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Editor’s Note: Elizabeth Yuko, Ph.D., is a bioethicist and writer whose work has appeared in The New York Times, Rolling Stone, The Washington Post, The Atlantic, and elsewhere. She is also an adjunct professor at Fordham University. The views expressed here are hers. Read more opinion on CNN.

(CNN) —  

In a recent unaired, cut-for-time commercial parody on “Saturday Night Live,” Phoebe Waller-Bridge asks Aidy Bryant for a tampon, but doesn’t want to do the hand-off in their college classroom. Bryant tells her not to worry, because she carries Tampax Secrets: tampons that come wrapped inside “other things you’d rather take out of your bag in public” – a litany of humorously awful things to take out in public, including dog feces, a dead mouse, a “respectfully folded Confederate flag,” and a signed copy of “Mein Kampf.” The message here is clear: women are conditioned to be so ashamed and secretive about our periods that we’d rather be seen carrying around a dead mouse than a pad or tampon.

Elizabeth Yuko
Karen Novak
Elizabeth Yuko

This sketch works because this is still the prevalent mentality in 2019; TV commercials for pads still show a thin blue liquid in place of menstrual blood. But it shouldn’t be this way. Fortunately, there are ways we can change that – starting with talking openly about periods to help normalize the conversation and break the stigma.

The period paradox

The stigma surrounding menstruation is difficult to overcome because it is something that most of us grew up with.

When it comes to period pain, it gets even worse. Approximately half the population of the world will have a period at some point in their life, and since research shows up to 90% of people who menstruate report having some sort of pain during their periods (moderate to severe pain for 20 to 25%) – this is a serious public health issue. And yet, there is very little research into the causes of and treatments for menstrual pain.

This is part of what I refer to as the “period paradox:” menstrual pain isn’t taken seriously enough as a medical condition to warrant research, while at the same time, a number of people point to the combination of pain and hormones associated with periods to characterize women as irrational or “too emotional.” This stigma helps drive the perception – explicit in some instances and insidiously implicit in others –that women shouldn’t be trusted with important tasks, like running the country or leading a corporation. This two-way stigma is a lose-lose situation for people who menstruate, and only reinforces the idea that we should never talk about it. After all, if simply mentioning period pain could mean others perceive you as weak or hysterical, there isn’t much incentive to be open and honest about it. But that needs to change, and we’re slowly getting there.

No euphemisms required

Though it may seem insignificant at first, one simple but effective way of helping reduce the stigma is by talking openly about your period. This is something I started out doing consciously – to make sure menstruation is seen as just another part of my everyday life – and eventually, I got so used to it that it was just a part of normal conversation, no euphemisms required.

Do I climb up on a chair in a crowded office and loudly declare that I am bleeding heavily through my vagina at that very moment? I do not. But I will walk down the hallway to the bathroom carrying a tampon out in the open, without shoving it up a sleeve. Or if I’m not feeling well or up to doing an activity and someone asks what’s wrong, I’ll tell them that I have particularly bad cramps that day (if that is, in fact, the case). And if an employer does not provide menstrual products in the restroom, you’d better believe that I’m going to bring it up.

There’s no need for gratuitous or overly graphic period talk just to make people uncomfortable, but if you find that you’re self-censoring when it comes to bringing up your period, try dropping it into normal conversation, the way that you’d tell someone that you have allergies or a cold.

And let me clarify that as a cisgender woman, I am coming from a position of privilege when it comes to talking about my period, in that I’m able to do so without fearing for my safety or well-being. Not everyone who identifies as a woman menstruates, and not all menstruators are women. Transgender and nonbinary individuals absolutely must be included in this conversation, though may not be able to participate as openly as others – at least at first.

Period progress

We have come a long way. In the last few years there has been a noticeable increase in the dialogue surrounding periods, especially when it comes to the accessibility of menstrual products. The “menstrual equity” movement is in full swing, led by people like Jennifer Weiss-Wolf, vice president of the Brennan Center for Justice (who coined the term) and Nadya Okamoto, the 21-year-old Harvard student who co-founded PERIOD, a nonprofit “menstrual movement.” In her book, “Periods Gone Public: Taking a Stand for Menstrual Equity,” Weiss-Wolf makes the case for why menstrual products should not be taxed or considered anything other than a necessity, provided in public restrooms alongside toilet paper. Meanwhile, Okamoto is engaging young people across the country and highlighting issues like ensuring accessibility to period products for those in schools, shelters and elsewhere. Nearly one in five American girls have missed school because of a lack of period products. And at homeless shelters, pads and tampons are considered nonessential items, and therefore are not provided – and are some of the least-donated products.

These conversations around menstruation and the products people require – along with a lot of lobbying and awareness-raising by organizations like PERIOD, Period Equity, Human Rights Watch, Global G.L.O.W., and the Homeless Period Project, among others – are working. In 2019 alone, 22 states introduced bills that, if passed, would remove the tax on period products. Ten states already have laws ensuring menstrual products are exempt from sales tax. In 2018 in Arizona, people started sending a male state representative tampons and pads in support of a measure to provide inmates with such products, and around the same time, the federal First Step Act passed with a requirement that the federal Bureau of Prisons provide free pads and tampons to incarcerated people who menstruate.

And earlier this month, New York became the first state to require that the manufacturers of pads, tampons and menstrual cups disclose the ingredients in their products – something not mandatory under the Food and Drug Administration, the agency responsible for regulating and approving menstrual products. This is a big deal because these products go either in or around the sensitive skin of the vagina and vulva, so it makes sense to know whether they contain any contaminants, fragrances, colorants, dyes or preservatives that may cause allergic or other adverse reactions.

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But we still have a long way to go. Period products are still taxed as nonessential items in 34 states, and the stigma around even talking about periods is still so much a part of our culture that it was (almost) a punchline on “Saturday Night Live.” We can do better. So let’s start talking about – and treating – periods as the natural, normal bodily function that they are. The more we can normalize menstruation, the closer we’ll be to getting rid of the stigma, shame and financial burden of unnecessary sales taxes.