Looking at Menstruation from Both Personal and Population Perspectives

Featuring Helen Osborne and Breanne Fahs

Breanne Fahs is Professor of Women and Gender Studies at Arizona State University, where she specializes in studying women’s sexuality, critical embodiment studies, feminist histories, and political activism. She has published widely in feminist, social science, and humanities journals and has authored six books. She is currently at work on her newest book, Fat and Furious, about the necessity of rage as transformational to the emotional, structural, and political dimensions of fatness. She is the founder and director of the Feminist Research on Gender and Sexuality Group at Arizona State University, and she also works as a clinical psychologist in private practice. Read more here.

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In this podcast, Breanne Fahs talks with Helen Osborne about:

  • Connection between menstruation, activism and political resistance.
  • The experience of menstruation in trans men.

Music by Skilsel from Pixabay.

Producer and audio editor: Clair Morgan


HELEN: Welcome to Talking About Blood. I’m Helen Osborne, host of this podcast series and a member of the advisory board for the Blood Project. I also produce and host my own podcast series about many aspects of health communication, and it’s called Health Literacy Out Loud. The Blood Project’s website includes a lot of important information about all aspects of blood that not only includes the science of blood, but also its meaning to people who bleed. Dr. Breanne Fahs is Professor of Women and Gender Studies at Arizona State University. She’s the founder and director of the Feminist Research Group on Gender and Sexuality at Arizona State, and also works as a clinical psychologist in private practice. Breanne has published widely in feminist, social science and humanities journals. She’s the author of six books, including Out for Blood: Essays on Menstruation and Resistance. Breanne, welcome to Talking about Blood.

BREANNE: Thanks for having me. I’m excited to be here.

HELEN: Now, menstruation, of course, is a topic that affects one time or another half of the world’s populations, but despite all that, I don’t think I’ve ever read a scholarly publication on the topic. Yours is the very first. Do tell. What prompted you to create a series of essays on menstruation and also combining it with the topic of resistance?

BREANNE: Well, there is a decent amount of research that has been done on menstruation. There’s the Society for Menstrual Cycle Research that has been in existence for decades. So it, you know, I certainly don’t want to take credit that I’m the first or the only to be doing this work. There’s tons of scholars working in this area. But I think it has been a little bit unusual to look at menstruation as connected to things like activism or political resistance. And so I wanted to do a book that really situated menstruation, not necessarily as an individual or personal experience only, but also as something that connected groups of women together that we think about in more of a political way. That was an important project of mine as a women and gender studies scholar. So the book really deals with menstruation from a whole range of topics, from things like menstrual synchrony and whether that is actually real, all the way to thinking about, you know, how they have to screen for menstruating women entering the island of Kamodo. And then, you know, kind of moving into…

HELEN: You’ve already peaked my interest.

BREANNE: How people have used menstruation like, you know, as a form of resistance, right? So people using it as an overt form of political rebellion. So I’m really interested in all of the ways that menstruation operates as a cultural text.

HELEN: That’s fascinating to me because what I’ve read is just on that personal level, not on a cultural level there. I want to explore so many of those topics. Start us off. Tell us a story.

BREANNE: Well, I think, you know, menstruation is one of those topics where everyone has stories and so many of them skew negative, right? So when you ask people about their early menstrual experiences, a lot of it is about what people don’t know and what they weren’t told. And then there’s stories about people bleeding through their clothes or having moments of embarrassment or stigma. And then there’s stories of feeling like, you know, kind of bummed out about bleeding, feeling kind of, you know, physically not great. So a lot of the stories that we have about menstruation in people’s narratives are really negative stories, but there’s a lot more to it that we can sort of think about, right? So I think, you know, a lot of women, when you ask them to sort of think about their menstrual experiences, they do feel upset and angry that it’s such a stigmatized topic, and that they’re going through this experience that they’re not supposed to talk about, and that they’re supposed to exert enormous amounts of effort to conceal. When I’m thinking about stories about menstruation, I’m also thinking about the ways in which I’m hoping we can shift the narratives away from, you know, only being this negative experience. Also tapping into people’s, you know, a little bit of the rebellious impulse that people have of not wanting their bodies doing natural things to be stigmatized, making room for, for people who menstruate way outside of the typical narratives that we make about that. So that, you know, kind of thinking about new stories about menstruation.

HELEN: I’d love to hear those, but I also want to put kind of book ends in this. You’re talking about our negative experience, and certainly, you know, you’re, I can think of so many personal stories and experiences I’ve had that certainly feels very familiar to me. Have you heard positive experiences that just women come into this with, with a positive experience? Or is it almost universally negative on a personal level?

BREANNE: No, I mean, there’s certainly positive. A lot of people feel really like they think positively about experiences, you know, talking to their mothers about menstruation. Certainly if we look more globally, there’s a lot of narratives around people starting to menstruate as a celebratory event or as a coming of age event, right? So we have those kind of stories. When I ask women, you know, I’ve interviewed many women about their positive and negative experiences with menstruation. Unfortunately, the most positive response that women typically have is saying that they’re relieved that they’re not pregnant, right? So, like, that’s kind of. People get a period when they, when they really wanted one because they didn’t want to be pregnant. I think that’s the one that floats to the top of the list. But also, I think, you know, it helps people to feel connected to their bodies. And, you know, we have some of that content too, right? Where people feel like it’s a part of what it means to be a person. It’s a part of the cycling of their bodies and of nature. So there, there’s some of that positive content.

HELEN: Thank you for all of that. I don’t want to move away from that personal experience yet. I wanna talk about the culture, but we’ll get there in a minute. But I want to talk about that personal experience, and something that really interests me is menstruation in the lifespan all the way from the time a preteen girl will start hearing about this, and probably her initial reaction to this, to the time when it doesn’t happen to our bodies anymore. Do you have an age way of looking at this too?

BREANNE: Yeah, I mean, it’s interesting to look at the kinds of stories that follow people who menstruate from the beginning until the end, right? So there’s a lot of misinformation, a lot of lack of information, a lot of pain in a lot of ways. And, you know, a coming up to understand menstruation is having very different meanings as we shift through our lives. So people feel very differently about menstruation when it involves issues of pregnancy or trying to get pregnant or trying not to get pregnant, as I mentioned before, and a lot of times, you know, at the end of menstruating life, people sometimes have a process of feeling joyful that it’s over, but also maybe grieving the loss of youth or of the ways that menstruation helped them to feel in tune with their bodies. So there’s a lot of different developmental things, right? And of course, if we look at teenage girls, they often come to menstruation in a much different way than someone who’s at more of the end of their menstruating life. So, yeah, I mean, and, and of course we, even to add an even more complexity for people who identify as trans and non-binary, menstruation can mean different things across the lifespan as well. So thinking about the ways that hormones might impact how much they bleed, feeling maybe some body dysmorphia around menstruation. There’s a lot of different aspects of it that we can look at developmentally.

HELEN: That is absolutely fascinating. Thanks for talking about the more personal. I want to delve into it because I know you even have an essay on The Blood Project about trans men who are bleeding. Tell us a little bit more about that.

BREANNE: Yeah. The essay that’s on The Blood Project, it was a study that I had done of trans men in my clinical psychology practice, thinking about some case studies that help us to understand some of the different stakes that trans men are bringing to the picture when they menstruate. So some of those case studies are thinking about in clinical work, trying to reframe menstruation away from being thought of as essentially and only and wholly related to the feminine. So trying to masculinize menstruation was one of the case studies I was sort of thinking about, but also the ways in which trans men may attach different stories to what menstruation means to them, and also not have a lot of cultural spaces to think about that or reflect on that, for example, with their families or their friends or their social communities. And so, menstruation sometimes becomes this kind of, you know, big source of distress without a lot of story attached to it. That’s true in general with menstruation. But the stakes are a little bit higher in terms of how that really impacts trans men’s, you know, kind of feelings about wellbeing or about what, what the meaning of menstruation is. So the essay’s thinking about some of those details.

HELEN: So this is someone who did not have the bottom surgery, so their body is still functioning as a woman in that way. Is that correct?

BREANNE: Right. So a lot of trans men are still menstruating and then, you know, every month they have to negotiate with that. And, and there’s lots of different issues. For example, you know, being outed unwittingly in a men’s restroom may have more dangers, for example, than being outed as menstruating for someone who’s cisgender, right? So thinking about just what are the stakes that are different for people who are menstruating in context where being outed in that way would have a different impact. So yeah, that, I mean, that’s part of what the essay is kind of thinking about as well.

HELEN: It was fascinating to read that, and I encourage listeners to be reading and following up on that. Now, you talked about bigger issues. You talked about resistance. I know when you and I were talking, you also use the term stigma. You talk about cultural implications of this. Tell us some more about what menstruation means more in a population level.

BREANNE: Yeah, I mean, I’m really interested in how stigma operates the way that negative meanings and connotations get attached to categories of people who are devalued in society. That’s kind of what I would define stigma as. This is coming from kind of the Irving Goffman sociological framework, but stigma really matters in the sense that, you know, we don’t, menstruation doesn’t necessarily need to be treated as this sort of, you know, gross or awful or traumatizing or negative experience per se. But often it ends up getting exacerbated by stigma for this need to be concealed, for the need to not talk about it. You know, people feel ashamed of their menstrual status. They feel like if, you know, if obviously many women recount bleeding through their clothes as a very traumatic and embarrassing moment of their adolescence or even later on, there’s many aspects where stigma kind of plays into how we think about and treat menstruation.

And, and you see this even in advertisements, right? So the way that menstrual products, they advertise their features as we will help you to better conceal your menstruation, essentially that’s what they’re all telling us, not necessarily about comfort or, you know, other kinds of dimension even smelling better. Like, there’s like a lot of things where the main objective of a menstrual product is to assist concealing your menstrual status. And in some ways that’s a, it kind of reinforces again, that stigma is very much what surrounds menstruation and what surrounds a lot of different body statuses that we demean and, and denigrate. So that’s sort of part of it too.

HELEN: Thank you. I think of it culturally too, I did read the book that came out a while ago, The Red Tent, about where women would go into a tent, be separated as I recall this, be separated from their families and loved ones to be separated while they were menstruating. Aren’t there rituals? You have to be ritually clean, cleansed. I don’t want to appropriate which culture it goes to. I think it’s Judaism, but I expect that it probably happens in other cultures too. Tell us a story about a, a cultural story like that we may have heard, or we might have understood correctly or not correctly.

BREANNE: Yeah. I mean, one of them that really stands out to me is that we often, especially, you know, kind of living in the US when we’re thinking about like, what do people around the world need in their menstrual lives? One of the things that we keep imagining that people need are better menstrual products, usually single use products. And in fact, what they, what we often find, you know, when you, for example, when you know people from nonprofits like go into different parts of Africa and talk to women about what are the things that you feel like you need, the thing that they most often bring up is both education about menstruation and physiological sort of meanings, but also pain management. So we from the West often think, well, people need products and they need better products. And many people, you know, many women are telling us all over the world, no actually what we need is we need better menstrual education, and we need pain management.

And I think this really speaks to how there’s kind of a disconnect sometimes between the things that we think other women need and what they actually tell us that they need. And so thinking about how we better align those things really matters. And then the example you just brought up with the, you know, the, the red tent or the separation, you know, one of the risks that really happens with women being separated in those ways is that they sometimes freeze to death or are bitten by snakes, or there’s, you know, there’s the, the actual risks of that are, are also physical in addition to operating from a place of stigma. Or if we look at, you know, African women often use cloth to absorb their menstrual blood. And one of the biggest aspects of whether that is sanitary or not, is whether they’re able to hang up their cloth rags in the sun so that they can dry.

But in order to do that, they have to not be stigmatized to the point that hanging up a menstrual rag is a problem. And so in the communities where hanging up menstrual rags and letting them dry out properly is accepted, that is a perfectly sanitary way of dealing with menstruation and, and menstrual needs. But in cultures where you can’t properly dry those rags, then that leads to like more kind of, you know, issues of challenging hygiene problems, right? So I guess my point again, is stigma is at the core also of how we sort of take care of our bodies and whether we can take care of our bodies in the ways that we need to. And that’s, that’s true in the US and throughout the world, right? So we need to open up space rather than close space for thinking about how do we allow room for people’s bodies to get the care that they need.

HELEN: Absolutely fascinating listening to you and hearing these stories. So this issue of stigma, is it a man-woman kind of a stigma and women feel less comfortable around men? Or could it even be women-women stigma?

BREANNE: Yeah. I mean, the thing about stigma is it doesn’t necessarily go away. It’s even operating on the level of intra-psychically, right? So when you talk to people about how they feel about menstruation, they also will say just sometimes that they feel like their own blood is gross, right? So sometimes when, okay, when people transition from using pads and tampons to trying a menstrual cup, one of the things that they find is that that is a very different, you know, visceral kind of physical interacting with menstrual blood that they’re not used to. And it can be a little shocking actually to interact with, you know, your genitals or your menstrual blood so directly and vividly. And so you see that stigma is not necessarily just communicated in those interpersonal interactions like buying tampons at a grocery store and wondering what the grocery clerk thinks, or, you know, talking about menstruation at, at the dinner table with the family, or, you know, openly disclosing menstrual status when you’re in a lot of pain at work or something like that.

Those are all instances where stigma can happen, but it also happens inside of our brains and inside of the way that we feel and our own attitudes about our bodies. And that extends into many different areas that also have that quality, right? So a lot of women describe feeling very squeamish about looking at, interacting with their genitals in general. And so of course that will also translate into the way that people interact with their menstrual blood. So I think we have to kind of imagine that stigma really operates inter psychically, interpersonally and culturally. On all of those levels. And it affects us deeply, and it’s hard to really excavate that even within ourselves. Even for myself, as someone who researches this and has been thinking about these topics for a long, long time, I still struggle at times with, you know, internalized menstrual stigma and can you talk openly about this? I mean, it’s still a tricky subject no matter how long you’ve been doing work in this area. So I, you know, I don’t, well, I don’t write out of that either.

HELEN: Thank, you know, thank you. Thank you for sharing that. Now, our listeners to this podcast, they are all somehow interested in blood, whether they are seasoned hematologists or physicians in other specialties, been working for a long time, they may be new to the health sciences, or, you know, in the early stages of the careers, or just people just curious and interested, what would you like to say to each of those groups, just ever so briefly, like what would you want each group to know? Do you wanna start with the seasoned professionals?

BREANNE: Yeah. When we think about medical professionals, the thing that I always want them to sort of think more about are the ways that stigma affects even the very nature of how people seek out medical treatment, what they disclose to doctors, how they talk about their bodies, whether they’re in the room at all with a doctor, right? And so there’s so many different aspects of that with bodies across the board, not just with blood, of course. I mean, you know, I have a friend, for example, who is very nervous about going in for a sleep apnea evaluation because she associates sleep apnea with fatness, which is another stigmatized category. And so that has stopped her from getting the medical treatment she needs. And I can’t imagine there’s not many implications of that also for people seeking out other kinds of medical care, that stigma affects the ways that people construct their own ability to care for their bodies. And so the more that we can work to make people feel comfortable about, you know, uncomfortable subjects, sometimes, the better medical care we give, right? So that’s one message I would definitely say is important.

HELEN: What about someone entering early stages of their career or professional life? What would you recommend at the beginning stages?

BREANNE: Yeah, I think, you know, another aspect that menstrual politics helps us to look at is that there’s all sorts of populations that are excluded from view. And that’s a really important thing that I think we all have to be thinking about all the time, right? So the ways that, for example, the typical story of menstruation holds that, you know, younger women are the focus of that, but actually we have huge blind spots around people going through perimenopause and menopause. We have blind spots about trans and non-binary menstruaters. We have blind spots about the needs of people who are homeless and how they negotiate menstruation. Women in prisons, that’s another big blind spot. There’s all these blind spots of populations that kind of get left behind or excluded or pushed out of view. And so I think, you know, with people coming to different, you know, early professional lives, trying to keep in mind groups of people that are often excluded from view seems like the most important message that I would want to communicate because it’s just such a common problem that we oversimplify the population of people that we think that we’re serving or thinking about when actually there’s a whole bunch of other people that are in that picture that often either get pushed out of view or are left out of view.

HELEN: You’re inspiring, you’re very inspiring, and you are so knowledgeable. I hope some people will pick up on that message and do something more with it. Anything just for the general population that you’d want us to know overall?

BREANNE: Yeah, I mean, I think the general population, I would say there’s so many things about menstruation that are interesting to kind of imagine and think about. I mean, one is just making room for menstrual, you know, the tensions that we have about menstruation, that it can be joyful, it can be terrible, it can be painful, it can be a revelation, it can be a connection to our bodies, but also to each other. So I would encourage listeners to sort of think about the many meanings of menstruation. But also, you know, thinking about how to imagine menstruation as a tool of resistance. You know, anything that has a stigmatized status also has the potential to really help us figure out new ways to rebel. And that matters too, whether that’s just like refusing silence or teaching your daughters to think a little differently about menstruation, or trying to work against stigma or trying out new menstrual products that don’t rely on single use to kind of imagine a, you know, of a different environmental perspective. There’s just so many things we can do to think about menstruation in a more political and social lens, I think.

HELEN: You’re great. So just leaving listeners with ways to learn more, tell us again about your book and how they can learn a little bit more. And this, some of this information will be on the website on Talking about Blood and The Blood Project.

BREANNE: Yeah. So my book is called Out for Blood: Essays on Menstruation and Resistance. You can pick that up in bookstores or on Amazon. I also was a part of a, a huge open access project called The Palgrave Handbook for Critical Menstruation Studies that has 72 chapters. They’re all free to access. And that’s a wonderful resource of everything. And you can imagine about the emerging field of critical menstruation studies. So for people who want to download individual chapters of the whole book, that’s a great resource as well.

HELEN: Good. Thank you. Breanne, thank you for everything for your scholarly work. Thank you for sharing all your great information and doing it with humor and humanity and wisdom. I’m talking about blood. Thanks so much for being a guest on this podcast.

BREANNE: As we just heard from Dr. Breanne Fahz, it’s important to consider the many aspects of bleeding and blood. And that, of course includes thinking about menstruation and all its many components of what it means to people and to populations. To learn more about the Blood Project and explore its many resources for professionals and trainees, patients, go to the blood project.com. I invite you to also listen to my other podcast series, and that’s about health communication, and it’s at health literacy out loud.com. Please help spread the word about this podcast series and the Blood Project. Thank you for listening. Until next time, I’m Helen Osborne.

HELEN: You are an inspiration. Thank you for that. As we just heard from Charlie Murphy, the integration, the interdisciplinary nature of science and art is so important. It makes us human. It brings out the humanity of all we do, including whether we are working with blood, teaching about blood, or just having our own blood system and understanding it more. To learn more about The Blood Project and explore its many resources for professionals, trainees, and patients, go to thebloodproject.com. I also invite you to listen to my other podcast series about health communication. It’s at healthliteracyoutloud.com. Please help spread the word about this podcast series and The Blood Project. Thank you for listening. Until next time, I’m Helen Osborne.