Menstruation is something half the world does for a week at a time, for months and years on end, yet it remains largely misunderstood. Scientists once thought of an individual’s period as useless, and some doctors still believe it’s unsafe for a menstruating person to swim in the ocean wearing a tampon.
A new book called “Period” by Professor Kate Clancy from the University of Illinois in the US counters the false theories that have long defined the study of the uterus, exposing the eugenic history of gynaecology while providing an intersectional feminist perspective on menstruation science.
Why did you want to research and write about periods?
I’ve been studying menstrual cycles and periods for over twenty years. What first drew me to them in college was the idea that you really could do research on something that you personally find interesting. I didn’t know anyone in academia or research – I didn’t know you really could study just about anything. And up to this point my exposure to periods was what I learned from my doctor and from sex ed in grade school.
The scholarly study of periods opened up a whole different way of understanding the body – we can look to the historical study of the body, we can look to different ways of measuring things, we can understand variation not just pathology. It was the beginning of my love of biological anthropology and human biology more broadly.
I wanted to write about periods for the same reason – I want more people to know what I know, that menstrual cycles are variable, responsive to environment, not inherently gross, and actually kind of weirdly cool.
It’s 2023. Why do you think periods are still misunderstood? Are they wilfully misunderstood?
Some of the misunderstanding is wilful and some is not. I think when people make jokes about “blood coming out of her eyes or wherever” (Trump) or giving a cis man a tampon as a way of saying he is weak (Tiger Woods) – two things that have happened in recent years among famous men in the US at least – then yes, it’s wilful.
Equating menstruation with weakness or emotional instability is such a tiresome, tired way of conceptualizing the uterus. I mean, if you’re going to be sexist, at least try to be clever about it.
Another wilful misconception, to my mind, is in evolutionary psychology, where they seem to want to make everything about fertility detection. Humans are often said to be “concealed ovulators,” which isn’t exactly accurate but means we don’t have really obvious changes in behavior, or sexual swellings, or other ways of indicating our fertile period. Bros who want to know exactly when menstruating people are most fertile are obsessed with “detecting fertile periods” and with knowing our sexual preferences at different phases of the menstrual cycle to avoid getting cuckolded (the venn diagram of incels and certain fields in evolutionary psychology is a near circle).
They are convinced there is some sort of intentional strategy that women and other menstruating people participate in that they can game to increase their own chances of getting a girlfriend, or something.
But I have also encountered so very many people who fundamentally misunderstand what a period is, why we have them, and what is going on in their or their loved ones’ bodies. When I was a kid I remember a friend’s boyfriend who thought menstrual blood came out of the belly button. More recently, I interviewed a high school biology teacher who has had students who thought periods were more like bowel movements, where you could hold them until you went to the toilet.
Almost every man who has learned I study menstrual periods (and many women) have asked me if they synchronize among people who spend a lot of time together (they don’t). And something I’ve heard from many people as they’ve been reading my book is that they had no idea how much variation in menstrual cycles and periods was in fact quite normal – adaptive even, as we are supposed to be responsive to environment. It’s been a relief to them to know they are not “irregular” but in fact typical menstruating people.
Why do you say gynaecology has a “eugenic” history? How does racism play into this discussion?
I say it has a eugenic history because it has a eugenic history. Gynaecology was founded on a number of things:
1) Pushing out midwives with massive experiential knowledge, most of whom were Black and brown, criminalizing their work, and shaming them out of the profession – maternal mortality increased when they did this.
2) Many of the procedures and practices we have today came from the unanesthetized and nonconsensual experimentation on enslaved people
3) Gynaecology is founded on the idea that we need to preserve the fertility of white women while limiting the fertility of “undesirables” – people of color, disabled people, incarcerated people. As late as 2010 we were still sterilizing incarcerated people (mostly people of color) after pressuring them repeatedly to consent.
Racism is central to the conversation on the history of gynaecology and the ethics of the discipline and its practitioners because the race of the patient is so often central to the type of care they receive.
Why do you challenge the notion of a “normal” menstrual cycle?
Because the idea that there can be one “normal” menstrual cycle is just bad science. Research shows that ovarian hormones are incredibly variable, even among ovulatory cycles that are fecundable (meaning, that person is likely able to get pregnant that cycle if they try). And we’ve known this for at least forty years. My lab shows it’s not just that the overall quantities are variable, but that the pattern of expression through the cycle is variable.
So that picture you saw when you were learning about what a menstrual cycle is in grade school is really not accurate. In fact, in our samples we see that pattern in less than a third of ovulatory cycles.
What this means is that when we think we are weird, or not normal, or there is something wrong with our cycles… a lot of the time that isn’t true. Of course if a person is experiencing pain, infertility, or other symptoms it is crucial they get seen by a doctor. It is also important, though, to recognize that some amount of variability we experience just means our systems are functioning as they should.
You talk about “medical betrayal” Can you unpick this for us?
Medical betrayal is a subset of a larger concept developed by Dr. Jennifer Freyd and others called “institutional betrayal.” Freyd defines institutional betrayal as “wrongdoings perpetrated by an institution upon individuals dependent on that institution, including failure to prevent or respond supportively to wrongdoings by individuals (e.g. sexual assault) committed within the context of the institution.”
Medical betrayal is the kind of betrayal experienced by medical institutions: both at the provider-level and system-level. When people are not believed, when they have to advocate for themselves for a decade or more to receive a diagnosis, when their ailments are understudied, when dealing with insurance is a full time job – that’s medical betrayal.
People with uteruses have a lot of betraying experiences in the medical system, and over time that can lead to a real loss of trust in science and in medicine. Sometimes this leads them towards treatments or methods that end up helping them a lot, other times they end up in the arms of charlatans. While I think there are limitations to Western medicine, it has many incredible uses and I find it really sad not only that the limitations are so centered around gonadal health, autoimmune and chronic diseases, and stigmatizing of fat people, but that this means that times when people with uteruses could really use health care, they may stop trying to get it.
How can we change these age-old notions of periods (and women’s bodies more broadly) as being dirty and taboo?
Periods are a fascinating case study for biology: instead of relegating the menstrual cycle to a short mention in sex ed it really should be featured in high school biology classes. I mean, you have tissue remodeling, you have immune regulation, you have the uterus itself which is basically the original 3D printer! Why don’t we study why and how humans menstruate, and how the uterus works, at this time?
I think if we bring back some of the wonder and curiosity it works better to reduce stigma than some efforts I’ve seen to normalize period blood (some of which, in my opinion, backfires because all it does is stimulate a disgust reaction in all the people who are already in the stigma camp). Whenever I talk to doctor friends I am appalled at how little they learn about the typical menstrual cycle or how or why periods do what they do (or, though this is a topic for another time, how they learn next to nothing about perimenopause and menopause). If the people who treat menstruating bodies don’t themselves know anything about periods I don’t know how we can get to a point where they are less stigmatized.
What’s the most surprising thing you learned while writing the book?
When I was a very junior scholar, I expressed interest in studying endocrine disrupting chemicals and how they might affect menstrual cycles. I was immediately told by someone very senior that “they don’t do anything” and that I should look elsewhere in my research.
Well, now we know that EDCs are everywhere, they are intensely harmful, and they do directly influence menstrual cycles, egg development, possibly even period pain or endometriosis. There are EDCs in tampons, pads, period underwear – but also in our drinking water, our food, and the air we breathe. A lot of this is due to fossil fuel extraction, plastic production, and exposure to plastics themselves.
These data were surprising to me not just because they contradicted what an expert once said to me, but because I couldn’t figure out why this wasn’t a bigger deal. Plastics, disinfecting our water, particulate matter in the air – as we completely destroy our planet we are destroying human health. I cannot imagine a more important thing to sound the alarm on, and there are decades of incredible work showing in every way we can imagine that human damage to our planet is also damage to humans themselves – damage we can’t individual-solution our way out of. We need to fundamentally rethink the way we engage with the world and the obligations we have to each other and the planet.
While I only put a little of this in the book, I ended up writing a separate article on this for American Scientist and have continued to follow this research both in collaborations in my lab as well as my next writing project.
What do you hope your readers go away with? What impact do you hope the book will have?
I hope talking about periods opens up bigger conversations for them around disability justice and what it means to create a true public where all humans can participate. Right now we have publics that are not fully accessible to children, caregivers, disabled people, immune compromised people, people of color, and menstruating people…to name just a few, and of course, these identities all can intersect.
It’s not safe to be a Black person driving on the highway; it’s not safe to go to a crowded indoor space as an immune compromised person; it’s not safe to breathe the air some days as a pregnant person.To participate in public life, too many people have to take risks for their physical and mental and emotional health – risks that we could reduce through reduction of fossil fuels, slowing of climate change, better ventilation and filtration of indoor air, an end to racist policing as well as abolition from the perceived need for policing at all.
I also want people to feel hopeful at the end of the book. The future is not inevitable, it’s not already set in stone. The future is up to us: what we imagine, what we work for, what we fight for.
Maybe the piece I imagine is about having better ways of having periods in public, and being able to suppress periods as needed with fewer side effects.
But maybe this gets you started imagining better air in your workplace, or an end to natural gas use in your home – and from there you dream bigger and bigger and bigger, working with coalitions of interested groups towards something brighter and ever more exciting.
Is there anything else you want to say?
I think that’s it! Thank you for the chance to talk about my book – I do hope people buy it, and read it, and use it to enjoy cool science and dream of a better world.
Picture at top is from Vulvani Gallery: Free stock photos around menstruation
Ginger Gorman is a fearless and multi award-winning social justice journalist and feminist. Ginger’s bestselling book, Troll Hunting, came out in 2019. Since then, she’s been in demand both nationally and globally as an expert on cyberhate and the real-life harm predator trolling can do. She's also the editor of BroadAgenda and gender editor at HerCanberra. Ginger hosts the popular "Seriously Social" podcast for the Academy of the Social Sciences in Australia. Follow her on Twitter.