Breaking silences and including everyone in the conversation An important aspect of education that drives destigmatization is breaking silences

and including everyone in the conversation about menstruation and menstrual products. This entails ensuring that all people, regardless of whether male, female, or non-binary, are knowledgeable about the workings of the menstrual cycle and menstrual products. This is imperative not only for destigmatization directly but

also for getting menstruation and menstrual products on the agenda, especially since men represent a large portion of positions of power throughout society.

Men’s understanding of menstruators’ matters is crucial to get good policies that address them. Inga T. Winkler, Lecturer in Human Rights at Columbia University stated that,

“Gender equality is about gender relations, and men have notable stakes in reproductive health. Men constitute a significant share of head positions, making decisions that greatly impact women’s everyday lives: from policy-makers deciding on matters such as the tampon tax, to principals choosing lightly-colored school uniforms without considering girls who are afraid of their period stain visibility.

Achieving gender equality will require structural changes, but to make these positive changes happen faster, we need men on board.” (Essity, 2019, p.21) Although risking stigmatization, women are increasingly letting men into the conversation, which is likely enhanced when men show an initiative and interest.

This also seems to be occurring to a greater extent currently, making such conversations easier. The greater an individual’s understanding of that which is stigmatized, the less likely they are to stigmatize, which may also lead to destigmatizing behavior in situations or group compositions where there is a greater risk of stigmatization.

A matter that was emphasized as destigmatizing in the data was educating everyone and including everyone in the conversation. The primary reason for this seemed to be in order to provide men and women, boys and girls, and non-binary people with the tools to subsequently communicate openly about menstruation, thus evading any awkwardness or other stigmatizing behavior once the topic arises, or in order to break the silence about it. A vital aspect seems to be that any kind of shaming needs to be eliminated, both in terms of shame surrounding menstruation but also shaming those who have little or no knowledge about menstruation and that might experience a sparked interest when a conversation is started.

A consequence of educating girls and boys differently regarding reproduction and the menstrual cycle is that boys are closed off from at least parts of the conversation, which fosters the idea about menstruation being something they are not allowed to concern themselves with. Correspondingly, the separation of girls and boys in education regarding menstruation fosters the idea that girls should

keep their menstruation a secret and maintain the culture of silence surrounding it. Instead, to avoid stigmatization, it is important that boys and girls receive the same education so that a conversation about the matter is fostered, and no group is left knowing less, risking that these individuals might become future stigmatizers. Louise Berg stated that,

“The fact that classes are still divided where girls go and talk about menstruation and boys are not allowed to take part gives birth to an idea in boys that ‘I am not allowed to talk about this,’ which means that they are not let in, and it means they don’t think about it. It becomes an initial taboo that they are not allowed to touch, and girls learn from the beginning that ‘this is not something I talk about; this is my secret.’”

Educating boys to the same extent as girls can also be a way to address the myths surrounding menstruation and menstrual products and to minimize the risk of misinterpretations that can lead to stigmatization. If the workings of menstruation become widespread and are considered common knowledge, myths and shaming practices will probably be eradicated, and destigmatization will follow.

Gynecologist Christina Lloyd stated that,

“…it is a question of knowledge, that there shouldn’t be a menstrual stigma, that there is still so much misinformation, so the knowledge is really important, and it should be self-evident.”

If boys and girls are educated equally about menstruation, then adults in the future will have more tools and fewer reasons to stigmatize menstruation. Nonetheless, until all children have access to such education, it is important to educate women and men as well. In some places, such as Northern India, it is common that men do the household shopping. This implies that, without specific knowledge or encouragement to purchase menstrual products, they likely will not do so.

Further, without a conversation about it, it is even less likely that they will purchase the kind of menstrual product that corresponds to his wife’s or daughter’s specific needs. Michael Moscherosch stated that,

“Education is extremely important. What I’m always saying is that don’t only educate the girls, educate everybody, the mothers as well as the girls, but also the boys and the men. In Northern India, for example, in many regions the shopping is mainly done by men. If they don’t understand menstruation, are they going to

buy any, or the right product for their wife or their daughters? Probably not. So, the girls don’t actually go out shopping, the women don’t go out shopping so much either, so the guys go shopping. I don’t know if you’ve ever asked a guy to go shopping for sanitary protections; that’s an interesting experience, because the guys go all nervous about it and they have no idea; they don’t want to be seen in the isle. And in India, there are places where they don’t even offer the products or they are hidden somewhere, and if men don’t ask for the product, they are not going to get it. That’s why I think it’s important that you educate the entire population about it, not just girls and women.”

This has also been identified at Essity, who educate around 2.5 million people per year about menstruation according to Sofia Hallberg, Nordic Communications Director. In their Hygiene and Health report for 2018 and 2019, Essity further emphasized that breaking the silence and talking about menstruation in an educated manner and by including it as a natural and normalized part of general education is an imperative way to destigmatize. The report stated that,

“Breaking the silence. […] Girls are encouraged to talk and discuss in an informed and positive manner to prepare them emotionally and physically for menarche and recurring monthly menstrual periods thereafter. […] Menstruation should be more talked about, let us make it our mission. Menstruation should not be seen as a taboo topic, but a natural part of education, development work, and other arenas.

Public and private actors should use their reach and influence to enable more open conversations about menstruation.” (Essity, 2019, pp.14 & 29)

Essity frequently discuss their communication, in terms of being a taboo breaking brand where they see themselves as somewhat of a pioneer who likes to take the first step and show others that there are ways to break the silence around menstruation. They use the metaphor of being an older sister to demonstrate to the metaphorical younger sister that if we can do it, so can you. The little sister is both other companies as well as users, and they apply it in terms of both advertisement and direct communication with users when they might ask for advice about product use or menstruation in general. Jenny Smith asserted that,

“I think this, that we jump first, we take that step that maybe the little sister doesn’t dare take and start talking about things and turn things upside down and create a debate, and that’s something we’ve really done in the past few years.”

One of their marketing campaigns, called #MensUtmaningen or

#TheMenstrualChallenge, was aimed at spreading knowledge and intensifying discourse about menstruation in sports clubs and women’s and girls’ teams. The reason they targeted these groups was twofold. Firstly, because it is one of the places where girls might be exposed to stigmatization if they are a so-called ‘early bloomer’ and might quit their activity as a consequence. Secondly, the menstrual cycle can affect women’s and girls’ performances, especially in sports, which is why an openness and a conversation about menstruation is preferable, especially since coaches are often male. Jenny Smith described the campaign:

“This was an initiative that we drove because we wanted to bring attention to all the girls out there who train but also those who don’t train as much by getting clubs to start talking more about menstruation and actually educating coaches, who oftentimes are men and who don’t even dare to speak the word and get it more on the agenda, and that it can actually really affect the girls on the team a lot and many of them even quit when their menstruation starts. If you’re the first one to get it, then maybe you stop because that can be horrendously tough.”

One way that has proven successful in the past to address this matter is to talk about it and signal to female athletes that they should not feel ashamed about menstruation as well as the ways it might affect them and their performance.

Instead, having a conversation about the matter might create an understanding of the status quo and result in solutions that are more suitable and productive for both the athlete and the coach at that given time, instead of wasting time and energy on something that is not going well that day. Smith asserted that,

“Just by starting to talk about things, because that’s how you remove taboos, you can actually get a lot of girls to stay in the club and also that maybe you get to feel like it’s ok, as a girl, to feel that ‘maybe I can’t perform as well this time because I’m menstruating, and I can tell my coach that and that’s okay and then he can tell me that I can go to the gym or something if there’s something I feel like I can’t do.”

The main goal of the project was to start a conversation among athletes and coaches about menstruation and normalize it in the context of sports, because all too often it is a matter that affects athletes to some degree but that is rarely discussed. Jenny Smith described the destigmatization strategy of the campaign as breaking the silence around menstruation by educating:

“If you sign up for this, that means you have to do these things in the club: you have to start talking about menstruation; you have to go through this training about menstruation. All coaches should start talking to the girls [about menstruation] and should carry menstrual products in their training bags;

obviously, the same way you have band aids.”

The campaign is successful in breaking taboos and destigmatizing menstrual products. What generated the most positive response is that the men involved found relief in being able to base conversations on knowledge they did not previously possess. These men had namely been struggling to break the silence, not because they did not want to, but because they were lacking in knowledge about what to say and how. Smith stated that,

“I think that what we got a lot of response to was that these men found it really comforting to have something to hold on to, some education and someone who started talking about it because they found themselves feeling very uncomfortable in that situation, of course. And then there’s a group of teenaged girls who are sitting there, not wanting to do anything or don’t want to come to practice or something – so, this way they got some tools. So, it’s not that they don’t want to, it’s a lack of knowledge that makes them not dare to talk about things.”

Another notion that points to the importance of education and knowledge in destigmatizing menstruation and menstrual products is the curiosity expressed by those lesser informed, as well as enabling an environment that fosters such curiosity and without stigmatizing on the basis of ignorance. For example, Odlén pointed out that when she talked to her male friends about her project to develop a new kind of menstrual product, she found them to be surprisingly positive and curious. She explained that,

“They are aware that they know very little about this question, and they are almost ashamed, and they really want to know more. They know that ‘this is the way society is, and that is why I have never felt like they need to find out more about these things, but now that you are talking about it, I realize that it is crazy that I don’t know these things,’ which is nice, but again, this is probably not very representative of men across the globe.”

It is an interesting notion that those who would traditionally likely be in a position of power and take on the role of stigmatizers are described as ashamed, because this signifies that, in this particular instance, the traditional stigma that places

shame on the menstruator or the person who discusses menstruation seems almost nullified, as the shame is instead placed on the person who lacks knowledge about menstruation. This implies that in this situation, menstruation is regarded as a natural process that everyone should understand, but social norms that stigmatize menstruation have prevented the development and dissemination of such knowledge among the public, and particularly men. While it is likely that this view is under-represented outside the scope of Sweden, Lund or even her friendship group, it is an interesting occurrence that the shame had shifted, signifying a destigmatization of menstruation in that particular instance.

In a different sense, however, discussing menstruation and menstrual products openly during lunch with both men and women present can be seen as an individual-level destigmatizing action, where other individuals are invited to a conversation about something traditionally stigmatized as though it were not. The more such conversations are held, the more the discourse surrounding the topic will increase and the individual level destigmatization will affect the structural level destigmatization and the process will continue iteratively.

Including everyone in the conversation can be received in various ways where people are more or less receptive to discussing the topic. Another instance where non-traditional interest and curiosity were expressed was recollected by Louise Berg, who stated that,

“Some people say, ‘that is a girl thing’ and what I say is: actually, I have been to schools and many parties where those most interested are guys who feel like ‘Oh!

Can I finally ask my questions now? Will you answer them?’ They can be a bit hesitant at first but slowly but steadily they come over, one by one, and want to ask a bunch of questions, which is a lot of fun.”

This can be seen as a further indication that discourse on menstruation is increasingly spreading into new spaces, out of the private sphere of women. It is an interesting notion that the initiative toward increasing that discourse is not only taken from the side of menstruators but also from men, who express an interest in menstrual products, functions, and experiences of menstruation. Again, this is an indication that attitudes are shifting from shaming and disgust toward encouragement and interestedness. Moreover, products, especially those that are new on the market, are being reclassified as fascinating rather than dirty objects to be hidden in secrecy. It is noteworthy that discourses and men’s openness to

discussing menstruation vary between cultures. The social context where men are intrigued by Louise Berg’s work in a private setting is very different from the public scene where many men are uncomfortable in the menstrual product aisle, as discussed by Michael Moscherosch. In the former, the proverbial ice has already been broken, Berg has taken on the role as the silence breaker and opened up the conversation. Unless this is done, however, the culture of silence makes people want to distance themselves from menstrual products, making purchases thereof uncomfortable. However, the more actors are let into the conversation, the more the culture of silence will be broken down, products destigmatized, and consumers will find it less uncomfortable to hover in the menstrual product aisle.

Another example where the conversation is spreading to include people who have traditionally been left out is with fathers who ask advice on how to speak to their daughters about menstruation. They are intent on showing their daughters that menstruation is not something they need to hide from their fathers and want to do so by starting a conversation in a constructive way, free of shame. If and when they succeed in doing so, they are proud of their destigmatizing achievement and want to share the outcome. Berg stated that,

“It varies a lot who it is, but I have, for example, heard dads with daughters that are soon going to get their period, who ask me how to talk to their daughters:

‘Louise, what do I do?’ Then afterwards, they like to tell me so I can say that they’ve done a good job, which is funny. ‘I spoke to my daughter yesterday!’ ‘Okay, well done.’”

This can be seen as a further indication of breaking silences through individual actions, namely fathers asking advice about how to discuss menstruation with their daughters and then doing so. Such actions can have the effect that daughters do not experience menstruation as stigmatized on the same level, nor as a question to be discussed only by women and hidden from men. By showing engagement and concern for their daughter’s health and well-being, menstruation can be redefined as a normal matter related to any person, regardless of whether male or female. Furthermore, this quote once again illustrates a shift in attitudes, or reclassification, from shaming and silencing to openness, acceptance, and pride.

“Before, it was more ‘you can’t talk about that stuff, [the market] is already saturated, people were more uncomfortable. Now curiosity has taken over and people want to be more modern. Like when I get a text message from my guy

friend in the middle of the night asking how you take out a menstrual cup because it must be slippery, and there is no thread to pull on.”

Breaking silences and including everyone in the conversation thus entails an important factor that contributes to destigmatization since it provides people with the tools to be able to discuss menstruation and menstrual products in a destigmatized and destigmatizing way. This is especially relevant for those who have previously been shut out of the conversation, often men and boys, from an early stage in their lives. These individuals often have a surprising will to engage in the conversation but may be hesitant due to the risk of feeling ashamed because they know so little about the matter, as it is often considered general knowledge by those who are having conversations about it in public currently, including many of my respondents. Instead of shaming, however, it is important that these men and boys are invited to join conversations, which may lead to a display of curiosity and enthusiasm toward learning more about menstruation and menstrual products.

5.1.2. ‘Myth busting’

What can be regarded as expert knowledge is debatable. Is it the health experts who know about menstruation or the women who live through the menstrual experience who really hold the expertise? In most cases, it is probably the health experts who are regarded as such, but it is not them who are destigmatizing menstruation or menstrual products today, contrary to what previous research states. We have had health experts with knowledge of the menstrual cycle since the late nineteenth and twentieth centuries, whose knowledge caused a shift from a disarray of ideas about the blood that exited women once a month toward the

‘scientific menstruation’ (Vostral, 2008). This led to a contradiction between conservative health experts, who applied patriarchal constructions prescribing women to certain practices and behaviors during menstruation such as taking “a mandatory rest from school and activities during their periods,” and feminist health experts arguing that menstruation is a natural and healthy process during which women should be able to continue with their normal lives (Vostral, 2008, p.4).

History has shown that it was the former set of ideas that gained traction, and in order to be able to do so, the idea that hiding one’s menstruation became