Like roughly 190 million people around the world, I suffer from endometriosis, a condition that leaves me in debilitating pain during my period. For almost a week each month, I have to endure a sharp, stabbing pain that confines me to my bed and restricts my daily activities. The prospect of being expected to work through that pain every month has discouraged me from applying for full-time jobs.
To suffer from painful periods, as I do, in a society that already stigmatizes menstruation is to add injury to insult. In India, where I live, people on their period are widely considered “impure.” Many are made to sleep on separate beds, eat from different utensils and plates, and avoid touching anything in their houses. Family members might prohibit them from entering the kitchen and places of worship. In many rural areas, menstruators are not even allowed to access their own homes; they must stay in designated outhouses for the duration of their period. So taboo is the topic of menstruation that pharmacists often sell menstrual care products in opaque, concealed covers. Millions of girls drop out of school because of a lack of menstrual hygiene facilities and the stigma surrounding menstruation.
So it was hardly surprising, yet disappointing, when India’s Supreme Court recently refused to entertain a petition that would’ve require all states to grant menstrual leave to female students and workers. The Court’s chief justice characterized it as a policy matter, which the constitution places under the purview of the executive branch and not the Court. Although he was technically justified in making this argument, that is little solace to the millions of menstruators who live in states where governments are failing to take action. Menstrual leave is a matter of gender equity and human rights and should be accessible universally.
Only two states in India, Kerala and Bihar, currently offer menstrual leave — to government university students and government employees, respectively — and the policies remain rare in both the developed and developing world. Several countries — including Japan, Taiwan, South Korea, Indonesia, and most recently Spain — have laws that entitle people to menstrual leave, as do some provinces in China. Some companies in the U.K., India, and Australia have also implemented menstrual leave policies.
The structure of these policies varies. Some offer three days of leave per year, others as many as three days per month, which may be paid or unpaid. Some require a doctor’s note. Some policies let employees choose between working from home, working in the office in a more comfortable area, or using paid leave. But all aim to ensure that menstruators can take time away from their normal work routine when they need it. Publicly available data on the way people use menstrual leave are limited, but a survey of workers in Japan found that less than 10 percent of menstruators there avail themselves of the benefit, while almost 50 percent wish to take such a leave but have yet to do so, often because they are reluctant to apply for menstrual leave to a male boss.
To suffer from painful periods, as I do, in a society that already stigmatizes menstruation is to add injury to insult.
In one U.S. poll, fewer than half of respondents said they would support a menstrual leave policy without reservations. Why do some people remain resistant? Studies suggest the reasons range from questions about fairness, to concerns about productivity, to worries about unintended consequences. But these fears are largely unsubstantiated.
One common concern, for instance, is that menstrual leave could medicalize and pathologize what is a natural biological process. Though it’s true that menstruation itself is not a disorder, menstrual cycles affect different people in different ways, and many people do suffer from menstrual-related conditions that prevent them from functioning normally during their period. Between 50 and 90 percent of menstruators suffer from pain from period cramps, known as dysmenorrhea. Endometriosis, the chronic disease that causes my debilitating pain, affects roughly one in 10 menstruators. Other people suffer from premenstrual dysphoric disorder, characterized by psychological and physical symptoms; polycystic ovary syndrome, which can cause unusual or long periods; and uterine fibroids, which can cause painful and excessive menstrual bleeding.
Even people who acknowledge these health complications might argue that menstrual leave is unnecessary because menstruators can simply use sick leave. It would be unfair, in other words, for women to get more leave than men. However, gender equity does not mean negating or ignoring gender differences, but rather acknowledging gender differences and taking measures to meaningfully address them. If menstruators were to regularly use sick leave for our periods, what would we do when we fell ill from other ailments? From that perspective, menstrual leave is a fair and compassionate response to a health issue that affects one particular societal group.
Yet another critique of menstrual leave is that it could further stigmatize women, and thereby do more harm than good. Due to societal prejudices and biases, people who are menstruating can be perceived as less competent, less likable, less attractive, and moodier. A formal menstrual leave policy may further ingrain these biases, some say, and propagate a misconception that menstruators are either too weak — or simply too unwilling — to work during their period cycle.
In one U.S. poll, fewer than half of respondents said they would support a menstrual leave policy without reservations.
These kinds of arguments carry a particular currency in India, a patriarchal society where menstruation is still heavily stigmatized. Last year, politicians dismissed a bill that would have enshrined menstrual leave in the state of Arunachal Pradesh, arguing that menstruation is an “unclean” topic and should not be discussed in a “holy place” such as the Legislative Assembly. Opponents of menstrual leave in India have argued that it would upset certain cultural norms, and that disclosing menstrual status could make menstruators more susceptible to discrimination. In his recent ruling, the chief justice of the Indian Supreme Court speculated that compelling employers to offer menstrual leave may disincentivize them from hiring women. (The chief justice’s claim is not supported by data, and some have observed that a menstrual leave policy implemented in the state of Bihar in 1992 did not lead to increased discrimination there.)
Arguments invoking potential future injustices place the burden of preventing discrimination on menstruators, rather than on the people doing the discriminating. Menstruators shouldn’t have to tough it out to prove their worth in a man’s world. Current workplace norms have been historically designed for an average man. If these norms are characterized by apprehension and prejudice against menstruation, it is the workplace that must change and become more accommodating, not menstruators.
Menstrual leave policies may even help to destigmatize menstruation and correct misconceptions that are prevalent in patriarchal societies like India’s. They could be accompanied by reproductive education and other activities to sensitize employees to the experiences of people who menstruate, and to ensure that menstruators can feel comfortable requesting leave.
But the primary aim of menstrual leave should be to offer rest to people who need it — a stance that makes sense not just from a human rights perspective but from an economic perspective. In one study, 80 percent of menstruators reported lower productivity on days they were compelled to be at work during their periods. Many CEOs and economists argue companies would improve productivity by allowing menstruators to get adequate rest, rather than forcing them to work through discomfort.
Of course, implementing transformative policies like menstrual leave inevitably brings tradeoffs, challenges, and potential drawbacks. But that should not be a reason to resort to inaction; it should motivate us to develop new interventions and work toward compassionate change.
Sneha Khedkar is a biologist turned freelance science journalist from India with a passion for writing about science where it intersects with society.