Menstruation is a fundamental part of the physiology of nearly half of the people on Earth. But we don’t talk about it that way–it’s taboo, unspoken, and ignored. Period stigma has left state governments across the country taxing period products as “luxury” items, failing to provide access to period products as the necessities they are for low-income menstruators. In this episode, Abdul talks about how period stigma leaves people without the period products they need to live their lives–and speaks with Lynette Medley, an inspiring activist working to solve that problem.

Transcript

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Dr. Abdul El-Sayed: COVID cases, nearing an all-time low, are starting to plateau in the United States, suggesting that they may start to rise sometime soon. Moderna and Pfizer applied for emergency use authorization for a second COVID vaccine booster, but if it were approved, the U.S. government wouldn’t have the funding to provide it. Nearly 10 million Ukrainians have left their homes and three million have left their country, creating one of the worst humanitarian crises in the world. This is America Dissected. I’m your host, Dr. Abdul El-Sayed. I’ve never menstruated. I don’t know what the experience is like. And honestly, because of the stigma around menstruation, it’s not really a topic of conversation I’ve had with many people. I do remember one time, though, when I was sent to a local pharmacy to pick up period products for a family member, and when one of the clerks asked if they could help, I mentioned what I was looking for. They gave me a look I can only describe as some parts pity and some parts disgust. Here I was, a grown man, a doctor, who understands full well that menstruation is a perfectly normal, perfectly healthy part of adult physiology for nearly 50% of the whole world, and I felt shame for helping my family member with a necessary purchase. And now that I say that, I feel ashamed about my shame. It’s completely messed up how society’s stigmatized a regular part of our human physiology. It keeps us from having honest conversations about what people need as they go through that experience. And that, well, that keeps us from providing people with those needs. And that’s not all. The majority of states charge a luxury tax on period products. But there is nothing luxurious about menstruating with dignity. In our country, our failure to talk about, let alone provide for access to period products, means that millions of people who need them go without them. Globally, 500 million people, that’s half a billion people, go without period products that they need to menstruate with dignity. In the U.S., nearly 17 million people who menstruate live in poverty, meaning that paying for their products may cost them access to other needs in their lives, and nearly 15% of them have gone without the products they need in that last year, 10% in the last month. What do they do? They keep tampons in for longer than they’re supposed to be, which leads to risk for deadly illness like toxic shock syndrome. Others resort to using things like socks or paper towels that are uncomfortable, dangerous, and defective. This week, I wanted to understand more about period poverty, its impact on poor folks across our country, and how leaders and activists are taking it on. I turned to Lynette Medley, founder and CEO of No More Secrets, which operates The Spot, a period hub in Philly. They offer free period products to folks in that community. We talk about period poverty, The Spot, and what policymakers need to do to end period poverty, after this break.

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Dr. Abdul El-Sayed: OK. Can you introduce yourself for the tape?

Lynette Medley: Lynette Medley, founder and CEO of No More Secrets Mind Body Spirit Inc.

Dr. Abdul El-Sayed, narrating: Lynette Medley’s work is a calling. After witnessing firsthand the consequences of period poverty and the lengths people in her community were going to access period products, she decided to do something about it. Her organization, No More Secrets, offers free period products to thousands of people across her community.

Dr. Abdul El-Sayed: Well, thank you so much for joining us, Lynette. I, you know, came across your work and was just immediately struck by both how important it is and how urgent it is. You run Spot, which you say is the nation’s first menstrual hub. Can you tell us what that means?

Lynette Medley: The Spot stands for Safety Programing for Optimal Transformation, so it is the nation’s first menstrual hub and uterine wellness center drop-in place for our communities.

Dr. Abdul El-Sayed: And before Spot, before you actually had a central brick and mortar space, you all were making deliveries of menstrual products door-to-door out of the back of your car. Can you tell us a little bit about that and what sparked your recognition of the need and your quest to address that?

Lynette Medley: Oh, definitely, definitely. So we’ve been doing this work for the last six, seven years, and we started it early on when we were having conversations with the community really about the MeToo movement at the time, about bodily autonomy, making safe choices and safe relationship choices, and in having those conversations, it was revealed to us from some of the young people that they engaged in survival sex, high-risk behaviors, and just stealing and everything else just to be able to get a pad or a tampon. And in having those conversations, we quickly said we have to do something. And I think the biggest thing that we learned was that it wasn’t covered by Medicaid or Medicare, so these young people were left to their own devices, so when we started reaching out for resources for them, we realized there weren’t any resources that address this so we started collecting products and then delivering to the communities. So we were actually doing around 80, 85 deliveries a week before we opened up The Spot.

Dr. Abdul El-Sayed: Wow. And how has that changed the lives of recipients?

Lynette Medley: It has changed their lives tremendously. It has allowed many of them to live in dignity, it’s allowed many of them to not get criminalized. Just think, if I’m stealing to survive, to get menstrual products, then again, I can enter into the penal system. If I have to stay in an abusive relationship, then again, I’m not living in dignity. Or if I have to basically sell my body or perform sexual acts, again, I’m, you know, being exposed to high risk behaviors and just being a detriment to myself and my community and my body.

Dr. Abdul El-Sayed: A lot of people, of course, who by virtue of their anatomy or by virtue of their privilege, take access to menstrual products as a given. How widespread is period poverty, lack of access to menstrual products?

Lynette Medley: You know, I’ve seen some studies they’ll say one in four or one in five, but I like to equate it any more, a little bit more. If you know how many people are in poverty in the United States, just say about 50% of their population are dealing with serious poverty. It’s the same population. You know, if you can’t afford housing or food or all of those other necessities, you cannot afford menstrual products because they’re not covered by anything. And then I would add the number a little higher, the percentage, because even though you have funding for food products, you know, you have, you know, food stamps and things like that, they do not have anything that covers menstrual products.

Dr. Abdul El-Sayed: And so, you know, we’ve come through the most acute phase of a, let’s hope, once-in-a-lifetime experience through this pandemic and it fundamentally changed people’s livelihoods. How did the pandemic complicate the experience of period poverty for folks, and how did it shape your work?

Lynette Medley: It changed my world and it debilitated our communities. So one of the biggest things is that, you know, period poverty is the inability to access menstrual products, in addition to waste management services, running waters, inoperable toilets. Pandemic shut down every resource that our communities depended on. And I think one thing that people always need to really realize is their positionality. The pandemic hit many of us, we’re shut in our houses doing TikTok video because everything we needed was inside of our home, when most of our marginalized and vulnerable community, all of the resources are outside of their homes and everything shut down. So they didn’t have schools, community centers, churches, you know, all of these things that they would normally need. So we went by doing 85 deliveries to 300+ deliveries a week. And in addition to menstrual products, we had to drive people around for places to be able to use water to use the bathroom to clean up, because again, they were dependent on all of these systems outside of their homes.

Dr. Abdul El-Sayed: Wow. And independent of your services directly addressing the in-access that people had, you talked a bit about some of the really dire circumstances that people were forced into to be able to access menstrual products. You know, what do folks end up doing if they just can’t get access to menstrual products? What kind of solutions are there, if any?

Lynette Medley: Well, I think one of the main things is they use unhealthy methodologies like anything else. They will use socks, they will use gloves, they will use rags, anything that they can use, which causes other infections and diseases. They will use used pad that they find in the trash, used tampons. You know, again, it just puts them at a high level of risk, you know, that can really harm their bodies.

Dr. Abdul El-Sayed: And you know, sometimes we, you know, obviously, if you just heard that, the circumstances of that, you know, make you shudder, but we also don’t appreciate that those infections are deadly. Toxic shock syndrome is, occurs because people, in effect, don’t have the menstrual products that they need. They overuse them for too long. And there are bacteria that release toxins into the body that can cause severe shock and actually kill folks. And so this really is a life and death issue. You all opened your hub. Tell me a little bit about what you do. How does the hub operate and who do you see coming in, and what’s their experience of the hub?

Lynette Medley: I’m so glad you asked that question. So the hub was opened up to create a safe space, a non-judgmental space to give people the products that they need. Of course, the menstrual products and including, you know, the waste management running water. But we see everybody. I think that’s what people need to realize. Even if we have, we have some people in deep poverty. We have some people who, you know, their economic situation has changed from not being able to work overtime, they have to stay at home with their children, to people whose jobs just don’t meet the necessities after paying for rent, paying for utilities. So we have people at all socioeconomic statuses, because there is nothing out there to bridge the gap for menstrual products. And I think people need to realize there’s nothing out there in the world to say, Hey, if you don’t have enough, here you go, here is something, for menstrual products. So the reactions we get first are, I can’t believe you created this. And when they walk in and see the fluidity of products and the, you know, the options and the choices, they’re just overwhelmed. Then they’re just crying. We have people who are in tears because, you know—and it’s not, and I want to reiterate, it’s not just people living in poverty. We have people who are middle class and they’re like, you know, for the last three cycles, my daughter and I had to use paper towels because it was easier to get paper towels then it was to get menstrual products. So this is the reality that people do, and suffer in silence. We haven’t created a space to talk about this. And then again, because the period is so stigmatized and it’s such a taboo subject, who are you going to say, Hey, I don’t have access to products, because we don’t really create spaces to really tell the truth about that?

Dr. Abdul El-Sayed: Yeah, I wanted to ask you about that. How is the taboo nature, the stigma about menstruation, how does that shape the global problem that we have? I mean, clearly you’re solving in part the problem in one community, but this is an issue that, you know, if it exists in Philly where you are, it exists everywhere. But we’re not having a conversation about that. We don’t talk about it. And in some respects, it’s because we just don’t talk about menstruation. How has the stigma shaped the circumstances? And then beyond that, what do we need to do to take on the stigma?

Lynette Medley: I think that we just need to be honest that we live in a misogynistic, patriarchal society that doesn’t always bring conversations around women’s health, women’s bodies, or people who menstruate or people with uteruses, into the conversation. It’s really not something that’s really talked about. So we have, you know, as a society, as a culture, as a nation, never embraced the menstrual cycle as a normal natural part of life. And I think because of that, it’s never been integrated in conversations of wellness and health and well-being. So, because we don’t even talk about it with the people who actually have it, or uplift them and say, OK, this is something we need to address, we don’t talk about it with non-menstruating individuals. So it’s really just something that’s left off the table. And the horrendous part is, again, when you’re talking about luxury, you know, in still, 30 some, 30 states, they still tax menstrual products as a luxury item. So I think the way to address it is to again, I always reiterate the menstrual hygiene products are one part of it, but we need to look at menstrual health as a system of care. We need to start addressing it as a health issue, as something that we need to make sure we care for and make sure that our populations have access to these so they don’t engage in high-risk behaviors, and they don’t end up getting these other health issues and health disparities related to lack of mental health and hygiene.

Dr. Abdul El-Sayed: No, it’s the crazy thing that you bring up that point that in 30-some states, these products are taxed as a quote unquote “luxury item,” I’ve never menstruated but from what I understand, there’s nothing luxurious about it. And this is a need, not a want, not an ask. This is a requirement, as you and your work are a testament to. So in this respect, government isn’t just not offering solutions, it’s in fact part of the problem. Can you talk about some of the policy circumstances that have led to the situation that we’re in and what you would like to see change when it comes to thinking about period poverty and how we take it on?

Lynette Medley: Definitely. Well, overall, whenever you talk about vulnerable populations, I always say those are populations who are oppressed intentionally by systems of power. You know, I hate to put it on them, but one of the things that was ironic was that during the height of the pandemic, government officials came together and added menstrual products to flexible spending. And it was ironic, I remember somebody was interviewing me about it with other organizations, and the other organization was talking about how great it was, and I remember getting on a mic and saying, This is really disgusting and discriminatory, like, how are you adding it’s to flexible spending during the time when 85+ of bleeding bodies, Black, brown, marginalized, disabled are losing jobs, and you never added it to Medicaid, Medicare, WIC or SNAP? You know, so I think that’s what it is. So, of course, if you’re not—and I always say, if you’re not in this space or if you’re not understanding the perspective of people who are in need, you wouldn’t even thought about it. But would they made was a decision that was helping their friends, you know, people who are all of a sudden struggling with something that they had never struggled with before, and OK, we’re going to add it to this. Half our community don’t know what flexible spending is, let alone have a flexible spending account, but how can you consciously sit at the table and add it to flexible spending and not add it to Medicaid and Medicare? Like to me, I’m still wondering, how did you make that decision? You know, so you understand that it’s a need, but is it a need only for the haves and not the have nots? And I’m struggling still with that decision that they made and still not considering it a medical device for the populations that need it most.

Dr. Abdul El-Sayed: Yeah, and just for context, for our listeners, a flexible spending account, FSAs, are, in effect, tax-harbored accounts that people can use, and it’s only really for employed folks, and it tends to be for employed folks who make above a certain amount of money. And so what Lynette is pointing to is the fact that when government includes it as something that can be paid for out of an FSA, a flexible spending account, it’s basically saying that this is only a need for people who have high enough income to have a flexible spending account, rather than putting it obviously into the set of goods and benefits that are supported by programs that are intended to support lower-income folks, things like WIC or Medicaid or SNAP. And you know, the point that you’re making here, right, is one about the way that government tends to disaggregate people by socioeconomic position. And you know, one area that I’ve thought and spent a lot of time on is on universal approaches to health care, whether that’s Medicare for all, or other approaches. And you know, what that does is that it creates programs that are equally engaged in no matter who you are, what your income is, or what your circumstances are. And you know, there is a quote from a social scientist that says that: programs for the poor are recipes for poor programs because they don’t have buy-in from everybody. And the point that you’re making here illustrates that really, unfortunately, perfectly. Had there been communities that have moved forward policies that you really think would address this issue?

Lynette Medley: No, not yet. I mean, I think many of the policies that are being presented or the legislation, it’s affecting one part of the community. So there are a lot of menstrual equity bills out there, and they’re very heavy bills and you’re talking about, you know, putting them in schools, adding them to prisons, workforces if you’re over 100 people, but I do not see a bill that is intentionally targeted towards the populations who need it most. Because when you have a bill that’s introduced as very heavy, with all of this information it’s almost like it’s a, you know, a privilege, you know? Like, Oh, well, we just need to add this in addition to whatever, not understanding it’s a necessity. So even if you put it in all the schools and all of the buildings and all of the churches, just like the pandemic shows, if they’ll shut down and they’re not open, what happens to our communities? They need to have ongoing access to menstrual products. That’s the bottom line. WIC, SNAP, Medicaid, Medicare—even put it in the schools. If free lunches are offered, you should get free menstrual products. So I do not see a bill that is basically going to encompass what we need for our communities. And my fear is that if an initial period equity bill, a menstrual equity bill gets passed where they’ll say, we’ll put it in the schools and all of the public buildings, my problem is people will say, OK, we’ve done, we’ve solved period poverty. And that will not impact our communities at all. So that’s why I’m always one to say, Hey, you need to bring the people who are really, you know, either experience period poverty themselves or really are dealing directly with individuals and communities who are experiencing period poverty.

Dr. Abdul El-Sayed: Hmm. I really appreciate that perspective. And you know, there is sometimes in government an approach where the people who are designing legislation design legislation around a limited perspective on the problem, rather than design their legislation and/or their administration around the the lived-experience of the people who experience that problem firsthand. And I think that’s a really important approach. Obviously, your solution is one that you’ve built out in Philly. Do you have plans to scale at all across other communities?

Lynette Medley: Yes. Well, actually, even though we’re located in Philly, our corporate office, like our office, No More Secrets offices in Delaware. So we do work in Delaware. We actually, so we service the whole tri-state area, and that’s Pennsylvania, New Jersey, Delaware, we even go out to Maryland, but we also ship nationwide. So we will ship anywhere. And currently we are, we have one historically black college university, HBCU, satellite hub at Lincoln University, and we’re also working with North Carolina Central University and possibly Cheney University to also open up satellite hubs on their campuses.

Dr. Abdul El-Sayed: That’s amazing. And where can people go to support your work?

Lynette Medley: They can go right to our website: Nomoresecretsmbs dot org, and everything is on there, from volunteering to donating to advocating. You know, I think people really need to know that we are not funded by the city and government, that we are really supported by our communities, private donors and just people who want to feed into the work that we do.

Dr. Abdul El-Sayed: Well, Lynette, I really appreciate you taking the time to educate us and share your experience and your leadership with us. That is Lynette Medley and her work. We’re going to include it in the show notes. I hope that you’ll check them out and you go to the website and support Lynette, thank you so much.

Lynette Medley: Thank you for having me.

Dr. Abdul El-Sayed, narrating: As usual, here’s what I’m watching right now. COVID cases are near an all-time low in the US, but they’re starting to plateau and could be begin climbing soon. The Omicron sub variant, BA-2, is enriching itself, now accounting for more than half of all cases. As you know, cases have been going up in Western Europe for some time. In fact, their BA-2 mini-surge is now starting to stabilize. What happens here? That remains unclear. There are two things though I’m worried about and I want you to pay attention to. First, I worry that we’re not going to put our masks back on fast enough. The new CDC guidance makes recommendations based on two other metrics, along with cases, hospitalizations and the proportion of hospital beds occupied by COVID patients. The problem here is that COVID surges can be explosive, particularly early, but this guidance doesn’t trigger mask wearing until at least after case rates have led to hospitalizations. So I worry that people won’t put their masks back on until COVID has that time to spread substantially. The other worry I have is about funding for tests, treatments, and vaccinations. Right now, Congress is still dawdling on the $15 billion, down from the original 30 billion the administration asked for. If cases do surge, I worry that we’ll be right back to where we were with the original Omicron: too few tests, too little treatment to go around, in the richest, most powerful country in the world. To that end, both Pfizer and Moderna have applied for emergency use authorization for fourth doses, Moderna enough for everyone and Pfizer for people over 65. Given new findings about winning immunity within a month of a booster, if cases surge, we may need to be boosted again. And right now, well, the federal government can’t even afford another booster. Congress, if you’re listening, can we get a move on? Finally, to the story that so many of us have been watching for the last month.

[voice clip] The western borders of Ukraine have become a sieve, a revolving door of despair. . . . More than three million people have fled Ukraine, that’s nearly 7% of the country’s entire population.

Dr. Abdul El-Sayed: 10 million people have been displaced by Vladimir Putin’s illegal, immoral war, and more than three million have left the country completely. While Ukrainian refugees have been welcomed with open arms, for now, it raises two questions. First, how long will the world be open to resettling Ukrainian refugees? Given past history? People tend to open their arms early on, but sometimes that hospitality wanes. And second, what about all the other refugees from places like Syria or Iraq or Afghanistan who need and have needed our support? Forced displacement destroys lives, it destabilizes everything people can build on. Refugees go without the food, the health care, the education they deserve. I hope that our listeners are doing what they can to support refugees. One great place to start is Doctors Without Borders. Please consider going to their website and making a contribution today. That’s it for now. On your way out, if you want to do me a favor, can you please rate and review our show? It does really help. Also, if you love the show and want to rep us, I hope you drop by the Crooked store for some America Dissected merch. We’ve got our logo mugs or t-shirts, our Science Always Wins t-shirts, sweatshirts, and dad caps, and our Safe and effective tees, which are on sale for $10 off while supplies last.

America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producer is Olivia Martinez. Veronica Simonetti mixes and masters the show. Production support from Tara Terpstra, Lyra Smith, and Ari Schwartz. Our theme song is by Taka Yasuzawa and Alex Sugiura. Our executive producers are Sarah Geismer, Sandy Girard, Michael Martinez, and me, Dr. Abdul El-Sayed, your host. Thanks for listening.