Over the preceding decade, the subject approach of menstruation has sharply shifted away from marginalization and privacy to recognition as a legitimate and pressing subject of inquiry and advocacy. It has changed from being a marginal movement, which was generally marked by relatively small-scale, localized, often volunteer-driven campaigns, to one verging on global mainstream relevance, gaining momentum in diverse contexts and communities. Professor Chris Bobel has been studying this movement since 2001, bringing unparalleled longitudinal insights into its growth and dynamics. Her continuous involvement allows an overview of what terrains of menstruation politics are changing, what activist agendas are moving and what challenges accompany the progression of the movement from grassroots to broader institutional accommodations. In this book, she not only describes these changes but also reflects critically and reflexively to further help the reader understand the complexity of the movement, which is at one and the same time personal, political and of global scope.
Bobel defines the menstrual activism she observed in the Global North during the mid 2000s as “a constellation of diverse efforts to resist the menstrual mendate of shame, secrecy, and silence” (p. 5). This earlier form of activism was radical in nature, heavily ensconced in unapologetic body positivity and directly fought both menstruation stigma and the ways in which the “feminine hygiene” industry profited from the stigma. Its point was to break down lingering cultural taboos, reclaim menstruation as a normal, visible biological function and work against the commodification of menstrual needs. Bobel notes a significant change in the last few years. Contemporary menstrual activism, increasingly visible, often operates along the lines of “menstrual equity” in the Global North and “Menstrual Hygiene Management” (MHM) in the Global South. While these approaches have received widespread public and institutional support, they constitute a watered-down version of earlier radical activity. Rather than centering stigma reduction, they tend to focus on securing access to appropriate menstrual products for those in need. MHM, in particular, dovetails with a neoliberal “girling-of-development” discourse in the Global South in which girls’ ability to manage their menstruation is cast as a path out of poverty for themselves and their families, communities and even nations. Bobel argues that boiling down a complex sociocultural issue into a tool of economic growth may come at the expense of grappling with deeper themes of gender, power and structural inequality.
In this book, Bobel provides a detailed frame analysis of the dominant Global South perspectives that advance the MHM movement. Her main argument lies in the widespread framing of “products = freedom” (p. 25) as overly simplistic and problematic. She observes that such framing reduces menstrual health to product provision and expresses and consolidates “the Western Imaginary of the Global South” (p. 7), in which developing countries are often considered passive recipients of aid. According to her, this approach maintains a culture of body negativity that is enmeshed in gender and menstruation stigma while supporting “market based solutions that favour consumption over social change” (p. 32). Her empirical effort is grounded in qualitative work combining fieldwork in India and East Africa, along with interactions with local organizations and practitioners, with the textual examination of online MHM materials. The analysis is informed by critical menstrual studies, critical development theory and postcolonial feminist scholarship, which allow the investigation of the power dynamics that drive MHM discourse. Relatedly, Bobel frames her work as an “invested critique” (p. 9), meaning the analysis targets the general structure within the movement evolves, not practitioners and advocates who, within the rigid pressure, need to present work to win funding and attention. She aims at reinforcing the MHM movement by pointing out its failures and helping it to become “more effective, meaningful, and durable” (p. 9), in a way that tackles not only product access but the complex sociocultural and political environment of menstruation.
Central to the question, “how does MHM frame its problems and solutions?” Bobel identifies two interrelated dynamic tensions shaping the movement's discourse. First is how MHM actors identify the core problem at the heart of girls' menstruation. She examines this through “stories of risk,” narratives she scrutinizes to uncover embedded “risk of stories”. According to MHM advocates, underprivileged girls in the Global South suffer from menstrual ills so adverse as to be incomprehensible to relatively well-off Western audiences. In these accounts, girls are often forced to use “inappropriate” and unsanitary substitutes for menstrual products or to stay indoors during bleeding. Illness, repeated absenteeism from school, eventual dropout and a life of poverty and social marginalization result in a downward spiral. Bobel observes that while such stories may be intended to provoke urgency and compassion, they are often based on inadequate, sometimes incorrect information and tend to sensationalize or simplify reality. In doing so, they “spectacularize” the figure of the “Third World Girl,” rendering her an object of helpless victimhood needing rescue, thereby legitimizing the intervention of benevolent-often white, Western- “saviors.” Beyond flattening the diversity and complexity of girls' lived experience, Bobel warns that this framing risks turning MHM into another form of neocolonial venture (p. 59), wherein proposed solutions are directed more by external imaginaries than by the needs and voices of the girls themselves.
The second set of constraints relates to how MHM actors frame their responses. Emerging as it does from the existing WASH (Water, Sanitation and Hygiene) field, MHM often approaches menstruation as a “hygienic crisis” that might best be solved through product-based interventions. Since traditional practices, such as the use of reused fabrics, are maintained as inadequate, most programs promote “modern” alternatives – such as disposable pads or menstrual cups – framing the change as a matter of dignity and basic human rights. However, Bobel points out that this framing anchors dignity with discipline, since the menstrual body must be regulated in such a way that no trace of menstruation can be had (p. 217). She argues that this approach entrenches long-standing views of classist lenses – as polluted and in need of control (p. 212), even as it opens new avenues for international business to expand product markets because MHM approaches currently center first and foremost on concealment and product access, none effectively resist menstruation stigma nor dismantle perceptions of the menstruating body as abject. She warns that framing in this way can stymie girls' ability to care for their bodies even as it fosters lifelong alienation, distrust and discomfort.
Bobel contests that girls deserve more than “a too-simple consumerist solution for a very complicated social problem” (p. 298). She criticizes the current MHM approach on the grounds of setting focus on personal, product-centered management at the expense of structural and cultural transformation. In its place, Bobel calls for a universal “360-degree approach” to menstrual stigma reduction and menstrual knowledge expansion (p. 310). This paradigm requires culturally appropriate interventions that situate menstruation within a larger biological cycle and as an important health indicator, reframing menstruation as a public issue rather than a private one. This involves situating girls as co-creators of knowledge and engaging whole communities in the fostering of body-positive cultures, with the intent of encouraging girls to “learn to read their bodies” (p. 315), thus improving lived experience in menstruating and bolstering embodied agency. The managed body is a lucid and engaging combination of solid theoretical grounding, empirical illustrations that are both compelling and illustrative and well-considered and actionable strategies aimed at improving menstruation environments.
From our (authors’) perspective, menstrual justice will necessitate radical rethinking that moves beyond consumerist tactics: reframing menstruation as a source of collective power of cultural innovation and if social solidarity, rather than a “hygienic crisis”, is solved through products alone. From the position of Durkheim on the sacred and the profane, public behavior should challenge stigma by recognizing the social value of menstrual blood. Drawing upon the work of Mary Douglas, social schemes provide meaning for perceptions of purity and impurity, including menstrual attitudes. Menstrual taboo is constructed in patriarchal religious discourses through the adjudication of female body processes as impure; this can be, however, ideologically rewoven by feminist thinking into different notions of sacred and profane (Kamat & Tharakan, 2021).
