Menstruation and Marginalized Communities

Menstruation is not just a biological process.

Menstruation isn’t just a biological process. It’s a social one; one that often leaves marginalized communities struggling to navigate a system that fails to adequately consider them. Such is the case for transgender folks, those of low socioeconomic status, as well as Black and Indigenous individuals. 

Inclusive language, simple changes in terminology, can go a long way. Cisgender women are not the only people who menstruate. Transgender men and non-binary individuals may also have periods, but unfortunately, are often left out of conversations about menstruation. This is an alarming issue, as it discourages gender-diverse folks from accessing necessary support and resources [1]. Therefore, instead of exclusively saying “women” or “girls” when talking about periods, it is better to use the terms “menstruators” or “people who menstruate”. As well, period products should be referred to as such, rather than “feminine hygiene products” [2].

17% of Canadian menstruators have suffered from period poverty. Amongst lower-income households, 1 in 4 report period poverty [3]. Period poverty refers to when one is unable to access necessary menstrual products, such as pads and tampons. To make up for this, individuals may use products for longer than is safe, risking detrimental health effects, such as toxic shock syndrome. These barriers result in skipping school, work, or other social events, further contributing to poverty. 

Black and Indigenous individuals who menstruate are at greater risk of being underdiagnosed and receive lower quality treatment for menstruation-related health conditions. For example, BIPOC patients are less likely to undergo minimally invasive routes when receiving hysterectomy, compared to White patients. They also see increased complications following endometriosis surgery [4]. 

The unjust treatment of Black individuals in reproductive medicine has deep historical roots. J Marion Sims, the so-called “Father of Gynecology”, built his legacy through unethical experimentation on enslaved women. Betsey, Lucy, and Anarcha were the names of three women, among at least nine, who suffered at the hands of Sims. Anarcha alone underwent 29 failed surgeries without anaesthesia [5].

So though Sims was able to make advances in gynecological care, namely surgery for obstetric fistula, it was at the cost of Black women’s suffering. The horrifying misconceptions that were used to “justify” these actions persist today: such as the belief that Black patients have higher pain tolerance, resulting in them being less likely to receive adequate pain management compared to other patients [6]. 

Tackling menstruation inequity sounds like an overwhelming task. After all, what can one person do to abolish a systemic problem? However, change begins with who is included in the conversation. Everyone can make a meaningful difference by choosing to actively include marginalized groups in discussions about menstruation.

References:

1. Baynes, Ella. “Periods and the Importance of Inclusive Language.” Freedom4Girls UK, 20 Jan. 2023, www.freedom4girls.co.uk/periods-and-the-importance-of-inclusive-language/.

2. Babbar, Karan, et al. “Inclusion Means Everyone: Standing up for Transgender and Non-Binary Individuals Who Menstruate Worldwide.” The Lancet Regional Health - Southeast Asia, vol. 13, 20 Mar. 2023, p. 100177, www.sciencedirect.com/science/article/pii/S2772368223000379?via%3Dihub, https://doi.org/10.1016/j.lansea.2023.100177.

3. WAGE. “Beyond the Pad: The Real Price of Period Poverty in Canada - Canada.ca.” Canada.ca, 2023, www.canada.ca/en/women-gender-equality/funding/equality-action/menstrual-equity.html.

4. Tam, J. “May 2025 - Volume 145 - Issue 5S : Obstetrics & Gynecology.” Lww.com, 2025, journals.lww.com/greenjournal/fulltext/2025/05001/comparing_the_experiences_of_black. Accessed 26 Jan. 2026.

5. Cronin, Monica. “Anarcha, Betsey, Lucy, and the Women Whose Names Were Not Recorded: The Legacy of J Marion Sims.” Anaesthesia and Intensive Care, vol. 48, no. 3, Nov. 2020, pp. 6–13, https://doi.org/10.1177/0310057x20966606.

6. Snipe, Margo. “Clinicians Dismiss Black Women’s Pain. The Consequences Are Dire.” Capital B, 6 Sept. 2022, capitalbnews.org/black-women-pain/.