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Lack of pressure from consumers to regulate

4. The Mechanisms of Destigmatization

4.2. The menstrual product stigma and first steps toward destigmatization

4.2.4. Lack of pressure from consumers to regulate

Furthermore, the Chemicals Agency pointed out that it is manufacturers who hold the responsibility for the safety of menstrual products, as per current EU legislation where they are classified as consumer products. They also stated that the manufacturers should work toward increasing their knowledge of the substances in menstrual products, especially those whose effects are largely unknown through current research. Rosen stated that,

“The manufacturers themselves should find out more about these substances that we don’t know much about….”

On the same note, Anna-Lisa Persson at the Swedish Consumers’ Association argued that with multinational supply chains it might be difficult for manufacturers to control the raw materials they source, but they are likely to have rigorous testing and requirements set on their suppliers. Without standards or regulations prescribing regular third-party testing, however, Persson argues that they as a consumers’ organization and, indeed, consumers, have limited capacity to determine the safety of the products they use. Persson stated that,

“One could suppose that [manufacturers] have the same types of criteria for the cotton they purchase regardless of the origin, but Persson states that often the composition of products is the same across production facilities and countries, but the amount of pesticides in the cotton can vary a lot depending on, for example, the country and time of year. So, it boils down to what controls each manufacturer has in place, but that we do not know. They might have great controls. It would be interesting to know how companies purchase their cotton and rayon and what their criteria are.”

In summary, respondents indicate the lack of knowledge, regulations, and standards pertaining to the safety of menstrual products – a matter likely connected with the stigma on menstruation and menstrual products and consequential neglect thereof in political decision-making.

“We have never had any indications that there might be problems with menstrual products, which is why they have just been left alone.”

The matter of communicating one’s menstrual experience and actually being conscious of one’s menstrual experience to the point where it could be communicated are both complex in the context of stigma. This is because stigma causes disassociation, which implies that people do not think or talk so much about that which is stigmatized as they would have, were it not stigmatized.

Consequentially, people hardly know about their own experiences, let alone other people’s, since they tend to ignore matters related to menstruation. Therefore, it is theoretically likely that the more stigmatized one experiences menstruation to be, the less consumers are likely to reflect on and know about their own and others’ menstrual experiences and products. This implies that consumer organizations, manufacturers, governmental agencies, and others that might be considered responsible for overlooking the safety of menstrual products may not be alerted of issues to the same extent as they might have, if products were destigmatized. Nonetheless, there is some communication of issues about menstrual products that has reached such actors, including the Chemicals Agency.

Rosen gave an example of a Finnish agency that performed investigations after having received multiple complaints of strongly smelling panty liners as well as physical symptoms caused by them. She claimed that,

“Scented panty liners, which is a product that seems to cause a certain amount of problems, should be controlled very carefully, if they should be sold at all […] We received tips during 2015 and 2016, I counted eight emails or letters in the past two years, and there are two from consumers who have experienced issues and the remaining six are things like ‘I bought these liners, they stink of perfume, shouldn’t you be looking at this?’”

Admittedly, out of the thousands of users of any given menstrual product on the Swedish market, the number of complaints sounds rather low. Nevertheless, the Agency followed up on them and found that there was not much else to do than discuss the matter with the manufacturers in question, because there were no legal frameworks or standards to compare the products to. Rosen explained,

“We have reported all the cases, especially those where there are concrete concerns to report. We have been in contact with those who sell these liners in Sweden and communicated a little with them. What we have been told is that they have not

added any perfume; rather, odor neutralizing substances have been added in production. They argue that there can be other perfume-like substances that aren’t actual perfume but that can cause the scent and I don’t really understand that because according to the emails we’ve received, they really stink and I’m thinking I need to go buy myself a carton, so I know. And then, they say they’ve done all kinds of tests and that they are safe to use. And then we haven’t gotten much further.”

Furthermore, another reason why there seems to be a lack of pressure from consumers about regulating or standardizing menstrual product safety is because they do not seem to have reflected on whether there are already regulations or standards. This could be for a number of reasons. Firstly, products that are used on or inside the body are commonly highly regulated, so people are likely to assume that menstrual products are as well. Finding out about the lack of regulations and standards for menstrual products often triggers responses such as surprise and anger among the respondents. Lisa Perby at MontlyCup has taken it upon herself to start lobbying to rectify the matter, because she is concerned that unsafe products might be placed on the market, lacking regulations and if their competition gets a bad reputation, then there is a risk that it might rub off on them as well. She stated that,

“It’s completely crazy that there aren’t any requirements at all. It is really frightening. Things we have inside our bodies that don’t have any requirements […] It worries me that there are new menstrual cup companies popping up the whole time without there being any legislation in place. We are very sensitive because we are very small; so, if one menstrual cup is harmful, then so are all the others.”

Gynecologist Christina Lloyd agreed, stating,

“Because of what I work with, it surprises me a lot when you tell me about the lack of standards and regulations on menstrual products because I haven’t even reflected on it, like ‘what? How can this be?’”

Generally, people in Sweden, in particular, place a lot of trust in the government and companies to protect them as consumers, but that trust still mandates some type of control function. Anna-Lisa Persson at the Consumers’ Association expressed that,

“In Sweden, we have a very high level of trust in our society, and that includes a trust in that products on the market do not contain hazardous chemicals. It is nice to have this image, but it can also go wrong when that trust exceeds reality and we do not have the controls in place to ensure that products are safe.”

Rosen at the Chemicals Agency agreed that rules and their enforcement through controls are necessary to ensure product safety. She claimed that,

“Companies have a responsibility, but there is no one controlling how or that they take that responsibility. And there is a lack of detailed rules, which would enable for an authority to control that they do. So, in theory, they can develop products and add, really, anything, and then say that ‘we think this is safe.’”

Persson implies that there should be third party controls, and not only controls within manufacturing companies – a point that some manufacturers, such as Michael Moscherosch at Johnson & Johnson, agreed upon. However, he further argued that, philosophically, it is impossible to prove the safety of a product, since a hypothesis can only ever be disproven. Hence, there is no way that companies could ever know for certain that their products are 100 percent safe. Nonetheless, he argued that they should do everything in their power to ascertain that anything they place on the market is as safe as they can be using any methods at hand. At the same time, he stated that this is not something they do for menstrual products because it is not part of their core business. He stated that,

“You can’t prove safety, you can do everything in your power that with the knowledge you have, the product is safe. External reviews, and all kinds of stuff, and I think that’s a great thing to do. We don’t do that so much in femcare, because it’s not really one of our key businesses.”

Arguably, this sounds like a contradiction of sorts. When discussing further, it seems as though Moscherosch bases this position on the notion that consumers see menstrual products as commodities – namely something you need, like toilet paper, a necessary evil, which you want to get out in the market in as simple and hassle-free way as possible. He stated that,

“I mean, femcare is probably not the biggest concern for consumers. They are much more concerned about what’s in their sunscreen or face cream or whatever;

there are other areas where they are much more interested. Because femcare or toilet paper are commodities; it’s just something you have to buy anyway, unlike

sun care. If you have concerns about coral reefs or skin cancer, then that’s a different decision. You can choose not to use sun care product and stay in the shade or carry an umbrella, but very few women can choose not to use sanitary protection. It’s a commodity. It’s just like very few people decide ‘I’m not going to use toilet paper because I don’t want the trees to be cut down.’ They say, ‘screw the trees, I need toilet paper.’”

Viewing menstrual products as commodities might further imply that they are seen as interchangeable without giving much weight to their potentially differing functions or other selling points. This could be an explanation for the low amount of variation among products on the market today. On the other hand, manufacturers frequently discuss the numerous ways in which they adapt products through innovation to consumer needs.

Furthermore, viewing menstrual products as commodities as opposed to products whose safety need to be regulated and monitored due to the way in which they are used, is in line with views that might be considered grounded in the stigma.

This brings us to the second reason why consumers do not exert any pressure for regulation or standardization. Because people do not talk about menstrual products due to the stigma in place, people rarely think about them more than what is necessary, let alone question their safety. Gynecologist Christina Lloyd was initially very surprised upon finding out that menstrual products were so unregulated. However, she then argued that the view of menstrual products as a commodity can be related to how government classifies products. Because menstrual products are classified as consumer products, it signals that there is no need to pay particular attention to them. She added that,

“I find it unbelievable that menstrual products are classified as consumer products and are so unregulated. Depending on how you classify products, their development will be directed in a certain direction. If they are seen as just any consumer product, supply and demand are what govern their development;

menstrual products will always have a high demand, but that is not because they are good products; rather, because nature demands that women use them. What I find is that you can generally choose what you buy and what you wear or want to eat, but this is a very important question.”

Berg, who considered the failure to regulate or standardize menstrual products as an obvious sign of the stigma agreed, arguing that it becomes almost comical when

products that people know are unhealthy but choose to consume anyway are much more regulated than menstrual products that cannot be dismissed as easily.

Discussing the lack of regulations and standards, she expressed that,

“These are things I have been really angry about as they don’t exist. There is obviously a product that is in contact with our most sensitive mucous membranes where the body is open, and the risk for infections is greater than normal. That explains a lot about the taboo, that we have standardized, like, chips I guess, and say that they can cause cancer, but you haven’t looked at these products that are used continuously and are much needed. And people say, ‘oh, we forgot this area, whoops!’ That is very much a typical example of the taboo. We haven’t forgotten anything else, it seems like, that is in direct contact with mucous membranes.”

The same applies regarding classifications, standards, and labelling products as organic. When it comes to food, according to Anna-Lisa Persson, it has to be at least 90 percent organically grown to be labelled organic, whereas menstrual products can contain much less. This is unless they are third-party certified, such as in the case of some tampons that have been granted the Nordic Swan label.

Persson explained that,

“There are different regulations on food, which has to be 90 percent organically grown to be certified, and skincare or menstrual products where only one percent is needed to be able to call them organic. If tampons are labelled organic, it can often be about 20 percent that is organic cotton because there are no regulations.

There’s third-party certifications that do their own testing like the Nordic Swan who did their own test of tampons, which resulted in that they removed their label from one of the brands.”

It seems as though one of the main arguments by respondents that menstrual products are not regulated or standardized is because the matter simply is not considered important, largely due to the stigma. Drevik stated that,

“To be blunt, we’re talking about a subject that the men would rather sweep under the rug and women don’t see as important. Because it’s a necessary evil, and that makes it difficult.”

In summary, a number of aspects can be connected to the lack of pressure from consumers to regulate menstrual products. Firstly, the lack of communication about issues with menstrual products, which could be connected to the difficulties

about identifying and talking openly about such issues. There seems to be some kind of vicious circle where the difficulty in talking about problems with menstrual products because of the stigma keeps people from expressing their wants and needs. As a result, manufacturers do not think consumers have any issues with the products, so manufacturers tend not to change products, or develop new kinds of products to suit consumers better; thus, the stigma is reproduced. Secondly, there is a high level of trust in the government, especially in Sweden, to regulate products intended for oral intake, alternatively used on or inside the body, which implies that consumers are less likely to question whether such products might be controlled and safe or not. Third, and finally, menstrual products are often seen as a commodity, or a product that does not deserve much attention from regulators, because it is a ‘necessary evil’ and people would rather think about it as little as possible.