of the month, is that your body is reacting to a number of complex sociopolitical factors that make you think you’re experiencing cramps, headaches, and mood swings, but there’s no scientific basis for it. I don’t know if you’ve heard of the Stanford Prison Experiment? Basically, a bunch of Stanford students were assigned to be guards, and other students were prisoners, and the guards ended up waterboarding the prisoners and all this wild shit. They were trying to study Naziism, but if you think about it, it also explains why so many women think they have PMS. People are pretty suggestible—most of them will believe anything you tell them.

You might not have realized that you can actually die from tampons if you leave them in too long. There’s this disease called tampon shock syndrome that basically causes your whole body to go into shock. This one girl lost her leg. You’re supposed to change your tampon every one to two hours, during your, you know, red sea, so you don’t get TSS. Like how guys have to shave every day or we end up with a 5 o’clock shadow. Sometimes it’s hard to remember things like this, but I’ve found that the more you apply discipline to one specific area of your life, the more disciplined you become overall. Have you read the Tim Ferriss book The 4-Hour Workweek? It’s about how you can actually fit a week’s worth of work into four hours. I think you’d dig it.

Well, actually, the reason tampons are taxed is that they’re non-essential goods. Like candles. The way to tell whether something is essential or non-essential is to ask yourself: Would I die if I didn’t have this? There are other ways to deal with your, you know, barbecue sauce bath, that aren’t tampons, so that makes them non-essential. Another way taxation works is that it’s used to disincentive certain behaviors. Like, for instance, there’s a tax on cigarettes because smoking gives you lung cancer. Are you familiar with how supply and demand works? Basically you draw two lines — the supply curve, and the demand curve — and where they meet is called the point of parity. Basically, if there were no tax on tampons, demand would outstrip supply, and then prices would skyrocket, and you’d be way worse off.

Trust me on this — I read that some tampons are actually made with hay and dental floss, because they’re cheaper than synthetic fibers, and they work just as well, for stopping the, you know, crimson tide. There’s this concept in economics—my sophomore year roommate actually minored in Econ—that explains that manufacturers prefer to use cheaper raw materials to maximize their profits. Like, if I were a chef, I would buy slightly expired ingredients, because they’re cheaper, and that won’t really affect the quality of the food. I found out that you can actually drink milk more than a week past its expiration date. Tim Ferriss talks about that in The 4-Hour Chef, which is pretty much my bible for weekly meal prep. If you want to start eating healthier, you should definitely check it out.

You probably didn’t realize that in some countries, women are ostracized during their, you know, lady leakage. They have to wear these red cloaks with white bonnets, and they’re called handmaids for those few days. That part is just in Syria. Actually, women used to be ostracized in the U.S. too. It makes sense, if you think about it, because of all of the estrogen. I read that large amounts of estrogen in the human body are actually more dangerous than large amounts of testosterone. In women’s prisons, the cycles of all the inmates actually sync up, and the guards have to be careful about riots. That’s what happened in this documentary I saw, Orange Is the New Black.

I promise you it’s totally possible to get rid of cramps through exercise. What’s the lady Advil called? Midol? Too much of that stuff can kill you. And it doesn’t actually work, either. I read it had the same effect as a placebo in a study of a dozen women who had their, you know, female flood. Exercise usually does it for me when I’m not feeling great. Have you read The 4-Hour Body? You might actually find it helpful. Tim Ferriss talks about how you’re supposed to work different muscle groups on different days, otherwise the lactic acid builds up, and your muscles explode. It happened to this one guy who did too much CrossFit. But I’d definitely recommend the book. Switching up your workout routine can actually help reduce body fat too.

Well, actually, prostate exams are supposed to be a lot more painful than cramps. A lot of men rate them as a nine out of 10 on the pain scale, which is one away from a 10. I think guys just talk about it less when we feel pain, you know, because of how we’ve been socialized. It’s way more socially acceptable for women to complain about cramps during, you know, your scarlet spillage. But when we drink milk that’s gone bad or something and our stomachs are completely messed up, we’re just supposed to grin and bear it. I actually don’t think epidurals would have been invented if men were the ones who had babies. It’s another one of those mind over matter things, you know? I could totally give birth if I had to.

It was a long and winding road that led me to the basement of a 19th century stately house in Brussels for my initiation. Lined along a narrow stairwell leading down to the basement with 40 or so other women, all in bare feet, all waiting in silent awe for Miranda Gray to personally welcome us into the Moon Mother sisterhood, I began to wonder, how did I get here? And why had I already begun to wish I had never come?

It all started with my 10-year devotion to hormonal birth control. To me it was man’s greatest invention, providing welcome relief from monthly cramps that left me prostrate in bed for three days, alternately fainting or vomiting. At 28, however, I had the sudden impulse to find a more natural solution to my menstrual woes. I came off the pill, bought myself a menstrual cup, and began exploring yoga, herbs, a life without coffee (temporarily), full moon circles, Red Tents, and natural gynecology workshops. I read everything I could get my hands on that promised to reset my dysfunctional cycle, including Red Moon by Miranda Gray.

I became a doula and began accompanying friends through pregnancy, abortions, and gynecological disorders including endometriosis, PCOS, and uterine cysts. The more I accompanied these processes the more convinced I became of the need for us to reconnect with our bodies and recover our autonomy. So when a training to become a Moon Mother — someone (usually a cis woman) who feels a particular devotion to the “divine feminine” and feels called to accompany other women with similar spiritual leanings, and to host individual and group Womb Blessings and Womb Healings — coincided with a family visit to Brussels, I put my skepticism aside and signed up for the two-day initiation into the world of Womb Blessings.

Somewhere between the initiation ceremony and the prescribed activity of coloring in a menstrual cycle mandala, I began to feel increasingly uncomfortable. Uncomfortable with the biological essentialism that was being preached from a pulpit adorned with crystals and porcelain fairies, with the idea that my whole world should be centered around my womb and its monthly whims, and with the imperative to embrace the “divine feminine” and rediscover my “authentic femininity,” as if my authenticity and my womb were one and the same.

Somewhere between the initiation ceremony and the prescribed activity of coloring in a menstrual cycle mandala, I began to feel increasingly uncomfortable.
Click To Tweet

Discomfort turned to anger as we were repeatedly told that our “women’s problems” stem from being disconnected and alienated from our wombs, our authentic femininity having been suppressed in us as children by both our families and wider society. There was never any mention of the system that causes this disconnect — you know, the white imperialist, capitalist, hetero- and cis-normative patriarchy that has forced us into binary conceptions of gender and sexuality, and submitted us to a multitude of oppressions. Only that our wombs held the answers to all our problems.

I was baffled by this omission. Perhaps the existence of structural violence, inequality, and reproductive injustice was taken as a given? Perhaps it was unnecessary to mention the many factors that harm our bodies, regulate the functions of our uteri, and determine who or what can enter and exit our vaginas? Superfluous the discuss things like violence, discrimination, sexual abuse, rape culture, lack of access to contraception, adequate health care and comprehensive sex education, restricted or criminalized abortion, and personhood laws that impact the lives of menstruators and pregnant people across the world on a daily basis?

Perhaps this was all just too messy, political, and depressing for a space that focused on “purity and grace,” where the answer to “women’s problems” was to build a global legion of empowered women vibrating with the divine feminine womb energy, spreading love, light, and kindness wherever they go? I could have done with a bit less purity and a lot more mess, so I decided to cut my losses and leave.

I never expected I’d be so angry and frustrated with what was supposed to be an empowering women’s retreat. For a long time I wondered if I was too cynical, or if angry feminist activism had taken me too far. Or is there something at the heart of menstrual spirituality that just doesn’t sit easy with my feminist principles?

Chris Bobel, in her book New Blood (2010), characterizes the menstrual spirituality movement as a branch of feminist activism that began in the 1970s and continues to the present day, despite occupying a marginal, if not irrelevant, position within feminism. It is led by mostly white, middle class, cis, able-bodied women, who use books, websites, workshops, retreats, womyn festivals, Red Tents, and full moon circles to reach their followers, blurring the lines between spiritual leaders, healers, artisans, and entrepreneurs.

Miranda Gray is just one purveyor of menstrual spirituality. The book that launched her career as a menstrual guru, Red Moon, was published in 1994. Gray has since published three more books, developed her own menstrual tracking app, The Flow, gives multiple Moon Mother, Red Moon, and other trainings across the world each year, and hosts five global Womb Blessings a year via meditations that can be downloaded from her website. According to Gray there are currently more than 3,000 practicing Moon Mothers across 60 countries and and an estimated 180,000 women participating in each Global Womb Blessing. As global women’s movements go, it is not insignificant. It’s relationship to feminism, however, is questionable.

Why We Must Stop Calling Menstruation A ‘Women’s Issue’

I spoke to other Moon Mothers and discovered that I am not the only one to have come out the other side with doubts.

Cecilia Perez is a founding member of a local collective, Guatemala Menstruante, which educates members and others on issues relating to menstruation and sexual health, provides educational workshops on the menstrual cycle, advocates for youth sexual education, and makes and distributes pads in Guatemala City.

Cecilia became a certified Moon Mother in 2016 at a training in Colombia. She was interested in the training as a way to develop new skills for accompanying women in Guatemala. “I had no kind of accompaniment or training when I started out with Guatemala Menstruante, we just learned as we went along, reading whatever we could and sharing experiences,” she says. “Reading Red Moon, it was great to see that someone else had been working on the same issues.”

Don’t Judge A Girl For What’s Between Her Legs

Orlagh McIlveen is an engineer from Ireland and a certified Moon Mother. She has a history of disruptive menstrual problems and, for a long time, used hormonal contraception to correct them. Following a miscarriage in 2015, she began searching for ways to heal and feel better about her body and her womb. “I read a lot, including books by Miranda Gray. I decided that since Miranda was coming to Ireland for the first time, I would go along,” she says. “I didn’t fully understand what a Moon Mother was, but I’m very glad I did it. (…) Connecting with other people with negative menstrual experiences and linking with other people who had miscarried or had trouble conceiving is very helpful for me.”

While both Cecilia and Orlagh remain connected with the other Moon Mothers, and offer individual and collective womb blessings on a voluntary basis or as part of their general accompaniment, they also express doubts around the tendencies toward essentialism and universalizing the “female experience,” the lack of inclusion of diverse identities, and the accessibility of the trainings.

Orlagh questions the movement’s strong aversion to hormonal contraceptives. “[They] are very useful for all sorts of reasons, and while they can disrupt the body’s normal hormonal systems, that’s kind of the point. A focus on ‘only what’s natural’ is fine if that works for you, as an individual, but not as a blanket, ‘This is the One True Way’,” she says.

Regarding the participation of trans women, queer, and non-binary folk, both Cecilia and Orlagh agree that while the Moon Mother movement does not define itself as trans-exclusive, the language and concepts used are couched in binary conceptions of gender and essentialist assumptions around women’s biology. According to Orlagh, “while Miranda is very clear that the womb blessing is for anyone with womb energy, rather than anyone with a womb, I think it needs to be clearer that this is not a trans-exclusionary movement — because for some people within the menstrual spirituality movement it is. [They] make claims of difference between ‘real’ women and trans women (…) The odor of TERF-ism [that] surrounds the movement as a whole really needs to be addressed.” In their practices, Orlagh and Cecilia are clear that participation is open to people of all identities, minus cis men.

The odor of TERF-ism that surrounds the movement as a whole really needs to be addressed.
Click To Tweet

Orlagh and I both also questioned the accessibility of the trainings we attended. While in Colombia the five organizations involved in hosting the event went to great effort to ensure women from across the country, including indigenous women and women of African descent, could participate, helping with travel, accommodation, and fees — but these considerations were apparently absent from either the Brussels or Dublin training. Orlagh says, “The cost of the training in itself will exclude many people from participating. I wish there was a way make it more accessible to everyone, not just those who can afford the hundreds of euros for the course, plus travel and accommodation. (There is a 10% discount for those on benefits, but it’s still a very hefty sum).”

More than 40 women attended the workshop in Brussels, each paying 225 euros and above, depending on the package they opted for. The workshop ran over Monday and Tuesday, which meant either you were on holidays, like me; a student; could afford to take two days off work; or could make suitable childcare arrangements. These factors might, in part, explain why participants in the Brussels training were predominantly white and middle class. According to Bobel, this participant profile reflects the overall trend in the movement: of all the menstrual spiritual activists Bobel interviewed for her research, 92% were white and 78% self-identified as middle or upper middle class.

If you add up economic accessibility, the essentialist overtones, and the majority participation of white women, what you are left with is a movement defined by rather considerable privilege with poor capacity for self-reflection or criticism. That this privilege so often goes unchecked in these circles also leads to widespread cultural appropriation. It is common for menstrual spiritual gatherings to take place in Red Tents or Moon Lodges, and for participants to be adorned with bindis and their spaces decorated with mandalas, yin yang, OM, and other “exotic” spiritual symbols. This mix and match of different cultural practices, rituals, and spiritual beliefs often occurs removed from their original context, with a minimum awareness of their spiritual meaning, and used for the benefit of people who have little or no connection with the culture or spirituality.

Pagan feminist Lasara Firefox Allen is a harsh critic of cultural appropriation in feminist spirituality, and insists on the need to decolonize spiritual practices. “For white people it means (…) paying attention when someone says that you are practicing their tradition without consciousness, relational awareness, or consent. It means taking seriously the topic of appropriation,” she writes in Jailbreaking the Goddess: A Radical Revisioning of Feminist Spirituality (2016). “It means not casually ‘god collecting,’ or cherry picking from the spiritual systems and cosmologies.”

Bobel is equally critical of the tendency toward cultural appropriation. She writes in New Blood:

“When it feels good, traditions of their culture can be deployed in the service of our self-improvement. To demarcate and sustain these separations, race and class privileges are invoked, though often not consciously. Indeed, unspoken privilege is the engine that propels feminist-spiritualist menstrual activism. The project of self-improvement, after all, is itself a privilege and one that takes cultural capital to enact.”

Despite my discomfort and cynicism regarding the Moon Mother experience, it became quite clear to me over the course of my day at the workshop how moved the women around me were, how deeply they needed a space where they could connect with their own bodies and other women.

I am sure that if I had done the training two years previously I probably would have felt the same. I had my Red Moon moment at the very beginning of this journey, when celebrating, rather than cursing, my period was still a mind-blowing concept. Cecilia and I both agreed that it was a necessary step in overcoming all the shame and aversion to our menstruation and our bodies that had been drilled into us from an early age.

But it was just a moment. As we kept learning, reading, sharing with other women, and participating in feminist activism, we became more aware of diverse identities, and of the daily challenges many women face that prevent them from “embracing their menstruation,” “flowing” with their cyclical energies, or discovering the “divine feminine.”

Why We Need To Talk About Queer And Trans People And Birth Control

Bobel’s principal critique of the movement is that it rarely, if ever, transcends “life politics,” instead remaining rooted in the individual search for self-improvement that is accessible to few. Furthermore, it sidesteps or ignores uncomfortable truths about the nature and origin of women’s oppression. Nevertheless, you could argue that the very act of gathering women together to learn from each other, share experiences, improve their body literacy, and recover autonomy over their sexual and reproductive health is in fact profoundly political.

Cecilia’s experience, and the spread of menstrual spirituality across the Americas, also challenges the assumption that this is a movement only for white, western, middle class women. In her accompaniment of people through pregnancy loss and gynecological illnesses, she focuses on helping them reconnect, heal, and overcome feelings of guilt, largely influenced by the culture of shame and secrecy that surrounds all aspects of sexuality in Guatemala. These actions defy the patriarchy’s attempts to keep us separate from each other, in competition with each other, and firmly within the control of the medical industrial complex.

The challenge is to ensure that our actions transcend the individual goal of self-improvement toward collective social actions. To use the energy generated in these gatherings to support our activism around sexual health and reproductive justice and in breaking down gender binaries. These spaces cannot, therefore, be void of a feminist political analysis that situates our personal experience within the context of a global system of repression and struggles for reproductive justice. It is only through that analysis that they will become truly inclusionary.

In Naturalis Historia, the Roman naturalist Pliny the Elder wrote that period blood has the power to stop whirlwinds, kill bees, and drive dogs mad…

If you feel compelled to chuckle, keep in mind that nearly 2,000 years later, menstruation is still shrouded in myth, taboo, and beliefs that are nearly as bizarre as what ‘ol Pliny was peddling.

In fact, the actual science of why people have periods is almost stranger than the myths. And while periods are part of the everyday lives of over half the population, the answer to the simple question “why do they exist?” is far from being common knowledge.

Humans — along with old world primates and certain types of bats — are one of the few species on Earth that menstruate. In these species, a drop in the levels of the hormone progesterone triggers the breakdown of the inner lining of the uterus. What follows is an extraordinary process of scar-free wound healing. The uterus can break down and regenerate every month, hundreds of times in a lifetime — all without ever leaving a scar.

This incredible process is practically unheard of in adult tissues, but, as many of us know, periods can also be debilitating. So biologists have been puzzled as to why this phenomenon should have evolved. And, more specifically, why did it only evolve in humans, old world primates, and certain bats?

Recent research suggests that the answer lies in an ancient conflict. It’s in the best interests of the father (or parent providing the sperm) for the mother (or parent providing the egg) to pour as much energy and resources into pregnancy as possible. But it’s in the best interests of the mother to balance the needs of pregnancy with maintaining their own health. In humans, this conflict has left its mark on our very DNA.

We each have two complete copies of the human genome: one paternal and one maternal. Usually, the two copies are equally active. But sometimes, the father or mother modifies their copy so that certain genes are “off” — most of the genes that are modified in this way are involved in fetal growth.

Herein lies the rub.

If both copies of those parental genes were active, the fetus would grow abnormally large. So, in the copy of the genome she provides, the mother’s body gets the hell in there and shuts those genes off.

Likewise, there are certain genes that repress growth, and if both copies of those genes were on, the fetus would be abnormally small. The father goes in and shuts those genes off. The size to which the fetus will grow is ultimately determined by this genetic tug-of-war.

This conflict has also driven the evolution of a particularly gruesome kind of placenta: the hemochorial placenta.

Some types of placentas don’t invade maternal tissues at all. But the hemochorial placenta — which all menstruating species have — burrows through the walls of the uterus and hooks into the mother’s bloodstream. Once the invasion is complete, the placenta can control the mother’s entire body by releasing hormones into her blood. So it was necessary for people with wombs to develop a defense system to mediate placental invasion.

This was particularly crucial because of another strange quirk of human biology: Human embryos are 10 times more likely than other mammals to carry an abnormal number of chromosomes. Some variation in chromosome number can be tolerated: For instance, three copies of chromosome 21 in Down Syndrome or only one copy of the X chromosome in Turner Syndrome. But in general, embryos with large parts of their genomes missing or duplicated will not be able to develop.

Why We Must Stop Calling Menstruation A ‘Women’s Issue’
theestablishment.co

Because so many human embryos are actually inviable, our species has an incredibly high rate of miscarriage. Fifteen percent of clinically recognized pregnancies end in miscarriage, but counting pregnancies that aren’t clinically recognized, that number is actually closer to 50%. Unfortunately, society tends to tell pregnant people that something is wrong with them if they experience miscarriage, when really, a high chance of miscarriage is just part of being human.

Periods result from an adaptation to those two things: the invasive, hemochorial placenta and the prevalence of chromosomal abnormalities. One thing that humans, old world primates, and menstruating bats all have in common is a phenomenon called “spontaneous decidualization.”

Decidualization is the remodeling of the uterine lining that occurs in preparation for pregnancy. In other animals, decidualization is triggered by the presence of an embryo, but menstruating species have taken control of that process. In these species, decidualization occurs cyclically, whether there is an embryo or not.

A high chance of miscarriage is just part of being human.
Click To Tweet

So why is this a good thing? Here’s why. Many people believe that the uterine lining thickens and changes in order to provide a hospitable environment for an embryo, but that’s not the whole story. Once the cells of the uterine lining turn into decidual cells, they gain the ability to sense whether or not an embryo is developing normally, even before it implants. If it is, the cells permit the invasion of the placenta. But if it’s not, the cells quickly self-destruct. By making the transformation into decidual cells occur cyclically, our species has made sure it’s prepared to defend against potentially harmful pregnancies before the embryo implants.

Some biologists argue that periods are just the coincidental result of combining spontaneous decidualization with cycling hormone levels. Once cells are decidualized, a drop in progesterone will trigger them to self-destruct. And, so long as pregnancy doesn’t occur, progesterone levels rise and fall each month.

It makes sense that periods might not have intrinsic benefit, because in the natural state, periods are pretty rare. Our ancestors, who were more frequently pregnant, only had about 40 periods in a lifetime. But some biologists think that menstruation does have intrinsic benefit. Because the uterus is able to repeatedly break down and rebuild itself, it may be able to learn from previous reproductive events and adapt. If this is true, it might explain why most pregnant people who experience miscarriage eventually go on to successfully conceive.

Menstruation is, in many ways, a potent symbol of the socio-cultural stronghold the patriarchy still wields. In a society that has become increasingly inured to the ubiquity of sex and violence, periods remain largely unmentionable, further complicating our long history with the uterine lining. But I tend to believe that — although he may have been oh-so-wrong in the specifics — Pliny the Elder was damn right when he wrote “over and above all this there is no limit to woman’s power.”

My chronic illness made it impossible for me to have both a menstrual cycle and a life.

“Maybe I should stop my periods.”

It wasn’t something I had ever before considered and I had, in fact, wondered if there could be potential, unknown, long-term ramifications when friends of mine stopped theirs. I had never considered my periods an inconvenience or gross or annoying; in fact, I had liked the rhythm of them. The times I had been on birth control I resented how it made me feel divorced from my body.

When I asked this question, I was sitting in my doctor’s office, nine months into antiviral treatment for chronic fatigue syndrome, 11 years after starting treatment for Lyme disease. The previous year had been hard. Though I had been significantly healthier than I’d been in a long time and had started running again, working hours that were closer to full-time and going out with friends, every month, in the week before my period, I collapsed.

In these weeks, I felt ragged, frayed; the simple act of my body functioning with regulatory actions felt like too much of a drain. My life required too much of me in these weeks and I’d stumble through work, cancel plans, and do as little as possible. I’d get cold and not be able to warm up again, no matter how many burning hot showers I took; fevers would flash through me, but I never retained the heat and I’d collapse in a heap of fatigue, wracked with fevers and chills, muscle pain, sore throats, and mental confusion again. When my cycle was over, I’d be better than I was during the flare-up but worse off than I had been before my period. Every month, I’d take another step down in my health.

I always wonder how to describe a fatigue so profound it feels like a weighted shroud, especially as so many doctors have not believed me. This is not just being tired, it’s a fatigue of dangerous proportions that feels like an emergency in my body, threatening to take me down again. When I was finally diagnosed with chronic Lyme disease, I’d been sick for over 11 years — 11 years of doctors who refused to believe that I wasn’t just seeking attention, 11 years of worsening chronic fatigue and tick-borne illness. These are diseases that, when not addressed, become steadily more serious and more difficult to treat.

The Hidden Battle For The Rights Of Chronic Fatigue Syndrome Sufferers

When I was 24, I moved back in with my parents, deep into third-stage Lyme. My hairline had receded dramatically, deep purple rings dragged on my always bloodshot eyes, my skin had gone gray and papery. My body was wracked with so much pain it felt like simple daily use of my joints was causing them to degenerate. I wondered if I would be able to walk in three years. I couldn’t follow conversations, words had lost significance for me, I could no longer read. My inability to engage with the world mimicked that of my grandfather’s Alzheimer’s Disease. I was so tired that I hadn’t laughed in years.

A decade-plus of treatments has stripped me of most of the worst effects of CFS and Lyme (the symptoms often overlap) and returned me to living a life more fully than I had ever been able to before. But I still declined each month with my period, and never quite got back to where I had been before the decline. I was doing better than I had been before I started my antivirals, I told my doctor, but I felt that I would never be doing well — unless I stopped menstruating.

My doctor, Jennifer Sugden, N.D., had treated me for Lyme and CFS with a variety of different protocols, including hormone replacement therapies. But I’d never suppressed my periods before. I had always collapsed the week before my period, but I thought that this was one more thing that would resolve as I got better. Instead, it seemed that the hormone changes around menstruation would always be an Achilles heel.

This is a common experience among patients with Lyme and chronic fatigue syndrome and some other tick-borne illnesses. Dr. Sugden says that when she discusses Lyme and CFS within the medical community of Lyme-literate doctors, they talk about how “women are typically harder to treat and some women really decline before or with her period.” Jose G. Montoya, director of the multidisciplinary division of Stanford’s Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Initiative, concurs, saying that “this phenomena is really pronounced in some women. You don’t have to dig this [information] out…that is so clear in some cases, that the disease is significantly worse right around their menstrual cycle.” He acknowledges that “we will have to be treating women and men differently, there is no question.” (It’s important to note here that menstruation is not just a “women’s issue,” and can affect trans and nonbinary bodies as well.)

So far, the research on ME/CFS has been meager at best and without a focus on female endocrinology. Stanford’s ME/CFS Initiative is currently recruiting subjects for a neuroendocrine study with women of child-bearing ages to hopefully give some answers on this subject. Eventually, Dr. Sugden says, “it wouldn’t surprise me if stopping periods becomes a part of protocol.”

So what is it about periods that can compromise some patients with ME/CFS and tick-borne illnesses so dramatically? Dr. Sugden points to an underlying problem: overworked adrenal glands. The adrenals produce cortisol, which regulates our circadian rhythm, and DHEA, which is the building block to produce estrogen and progesterone. “It’s having to produce DHEA on a cyclic pattern when the adrenals are not strong enough to produce it on a monthly cycle,” Dr. Sugden says about the monthly decline some people experience. “But when you replace the hormones and suppress periods, the glands can focus on healing themselves. You allow the adrenals to NOT produce DHEA and your body can produce cortisol at the rate it needs to.”

My doctor said it wouldn’t surprise her if stopping periods becomes a part of chronic fatigue syndrome protocol.

After three months of supressing my periods, I realized that I hadn’t had any extreme crashes in my health. While I wasn’t fully well, my health was steadier and I was incrementally getting better. Six months later, I was stable enough to start chasing dreams again. I packed up and moved to Mexico City, a place I’d been talking about moving to for years. I never did because I needed my family and my doctors close and I didn’t want to move abroad when I would have to live my life tight, watching to never do too much.

It’s been a year now and I live more easily than I ever thought possible. I’ve settled into my new home and language, work full time, and still have energy left over for friends, exploring, and climbing trips. In many ways, stopping my periods helped give me back my life.

Looking For A Comments Section? We Don’t Have One.

]]> https://theestablishment.co/why-are-inmates-still-being-denied-access-to-menstrual-products-380e707fab82/ Mon, 10 Oct 2016 16:00:00 +0000 https://theestablishment.co/?p=6894 Read more]]> “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.”

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?

There’s one thing cis and transgender people agree on—trans women and transfeminine people don’t get periods.

Those of us who were assigned male at birth (AMAB) generally came out of the womb without ovaries or a reproductive system that can support a pregnancy, so we don’t bleed every month in preparation for one. It’s generally seen as one of the net positives about being a transgender woman as opposed to a cisgender gal; before and after I started transitioning, my cis girlfriends came to me with their tales of woe — bloating, cramps, violent mood swings, nausea — all sometimes too intense for them to reasonably get out of bed. “You’re so lucky,” they’d moan, and I would shrug sheepishly, implicitly agreeing that I was fortunate to never share in those experiences. That would be impossible. Right?

Imagine my shock, then, when I talked with my friend Ashley last month, just before she went into the hospital for a few weeks. Nervous about the length of time she would have to stay, she told me the reason for her reticence: “I’m due for my period in a couple days, and that’s going to really suck.”

Uh, what?

Ashley’s a 23-year-old trans girl who’s been on hormone replacement therapy (HRT) for over a year. She takes a cocktail of the antiandrogen spironolactone and estradiol, a form of estrogen. About five months into her treatment, she began experiencing a predictable pattern of symptoms: First would come the soreness and swelling in her chest along with bouts of nausea; the next day, she’d endure painful abdominal cramping lasting minutes at a time, as well as constant nausea, hot flashes, dizziness, photosensitive migraines, and bloating. This cycle, she says, lasts for about six to seven days and repeats roughly every five weeks.

About five months into her HRT treatment, she began experiencing a predictable pattern of symptoms.
Click To Tweet

If those symptoms sound familiar, it’s because billions of cis women all over the world experience similar symptoms while menstruating. Along with insomnia, general muscle fatigue, joint pain, acne, and a host of other side effects, all the afflictions Ashley reported are symptomatic of premenstrual syndrome (PMS) and/or premenstrual dysphoric disorder (PMDD). (Debilitating symptoms can be indicative of endometriosis and shouldn’t be considered a natural part of menstruation for people with uteruses — folks, call your doctors!)

Intrigued by Ashley’s disclosure, I put out a call online for trans women to get in touch with me if they had experienced regular symptoms like hers since they began HRT. It turns out, Ashley’s not alone in her experiences — it’s not impossible for me to develop a “period” after all.

The respondents to my question varied in age, length of time on HRT, dosage level, and administration method — while some trans people take their hormones in pill form, others choose to use patches or intramuscular injections — but they all reported similar results. Most seconded Ashley’s accounts of pain and nausea, and added that they experienced intense mood swings. One agender respondent, Blue, reported immobilizing cramps that were 30 seconds long, extreme mood swings and depressive episodes, and constant headaches — all beginning six months after starting HRT, and appearing regularly for the past five months.

Aspen, a 24-year-old trans girl, said that although she almost always felt nauseated in the morning, she’d recently experienced excruciating “morning sickness” for a nearly weeklong stretch before it abated — almost without a trace. Still another respondent, who requested to remain anonymous, said they had “a lot of really bad period shits where it’s practically explosive it’s so horrible.” (Menstrual diarrhea isn’t as known or discussed as other symptoms, but it is definitely a thing — to nobody’s relief.)

After speaking with about 10 diversely identified people who identified as having PMS-esque symptoms, I saw only one possible explanation: AMAB trans people can and do seem to experience period-like symptoms as a part of HRT. Just like cisgender women, our period experiences range from barely noticeable or almost nonexistent to debilitating. I haven’t identified a hormonal cycle of my own, but it was clear that others had, and they weren’t limited to feeling sad and wanting chocolate (though Ashley did wryly note that she “had to be talked out of putting chocolate syrup on [her] hot dog” during a recent cycle).

Scientifically, I was puzzled; were these symptoms strictly psychosomatic, driven by knowing feminization of these individuals’ bodies? Or were they a direct result of the physiological effects of HRT, an awakening of latent femininity in AMAB bodies? After all, there’s only one gene separating testicles from ovaries in adult humans, and all human embryos are primed to develop ovaries until a chain of genes on the Y chromosome get involved. Plus, animals of all kinds (like frogs and hawkfish) change sex frequently in response to environmental stimuli. I certainly didn’t consider my informal surveys to be comparable to a clinical trial, but the anecdotal data I rounded up was strong.

Just like cisgender women, our period experiences range from barely noticeable or almost nonexistent to debilitating.
Click To Tweet

In fact, I even heard from a cis woman whose mother was prescribed HRT after having her ovaries removed, and who experienced cyclical back pain, bloating, and frequent urination/defecation — “everything but the bleeding.” “[My mother] actually has a healthier, regular cycle without most of her reproductive system than I do while still having mine,” griped the respondent. Given the dearth of medical literature regarding the effects of HRT on transgender people, why wouldn’t it be possible for AMAB people to experience something akin to a bloodless period? After all, side effects like bloating, cramping, nausea, and breast soreness are well-documented side effects of estrogen therapy. Is it such a stretch to believe that these effects could be experienced cyclically?

This is a phenomenon that clearly requires greater study — in all of my research on the topic, I couldn’t find a single scientific examination of the matter. Perhaps part of the problem is that so few people know about it. The general cis population is understandably in the dark, because lots of trans people aren’t aware of it as a broad phenomenon either. Though a few of my respondents had discussed their symptoms in private trans groups online, most had assumed they were the only ones who were getting their “periods.”

There is one group with strong views on the matter, however. If you listen to trans-exclusionary radical feminists (TERFs), we actually can’t experience period-like symptoms . . . because, well, we just can’t. After I put out the call for interviewees on my Tumblr, the TERF brigade leapt all over my post and covered it in some of the most vicious, unprovoked vitriol I’ve ever seen — from accusations of sexism, to claims that those talking about this were “delusional” and “parasites,” to outright threats (“i’ll gladly help them if they want to bleed from their genitals once a month”).

I was shocked and confused — I had gathered enough anecdotal evidence to suggest a truly fascinating hormonal phenomenon, but these people had no interest in challenging their preconceived notions of what was possible for transgender people (notions that, I’ll reiterate, I used to share as well).

But then again, perhaps this shouldn’t have come as such a surprise to me. Whether it’s in a conversation with our medical providers, friends, or even immediate family, trans people — AMAB folks in particular — have historically been met with violent opposition when discussing their feelings and medical needs. We’re often told we’re exaggerating things, seeking attention or sympathy, and that our reality can’t possibly be as we describe it. Sometimes these verbal assaults turn physical. When I asked how these attacks made them feel, Blue laid down some truth:

“I’ve always been terrified to mention [these symptoms] to anyone for the reason of feeling as though it wouldn’t go over well with anyone . . . My neurodivergency alone makes me feel as though I have to slowly kill myself at school or work (when I was in either) in order to be accepted and acknowledged. I don’t respond to criticism well at all, so I am horrified. It’s an especially odd topic for someone like me, an agender individual, who dreams every night that they might wake up AFAB instead of AMAB, [but] doesn’t really desire to relate to these symptoms in the end. It’s sad that it might not be easy to find a safe way to ever have a discussion on them.”

Trans people have historically been met with violent opposition when discussing their needs.
Click To Tweet

On the other hand, Ashley said she tries to focus on the positive. Although her mother has accused her of exaggerating her symptoms in the past, and she’s afraid to contradict those who say she’s just “looking for attention,” Ashley tries to educate those cis women who say she’s “lucky” not to bleed. “Well, actually,” she grins, “I don’t have a uterus, but I have some of the downsides.” At the end of the day, she’s glad to have a little more solidarity with her trans siblings now that she knows some of them share her experiences: “It’s good to know I’m not alone.”

Hopefully, one of these days, the medical community will dive into the matter and confirm what Ashley already knows — that periods aren’t just for vaginas anymore.

When life gives you lemonade you turn it into . . . chum? #MENSTRUATIONMATTERS