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Abstract

Background:

The literature on menstruation defines period poverty as the inability to access sufficient period products, education, and sanitary facilities needed to manage menstruation healthily and effectively. While research has identified shortcomings of healthcare in the carceral setting, period poverty behind bars has remained largely absent from criminal legal discourse.

Objectives:

The current study examines the interplay of period poverty and carceral control to introduce the novel concept of menstrual victimization, defined as the physical, emotional, and financial victimization that results from period poverty perpetuated through carceral control.

Methods:

The study uses qualitative content analysis to systematically gather and code journalistic accounts pertaining to the menstrual experiences of incarcerated and previously incarcerated females, criminal justice practitioners, and journalists. The analysis uses literary pieces (n = 99), which were coded deductively and guided by concepts related to structural violence and radical feminist criminology.

Results:

The findings shed light on the unique structural harms incarcerated menstruators face and reveal the dearth of needed empirical research on period poverty in carceral spaces. The narratives in the sample revealed how manufactured scarcity of period products within carceral spaces is used as a means of oppression by institutional agents. The emergent themes highlight how the intersection of period poverty and carceral control led to menstrual victimization characterized through shame, humiliation, control, and coercion.

Conclusion:

Potential outcomes associated with understanding menstrual victimization in the carceral setting are discussed, including reducing menstrual stigma, disseminating health education, minimizing health disparities, and ultimately, shifting modes of holding accountability away from oppressive, retributive, and controlling tactics.

Plain Language Summary

Exploring how access to period products is used to harm people who menstruate in correctional facilities using an analysis of journalistic accounts

Period poverty is defined as the inability to access sufficient period products, education, and sanitary facilities needed to manage menstruation healthily and effectively. Research reveals the shortcomings of healthcare in prisons and jails but period poverty in prisons is largely unexplored. The current study uses published media and research reports discussing menstruation in correctional facilities to examine how the control of period products, access to washrooms, and medical care impacts is used to harm people who menstruate experiencing incarceration. The findings suggest correctional staff leverage access to menstrual health resources to control, coerce, shame, and humiliate incarcerated menstruators. In conclusion, we offer potential reforms are discussed including reducing menstrual stigma, providing health education and care, and ultimately, holding staff accountable and shifting away from oppressive, punitive, and controlling tactics.

Keywords

menstrual justice menstrual victimization menstruation period equity structural harm victimization

Introduction

Throughout American history, the carceral system has centered men in its design, implementation, policies, and practices.^1
–3 However, since the 1980s, the number of incarcerated women has significantly increased across jurisdictions, making women the fastest-growing demographic in American prisons and jails.⁴ The extant literature posits that women who are incarcerated present a unique set of needs, both physically and emotionally, which require gender-responsive policy and programming to not only be effective but humane.^5
–7 In particular, feminist scholarship highlights the need to bring awareness to and address menstrual health and period poverty in carceral spaces.^1,8

Menstrual health centers the physical, mental, and social needs of menstruators through education, resources for hygiene management (i.e. pads, tampons, toilets, showers), consistent and timely menstrual healthcare, and the ability to participate in a society free of psychological distress due to stigma.⁹ The lack of access to period products, education, and sanitation facilities for effective menstrual hygiene management, has been termed “period poverty” by the American Medical Women’s Association (AMWA).¹⁰ Period poverty is most often discussed within the realm of public health and used to explore outcomes when necessary menstrual resources are absent or unattainable.^11
–18 The consequences of period poverty for those incarcerated, however, have remained largely unexplored in criminological research.^19
–21

Carceral control, or the perpetuation of social stratification through hyper-surveillance, dehumanization, and stigmatization,²² can contribute to the prison setting being an unsafe and harmful space for menstruators. Through a qualitative content analysis of journalistic accounts pertaining to the menstrual experiences of incarcerated and previously incarcerated females, the current article introduces the novel concept of menstrual victimization, defined as the physical, emotional, and financial victimization that results from period poverty perpetuated through carceral control.²³ Guided by a radical feminist framework, findings shed light on the unique structural harms incarcerated menstruators face and reveal the dearth of needed empirical research on period poverty in carceral spaces. Potential outcomes associated with understanding menstrual victimization in the carceral setting are discussed, including reducing menstrual stigma, disseminating health education, minimizing health disparities, and ultimately, shifting modes of holding accountability away from oppressive, retributive, and controlling tactics.

Radical feminist theory and structural violence

This study draws upon a theoretical framework informed by concepts of structural violence and radical feminist theory. Structural violence describes social contexts that are, as Farmer et al.²⁴ explained, “embedded in the political and economic organization of our social world” (p. e449). These “social arrangements” are violent because of the harm they cause, both through physical abuse and the perpetuation of inequalities that lead to detrimental outcomes for those subjugated. Criminological theory largely ignored the correlates and causes of female criminality at its inception and therefore, the needs of system-involved women were neglected.²⁵

Radical feminist theory shifts the narrative to focus on the experiences of women and the patriarchal structures that fuel women’s subjugation through the control of the body.^26
–28 Patriarchy is a social system where men hold primary power and dominate in roles of political leadership, moral authority, social privilege, and control of property. It is a system where societal structures and institutions are organized in a way that favors men and reinforces traditional gender roles. This power hierarchy can manifest in various forms, influencing aspects of culture, economics, politics, and family dynamics,^29,30 and is further complicated by the intersection of gender with race and class.^29,31 The menstruating body is stigmatized and sanitized in patriarchal societies which functions as a mechanism of control perpetuating the inferiority of women.^32
–34 The purpose of this study is to analyze patriarchal power in carceral spaces, and the outcome of structural violence perpetrated against incarcerated menstruators.

The criminal legal system regulates and controls the female body.³⁵ Radical feminism would suggest carceral spaces are inherently patriarchal by design, characterized by total control and a lack of consideration for women’s unique needs.^3,24,36 Incarcerated women are often framed as immoral, and methods of reform have been steeped in misogynistic ideals of returning women to a moral state of being “good wives, mothers, or domestic servants” (p. 160).² These methods of “reform,” disguised as chivalry, have evolved over the years to serve as mechanisms of social control.^36,37 According to radical feminism, women are kept subordinate to men by situating women in vulnerable positions, particularly through control of the body and sexuality.^27,28,38,39 Therefore, understanding how patriarchal control is levied against incarcerated women is imperative for a holistic understanding of the female experience in prison. The current study fills this gap by examining how the inherent patriarchal structures in carceral spaces subject incarcerated menstruators to structural violence.

Menstruation in the carceral setting

Carceral spaces are unique in that the personal experience of menstruation is publicly managed by the carceral institution; a dynamic antithetical to how menstruators are socialized to privately care for their menstrual health.^34,40 Despite the legal requirement of carceral facilities to provide basic essential needs, period poverty persists behind bars. A recent study shed light on period poverty in Kansas City jails, demonstrating that over one-third of respondents had to purchase or barter and trade for period products.⁴¹ Over half of the respondents received less than five period products at intake and approximately half had to use their period products longer than they would have liked to. In addition, 23.1% suffered negative health consequences and 24.4% had to sit out from physical activities as a result of period poverty behind bars.⁴¹

The financial inability to purchase products from commissaries or gain unrestricted access to sanitation facilities can have an impact on incarcerated menstruators’ participation in pro-social activities, like family visitation. Menstruators have skipped visitation with family or case workers due to a lack of access to period products.^42,43 Some do not want to go through the mandated tampon removal process during a strip search after visitation and others are fearful they will bleed through the shoddy product they are provided.^43,44

Many advocates believe that institutions ration period products as a method to control the women who are incarcerated.⁴⁴ Furthermore, Greenberg⁴⁴ contends correctional officers restrict period product access as a way of minimizing women’s self-esteem. Inadequate female care in carceral settings has led to the internalization of menstrual stigma. Incarcerated menstruators have reported feeling unclean while menstruating, lacking sufficient knowledge about menstruation, needing to keep discussion of periods private, and concealing when they are menstruating.⁴⁵ Understanding the unique experience of menstruating while incarcerated, while acknowledging some parallel experiences, such as shame and stigma identified in free world menstruating populations, are essential for recognizing the collective experience of menstruation. The current study employs an interdisciplinary perspective that examines the interaction between the distinctive power dynamics of carceral control and the weaponization of menstruation to perpetuate structural violence, leading to menstrual victimization.

Methodology

Sample

The current study conducted a directed qualitative content analysis, beginning in January 2023 through July 2023, to systematically collect literary accounts of incarcerated menstruators who have experienced period poverty in carceral spaces.²³ People who are incarcerated represent a vulnerable population that can be difficult to reach due to administrative barriers and whose recruitment in research can, at times, be exploitative. Literary accounts, therefore, provide access and insight into the lived experiences of incarcerated menstruators in a less intrusive manner. Literary accounts also provide a scope of how carceral menstruation is publicly and socially discussed, which requires analysis, as these narratives reflect and influence broader cultural perceptions of incarceration, menstruation, and incarcerated menstruators.

Qualitative content analysis systematically analyzes communication methods to develop a conceptual model that explains a phenomenon.^23,46,47 The current study employed a directed form of qualitative content analysis which uses an established theory to guide the deductive coding scheme.⁴⁷ The initial sample included 536 literary pieces (n = 536). All literary pieces were eligible for inclusion including peer-reviewed journal articles, news articles, blogs, government reports, or transcribed interviews. Once filtered through the inclusion criteria discussed below, the final sample included 99 items (n = 99).

Data collection

We used the terms “periods,” “period products,” “menstruation,” “period poverty,” “menstrual injustice,” “pads,” “tampons,” and “feminine hygiene,” in combination with “jail” “prison” and “incarceration” to develop 24 search terms. The search terms were entered into two search engines, Google and the Arizona State University [ASU] One Search Library database. Each term was searched individually on Google and each article on the results pages was reviewed until the search results ended, then the next search term combination was entered.

Each search term was then entered into the ASU One Search library database, which surveyed over 700 databases, including JSTOR and PubMed. All articles found under each search term were considered for inclusion. If more than 200 articles came up under the search term in the ASU One Search library database, the search criteria were filtered to solely include peer-reviewed journal articles, news articles, and magazine articles from 2017 to 2023. We chose the temporal cut off, because, in 2017, the First Step Act, which supposedly ended unnecessary restrictions on menstrual products in carceral spaces, was signed into legislation.⁴⁸

Once all the search results were uploaded into a spreadsheet, we began to refine the data by excluding any duplicate articles. In addition, we ensured that each piece met four specific criteria. First, the piece had to be published after 2017. Second, the piece had to discuss menstruation, menstruation products, menstruation education, or access to sanitation facilities for personal hygiene in a carceral space, jail, or prison. Third, the piece had to include personal experiences or accounts by either currently or previously incarcerated menstruators regarding period poverty in the carceral space (i.e. lack of access to menstrual products, sanitary facilities, education, and healthcare). Pieces met this criterion by including either direct quotes from previously or currently incarcerated menstruators, and/or court documents, testimonies, government reports, or empirical research reports. Fourth, the piece had to do more than simply summarize legislation efforts or general information about statistics. While the original sample included pieces from around the globe, this study focuses specifically on the narratives of menstruators in the United States, therefore, the final US-focused sample resulted in a total of 99 pieces for analysis.

Data analysis

The final sample (n = 99) of literary pieces was coded using an emerging coding scheme, a modified grounded theoretical approach in which the data are used to develop a theory and then applied to the rest of the data.⁴⁹ A Google form was used to collect information about each piece, including the author, year, publication outlet, and quotes illustrative of gendered power and harm. These forms were then converted into a report that grouped quotes by physical harm and emotional harm. These quotes were then further parsed by the following coding themes: Period Poverty, defined as any mention of the lack of access to menstrual products, education, sanitation, or healthcare within the carceral setting. Power is defined as any mention of an individual, staff, or other incarcerated person, or the facility, administrators, or government restricting or leveraging access to menstrual products, education, healthcare, or sanitation. Physical Violence is defined as any mention of rape, sexual assault, assault, and nonspecific sexual violence, including strip searches in the context of menstruation. For example, any narrative that discussed sexual intercourse in exchange for or to barter for access to need menstrual resources was coded as rape. All other forms of sexual violence were coded as sexual assault or nonspecific sexual violence. This would include any unwanted physical contact of a sexual nature in relation to period poverty. Strip searches were coded as sexual violence due to recent literature identifying strip searches in the carceral setting as a form of sexual violence.⁵⁰ And, finally, Exposure to Health Consequences, defined as any adverse health result related to period poverty in the carceral space, including being denied access to collection methods in a timely, accessible, unrestricted manner, as well as reliable access to washing facilities including showers or handwashing. The inability to access safe disposal methods for used period products was included due to the potential exposure to bloodborne pathogens. Being forced to remain in soiled clothing or period products was included as well because of the link to increased risk of infection.

After each article was coded according to these themes, we reviewed the data to develop the conceptual model of menstrual victimization. Figure 1 illustrates the conceptual model that informs and is informed by the data. Period poverty is used as the construct to explore the absence and deprivation of menstrual resources in carceral spaces. The interplay of stigma, shame, and sexism results in global period poverty, while the interplay of oppression, punishment, stigma, and dehumanization within carceral institutions defines the experience of carceral control. The intersection of period poverty and carceral control precipitates menstrual victimization, characterized by coercion, control, shame, and humiliation, and the outcome of menstrual victimization is most often physical and psychological harm. Not everyone who menstruates identifies as a woman but menstruation is a function of the female reproductive system. Therefore, we use the gender-inclusive term, menstruator, in reference to anyone who experiences menstruation, but in the results, we refer to the gender mentioned in the parent source (i.e. the pronouns she, her, or the term woman is identified in the text). When gendered pronouns or terminology is not identified in the parent source, “female,” “menstruator,” or “people who menstruate” are used.

Figure 1.

Menstrual Victimization Conceptual Model.

Results

While prior literature has identified the presence of period poverty in carceral spaces, the findings of this qualitative analysis uncovered the unique dynamics of menstrual victimization. Overall, the narratives in the sample revealed how manufactured scarcity of period products within carceral spaces is used as a means of oppression by institutional agents. The following sections highlight how the intersection of period poverty and carceral control led to menstrual victimization characterized by shame, humiliation, control, and coercion.

Shame and humiliation

Articles within the sample described how carceral institutions did not provide any period products or enough quality products to adequately manage the variation in menstrual flow or body shapes and sizes. When products were provided, they were usually of inferior quality compared with those that could be purchased in the free world. One of the articles described a 24-year-old woman being held at a New York police department shortly after being arrested who, when asking for a pad, was told an ambulance would be required to obtain one. She explained, “After about an hour and a half, they produced a sterile gauze pad, apparently obtained from an ambulance. It was the kind of rectangular gauze used to bandage an arm with no adhesive.”⁴⁴ According to the FBI Uniform Crime Report (UCR), females make up about a quarter of all arrests.⁵¹ The lack of immediate access to period products within the police station demonstrates how, despite 1.9 million arrests of females in 2019 across the United States, menstruators’ needs are an afterthought in this context.

Another article described one woman’s experience in Texas who unknowingly had uterine cancer while she was incarcerated, which resulted in heavy bleeding during her periods. She was not given adequate period products, she said, “I was scared to go eat because I was bleeding so bad.”⁵² Her denied access occurred after Texas had passed a law requiring the provision of period products. Authorities charged with holding others accountable for adherence to the law may circumvent the same accountability, demonstrating how “crime” is defined contextually and based on power. Therefore, merely passing legislation without liability and oversight may render isolated legal solutions futile. The woman featured in the story chalked up the continued withholding of period products to the gendered nature of correctional institutions, “I like to say that it’s a man’s world inside of a man’s world.”⁵² Extant literature corroborates this sentiment regarding the gendered nature of correctional institutions in which the needs of incarcerated women remain an oversight despite the recognition for gender-responsive programming in the criminal legal system.^6,7

One woman interviewed in The 19th who was incarcerated in Connecticut described the pads she was provided by the prison as thin with poor adhesive and no wings. She recalled an instance where a woman’s pad fell out of her pants onto the floor so she “stepped on it, hiding the pad beneath her boot to save her from humiliation.”⁵³ This act exemplifies the menstrual concealment imperative defined by Wood³⁴ as the practice of self-surveillance and grasp at control within a patriarchal system that perceives menstruation as shameful and “dirty.” The inability to manage menstruation in private exacerbated psychological distress for incarcerated menstruators.

A Mother Jones article similarly described a story of humiliation regarding a 20-year-old female incarcerated in a California jail who had been arrested during a mental health crisis:

She quickly soaked through all the pads she’d been provided, and commissary tampons wouldn’t be available for days. When her mental state deteriorated—she’d been arrested during an episode of psychosis and the jail had denied access to some of her medications—she wound up in an isolation unit without any clothes or tampons, sitting in her own menstrual blood. “It was horrible,” Martin, now 23, recalls. “It just makes you feel like an animal.”⁵⁴

This female’s story provides an additional layer to the dehumanization that occurs in the carceral context. Menstruation is often described as and taught to be an experience that should be managed privately and autonomously.⁵⁵ Withholding basic hygiene essentials, such as pads, tampons, and pantyliners, removes bodily autonomy and the capacity to manage menstruation safely and comfortably, which can elicit feeling subhuman, as this woman described.

In an Arizona state women’s prison, a previously incarcerated woman described a woman’s experience she witnessed while incarcerated, further affirming the inadequate provision of product, shame, and apathy in carceral spaces:

The woman in the cell next to mine was on her period and had borrowed extra pads from other women but it wasn’t enough. She had bled on her jumpsuit, but she was still required to wear this blood-stained jumpsuit to the chow hall in front of everyone. I could feel her shame. I wanted to scream at the officers that she didn’t deserve this. My heart physically hurt and my body noticeably tensed.⁵⁶

The collective experience of menstruation did not alleviate the internalized shame associated with menstruating. Instead, those interviewed recognized the humiliation and shame that results when what is socially expected to be managed in private becomes public. In addition, they expressed sharing the shame alongside the person whose menstruation was exposed. While menstruation is a natural and expected occurrence, females expressed a need to conceal the experience from others, particularly from males.⁵⁵ Moreover, the heightened need for self-surveillance during menstruation increases body consciousness and elicits feelings of disgust and shame, which has been described as a form of self-objectification used to separate the self from the “unclean” menstruating body and conform to traditional standards of femininity.^32,33,40 Also, females mentioned feeling bonded to other females simply through the shared experience of menstruation, which compelled them to help maintain other menstruators’ privacy.⁵⁵ In other words, societal stigma, shame, and sexism require females to menstruate alone and in private to alleviate the discomfort of others around the issue, and these expectations are attempted to be upheld by incarcerated females.

Because of the tacit and internalized rules of bleeding in private, previously incarcerated females described strip searches while menstruating during intake or going to and from visitation as one of the most humiliating and violating carceral experiences. The articles identified mental and physical harm as a result of these nonconsensual and invasive procedures. As one woman described, “Sometimes officers laugh at them during strip searches . . . The laughter part of it . . . It’s humiliating, and it makes you feel—like me, I’m aware of my self-worth, but not all women can say that, that they have self-worth.”⁵⁷ The degradation experienced during these incidents impacted their perceptions of self. Carceral control and period poverty, both inundated with shame and stigma, intersect and compound to break down self-worth and dehumanize. Therefore, signaling that those who are incarcerated are unworthy of respect and humanizing treatment.

A previously incarcerated woman in Virginia recalled how prison officials did not consider menstruation during strip searches, “No matter how much you’re bleeding, whether you’re dripping on the floor, it doesn’t matter . . . You still will be strip searched fully.”⁵⁷ In an Illinois correctional facility, a group of women were strip-searched as part of a training exercise with new hires:

Then, the women were escorted in groups to be strip-searched. In addition to the usual strip search humiliations, women on their menstrual cycles were ordered to remove their tampons and pads and were not allowed to do so in private. The floor became soiled with blood from the women on their menstrual cycles, and they were not given new tampons or pads to use when getting dressed . . . While all of the other women were being strip-searched, blood continued to flow down menstruating prisoners’ legs and onto the floor, and prisoners had to stand barefoot in other people’s blood. All the while, guards yelled obscenities at them, calling them dirty, smelly, and bloody.⁵⁸

The psychological toll was further described by another previously incarcerated female, “You don’t get used to it . . . You can only find better ways to cope with the emotional fallout each time.”⁵⁷ A female previously incarcerated in Maryland explains the aftermath of when a female is denied a new tampon or pad after having to remove theirs during a strip search:

But then when you’re not given a fresh pad to leave visiting with. Now you have to walk back to your housing unit, or your job assignment, and you run the risk of bleeding through your clothes and then, when you have laundry, you have one laundry day unless you know the laundry clerk. You have to wash it in the shower which pisses off everybody because nobody wants you washing out your clothes in the shower that they have to use; the janitor sink, your toilet, there’s no way to dry it so you’re having to hang up clothes so it’s just easier for people.⁵⁹

Without the receipt of a new pad or tampon following the forced removal, and as a result of the inadequate provision of quality period products generally, many incarcerated menstruators innovated collection methods. In many cases, menstruators used the issued pads to fashion homemade tampons, while others used bedsheets,⁶⁰ newspaper,⁶¹ notebook paper,^62,63 cotton swabs held together with floss,⁶⁴ cotton balls,⁶⁵ mattress stuffing,⁶⁶ socks,^67,68 rags,^16,65,69,70 toilet paper,^68,71 old underwear and pieces of clothing,^70,72 soiled sanitary pads,⁷³ towels,⁵³ and cardboard.⁷⁴ Women have used acts of agency in an attempt to achieve autonomy within a patriarchal society.⁷⁵ As such, menstruators in carceral spaces may exercise agency by choosing to manufacture their preferred collection method, tampons, to attain a form of autonomy in carceral spaces characterized by the deprivation of autonomy.

Health complications often resulted from the use of makeshift products. One female explained,

I’m not wearing gloves, and so you know at least I’m obsessive about washing my hands and all of that sort of stuff but that’s not true of everybody, plus there’s also no way to just store them in a safe and sanitary method. So, the, you’re playing Russian Roulette with your reproductive health, because if you get an infection, you get toxic shock, you have to have a hysterectomy, I mean you’re playing Russian roulette in, and you, that is not something that’s supposed to happen just because of your incarceration.⁷⁶

The woman did indeed end up getting Menstrual Toxic Shock Syndrome (TSS), a life-threatening bacterial infection, from using her homemade tampons and required an emergency hysterectomy after being released.⁷⁶ TSS is often associated with the use of tampons but more recent research has linked menstrual TSS to other collection methods as well such as menstrual cups.^77,78 A report from Missouri found that approximately one-third of incarcerated women who used makeshift tampons reported getting vaginal infections.⁷⁹ When access to menstrual products is insufficient, menstrual TSS is a potential consequence. The presence of period poverty in the carceral environment diminished, if not eliminated, the ability of incarcerated menstruators to maintain their menstrual health.

Many women were refused medical care for their menses, and those who were able to access care were denied continuity of care. One woman explains how she was initially offered birth control to control her menstrual bleeding but was denied after her first dose:

A few days later, the bleeding stopped. It felt like magic—until it came time for my next dose. By then, the nurse who’d suggested I get the first shot had left, and her replacement told me I could not get birth control in jail. In fact, she said the prior nurse should have never let me get it in the first place. Apparently, something as trivial as bleeding every day for weeks didn’t require any treatment.⁸⁰

Furthermore, she explains how a male guard scorned her, questioning “why I’d gone on birth control in jail—as if he were some sort of authority on women’s health.”⁸⁰ Another woman who sought medical attention for continuous heavy vaginal bleeding was told “nothing was wrong” by medical personnel in the prison. She explained how the bleeding got worse during her incarceration but it was not until she was released that she was able to access treatment for an ovarian polyp.⁵³ The medical negligence and menstrual victimization within carceral settings allude to the historical and systematic forced sterilization of marginalized and stigmatized populations^81,82 and demonstrate the apathy menstruators receive in carceral spaces. Forced sterilization has been used to systematically eliminate traits deemed “less desirable” by those in power. Impacting females’ ability to procreate demonstrates the carceral institutions’ capacity for control by inflicting long-term and generational consequences.⁸¹ Furthermore, this aligns with the theoretical construct of radical feminism in which the oppression of women is maintained through the control of the female body, including reproductive choice.²⁷

Control and coercion

The deprivation of autonomy and subsequent forced reliance on carceral agents create a power imbalance in carceral spaces that exposes incarcerated females to vulnerable situations in which they can be victimized. A law review discussing menstrual equity refers to the absence of adequate period products in carceral spaces as “artificial scarcity” that is “a toxic mixture in an institution where custody and control are already coercive” (p. 86).⁸³ Because menstruating is “not a choice,”⁸⁴ the use of period products as a means to control and coerce behavior was a common theme expressed in the sample in both domestic and international articles.

“Weaponization” was a term employed by many of those interviewed throughout the articles. One previously incarcerated woman reflected on her experience with prison-based period poverty, “In the moment, those individual acts seemed like shame-inducing one-offs. But when they happen enough, those one-offs add up to something more. Looking back, I see how the prison system weaponized our bodies to take away our dignity.”⁸⁰

Another previously incarcerated woman in Maryland described how period products are tokens of control, “Pads and tampons have become weaponized. They are withheld in order to get certain behavior, and they are doled out in whatever amounts and at the convenience of correctional staff (when they are distributed at all).”⁸⁵ Other articles use the words “dangerous power dynamic”⁸⁶ or “officer-prisoner power dynamic”⁷¹ to explain how period products are used to control menstruators who are incarcerated. As one woman explained, “If you’re that desperate for one, you’d give up literally everything for it.”⁸⁷

Another previously incarcerated woman stated,

But what I saw was that our systems have weaponized menstrual hygiene products and women have to do, you know, we have to beg, we have to borrow, we have to trade favors for just the basic products that we need and the problem with that, of course there’s so many problems with that, but that, when someone is in a state or jurisdictions care, custody, and control they’re required to provide the most basic of needs and they don’t and so that’s why women have to go to the measures that they do.⁷⁶

A weapon is defined as a thing used for inflicting damage.⁸⁸ Therefore, the use of the term by those with lived experience demonstrates their belief that the carceral system used forced scarcity as a means to cause harm.

A Colorado sheriff reaffirms how systemic menstrual resource scarcity creates the opportunity for victimization:

By forcing women to pay for an item that is a basic need, we create a system where an individual may feel pressured to barter or borrow the item and be placed in the uncomfortable and vulnerable position of owing another inmate,” . . . “These unnecessary scenarios can lead to violence and assaults.⁸⁹

Social standing is already a thorny dynamic to navigate in prison due to the impotence imposed upon those incarcerated.⁹⁰ While race, class, and other markers can impact certain incarcerated individuals’ level of power and access, the creation of a scarcity of menstrual resources results in yet another sense of division between “haves” and “have nots” inside. These dynamics become even more dangerous when the “haves” are agents of the criminal legal system with power and authority.

The most frequent narratives of correctional staff exerting their power included using their position to deny the provision of period products and access to medical care or sanitary facilities, leveraging period products as a tool to control behavior or elicit sexual favors, and humiliating the person menstruating. In Connecticut, a formerly incarcerated woman described attempts to get period products from guards as “a constant negotiation” stating, “You’d ask a CO for pads or tampons, and he would ask you questions like, ‘How long have you been bleeding? Didn’t I give you a pad yesterday? How long is this one going to last?’”⁹¹ In Arizona, one woman shared the same sentiment of negotiation, describing how “bloodstained pants, bartering, and begging” for period products was a common encounter.⁹²

The testimonies of women in the sample who have experienced incarceration consistently identified how they were at the mercy of correctional staff to allow them to autonomously care for their bodily needs. One woman stated, “It depends on the day or their mood . . . It’s humiliating and embarrassing, but there’s nothing else you can do. And their response is, ‘You shouldn’t have come to prison.”⁸⁷ Those who are incarcerated face compounded, internalized, and externalized shame as a result of the latent stigma associated with both menstruation and incarceration.

Multiple articles in the sample described how withholding period products were used as a form of punishment and control. A woman incarcerated in Arizona described obtaining access to period products as a “demeaning and unnecessary” “game” between staff and incarcerated women.⁹³ Menstruators were often faced with the decision to either oblige correctional officers’ demands or go without essential period products. One article described a federal investigation into an Alabama women’s facility, “Prisoners there were forced to choose between the humiliation of going without menstrual products for months at a time and being raped by men who had power over them.”⁶⁶ In Florida, a state representative expressed how stories of using socks as pads and trading sex for sanitary products told by incarcerated females to legislators “left him horrified.”⁶⁷ In New York, an article regarding incidents committed by certain corrections officers in 2020 described him as “just one of many corrections officers who was accused of sexually abusing female inmates in exchange for scarce hygiene products.”⁶³ A previously incarcerated individual stated in a newspaper article, “Often, such abuses are described as rarities or one-offs. But I have lived this. Thousands of women face these conditions every day.”⁶⁰ The use of sexual violence to punish or control reaffirms the radical feminist perspective in which the control of the female body and sexuality through rape maintains male dominance and furthers female oppression.^38,39 Data frequently highlighted how guards often “rationed menstrual supplies as a ‘form of intimidation or punishment.’”⁶⁰ The punishment for breaking the law, therefore, is not merely the removal of freedom, but numerous traumatic carceral events that occur throughout confinement.

Discussion

The existence of period poverty in carceral spaces has been noted by scholars and journalists around the world; however, there is still limited data exploring the range of impacts period poverty has on incarcerated menstruators. The current study filled this gap by conducting a qualitative content analysis of journalistic accounts and identified pervasive menstrual victimization, which sits at the intersection of period poverty and carceral control. Specifically, the data demonstrated how menstrual victimization is committed by criminal legal entities through compounding shame, humiliation, control, and coercion, leading to physical and psychological harm of incarcerated menstruators.

The retributive aspect of a prison sentence is said to be the removal of freedom, and the level of punishment delegated through the length of a prison sentence, is supposed to match the level of harm committed.⁹⁴ However, as demonstrated by the data, punishment extends beyond the sentence to include the conditions of confinement. Simply for being incarcerated, menstruators were further punished through inadequate access to the proper quantity and quality of period products. The stigma and dehumanization of incarcerated individuals,⁹⁵ compounded with the stigma of menstruation,⁹⁶ resulted in shaming and humiliating acts by carceral agents, that is, forcing menstruators to bleed on their clothes, bleed on the floor, prove their menstruation, and take out their tampons in front of others. These acts and the subsequent internalized shame led some incarcerated females to question their self-worth and feel subhuman, illustrating tangible aspects of the often illusive carceral dehumanization process.

Beyond humiliation, carceral agents often used period poverty as a means of control and coercion. As Garland²² noted, the carceral system has evolved to be a managerial entity of marginalized populations through hyper-surveillance, criminalization, and incapacitation. The data identified how forced scarcity of period products was used to govern incarcerated females’ behaviors and bodies. Because menstruation is an assured recurrent biological event for most females, those interviewed felt carceral agents saw it as a reliable tool for manipulation.

The sexual abuse described by those with lived experience further highlights the dehumanization process and elucidates many carceral agents’ perceptions of those incarcerated as objects undeserving of dignity and respect. These perceptions can be, in part, built through a lack of education and understanding, resulting in apathy and, at times, cruelty. Therefore, to curb the physical and emotional harm that results from menstrual victimization, interventions must center on increasing knowledge, empathy, and equity.

We offer two levels of policy recommendations: reformist and abolitionist. The first accepts the existence of a violent and oppressive system and suggests ways to ease the inevitable pain of the carceral experience, while the latter suggests alternatives beyond carceral spaces to hold accountability. Applying a reformist lens, we must first recognize that the carceral system is situated within a capitalist framework that attempts to maximize profits and minimize costs. Thus, while there is a need for free access to unlimited menstrual products in carceral spaces, there is also a need for affordable period products generally.

In the United States, one person spends an average of US$70 per month on period products.⁹⁷ Period products are subject to sales tax in 21 states, meaning that many states profit (an estimated US$110 million annually) from female menstruation.⁹⁸ To incentivize carceral spaces to provide access to unlimited products, it will be important for broader legislation to mandate the provision of free period products in schools and other designated public places as well. Several places, including Ann Arbor, Michigan,⁹⁹ and the country of Scotland¹⁰⁰ have already set this precedent by making comprehensive free provision statutes. Moreover, in the past 20 years, other parts of the globe have been integrating WASH (water, sanitation, and hygiene) strategies to develop infrastructure that supports menstruators’ menstrual hygiene management.^101
–103 The period products provided should also be of varying absorbances and sizes to accommodate all body types and menstrual flows. These kinds of policy shifts are likely to influence cultural perceptions of menstruation to include dignity and comfort, which could have an impact on carceral stakeholders’ perceptions and policies as well.

In addition to free access to period products, there is a need for enhanced access to sanitation facilities including toilets, showers, and laundry services. Female institutions should allow access to showers twice a day to accommodate the needs of those menstruating, as well as provide access to laundry services at least twice a week.¹⁰⁴ To be granted access, however, there should be no need to prove menstruation.

There is also a need for gender-responsive care in carceral facilities. Data find that incarcerated females’ pathways to prison differ from males and are often characterized by extensive physical, emotional, and sexual trauma and abuse.^104
–106 Because of these histories, it is particularly important for gynecological exams and procedures to be trauma-informed and for carceral practitioners to specialize in this kind of care.^107
–109 Correctional officers engaging with incarcerated individuals should also receive trauma- and gender-informed training to understand how to best engage and interact in a way that is sensitive, empathetic, and attuned to how their behaviors may be triggering or retraumatizing.^110,111

Beyond training current correctional officers and ensuring newly hired officers are adequately educated, there must be accountability for those officers who have engaged in coercive, humiliating, or shaming behaviors. Because the carceral system is steeped in oppressive power dynamics, it is not enough to expect incarcerated individuals to file complaints against officers, as this can often result in retaliation.¹¹² The Active Bystandership for Law Enforcement (ABLE) is a training created by the Center for Innovations in Community Safety at Georgetown University and aims to create a police culture “in which officers routinely intervene-and accept interventions-as necessary to: prevent misconduct, avoid police mistakes, and promote officer health and wellness.”¹¹³ While evaluative research of ABLE is still pending, this kind of training could be vital for incentivizing correctional staff to hold each other accountable and shift the culture to a high standard of care and support for those incarcerated.

Data suggest, however, that many reformist efforts in criminal justice policy and practices rarely have a sustained positive impact, and when they do, those changes are often incremental.¹¹⁴ An abolitionist framework, on the contrary, asks, what is the purpose of carceral institutions? The majority of females in state and federal prisons are incarcerated for drug and property offenses.¹¹⁵ If carceral institutions intend to increase public safety, we must explore how we define safety and question whether entering females into traumatizing and oppressive institutions that disregard basic female needs truly reduces victimization.^116,117

Limitations and future directions

The stigmatized nature of both incarceration and menstruation likely contributes to the dearth of research examining the novel concept of menstrual victimization in the carceral space. The narratives included in this research identified only a small portion of menstruators who are and have been incarcerated while menstruating in the United States. The sample is limited in scope due to the use of journalistic accounts that only represent menstruators who have been accessed by the media, researchers, or practitioners. Because the media is often profit-driven and therefore focused on gripping headlines, it is possible that the experiences of those interviewed were the most heinous and may not be representative of the experiences of most menstruators. Regardless, the fact that these females had these experiences at all provides insights into the faults of the carceral system. In addition, the sample is restricted to literary pieces published in English and is not an international representation of menstruators’ experiences in carceral spaces. As such, despite the expansive systematic search, the sample is likely not an exhaustive list of all literary pieces that discuss menstruation in carceral spaces, which should be considered when interpreting the results. Finally, the initial coding of the sample was conducted by one member of the research team and then the researchers worked collaboratively to organize the findings into broader themes. Therefore, a power analysis was not conducted to justify the sample size, which is a limitation of the methodology.

Next steps would be examining potential long-term consequences of menstrual victimization, particularly chronic health complications such as infertility or infection, and their impact on re-entry using longitudinal data collection. In addition, future research should seek to be intentional in providing space for currently and previously incarcerated females to share their experiences of menstruating in carceral settings. Gender inclusivity should also be prioritized, which would mean including all gender identities in the conversation around menstruation. Furthermore, research should continue to explore the ways and spaces in which menstrual inequity and period poverty harm menstruators. This would include the consideration of populations often pushed to the margins, such as those who are incarcerated. Finally, we should seek to evaluate and innovate ways to dismantle the systemic oppression and structural harm that embody the current carceral experience.

Conclusion

The current study provides insights into the manifestation of sexism in carceral spaces. Findings demonstrate how the unfounded stigma of menstruation, interwoven with carceral control, leads to a physically and emotionally harmful environment for incarcerated women. While we present several policy recommendations to reduce menstrual victimization, these changes can likely only be sustainable with preceding cultural shifts that disentangle menstruation and shame and encourage the humanization of those incarcerated. Destigmatization of both menstruation and justice involvement will hopefully lead to the provision of free period products like the assumed and largely accepted free provision of toilet paper and soap in carceral spaces. To activate and fulfill this process requires critical conversations, education, and exposure. Therefore, we encourage menstruators to continue to challenge the status quo by speaking openly and candidly about their menstrual experiences as an act of resistance against the menstrual concealment imperative,³⁴ and we implore non-menstruators and, particularly carceral administrators, to listen with curiosity.

Supplemental Material

sj-docx-1-whe-10.1177_17455057241240931 – Supplemental material for “For men, by men”: Menstrual victimization and the weaponization of period products in carceral settings

Supplemental material, sj-docx-1-whe-10.1177_17455057241240931 for “For men, by men”: Menstrual victimization and the weaponization of period products in carceral settings by Kathryn Tapp and Abigail Henson in Women’s Health

Footnotes

Acknowledgements

The foundational paper for this manuscript won the Division of Feminist Criminology’s Gradaute Student Paper Award within the American Society of Criminology in 2023.

Declarations

ORCID iD

Kathryn Tapp

Supplemental material

Supplemental material for this article is available online.

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Supplementary Material

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“For men,by men”: Menstrual victimization and the weaponization of period products in carceral settings

Abstract

Background:

Objectives:

Methods:

Results:

Conclusion:

Plain Language Summary

Keywords

Introduction

Radical feminist theory and structural violence

Menstruation in the carceral setting

Methodology

Sample

Data collection

Data analysis

Results

Shame and humiliation

Control and coercion

Discussion

Limitations and future directions

Conclusion

Supplemental Material

sj-docx-1-whe-10.1177_17455057241240931 – Supplemental material for “For men, by men”: Menstrual victimization and the weaponization of period products in carceral settings

Footnotes

Acknowledgements

Declarations

ORCID iD

Supplemental material

References

Supplementary Material