Redefining menstrual equity in prisons: Why menstrual equity demands prison abolition

by Regan Moss and Miriam Vishniac

As the menstrual equity movement has diffused across the United States, public policy efforts have been directed towards period product provision in women’s carceral facilities. The menstrual equity movement is concerned with the structures and systems that create, facilitate, exacerbate non-dignifying menstrual health experiences, such as period poverty. This attention has been in response to reports of women in prison having to go without these basic necessities regularly in prisons across the U.S. (Toon, 2019; Bozelko, 2015). While 25 states and the federal government have passed some form of legislation aimed at making menstrual products more available, all present policies are inadequate at addressing menstrual health needs and lead to adverse effects for those that are incarcerated. Many of these laws only ensure access to pads and no other types of menstrual products, do not ensure these products are easily accessible in the housing unit, and do not ensure free, reliable access for all.

We believe, as menstrual health scholars and abolitionists, that the structure of the US carceral system is inherently anti-menstrual equity and creates an environment in which it is impossible to have a dignifying menstrual cycle experience. These policies, aimed at addressing the material needs that were highlighted through reports of injustices within facilities (such as reports of sexual violence in exchange for a pad or a tampon) were meant to fix what we believe to be a much more complex issue of menstrual injustice – an injustice that we argue cannot be fixed within the confines of the prison industrial complex. We will argue for prison abolition as a needed tenet within the menstrual equity space by exploring inadequacies in existing policies as well as by highlighting the inability of rigid structures within the carceral system to account for nuanced menstrual experiences. Further, we will identify how violence is enacted through the prison system in the form of menstrual discrimination. Thus, menstrual inequities become enshrined within the prison system as a means to control, shame, and discriminate.

Product Provision and Prison Policies

On the most proximal level, product provision as defined through state policies does not fully address supply demands. The period products provided in US facilities are supplied through chosen prison vendors. Such pads and tampons are of poor quality, uncomfortable, and have yielded reports of infection and toxic shock from the American Civil Liberties Union (2019) Moreover, allotted supplies of period products do not account for the (often unpredictable) variance in flow and volume of menses blood per menstruator and per period as well as the significant variance in product absorption. Texas only ensures up to 10 free menstrual products a day and the majority of laws use general terms like ‘as needed’, such as in Arizona, Louisiana, Missouri, etc. Ambiguity in policies often results in an individual’s supply of and access to products being up to the discretion of the warden or even individual prison employees. Individuals are forced to substitute or bleed on themselves, sometimes in white uniforms. The inflated prices for period products in prison commissaries make them inaccessible. A majority of policies indicate that individuals are given limited monthly allotments of period products and do not have free access throughout the month, whenever desired. This is the case wherever these products are not kept in the housing unit, such as in New Jersey. The unpredictability, multidimensionality, and multiplicity of menstruation demands more than physical products, but at minimum, material that can be accessed wherever and whenever.

Present procedures for obtainment, such as asking a guard for products, perpetuate shaming and give rise to issues of safety, often resulting in psychological and sexual violence. Moreover, individuals cannot ensure that they can regularly obtain the products they need to feel dignified while on their period, given the aforementioned limit on the number of products. Failure to account for the processes through which individuals in facilities obtain products fails to account for the internalized shame and perceived gender discrimination that arise in making menstruation a forcefully public matter but individual’s responsibility. The stigma against menstruation makes it a matter of public shaming when someone fails to keep their flow hidden and private, every menstruator’s personal responsibility.

There is no room within the prison system to anticipate and prepare for future needs: stockpiling basic supplies such as ibuprofen, pads, tampons, and underwear is not allowed. The inability to stockpile is a clear conflict with the unpredictability of menstrual times and flows. It is impossible to create a bill with enough nuance to account for individual menstrual health needs. Such an attempt would defy the inherent complexities of menstruation in both the corporeal and embodied perspectives.

Prison Philosophies and PsychoSocial Dimensions of Menstrual Wellbeing

Even if such issues are addressed through product provision, the very structuring of prisons is in direct opposition to menstrual health: the policies and procedures that underpin the way of life in US prisons are fundamentally opposed to reproductive justice and make it impossible for individuals to menstruate how they wish to. Specifically, individuals’ health needs are subjugated to showering schedules, unpredictable laundry schedules, long wait-times for ibuprofen and pain management tools, etc. For example, Alaska only requires access to showering and bathing facilities three times a week, meaning those who have bled on themselves may spend days in their own menses. This can result in psychological distress, vaginal infections, and other adverse social consequences. Menstrual health is multidimensional and needs associated with pain, hormonal changes, etc. must be observed as well.

The health needs of individuals are forced to adhere to prison schedules, which is inherently impossible. An intangible aspect of health is bodily sovereignty. That is, even if material needs are met, health cannot be achieved if an individual is rejected the right to care for and exist in their body as they wish. The inadequacies of existing policies highlights the focus of the menstrual movement as a whole, that is often oversimplified to a matter of material provision and access to period products. The material focus seeks to drive cessation or a control of menses blood and rejects opportunities to support the right to dignifying menstruation. Such inadequacies also speak to the lack of nuance that many policy makers possess concerning women’s[1] health needs. Even when people who menstruate are engaged in the design of policies, the average period is inscribed into law as the norm. As prisons are built for male bodies (i.e., with no attention to reproductive needs or perinatal care needs) and lack proper disposal facilities for used menstrual products, regular access to private spaces to change products, and menstrual health across the life course and throughout the cycle are not accounted for. The lack of nuance is evident by the lack of consideration to variance in flow, product preference, and symptoms across the menstrual cycle. The inadequacies also reveal the general ignorance towards menstrual well being and dignity inside and outside of the prison system: menstrual wellbeing and dignity are achieved through a variety of rituals and lifestyles and experienced differently across cultures, stages in life, and even period to period. Menarche and menopause within prisons have not been addressed with any existing policies; needs beyond the menstruation phase remain unacknowledged (e.g., exercise during follicular phase); menstrual conditions like endometriosis and PCOS are unaddressed. In recognizing the necessity to meet needs across the life course and throughout the cycle, it is even more apparent that individuals are revoked the right to menstruate with dignity while incarcerated.

Photo credit: RDNE Stock project via Pexels

Menstrual Discrimination and Prison Violence

The gendered dimension of prisons is a particular injustice when it comes to menstruation. As jurisdictions discuss housing people based on their lived gender identity, there has been no effort to ensure access to menstrual products in men’s prisons, erasing trans, non-binary, and intersex menstruators from the conversation entirely. Many incarcerated menstruators are forced to ask male guards for the basic goods needed to feel dignified while on their period. As such, the needs of women are subjugated to men and parallel the financial and psychological abuse that is commonly rejected outside of prisons, but excused within. The taboo is forced into public scrutiny in squat-and-cough procedures, routine strip-searches, and the staining of uniforms.

Intersectional Analysis of Menstruating Within Prisons

Our present analysis would be inept if it did not consider how experiences of menstruating within prisons remain inequitable. That is, the structures, policies, and procedures of the US prison system leverage class, race, disability status, age, and nationality as a means to further enact control and menstrual discrimination. As mentioned prior, individuals who are transgender likely experience heightened violence as well as the psychological dimensions of period poverty. Depending on the state, trans individuals may be housed in a prison that does not distribute menstrual products at all. Access to period products in prisons is also variable by class: those with less money (and less external social support) are unable to purchase items for sale in the commissary. Further, guards are likely to be harder on women of color and more likely to deny them access to menstrual products or punish them for menstruating: in women’s prisons, Black women get some of the harshest punishments. Nationality is also a strong predictor of discrimination within prisons. Across the lifecourse, menstrual experiences vary. Women who are approaching menopause (i.e., experiencing perimenopause) can have less regular, more extreme periods. Unreliable access to products and the inability to stock supplies likely lead to unanticipated accidents; thus, heightened anxiety.

A Way Forward: No Menstrual Equity Without Prison Abolition

The question remains: if the prison system is inherently anti-menstrual health in its genesis, policies, and tension with (menstrual) health rights, what can we, as members of the menstrual equity movement, practically aim for, if not abolition through the release of those who do not need to be incarcerated for public safety?

However, given the possible scale of the harm being done to thousands of people that are incarcerated, there are some policy changes within prisons which could alleviate the problems faced by menstruators and be seen as short-term, concurrent goals with abolition. Ultimately, menstrual health must be committed to on a state and federal policy level, with attention to needs at menarche to post-menopause, or else menstrual health will remain subjugated to the anonymous power of capital and the prison industrial complex as evidenced through the policies and procedures of facilities within the carceral system.

The best possible solution for period product access within the prison context is a free, central dispensary located in the housing unit with toilet paper and a variety of menstrual products – (pads, tampons, and other commonly used products for managing menstrual flow) – in a variety of sizes and absorption levels. This dispensary should be constantly kept stocked by prison staff. Incarcerated menstruators must be able to take as much as they need, carry as many as they like on their person, and keep as many as they wish in their personal cells. When certain facilities have tried this, they have found no hoarding issues once incarcerated menstruators trusted the supply would not disappear (American Bar Association, 2019.) Further, given the obvious ties to dignity, shame, and even the ability to focus, menstruation must be considered in all women’s prison programs and access to products seen as a basic requirement for participation. Since the free products offered by correctional facilities are frequently too low-quality to meet absorbency needs and preferences, there should be a provision that menstrual products have a method for independent quality testing. Incarcerated menstruators must have free access to the basic necessities, such as soap, shampoo and conditioner, and a shower and change of clothing whenever they soil themselves, wherever they are. Pain medication must be made available to menstruators for free in small amounts, and prison uniforms should not be white.

Rules should be examined and adjusted for conflicts with menstruation, and prison staff must not be allowed, under any circumstances, to deny menstrual products or to discipline or shame someone for menstruating. Routine strip-searches done without specific safety concerns should be abolished.

Ultimately, none of the aforementioned policy changes will ‘fix’ problems faced by incarcerated menstruators, since they are still trapped in a system that was not built for them and does not take their needs seriously, but it would have a significant impact and at least create a baseline level of menstrual provision and policy in spaces of confinement. While menstruation has generally been ignored within the carceral system, research reveals it has a large impact on the health and well-being of incarcerated menstruators. Facilities and programs which claim to support women can no longer avoid the topic. Menstrual health is a matter of human rights and the lack of attention to people who are menstruating while incarcerated is an injustice and human rights violation.

We argue that every menstrual equity activist must be an abolitionist. The prison system is functionally opposed to bodily sovereignty and thus, health cannot be achieved, even if material (e.g., pads and tampons) is obtained. Abolition is both an event as it is a framework, one that strives for dignity for each and every person. The menstrual equity movement aligns with the abolitionist movement in the belief that structures must change so that individuals are better cared for. Period poverty is addressed through structural change and communal core, core tenants of the abolitionist framework. Considering biopsychosocial definitions of period poverty, embarrassment, stigma, shame, and violence are drivers of period poverty. Likewise, they (e.g., stigma, shame, embarrassment) underlie the philosophy of punishment that is the platform for the US carceral system or is a product of such (e.g., stigma, shame, violence, etc.). Thus, individuals opposed to period poverty must, too, be abolitionists.

Regan Moss, BS is an MPH student at Columbia University, studying Population and Family Health with a focus in Public Health Research Methods. Her work focused on social and structural determinants of health (disparities) (SDOH), particularly around reproductive, menstrual, and maternal (mental) health, as well as the promotion of health equity in obstetric and gynecological practice. She focuses on maternal-child health, mental health, and reproductive health among female sex workers (FSW), individuals in rural communities/maternity care deserts, and within the carceral system (e.g., prisons, jails, probation, detention).

Miriam Vishniac (she/her/hers) is the founder of the Prison Flow Project, the first compendium of official rules around the provision of menstrual products in U.S. prisons. Her doctoral dissertation, The New Correctional Afterthought: Menstruation and Incarceration in the U.S.A. (submitted in 2024 at the University of Edinburgh), focuses on access to menstrual products and menstrual discrimination in U.S. prisons. She received her B.A. in Biochemistry from Oberlin College in 2010 and her Master of Public Policy with a concentration in Civil Rights from George Washington University in 2018, and uses her multidisciplinary background to find new approaches and perspectives on problems involving gender inequality, racial injustice, and menstrual activism.

[1] We recognize that not all menstruators are cisgender woman; however this is a feminized issue and present evidence informs how cis women are impacted.

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