Gendered Dis-abilities: A Probe into the Intersections of Menstruation, Disability and the Discourse of Discrimination
Reshma JoseDr. Fancy Paul
Turning an inquisitive lens into the construction of meanings and associations characterising the dual experiences of menstruation and disability reveals the culture of stigma, shame and marginalisation that surrounds them. Grounded on the possible interdisciplinary link between the emerging academic fields of Critical Menstruation Studies and Disability Studies, this paper attempts to critique the ways in which the experiences of menstruators with disabilities are marginalised in our cultural milieu, especially in the Indian context. The study aims to bring to light how even the contemporary menstrual narratives of empowerment and de-stigmatisation are non-inclusive of menstruators with disabilities whose voices remain unheard. Along with the theoretical inferences drawn from Critical Menstruation Studies and Critical Disability Studies, the paper will also make use of the concept of Intersectionality as an analytical tool to address the questions guiding the study. The paper intends to delve into the varied vantage points of ‘the disabled-menstruator intersectionality’ to call attention to the absence of representations in the mainstream menstrual narrative and advocate for more inclusive conversations.
Keywords: Menstruation, Disability, Intersectionality, Human Rights, Ableism, Gender, Stigma.
In spite of all our advances as a species, menstruation is something that remains a relative mystery for many people even today. As Amanda Laird rightly affirms in Heavy Flow: Breaking the Curse of Menstruation, “we live in a culture that seems to have no taboos left, yet period shame still persists” (2019, p. 12). Our attitude towards menstruation is underpinned by centuries of shame, discrimination, fear, misunderstanding and taboo. Reinforced by various religious, cultural and gendered norms on bodies, purity and propriety, a natural biological process is being perceived as embarrassing, extending even to the mere mention of the word, both in public and private. It is either rendered socially invisible, shrouded in privacy and largely concealed, or it becomes visible and even more stigmatised. Correspondingly, another significant area which remains stigmatised across nations and times is that of people living with disabilities.
Studies suggest an estimated number of more than 1 billion people worldwide who experience some form of disability, of which a major proportion comprises women. According to the UNICEF Guidance Note on Menstrual Health& Hygiene for Girls and Women with Disabilities, “Girls and women with disabilities face a double stigma due to both social norms around gender and menstruation and having a disability”. Grounded on the possible interdisciplinary link between the emerging academic fields of Critical Menstruation Studies and Disability Studies, this paper attempts to critique the ways in which the experiences of menstruators with disabilities are marginalised in our cultural milieu, especially in the Indian context. The study aims to bring to light how even the contemporary menstrual narratives of empowerment and de-stigmatisation are non-inclusive of menstruators with disabilities whose voices remain unheard. The paper titled “Gendered Dis-abilities: A Probe into the Intersections of Menstruation, Disability and the Discourse of Discrimination” thus intends to delve into the varied vantage points of ‘the disabled-menstruator intersectionality’ to call attention to the absence of representations in the mainstream menstrual narrative and advocates for more inclusive conversations.
Menstruation and Disability in Context
Across cultures and historical eras, any serious inquiry into the form, function and meaning of menstruation is most often circumscribed by a culture of shame, concealment and silence. The complex interplay of patriarchy, sexism and capitalism is at the root of the global culture of taboo, discrimination and marginalisation that surrounds this natural biological process. The recent shift in the public discourse around menstruation is crucial, owing to the dual advantages of ensuring health benefits along with providing a key entry point for gender justice. Relocating menstruation from the margins to the centre recognises the body as foundational, urgent and politically relevant. Honest and well-informed conversations about menstruation, and more broadly, about how our bodies work is a vital step towards developing body literacy. The burgeoning field of Critical Menstruation Studies and the contemporary discourses around menstruation in the global and local contexts shine a bright spotlight on the positive change initiated in the domain. An outgrowth of the third-wave feminist movement, menstrual activism questions “the dominant cultural narrative of menstruation that constructs a normal body process particular to females as disgusting, annoying, taboo, and best kept out of sight and out of mind” (Bobel, 2010, p. 6). The way in which an ordinary organic occurrence has turned into a reason behind gender discrimination and inequality has been a major focal point of menstrual scholarship. As Linda Steele and Beth Goldblatt argue in “The Human Rights of Women and Girls with Disabilities: Sterilization and Other Coercive Responses to Menstruation”, “This is exacerbated for women (including those with disabilities) who are positioned outside of normative constructs of the white, able, middle-class woman” (2020, p. 79). In countries like India, attitudes to disability are shaped by religious and cultural belief systems, which mostly end up in the stigma and social isolation of the disabled.
The beginnings of Disability studies as an academic field can be traced back to the twentieth-century disability civil rights movements in the West. As Simi Linton proposes in Claiming Disability: Knowledge and Identity, “The field explores the critical divisions our society makes in creating the normal versus the pathological, the insider versus the outsider, or the competent citizen versus the ward of the state” (2010, p. 2). A meeting point of critical academic discourse and social change, the discipline focuses on the construction of meaning surrounding disability. It challenges how the experience of disability is defined by social and cultural constructions, thereby questioning the boundaries of what is normal and what is not. Critical disability studies scholarship identifies two variant models of disability which are the medical and the social approaches. According to the medical model, “disability is positioned as an individual, biomedical deficit which individualizes and pathologizes the disabled body as the natural target of medical and care interventions” (Steele& Goldblatt, 2020, p. 79). Divergent from the more prominent medical model, the latter “views the origins of disability as the mental attitudes and physical structures of society rather than a medical condition faced by an individual” (Buder& Perry, 2021). As per the social model, disability thus becomes a social construct shaped by systemic barriers, depreciative attitudes and the resulting social exclusion of the people involved. The framing of disability as something that demands to be fixed/cured/solved by medical intervention limits it to an issue of the individual rooted in their bodies.
Along with the theoretical inferences drawn from Critical Menstruation Studies and Critical Disability Studies, the paper will also make use of the concept of Intersectionality as an analytical tool to address the questions guiding the study. As Patricia Hill Collins and Sirma Bilge elucidate in the work Intersectionality,
“Intersectionality investigates how intersecting power relations influence social relations across diverse societies as well as individual experiences in everyday life. As an analytic tool, intersectionality views categories of race, class, gender, sexuality, class, nation, ability, ethnicity, and age- among others- as interrelated and mutually shaping one another. Intersectionality is a way of understanding and explaining complexity in the world, in people, and in human experiences” (2021, p. 1).
Using the framework of intersectionality to understand the double marginalisation experienced by disabled- menstruators will unravel the multi-layered difficulties of being a woman in an overarchingly patriarchal society and simultaneously being disabled in a system which looks down upon anything which is different from the accepted narratives of normalcy and able bodied-ness.
The Intersections of Disability and Menstruation: A Critique
“Menstruation is a key site for discrimination and violence against women and girls with disabilities” (Steele& Goldblatt, 2020, p. 77) and the human rights violations they encounter in connection with menstrual management is an aspect that demands critical attention. Without much exception, menstrual hygiene management is a major challenge faced by disabled- menstruators who mostly depend on family members, caretakers or medical professionals to get their day-to-day activities done. Their inability to manage menstruation without external support and the chances of severe menstrual behaviours, as well as physical and psychological changes, worsen the menstrual experience, not to mention the stigma surrounding the same. The severity of menstrual symptoms and complications vary across individuals depending on their type of disability, probably the worst sufferers being women with intellectual impairments. Menstrual cramps, erratic and emotional behaviours, mood swings, social withdrawal, irritability, fear of blood, tendencies of self-injury, increased hyperactivity, poor hygiene management and many more issues can be identified in the list. Studies have proved that the consequences of this menstrual management crisis for the disabled include social isolation, menstrual suppression and even forced sterilisation.
Forced Sterilisation: The Human Rights Question
As Steele and Goldblatt observe, “Sterilisation is one particularly extreme and severe manifestation of menstrual discrimination against women and girls with disabilities” (2020, p. 81). Sterilisation procedures like hysterectomy, tubal ligation, and endometrial ablation will have lasting impacts on menstruation and reproduction. The framing of disabled people as mere bodies which require medical intervention and external management leads to crucial human rights violations. “While courts are generally protective of the fundamental and constitutionally protected rights of individuals with disabilities to procreate, they effectively shift the decision-making around sterilisation and menstrual management from the individual into the hands of medical professionals” (Nair, 2021, p. 181). In many jurisdictions, non-consensual sterilisation of disabled women and girls is legal, a few examples being countries like Australia, France, Germany, New Zealand and the United States of America. The reasons behind the choice of permanent sterilisation by parents and carers can be many, ranging from the troubles of managing menstruation hygienically to the way it worsens pre-existing health conditions due to hormonal fluctuations. On a graver level of reasoning, it is chosen to prevent reproduction altogether, which naturally leads to the permanent termination of menstruation. The justification attributed to sterilisation as a medical remedy beneficial to the quality of life of disabled menstruators rests on the socially constructed premise that “women and girls with disabilities are…unable to manage their own menstruation and their menstruation is…redundant and/or posing a threat to themselves or others” (Steele& Goldblatt, 2020, p. 82).
Though the rights of women with disabilities in relation to menstruation are protected under the international human rights law, many times violations do occur. In many cases, forced and non-consensual sterilisation procedures through the manipulation of the individual’s consent lead to the denial of bodily autonomy, personal integrity and reproductive rights, questioning their basic human right to live with dignity. “Although their reproductive rights are enshrined in numerous legal instruments, an alarming 93% of women and girls with disabilities in India have been, and continue to be denied them” (Bunga& Matthew, 2020), proposes the article ‘Women with Disabilities and Forced Sterilisation in India’. The vulnerability of women with disabilities to sexual violence, the lack of proper support systems from society and even the government and the burden of taking care of them in a society which stigmatises disability, severe measures like sterilisation emerge out of helplessness rather than inhumanity. Thus, the intersections of gender-based and disability-based violence experienced by disabled menstruators operate at multiple levels, that of the personal, institutional and even structural.
Denial of Sexuality: The Question of Discrimination
The tendency to label people with disability as asexual and the conscious societal urge to disregard their sexuality are prevalent in the Indian cultural context. The general perception of people with disabilities as either asexual- lacking any sexual feelings or hypersexual- with little control over their sexual instincts disregards their individuality as normal humans with feelings and emotions like the rest. Most often, people with disabilities are dependent on others throughout their lives, which makes society conveniently forget about their sexuality, and they are categorised as eternal children who are in need of external support. In the Indian context, till recently, the mainstream media representations of people, specifically women with disabilities, have never gotten out of the conventional closet of sentimental tragedy aimed to arouse audience sympathy, not to mention any reference to their sexuality. Movies like Peranbu, a 2018 Tamil language film which touched upon the topic of the sexuality of people with disabilities, have taken a bold step in addressing this complicated issue. The director of the movie, Ram, reflected in an interview that he wanted a world that saw the disabled as sexual beings and prospective partners (Rao, 2019).
Realistic depictions of the challenges faced by disabled characters and their caregivers on screen have the potential to reshape societal perceptions and break stereotypes. Amudhavan, the confused father in Peranbu who struggles to deal with the developing sexuality of his teenage daughter Paappa, who suffers from cerebral palsy, is a prototype of our mainstream society, which turns a blind eye towards the disabled and their needs. Poignant portrayals of the disabled girl’s sexuality and biological desires call attention to the need to normalise the sexuality of people with disabilities. The movie depicts the menarche of the girl as an added burden, and the single parent’s helplessness in managing her menstruation and puberty is a microcosmic representation of the bigger picture. Mainstream media has a significant role to play in deconstructing the prejudiced and stigmatised representations of disability in our society and creating awareness about their predicament.
The Problematics of Ableist Discourses: The Question of Inclusion
Another important aspect of the disabled-menstruator intersectionality is the dominant ableist narrative characterising the discourse surrounding menstruation. “Individuals with disabilities are frequently subject to oppression due to ableism- a system of beliefs that not only signals disability as a form of difference but constructs it as inferior” (Nair, 2021, pp. 180-81). The empowering tales of contemporary menstrual discourse, consciously or unconsciously, highlight the able-bodied menstruators and their subjectivities. Without many exceptions, modern menstrual product advertisements display “a view of how the menstruating body should occupy the world- strong, capable, independent, autonomous- without accommodation or assistive aids” (Nair, 2021, p. 180). Considering the fact that even the seemingly progressive menstrual narratives put forth a stand that is definitely ableist, the marginalisation faced by disabled menstruators who might be unable to change their pads without another person’s help or who might not have much of a say in decisions regarding their bodies becomes problematic.
As already discussed, many disabled menstruators encounter shame and face hardships in managing their periods owing either to the additional burden on their caretakers or to their inability to follow proper menstrual etiquette. On the other hand, we should not belittle the opinion of a minor section of disabled women who feel that menstruation makes them feel ‘normal’ like others. Analysing the mainstream menstrual narratives through the lens of the able-bodied/ disabled dichotomy will prove that the ideologies underlying them are not entirely free from a patriarchal-capitalist silhouette. The commodification of the human body under industrial capitalism has eventually led to the rejection and marginalisation of disabled bodies, which were perceived as unproductive and resultantly useless. The patriarchal construction of the independent-able-bodied man in contrast to the dependent weaker woman also sidelines the disabled as powerless and incapable. As Prianka Nair proposes in “Menstruation: An Ableist Narrative”, “Introducing a disability perspective also permits us to interrogate why popular depictions of the menstruating body are inadequate, how they continue to reinforce and romanticise values like independence and productivity, and validate structures that grant power and privilege to those values” (2021, p. 181). Thus, critical menstruation studies scholarship and contemporary menstrual discourse have an important role to play in shifting the menstrual experience of the disabled from the margins to the centre, thereby creating spaces for their unheard voices.
Conclusion
Though the intersections of the disabled-menstruator dilemma can be examined from many more critical standpoints, the paper limits itself to the areas discussed above and will conclude by briefly outlining the probable solutions to tackle the issue. As mentioned in the UNICEF Guidance Note on Menstrual Health& Hygiene for Girls and Women with Disabilities, “Access to safe and dignified menstruation is fundamental to all menstruators”, including those who are disabled and “stigma, misunderstandings, and exclusion can lead to harmful practices”. At the outset, the stigma and discrimination associated with both menstruation and disability should be addressed effectively, empowering family members and caretakers to support girls and women with disabilities to manage menstruation safely and with dignity. Educating carers to understand the menstrual needs of their wards and offering them proper training in tackling related challenges can make menstrual management easier for both the individual and the carer. Innovative steps in designing disabled-friendly menstrual products that cater to their special needs are a welcome change. Subsidisation of MHM products for the disabled will lessen the burden of affording period products for disabled menstruators. Collaborative initiatives of the government and society at large can play a great role in addressing the needs of menstruators with disabilities and bringing positive changes in their lives. The academic fields of Critical Menstruation Studies and Critical Disability Studies have the power to catalyse a transformation in addressing the subjectivities of disabled menstruators and repositioning them from the margins to the centre. Let our conversations be more inclusive and empathetic.
References
Bobel, C., Winkler, I., Fahs, B., Hasson, K. A., Kissling, E. A., Roberts, T.-A., Steele, L., & Goldblatt, B. (2020). The Human Rights of Women and Girls with Disabilities: Sterilization and Other Coercive Responses to Menstruation. In The Palgrave Handbook of Critical Menstruation Studies. essay, Palgrave Macmillan.
Buder, S., & Perry, R. (2021, November 5). The social model of disability explained. Social Creatures. https://www.thesocialcreatures.org/thecreaturetimes/the-social-model-of-disability
Bunga, A., & Matthew, T. (2020, March 11). Women with disabilities and forced sterilisation in India. Feminism in India. https://feminisminindia.com/2020/03/12/women-disabilities-forced-sterilisation-india/
Collins, H. P., & Bilge, S. (2021). Intersectionality. Polity Press.
Guidance note: Menstrual Health and Hygiene for Girls and ... - UNICEF. (n.d.). https://www.unicef.org/media/98881/file/MHH-Disabilities-Guidance-Note-ENG.pdf
Laird, A. (2019). Heavy flow: Breaking the Curse of Menstruation. Dundurn.
Linton, S. (2010). Claiming disability: Knowledge and identity. New York University Press.
Nair, P. (2021). Menstruation: An Ableist Narrative. Columbia Journal of Gender and Law, 41(1), 180–89. https://doi.org/10.52214/cjgl.v41i1.8833
Rao, S. J. (2019, February 19). “I want a world that sees disabled people as sexual beings and prospective partners”: Director Ram. Silverscreen India. https://silverscreenindia.com/movies/features/i-want-a-world-that-sees-disabled-people-as-sexual-beings-and-prospective-partners-director-ram/