Inga Winkler Connects Menstrual Health and Human Rights

Inga Winkler is an Associate Professor of International Human Rights Law in Central European University’s (CEU) Department of Legal Studies. Her research situates menstrual health in the context of human rights. She serves as project director for the working group on Menstrual Health and Gender Justice, which creates momentum around menstruation, awareness and action. She also co-edited the Handbook of Critical Menstruation Studies, which provides a comprehensive and multidisciplinary view of the state of the field, opening up new directions in research and advocacy.

Ahead of Menstrual Hygiene Day on May 28, a global day of action that fosters menstrual health education and aims to end stigma on the topic, CEU spoke to Winkler about her research on menstruation and human rights. This is an edited interview conducted on May 17.


What would you like to point out about the significance of menstruation in a social and human rights context?

What I find so fascinating about menstruation is that, yes, it's a physical and very normal process which happens to half the population at some point, but it’s so much more than that. It’s about the meaning we ascribe to menstruation. Wherever you look in the world, regardless of region, religion, class etc., there's always some socio-cultural meaning. There are many political questions around menstruation, and when you link to these bigger issues, it's not just about the bleeding. It’s about living in a patriarchal society and how we perceive and stereotype women and people who menstruate - it’s about what we ascribe to menstruation. Not always, but too often these stereotypes are negative—labelling people who menstruate as “too emotional” or “hysterical,” as someone who's not to be trusted with any decision making. Menstruation therefore has an obvious impact on how people are perceived in the workplace which relates to decisions about promotions and the gender pay gap – this is one area where it plays out.

Also, when you look in the context of healthcare, there are many studies that indicate significant diagnostic and treatment delays for menstrual health conditions. Most of this work has been done on endometriosis, where we know that the average delay is seven years or more just to be diagnosed. Many people I talk to who have endometriosis, and who have finally been diagnosed, share similar stories: first, doing nothing and being conditioned to think that pain is normal and that this is something we have to deal with and suffer through. Once they start seeing healthcare providers they experience delays and not being taken seriously which leads them to move from one provider to the next. This is where we see the impact of menstrual stigma. It impacts so many different areas of life from healthcare, to work, to education, to participation in public life, so that's why I think menstruation really matters. And placing it in the framework of human rights helps us to better understand the impact of menstrual stigma.

How do you describe menstrual literacy?

Menstrual literacy is the sense of knowing yourself and your body. We need to consider menstrual education in the context of sexuality education and puberty education. Menstrual stigma has such profound impacts because we are conditioned not to talk about menstruation. Just look at the advertising for menstrual products. Traditionally, it's blue liquid and someone who's happily dancing or something flowery. There's no blood and nothing real about menstruation in this depiction. And that’s only changing very slowly.

I teach a course at CEU called “Menstruation, Gender and Rights” and the students have a lot to share. Regardless of where they come from, many of them have terrible experiences with menstrual education and mention being made uncomfortable, keeping the discussion as brief as possible, presenting menstruation as something to be managed and something technical. Menstrual literacy is about understanding not only the period of bleeding, but also the menstrual cycle more broadly, and how that links to hormones and ovulation. That is what I mean by menstrual literacy. It’s about making the linkages to sexuality and understanding one’s health including contraception, changes over the life course, as well as thinking at a socio-cultural level about what menstruation means to you, and also having men and boys involved in these conversations.

When we think about menstruation in a cultural context, we can challenge some of the stereotypes and stigma. It requires an open conversation that is not hushed. One exercise I did with students was to collect different euphemisms for menstruation. Every language has them. In German, one euphemism translates to “strawberry week.” In English some of the most common ones are “shark week” or “Aunt Flo.” They seem funny but what they do is conceal and prevent an open conversation about menstruation because it's considered taboo. It carries through the ads I mentioned, the euphemisms and even these experiences of concealing a pad or tampon up one’s sleeve on the way to the bathroom. So, I think menstrual literacy is badly needed, as well as menstrual awareness and greater public attention to menstruation.

In the introduction to the Handbook of Critical Menstruation Studies, you write that “Menstruation is fundamental, because it's ultimately about power relations.” Can you say more about that?

We have to understand menstruation in the context of patriarchal power relations, place it within societal gender relations, and how gender intersects with other forms of marginalization and discrimination. For example, these power relations become obvious when you consider conditions of detention, prisons and jails. One of the women we interviewed for a study shared that she was in prison and received a couple of pads when she was bleeding, and to get new pads she had to bag them up and show them to the male guard to actually prove that she had used the pads. Obviously that guard has such enormous power, and this process is a manifestation of that power.

We see that in many different contexts, for instance in how society deals with homelessness, where you have shelters that sometimes do stock menstrual products, which is great, but then there can be a tendency of the people who run the shelter to give them out individually, so that people who need them are put in the position of having to request them. Teachers have so much power in whether and how they deliver menstrual education, and how it shapes their students’ thinking.

Those power relations are everywhere and influence how we think about different groups in society, and who we consider “important,” so to speak. Menstrual stigma intersects with other forms of marginalization and stigmatization. These stigmas have an impact on many human rights, including the rights to education and health, participation in public life, cultural rights, and the rights to water and sanitation. All those intersect with menstruation.

What are some of the current menstruation-related initiatives and actions at CEU that you’d like to highlight?

I've been working with a lot of people on campus and closely with CEU’s Gender Equality and Diversity Officer, Ana Belén Amil, regarding an initiative to pilot providing menstrual products in all the bathrooms at CEU. We are about to run a survey regarding the pilot to learn if we need to change anything, and beyond that, about what it would take to make CEU a menstruation- and menopause-friendly campus.

What I'm most excited about is my students because they've been running with the topic. They were the ones who developed the survey; they are writing about menstruation; and they have been leading workshops where they do a menstrual quiz for educational aspects, in a fun and engaging way. They've been creating collages and menstrual art. There's another student initiative together with WAVE (Women Against Violence Europe) to integrate menstruation and equality and they are going to do an event—the Wave Rave—in early June.

The students are developing their own initiatives, which creates a lot of energy. The whole notion of being silent, of keeping menstruation invisible prevents us from talking to others about menstruation. But what I find whether it's in my course or when I do interviews, as soon as you start talking about the topic everyone wants to share their experience and people are usually quite open. So I feel like something is changing and shifting in a positive way.

What else would you like to amplify on this topic?

So much of what's happening in the menstruation space more broadly is driven by getting products to people, which is of course super important. I'm privileged to have access and I think it's great we're doing this at CEU. But there's so much more – and the human rights angle gets to the “so much more.” It gets us to think about how menstruation and stigma impacts many layers of human rights.

The upcoming day of action on May 28 is called “Menstrual Hygiene Day” and I think this language is too limiting since it focuses on the hygienic “management” of menstruation. That language reinforces this idea that there's something that we as people who menstruate need to do to stay hygienic and manage the “mess”, and it doesn't acknowledge the messiness and the embodiment of menstruation. It relates to controlling women's bodies more broadly, so that is problematic. When we speak instead about menstrual health, we open up the conversation to discuss menstruation in a more encompassing and holistic way, thinking about health implications, what needs to happen at work, and how to improve menstrual education. Let’s make it menstrual health day!