The Relevancy and Urgency: 8^th December, a Day for Dignified Menstruation

Dignified Menstruation is a groundbreaking approach to assess the activities across all sectors for equality and justice. Simply, it is a solution for a long struggle and a journey for equality and justice for many of us. To know more about Dignified Menstruation, we need to unveil menstrual discrimination as the other side of Dignified Menstruation or as a problem.

Menstrual discrimination is an umbrella term that refers to a range of perceptions and practices around menstruation, including taboos, shyness, stigma, restrictions, abuses, violence, and deprivation from resources and services throughout the life cycle of menstruators. It is not a single act or event or period. Irrespective of education, region, or religion, it has been in practice all over the world in different names (5000 euphemisms), forms, and magnitudes. It is also not linear but complex and multifaceted. Menstrual discrimination plays a primary role in constructing and socializing the power relationship and reinforcement of the patriarchal practices. It starts from childhood and goes in a spiral way throughout the life cycle of both menstruators and non-menstruators and forms a vicious circle. According to the UN’s definition (1993), it is a form of sexual and gender-based violence (SGBV) and also fuels other forms of SGBV, including child marriage, to occur. One menstrual perception and practice may fall more than two types of SGBV’s. For instance, if a menstruator is not allowed to cook food in a kitchen because of menstruation, it is a form of physical and emotional violence as well as deprivation from resources and services as per the UN’s definition of SGBV. Likewise, it is a violation of human rights. In the above example, there are multiple forms of human rights, such as the right to dignity, the right to freedom, the right to equality, the right to food, the right to mobility, the right to health, etc., that are violated.

In the course of the human rights movement since 1948, the menstrual discrimination is missing. It is not considered a violation of human rights, though there are many international human rights instruments such as CEDAW 1979, the Beijing Platform for Action 1995, the Child Rights Convention 1989, SDG 2030, ILO C 190, etc. in place. The menstrual discrimination is not included while having conversations around sexual and reproductive health and rights (SRHR) campaigns. The anatomy and physiology of human reproductive organs or menstrual management is not able to unpack the menstrual discrimination. Even the Gender Equality and Social Inclusion (GESIs) policies have yet to acknowledge the complexity of menstrual discrimination and the effect of it in all the aspects of the lives primarily as determinants for power relationships and patriarchy. 

Likewise, menstrual discrimination is missing in yearly celebrations globally, such as February 14: One Billion Rising, March 8: Women’s Day, April 7: World Health Day, May 1: Labour Day, May 28: Menstrual Hygiene Day, June 5: Environment Day, July 11: Population Day, September 21: Peace Day, September 28: Abortion Day, October 11: Girl Child Day; November 25-December: 16 Days of Activism, etc. These days are linked with the Dignified Menstruation directly and indirectly but are not dedicated to Dignified Menstruation as specific days. Many activists/scholars claim that the May 28 is enough to address all the forms of menstrual discrimination. Indeed, May 28 is Hygiene Day, which has two implications: i) it is primarily focused on menstrual management. It only addresses a few aspects of discriminatory menstrual practices and does not necessarily guarantee the dignity of menstruators; ii) the menstrual blood is pure and clean, so it should not be sanitized as we sanitize the hands after touching the patients or clients after vaccination or in family planning clinics. On the other hand, if we keep saying the menstrual hygiene, we are imposing the biased ideas psychologically that the menstrual blood is impure and dirty. Recently, a few organizations including GSCDM, started to mark the 28th of May as Menstrual Health Day. The definition of menstrual health is revised in 2021. However, it is primarily concerned with health issues related to menstruation and menopause. The social and cultural norms that are formed and shaped by menstrual discrimination have been the same or not been prioritized. Because of such a bunch of social and cultural norms associated with menstruation, discriminatory menstrual practices are being provoked. For instance, the reason access to quality menstrual pads is a problem is because menstruation is considered a dirty, impure, or unclean state of weakness, and menstruators are also considered as inferior, disadvantaged, or unimportant at home, school, community, workplace, parliament, and everywhere. Of course, there are many other factors of inequality and injustices. Menstrual discrimination is primary, whether that’s in the global north or global south.

For GCSDM, each moment is a dignified menstruation moment, and we wish for celebration every moment. Practically, it is not feasible. Therefore, by considering the menstrual discrimination as SGBV and a violation of human rights, the 8th of December is selected to mark as the dignified menstruation day. 8^th December represents the 14^th day of 16 days of activism and also represents the month of human rights, December. It emerged from the lived experience of a survivor of menstrual discrimination from the global south. In summary, the Dignified Menstruation is a Decolonized, Innovative, Holistic, Transformative, and Feminist human rights and life cycle approach for equality and justice in all aspects of life. This approach accelerates the inclusion because it divides the population on the basis of uterus like menstruator and non-menstruator, fosters the equal power relationship where the non-menstruators socialize with a sets of accountability and menstruators socialize with pride and power. It also helps to dismantle patriarchy. More importantly, it’s not confined to five days of bleeding only. In other words, it is the approach beyond menstrual products, WASH (Water, Sanitation, and Hygiene). It plays a crucial role in preventing SGBVs, including child marriage. And of course a boon for improving the SRHR and comprehensive sexual education as an entry point. The dignified menstruation-friendly home, school, and community allow enough space for bodily autonomy and making choices. Having and rejoicing in the Dignified Menstruation is all about the promotion of human rights. In short, Dignified Menstruation is an appeal to change the narrative around menstruation from hygiene to dignity and five days of bleeding to a life cycle approach.

GSCDM also likes to clarify that the initiation to mark the 8th of December as Dignified Menstruation Day is not in competition with any organization or individuals. It started from pain and struggles. Based on decades of long experience of working around women in peace and politics, prevention and response to SGBV through various organizations and capacities, the founder of GSCDM urges us to challenge our deeds and endeavor to fill the gap. Just 2 days before Human Rights Day, or the completion of the 16th day of activism, 8^th December is just a combo to remind all stakeholders to embrace the menstruation, which is a means of our [human] existence. By this note, as a founder of GSCDM, I appeal to each one of you from all the corners of the world to advocate for dignified menstruation because the root of all of us is menstruation.

Dignified Menstruation (DM)

To understand DM, you must first know about its symbol, which is a drop of blood that transform into a globe with latitude and longitude lines. The red color symbolizes menstruators, the more than half of the global population who were born with a uterus and ovaries. The variation in the hues of red is a reminder that bleeding varies over the five days of the average period of menstruation and over the life cycle of a menstruator.

By definition, DM is a state of freedom from any of the forms of menstrual discrimination associated with the life cycle of menstruators, including taboos, stigma, shame, abuse, restrictions, violence, deprivation of resources and services throughout the menstruators in all diverse settings (GSCDM), 2019). Radha Paoudel Foundation(RPF)/Global South Coalition for Dignified Menstruation (GSCDM) is the creator and disseminator of this concept. About four decades of struggle, pain, sufferings of Radha Paudel worked to bring the concept of Dignified Menstruation in Nepal and beyond.

For easy understanding, DM can be explained as follows:

WHAT: Freedom from all forms of discrimination

WHO: Those who were born with a uterus and ovaries

WHERE: 24/7, including during pandemics and other crises

WHEN: From birth to death

HOW: With individual, school, community, nation, and global policies.

Because menstruators are everywhere that humans reside, menstruators should always be prioritized and remembered.

International Day of Dignified Menstruation: 8th December

Each moment, each day is indeed a moment/day of DM. However, because it is impractical to celebrate DM each day, GSCDM has chosen to mark the official International Day of Dignified Menstruation on December 8.

This day was initiated by RPF/GSCDM and inaugurated in 2019 for the following reasons:

• There was a need for an International Day of Dignified Menstruation to address the multi-factorial complexities of menstrual discrimination and bring global awareness.
• Menstrual discrimination is a violation of human rights.
• Menstrual discrimination is not only SGBV in and of itself but also the cause and effect of other forms of SGBV,
• December 8 falls on the 14th day of the 16 days Activism against VAW.

That said, GSCDM/RPF marks DM throughout the year by observing local, national and international days. For example, it marks menstrual month in May and Women’s Health Day or Menstrual Management Day on 28th May.

By using the word “hygiene”, we imply that menstrual blood is dirty. GSDM/RPF marks the menstrual month of May month through the notion of Menstrual Talk Dignity First. Based on expertise and resources, anyone can organize a program based on her expertise and resources. Whatever the program, GSCDM/RPF appeals to the organizers to place dignity at the center. It is vital to prioritize dignity and reject all implications of shame and taboo during any celebration, workshop, or education program.

Themes:

2019: Dignified menstruation prevents SGBV and promotes human rights

2020: Menstrual talk dignity first

2021: Dignified menopause is a human right not a privilege

2022: Dignified menstruation ends child marriage

2023: Dignified menstruation is integral for ending sexual violence and child marriage

2024: “Upholding Dignified Menstruation: Fundamental to Sexual and Reproductive Health and Rights”

As a pioneering country for dignified menstruation, the government has achieved following milestones;

• 2017: Policy on Dignified Menstruation (draft)
• 2018: Effectiveness of menstrual law: three months in jail, USD30 fine, or both
• 2019: Free distribution of menstrual pads in public school
• 2019: Menstrual shed-free country and initiation of DM Day on 8 December
• 2020: Campaign for the dismantling of menstrual sheds and promotion of DM
• 2020: Organization of a three-day international workshop on dignified menstruation
• 2021: Address at the Dignified Menopause Summit and observation of World Menopause Day (18 October)
• 2021: Dignified menstruation incorporated into gender equality policy
• 2022: 90% VAT reeducation [D1] and 1% on [D2] the raw materials of menstrual pads; Gandaki Province allocates budget for DM
• 2023: Allocation of the budget for the free distribution of menstrual pads across the country. Gandaki Province and many municipalities incorporated DM into their policies.

December 8, Dignified Menstruation Day, a day of 16 days activism

There are numbers of reasons to mark the 8th December is a dignified menstruation day as 14t day of 16 days activism since 2019. The 16 days activism against the violence for girls and women is global campaign for prevention of various forms of SGBV, celebration of success around it and promotion of human right, for 16 days every year from November 25 to December 10 since 1991. Here, the menstrual discrimination itself a form of SGBV in many ways according to UN. Menstrual discrimination affected the lives of menstrurators from womb to tomb even after the death in some culture. According to the UN categorization, there is violence directly related with menstrual discrimination. The physical assault (beating, biting, burning, kicking), punishment for defying cultural norms are under physical violence, the verbal abuse, confinement, social exclusion, humiliation, manipulation are under the emotional/psychological violence, the attempted rape, rape, sexual assault, sexual exploitation are under sexual violence and the denying girls their right to education, giving boys/men preferential access to food or services are under the denial of access to resources and services. Therefore, menstrual discrimination is purely a form of SGBV and violation of human right in many ways. It plays role for cause and effect of SGBV too. For instance, the denial the right to education is itself of the violation of human right. It leads for child or early marriage. That leads to early child bearing and might get complications and also impact on economic opportunities in short. Thus, dignified menstruation is an element of 16 days activism.

Secondly, all stakeholders must be clear on the language. Because language construct the mind set and guide to choose the behavior in common sense of human civilization. The history, background and practice of menstrual hygiene day is for water, sanitation, products and infrastructure. These are important elements for DM but not guarantee the dignity of menstrurators throughout the life cycle within all identities. RPF/GSCDM urge to called dignified menstrual hygiene day which help to bring the stakeholders towards the dignity of menstrurators. Talking constantly about hygiene also often allow to think or reinforce the idea of menstrual blood is impure and dirty that is why menstrurators should care or hide. The suicide of 14 years girls in Kenya in 2019 where the government initiated free menstrual pad scheme since 2017, was an example to rethink more loudly around the impact of menstrual discrimination among us (Hervey, 2019). Of course, the menstrual hygiene day helps to create the space for menstruation and breaking the silence but it does not covers the all aspects of menstrual discrimination throughout the life of menstrurators. Here, RPF/GSCDM encourage to all readers to think that the dignified menstruation is not only for five days or 60 mil blood. It is about throughout life cycle within all identities, complications associated with menstruation, social, political, economic, environmental, technological aspect of menstruation.

DM is for reconstruction of the power that constructed and shape since childhood. Any form of menstrual discrimination leads the idea of menstrurators are an `impure’, `inferior’ `powerless’ and disadvantaged. In other hand, the non-menstrurators considered `pure’, `superior’, `powerful’, and `privileged’. Due to deep silence and ignorance around menstruation at home and school, where both are mostly feeling of `shocked’, `disgusted’, `discomfort’, `surprised’, `hated’, and so one which constantly feed to them and community that the menstrurators are inferior and others are superiors. The unequal power relations and gender norms formed and practiced in a way that become culture or tradition or taken for granted. Eventually, the SGBV is manifested in many ways. Globally, one out of three women experienced SGBV at their life time but it does not reflect all forms of violence that occurred from menstrual discrimination. In order to deconstruct and reconstruct the power, the dialogue on dignified menstruation should constantly happen everywhere. As a result, the menstrurators considered themselves pride and acknowledge that they deserved the dignity and non-menstrurators acknowledge the essence of menstruation or presence of planet. For achieving overarch goal of gender justice and human right, needs to celebrate the menstruation throughout 24/7. Practically, which is not possible therefore dedicated day for DM significantly urgent and important. Finally, DM is urging everyone through the lens of human right across all sectors and levels therefore chose the month of December as human right month.

Global Understanding on GBV:

Let us examine the meaning of GBV as defined by the Convention on the Elimination of all Forms of Discrimination against Women (CEDAW),“Violence that is directed against a woman because she is a woman or that affects women disproportionately.” More generally, GBV can be “any act of violence that results in, physical, sexual or psychological harm or suffering to women and girls, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life”.  Additionally, it is globally recognized that GBV has no boundaries across nation borders, cultures, class, race, sexual orientation, or religion.  Thus, it is evident that GBV is the consequence of power and privilege and the unjust distribution of power in society.  Power is dynamic and there are many ways to construct/hold power, one of which ways is directly related to menstruation. Regardless of an individual’s identity, approximately half of the earth’s human population has/is going through menstruation.  However, while menstruation is a global truth, normal and biological, everywhere there is some form of taboo, stigma, or restriction during menstruation. All restrictions live on the spectrum and there are various forms of restrictions, some are visible while others are not, some are popular in the media and some are not, some are backed by religion, some with poverty and so on.

Menstrual Practice/Restriction constructs the Power

In Nepal, research conducted on menstruation shows that girls usually between the ages of 6-12, most pre-menses, become aware of menstruation through their mothers, relatives, and school and are taught that menstruation is an “impure” state of “impurity”, a state of “shame, humiliation” and a state of “powerlessness”. They are told this directly with words as well as see it visibly through watching their mothers, sisters, and menstruating individuals in their communities’ practice menstrual restrictions.   In other hand, around the same age, boys are also taught or aware through their family, school and community that their absence of menstruation means state of “purity”, “power” and “superiority”. They see that the men in their lives and the community were not bound to any restrictions, or limited in any way, that they instead have the power to limit and restrict the ones who did menstruate. As they grow up, girls are then socialized for tolerance, acceptance and docile tendencies, and discouraged to question where boys are encouraged and awarded for questioning, challenging, and privileged to use violent words and actions under the guise of “boys will be boys”.  As children develop, they began to understand the power dynamic and become aware of the cause and effect of power and privilege but are indoctrinated through society gender norms and values and thus act on their conditioning. Girls continue to replicate their learned and internalized docile behaviours while boys continue to hold and display power, both playing into the roles of the victim and the perpetrator. For details: https://researchopenworld.com/menstrual-restrictions-and-its-impact-on-empowerment-a-case-from-jumla-nepal/

Menstrual Practice is underlying cause for GBV

Therefore, keeping GBV’s definition in mind, it is evidently clear that girls, women, individuals who menstruate regardless of caste, class, race, education, religion, nationality are subject to various forms of visible violence due to the invisible violence sustained by deep ignorance on menstruation, biases on menstruation as a “women’s issue” or a “private issue”, and global silence due to stigma and shame.  Due to the stigma, shame, and taboo around menstruation, there are adverse immediate and long-term impact on one’s mental, physical, emotional, and social health including all forms of gender- based violence, rape, murder, sexual assault, death, and more. Due to the dissentient value imposed on menstruation and menstruating individual, their inter and intra level of peace is destroyed. Their human rights (right to dignity, right to food, right to health, right to education, right to mobility) is significantly compromised at multiple layers throughout their life cycle. These rights are also globally recognized as constitutional rights in many nations like Nepal. More importantly, these rights are directly connected to one’s inalienable human rights which are global.

Linkage between Menstrual Practice/Restriction and GBV:

Here, there are various global studies which show evidence on GBV which are linked with the impact of menstruation discrimination. Likewise, international statistics show that globally girls and women suffer from GBV^[1]:

1. Between 40 and 50 percent of women in European Union countries experience unwanted sexual advances, physical contact or other forms of sexual harassment at work (World Health Organisation (WHO),
2. Early and forced marriage is a violation of women’s rights. Almost 750 million women and girls alive today were married before their 18th birthday, and more than 20,000 underage girls are illegally married every year (UNICEF)
3. An estimated one in three girls around the world will experience physical or sexual abuse or violence in her lifetime (United Nations Population Fund)
4. Women and girls account for 71% of human trafficking victims, with nearly three of every four trafficked for the purpose of sexual exploitation (United Nations (UN))
5. At least 200 million women and girls alive today have undergone FGM, with most experiencing FGM before age of 5 (UNICEF)
6. One in 10 women in the European Union report having experienced cyber-harassment since the age of 15 (including having received unwanted, offensive sexually explicit emails or SMS messages, or offensive, inappropriate advances on social networking sites).
7. The risk is highest among young women between 18 and 29 years of age (UNWomen)
8. Eighty-two per cent of women parliamentarians who participated in a study conducted by the Inter-Parliamentary Union in 39 countries across five regions reported having experienced some form of psychological violence while serving their terms (InterParliamentary Union)
9. According to a 2016 ActionAid Survey, 79% of women living in cities in India, 86% in Thailand, and 89% in Brazil have been subjected to harassment or violence in public, as had 75% of women in London, UK (ActionAid)
10. In a survey of 3,706 primary schoolchildren from Uganda, 24 per cent of 11 to 14-yearold girls with disabilities reported sexual violence at school, compared to 12 per cent of non-disabled girls (UNWomen)
11. At least 140 countries have passed laws on domestic violence, and 144 have laws on sexual harassment. However, though laws exist, there are extremely low levels of compliance, and implementation of regulation in majority of countries due to variety of reasons, some due to weak or no enforcement power and others due to the violent patriarchal culture of society.   For example, 37 countries still exempt rape perpetrators from prosecution if perpetrators are married to or or subsequently marry the victim (World Bank Group)
12. In Australia, Canada, Israel, South Africa and the United States, between 40 and 70 per cent of female murder victims are killed by their intimate partners (WHO)xi. 12. Conservative estimates suggest that 20,000 to 50,000 women were raped during the 1992-1995 war in Bosnia and Herzegovina, while approximately 250,000 to 500,000 women and girls were targeted for rape in the 1994 Rwandan genocide (UNIFEM)
13. Approximately once every ten minutes, somewhere in the world, an adolescent girl dies as a result of violence (UNICEF).
14. Around 120 million girls worldwide (slightly more than 1 in 10) have experienced forced intercourse or other forced sexual acts at some point in their lives. By far the most common perpetrators of sexual violence against girls are current or former husbands, partners or boyfriends (European Commission).
15. Women who have been physically or sexually abused by their partners are more than twice as likely to have an abortion, almost twice as likely to experience depression, and in some regions, 1.5 times more likely to acquire HIV, as compared to women who have not experienced partner violence (WHO).

Through analysis of statistical evidence, definition of GBV, and the impact of menstrual restrictions/practice, the intersectionality between GBV and menstruation are clear. We can only imagine how much suffering and GBV was constructed due to menstrual discrimination before we started talking about the Human Rights Declaration 1948 or Convention on the Elimination of All Forms of Discrimination Against Women 1979 or Declaration on the Elimination of Violence Against Women 1993 or Beijing Declaration and Platform for Action 1995 or Optional Protocol to the Convention on the Elimination of All Forms of Discrimination 1999 among girls and women globally because menstruation, as a natural, biological, and inevitable process since day 1 of the human existence.  In empirical analysis, it is evident that the  mortality and morbidity rates are increasing both in prevalence and incidence among girls and women due to childbirth, pregnancy, reproductive diseases, STI’s, HIV, and GBV violence; furthermore it is evident that the majority of these deaths are preventable but are delayed in diagnosis and treatment due to shame, stigma, and taboo. In order to mitigate and ultimately eliminate these disparities, it is essential that menstruation is a top priority and entry point for human rights and women’s health.  

1. No One leaving Behind:

   From the data above, it is indisputable that GBV is prevalent across the entire globe in various ranges and forms and is significantly impacted by menstrual restrictions/practices. Today, there are global efforts being made to achieve the 2030 Agenda for Sustainable Development 2015. In order to achieve these goals, “dignity during menstruation” or “dignified menstruation” must be highly prioritized due to having significant connection with many goals: Goal 1 -No Poverty, Goal 2-Zero Hunger, Goal 3-Good Health and Well-being, Goal 4- Quality Education, Goal 5-Gender Equality, Goal 6-Clean Water and Sanitation, Goal 8-Decent Work and Economic Growth directly and indirectly.