On Menstruation, Education, and Activism: An Interview with Saniya Ghanoui

Saniya Lee Ghanoui is a historian and critical media studies scholar focused on the intersection of gender and sexuality, medicine, and media. Through her studies, she became intrigued by how society created stigma and taboo around the menstrual cycle, which led her to focus on critical menstrual studies; investigating the construction and depiction of menstruation in television, the history of menstrual education films, as well as the history of sex education in the United States.

Saniya is currently the Program Director for Our Bodies Ourselves Today, an online platform launching in September, developed from the original Our Bodies, Ourselves to provide people with trustworthy, inclusive, accessible, and comprehensive information about health and sexuality in an online format.

In this interview, we dive right into the stigmatization of menstruation before exploring other topics like menstrual education, how menstruation is portrayed in media, menstrual data tracking and positive strides forward for menstrual education and activism. We cover the bloody mess of it all!

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Scarleteen (ST): How did we get to this place where we have a thousand euphemisms for menstruation (shark week, aunt flow, on the rag, etc.)? What are some of the key things that have led to society, as it is now?

Saniya Ghanoui (SG): That’s such a great question! It’s a multi-layered question, so my answer, I think, would have to be multi-layered as well. We use, on a whole, euphemisms and euphemistic language when we don’t want to talk about something. I think that’s one reason, instead of saying the menstrual cycle, we have created other ways of talking about it. “The Period” is perhaps the most common one. I mean, the period is not some medical term, it is a euphemism for one aspect of the menstrual cycle.

We as a society — and every society does this — have created a specific type of language that buries or hides what we really are talking about. Sometimes that language is done, I would argue, to elicit a funny response or response that is meant to put you at ease. When someone says “Aunt Flow” or “On the Rag” these are terms that can bring about amusement, but what it’s also doing is it’s hiding and disguising very natural language that needs to be normalized, that needs to be accepted, and then needs to be talked about.

I think there’s very much a gendered part to this as well. A way of controlling bodies is to patrol and police the language that we use to talk about bodies. Creating euphemisms is one way of doing that. Euphemisms both support [shame and taboo] and also emphasize the gender distinctions between women and others who menstruate and those who don’t, as well as the misogynistic understanding of how we treat bodies that is couched in shame and taboo.

ST: Until I was probably 14, I was predominantly hearing euphemisms for menstruation. All it did was lead to confusion because I was hearing all these different words, not knowing what was really happening with my body, or if they all even meant menstruation or something different that was supposed to be happening! And, like you said, what that language is doing is automatically scripting shame into this process.

SG: You commented that there were moments of confusion where you were not quite sure, and I think that’s actually another aspect. Euphemistic language prohibits proper education: about the menstrual cycle, about one’s body, and about puberty. That can be a very confusing time, particularly if you’re going through those questions of: What to expect? How is your body supposed to respond?

Education is one way of providing bodily autonomy. When we take away that education and replace it with something like “Shark Week “or “Aunt Flow” you’re robbing someone of their bodily autonomy because then they don’t know how to ask questions they might have about their body, they don’t even know the language to use to speak about it. It creates this confusion that really is detrimental because it’s about stripping away agency. Education is crucial in bringing back that power over one’s own body.

ST: So, how would you envision, in a utopia, menstrual education?

SG: There are so many things I want to respond to [with] this question, and I’ll probably even forget some! One, discussions about the body need to start very early, discussions about proper body parts need to start early, and we need to talk about what the menstrual cycle actually is very early, too. In general, at least in public school systems, these don’t start until very late, sometimes a year before someone starts menstruating. That’s not giving people time to learn, absorb, understand, ask questions and respond before they even start menstruating.

It also needs to be holistic and comprehensive. Often in public schools, they would separate [learners by gender]. We should not be doing that. All genders need to learn about the menstrual cycle, need to learn what it is, and need to learn about it not only in connection to reproduction. I should clarify that I’m talking from a US perspective right now. But, in the United States menstruation is often taught [only] in connection to reproduction: here’s what’s happening when you have a period, here’s what happens when you have sex, when you get pregnant, your period stops, then you give birth, maybe you’re nursing and then your period starts again.

Very rarely do we talk about the menstrual cycle holistically: What does it mean to your health if you do menstruate? What does it mean if you don’t menstruate? What does it mean if you stop menstruating? We very rarely talk about menstruation in connection to nutrition, for example. So, we really need to pull menstruation away from a focus on reproduction to a larger understanding of health and human rights. One’s ability to take care of themselves and to have a healthy menstrual cycle is connected to their class, their geographic location, the environment, to race, to access to education and products, and so forth. It’s really important that we introduce education in a very comprehensive manner.

Another thing I will add…a lot of menstrual education in the United States is taught by the companies who are making pads, tampons, and other menstrual products. Whether that’s co-sponsoring or co-producing a film, they’re creating booklets and pamphlets for people to distribute. That’s a huge problem, [connecting] capitalism and education and commercialism. When someone or a company is trying to sell you something they have a very specific agenda, and your education and well-being are not their number one priority. Instead, it’s to sell you something and to get you hooked in as a consumer, and as a buyer early and often. Education should not be coming from the product companies who have this very, very specific goal and perception about menstrual education.

ST: I wanted to go back now to the first paper you wrote about television and other media portrayals of menstruation. Where have you seen some of the best and some of the worst portrayals of menstruation on TV and film?

SG: I’m going to counter that question a little bit and instead of using the metrics of best and worst, I’m going to talk about the differences. One of the earliest representations was in a TV show from the 1970s, called All in the Family. The show was based around a couple living in Queens in New York City. The husband was this very prejudiced, racist, sexist man. He was married to a woman who was very sweet. They portrayed her as not very intelligent but very welcoming – they were almost polar opposites of each other. And what was interesting about that was actually not the portrayal of the menstrual cycle, but of menopause.

There’s one episode where the wife is meant to be going through menopause. She’s grumpy, she snaps back, and her husband doesn’t know how to respond. What was interesting and what really piqued my interest is the way that the show flipped the gender roles via our understanding of the menstrual cycle and menopause. She basically became the husband, and he became the meek one. He got a taste of his own medicine, so to speak, and he didn’t know how to respond.

There have been different nods to menstruation throughout the history of television; it’s been in cartoons and things like that. Another famous one is in The Cosby Show, Bill Cosby is a whole other conversation we won’t go into today, but it was a hugely popular show at the time in the late 80s early 90s. They had this event called Women’s Day or something like that, where in one episode they celebrate that the youngest child got her first period. But, what’s interesting about that is, again, we see a very clear distinction between genders. The mom and the sisters participate in Women’s Day to celebrate the fact that the youngest child got her first period. But, the dad who’s played by Bill Cosby in the show, is an OB/GYN. This is his area of expertise or one part of his area of expertise and he is absent from this storyline! Again, there’s a really interesting connection of how they’re distinguishing the menstrual period solely based on gender. Now that we know more about who Bill Cosby is, it brings a whole other layer, unfortunately, to the story that we don’t have to get into here, but I do think that portrayal is very, very interesting.

I haven’t watched, I will admit, as much television in the last five years, so I don’t know some of the newest representations and portrayals. But, you do see it in a lot of coming-of-age shows. So, there was a Beverly Hills, 90210 episode, there was an episode of Degrassi in the 90s, and more. There have been more graphic portrayals in something like South Park and so there’s been a wide variety of portrayals of the menstrual cycle on TV.

ST: I’ve started to hear a lot of discussion among my peers around government surveillance on menstruation specifically things with period tracking apps. With this whole new world of menstrual data, I was wondering if you could speak to a little bit of how it’s being used: the good, the bad, and the ugly?

SG: I’ll give you my take with the caveat that with the recent overturn of Roe v. Wade and Casey v. Planned Parenthood we’re entering into a very different legal territory. There might be things happening in regards to surveillance by the government, and there will potentially be lawsuits about it that I can’t necessarily predict. We’re in very uncharted territory. Given the overturning of Roe, we do know that there are menstrual cycle tracking apps out there that are not the best in terms of their ethics and morals, potentially sharing data with either police or government organizations. That can be an issue if someone lives in a place or part of the country where abortion is either now illegal or will soon become illegal. As much or as many times as the politicians say they’re not going after pregnant people that’s just not how it works. Pregnant people are always hurt when you limit abortion. I’m not going to speak to one particular app, but I do think it’s something we need to be conscious of.

Margaret Johnson is a professor at the University of Baltimore and is an attorney and a law professor. She wrote a wonderful piece about how a government official in Missouri was using legally obtained data, I believe, from a Planned Parenthood to track the menstrual cycle of people who had visited that clinic. That’s not through a period app, I want to be clear, that was something separate. That is one example of how government officials are using this information to track the cycles and then potentially, or subsequently, the pregnancies of people who are monitoring their own menstrual cycle. So, what does this mean in terms of should you or should you not use a menstrual cycle app? I think it’s important that people really do their research in making the decision that is best for them for how they want to track their menstrual cycle if that’s something they do. That doesn’t mean every app out there is horrendous, there are, I imagine, some apps that are taking this very seriously.

ST: It’s something that I find pretty disappointing. Specifically, in light of our previous conversation, on how education translates to bodily autonomy and awareness. Tracking a menstrual cycle is one way to gain knowledge and education about your own body and that is something that should never be exploited.

SG: There are numerous reasons someone may want to track their cycle and sometimes that has nothing to do with whether they are pregnant or want to become pregnant. Some people just want to track it for their health reasons, some people, as you point out, see it as knowledge that they can use if they need to go see their physician or if they want to get on birth control, for example. So, this knowledge is important, and people should have access to it. Unfortunately, we are living in a time where government officials could use that information to the detriment of the menstruators who are tracking their cycle.

ST: I want to open up our discussion because, of course, people menstruate all around the world. So, I was wondering if you knew or have come across in your research more about how menstruation has been approached in other cultures and what we can learn from them.

SG: This is not my area of expertise, and so I don’t know if I can get into it deeply. Most of my research has been in the United States in terms of menstruation with a touch in Western Europe. It’s wonderful to see how people approach education differently and how creative I’ve seen different people across the globe get in terms of menstrual education. I’ve seen folks who, young people I’m talking those in their teens and 20s, are creating Zines or creating comic books and things like that. I think is a wonderful avenue of menstrual education that you don’t see as often in the United States, I do think that’s changing and that’s growing, and I do see that there’s a much younger crowd coming up in the United States which is wonderful. I think the changing age dynamics across the globe is really crucial to bettering our understanding of the menstrual cycle and education.

One thing that’s happening quite often is also this approach of menstrual equity or period poverty, depending on what term you want to use, of trying to get menstrual products in the hands of people. The problem with that is that’s only one small portion of this larger aspect of menstrual equity. What’s been wonderful to see in other parts of the world is how people are taking a more comprehensive approach to this. It’s not just about giving someone a pad, but are you recognizing the environmental factor, are you connecting this to how people need to have a clean living environment in order to take care of their menstrual cycle to maintain their own health and happiness. I have seen young people across the globe bring a more holistic approach to understanding the menstrual cycle, which I do think is very critical.

ST: There are a lot of people who menstruate that our society isn’t looking out for whether that’s in the creation of products or the marketing of those products. Specifically, I’m thinking about people with disabilities and people who are transgender or gender nonconforming. I was wondering what you’ve seen paving away for a better future for menstrual products, education, and inclusion.

SG: Yeah, this is such an important point, and I think it’s a difficult one because, on a whole, I feel like mainstream society still very much treats the menstrual cycle in the gender binary that women menstruate and men don’t. That’s not the way we should be looking at it because that’s not how it exists. We know plenty of women who don’t menstruate and we know plenty of men who do menstruate, and we know people who don’t identify as either who may or may not menstruate. It’s really important that we look—while gender is very much part of this issue of shame and stigma—to the connections to transphobia, for example. We can better our understanding of the menstrual cycle by recognizing that it is not based in the gender binary. It’s unfortunate that there are still people who very much see that and play into that, and product companies play into that.

There have been some educational films …for disabled people to manage their menstrual cycle. There’s one called All Women Have Periods from the late 70s and it shows a young girl who has Down’s Syndrome. It’s meant to show how you change the menstrual pad, what you do, what it looks like, what it feels like — that kind of thing. There has been some educational material out there, but unfortunately, it’s really few and far between and isn’t integrated into mainstream educational practices. It’s not integrated into public school settings, and it’s not integrated into many doctors’ offices. There’s so much room for growth and improvement. I think it’s important to note that by bettering that, we better menstrual equity for everyone. This is not an “I take a piece of the pie, so you have less…” kind of thing. It’s important, as you point out, to educate people on the products that are available and how to use them, and how to decide what products are best for you.

The pink and the purple and the marketing and things like that, oh, my goodness, I would love to get away from all that. It is just all over the place and it’s been that way for quite some time. There is a very distinct aesthetic that goes with mainstream menstrual products and some companies have tried to get away from that. For example, Kotex did this whole “U by Kotex” years ago where you could design your own cases that you can carry your menstrual products in. But, it’s still based on this idea of secrecy and consumerism and so it’s reinforcing the old gender tropes that are based on our understanding of this patriarchal society of how to manage the menstrual cycle.

I don’t want to completely say that there’s nothing good, there is some wonderful stuff out there. Cass Clemmer is a menstrual activist and they are pushing back against the binary in menstrual education. They have a wonderful coloring book that is just fantastic. It has a Toni the tampon character and then it’s basically an educational coloring book on what types of menstrual products are out there. But, it really helps dissolve this gender binary that is very much ingrained in the menstrual health world. It’s hard and it’s not going to happen overnight but there are people doing wonderful work out there.

ST: Although you have already touched on this a little, to end on an inspiring note, what other organizations or people have you seen that are really doing excellent work? What is going on at the moment that people should keep their eyes on and stay connected with?

SG: I want to start by saying, I don’t know you I just met you today, but I feel it’s people like you. There are young people out there in their teens or early 20s working to change everything, all this negative and deeply ingrained stuff we’ve talked about. I’ve seen this all across college and university campuses, particularly in the United States but also globally, as well. Things like making sure that menstrual products are in all bathrooms not just women’s bathrooms, for example. Those are small steps. It’s not going to change everything overnight and it’s not, in and of itself, going to solve all problems. But, to see young people engaged in this is absolutely thrilling. I’ve witnessed them on their home university campuses start programs to bring menstrual equity to the forefront of the conversation and to get admin, university administrators, and deans involved in this too. There are also wonderful organizations all across the globe that are doing different work. I came at this more from a research point of view, I am on the board of the Society for Menstrual Cycle Research. We have regular conferences, and we take a more research-centric approach. There are wonderful organizations who are doing more on-the-ground work, creating zines and comic books. I’m very impressed by the energy that’s been behind this, particularly in the last five years or so, and the sustained energy now not just via menstrual health, but how it’s connected to so many different aspects of human rights: this is about the environment, this is about classes, about race, this is about gender.

The last thing I’ll say is I love to see how people are trying to change the law, and I think that’s important too. It is important that we change our understandings of the law so that we can bring about equity. In the United States inequality is built into the law, and so we need to change that. One avenue that I’ve seen people do that through, is Title IX. I am intrigued to see where this goes and how people get involved with these issues in the future, whether that’s Title IX in their university campuses, or with other educational programs, but to bring about equity through legal means I think is also one important and critical avenue.

For more great menstrual activism or resources check out these orgs: