Menstrual self-care and self-knowledge as practices of resistance: Voices and reflections from Latin American menstrual activists and educators

Andrea Isabel Aguilar Ferro

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Introduction 

This research paper seeks to understand the role that self-care and self-knowledge can play in resistance to menstrual injustice^[1] and in pursuit of menstrual health, justice, and dignity in Latin America. I do not intend to discuss self-care and self-knowledge in an encompassing or generalizable way. I consider this paper as a contribution to wider conversations and constructions of menstrual justice. I conducted research with feminist menstrual activists and menstrual educators from México, Guatemala and Perú. I explored their experiences of menstrual activisms and their understandings of feminisms and menstrual care. Through this research I intend to position self-knowledge and self-care as means for women, girls, and menstruating persons^[2] to overcome the internalized hegemonic narratives and menstrual injustice, and thus gain menstrual autonomy. Menstrual self-care and self-knowledge are not something inherent to our human experience. They entail practices and doings that we learn from/with others when we collectivize and transform our menstrual experiences, which are plural and not necessarily individualized.

In the following pages I will first discuss menstruation and hegemonic menstrual narratives to render visible (some of) the sources of menstrual shame and stigma. I will also reflect on recent menstrual activisms in resistance to the hegemonic menstrual narratives. Then, I will share about the methodological aspects of the research I conducted with menstrual activists and educators on menstrual self-care and self-knowledge. To present the data collected, I will converse with my participants’ extracts in the text. Lastly, I will discuss the data and draw conclusions derived from this research experience. 

Flowing through the context of menstruation^[3]: hegemonic narratives, menstrual care, and menstrual activisms

Menstruation, despite being shared by half of the population in the world, has different interpretations, meanings, and values according to cultural and social contexts. However, most of these interpretations are often negative and continue to be means of oppression and control over menstrual bodies (Tum Teleguario, 2017). In previous research I conducted, I reflected on how, despite that menstruation is often depicted as a completely “natural” phenomena, there is nothing natural in the menstrual experience (Aguilar Ferro, 2021). Menstruation, rather, is an experience intertwined with both material aspects (menstrual blood as matter and the cycle as having physiological dimensions) and social aspects (including symbolic, emotional, political, historical, and economic, amongst others), simultaneously.    

Menstruation can also be understood as one of the products of our sexuality. However, it has been expropriated through misinformation and the imposition of a taboo that has called us into silence and secrecy (Aguilar Ferro, 2021). We often lack information about our cyclic bodies, about the phases of our menstrual cycle, the effects it can have over our bodies and overall well-being. This is part of experiencing menstruation in injustice. Johnson (2019) emphasizes on how “menstrual injustice affects all menstruators differently based on their location at the intersections of gender, gender identity, race, class, and disability, for instance, as well as privilege and disadvantage” (p.79). In this sense, she suggests that menstrual injustice can be understood as one of the ways in which patriarchy, classism, transphobia and other systems of oppression operate (Johnson, 2019) and are embodied, in diverse ways by menstruators.

Knowledge about how to experience and signify menstruation, and how to care for our menstrual bodies, comes from a variety of sources: this knowledge is relational. These sources may include teaching contents at school, menstrual products advertisements or campaigns, social media, feminist/menstrual activisms or activities, books, movies, amongst others. These sources are key in the construction of menstrual narratives. However, some of them acquire hegemonic (and sometimes violent) manifestations.

Hegemonic narratives about menstruation are also part of patriarchal views over women and cyclic bodies. The idea of menstruation as a symbol of contamination or as something dirty is, even nowadays, sustained by a diversity of discourses, practices and institutions (Garlo, 2014). However, this is not a coincidence, rather the stigmatization has been utilized by patriarchal powers across cultures and societies to sustain the subordination of women. In many cultures there are legends about the negative effects that a menstruating woman produces. Flowers die, fragile objects can be broken, mayonnaise turns liquid, she can weaken men and can even make a man impotent if she has sexual relations with him during her menstrual period. In many languages, menstruation is colloquially referred to as a “curse”, a term that is linked to the biblical story regarding menstruation as one of the curses that Eve received for eating the apple from the tree of knowledge (Paszkiewicz, 2016). In some Latin American countries, menstruating women are asked to stay away from babies and toddlers because they are often linked to “mal de ojo” or “evil eye^[4]” (Gracia, 2014). Menstruation, then, has been constructed as a source of disease, pollution, and negative experiences.

The idea of menstruation as something “bad” is also present in scientific texts from the Classical Era, which made up the Greek and Hippocratic corpus corresponding to the 4th century BC. For instance, some of the texts refer to menstruation as a dangerous, polluting and mysterious substance (Castellanos De Zubiría, 2009). The medical-philosophical Greek discourse has greatly influenced Western culture and our cultural narratives about our bodies and fluids. It is mainly constructed with a basis of binaries and hierarchic categories, where women and menstrual blood are imperfect and impure, in relation to, men and semen which was constructed as a perfect and pure substance (Héritier-Augé, 1989). These categories have also been masked under the notion of “natural” aspects, essential to one sex or another, thus being difficult to challenge, criticize and tackle.

Historically, menstruation, which carries emotional meaning (Young, 2005), has been stigmatized and lived, for a wide majority of menstruating persons, from the relational emotion of shame. Menarche, which may be experienced between 9-15 years old, is often lived in fear and silence. The main emotions we experience are often linked with shame (Aguilar Ferro and Gómez, 2020), which is a learned emotion and is not inherent or a “natural part” of our menstrual experience (Aguilar Ferro, 2021). As Stubbs and Sterling (2020) notice, small girls are often reluctant or unable to see or name their genitals, thus “developing agency in self-care or explorations of sexuality is unlikely” (p.233). Shame, as a control mechanism and as a primary structure of women’s lived experience, then, begins to install in our bodies with the first menstruation, however, shame will extend far beyond menstruation to become generalized as a sense of inferiority of the “female” (or feminized) corporeal subject (Kurks, 2001).

Chandra-Mouli and Patel (2020), address this idea as follows:

Being unprepared for menarche, being excluded and shamed during monthly periods, being hindered in self-care and uncared for when unwell, undermines a girl’s sense of being in charge of her life, her sense of self-worth and her sense that the individuals and institutions around her are responsive to her needs (p.629). 

One of the consequences of the shame that causes menstrual stigma is our perpetual state of self-surveillance, specially to hide our menstrual status (Johnston-Robledo and Chrisler 2013). In some contexts, mostly in Low- and Middle-Income Countries, girls lack the means for self-care and support to live their menstruation in a comfortable way and this has often been neglected as a right but rather experienced as a privilege. Many girls are not able to carry on with their daily life. This can establish a foundation for disempowerment, which can be manifested not only during the days of menstruation but can be experienced in life in general. The idea of secrecy has prevented us from speaking about menstruation collectively so that we cannot challenge menstrual stigma and taboo (Tum Teleguario, 2017). Keeping menstruation in secret also deprives us from accessing assertive information that contributes to the exercise of our bodily autonomies, as well as knowing and caring for our menstrual bodies. In this sense, many of us, as children or even as adults, do not learn how to take care of ourselves. We often do not know our own bodies or our cycles, and our contexts are not responsive to our menstrual needs (that exceed menstruation itself but intersect with other aspects of our lives).

The idea of “menstrual care” has often been linked to understanding “care” in a reductionist way, mainly related to the access to technologies to manage menstrual blood. According to Bobel (2019), this type of menstrual care doesn’t “challenge menstrual stigma, it accommodates it” (p.26). This focus on the products to manage menstrual blood keeps menstruation hidden, and thus prevents us from normalizing menstruation. This “hiding menstrual blood” practice is grounded in the menstrual taboo, stigma, and sexism (Bobel, 2019). This narrative has been common among Menstrual Hygiene Management (MHM^[5]) practices and discourses. Jennifer Thomson et al. (2019) argues that MHM renders invisible other important aspects related to the work around menstruation, such as menstruator’s understanding about their cycle or her sexual and reproductive health. Discussions of taboo and stigma are also absent from the MHM discourse, which is essential “given how central these are to an understanding of menstruation in all contexts, and the severe impact that these can have on women and girls’ rights, dignity and wellbeing” (p.12). 

As Bobel (2019) indicates:

This narrative hinges on the belief that all that ails the poor girl in the Global South is a lack of access to menstrual care. This is the core message of MHM: Give a girl a pad and change her world. MHM discourse so consistently situates the pad as the key that unlocks girls’ potential (and saves them from a tragic life), that I often think Malala’s famous pronouncement during her UN address could be amended to “One child, one teacher, one book, one pen, one pad, can change the world” (p.57). 

Caring for the menstrual body is way more complex than access to products. In this sense, achieving menstrual health, justice and dignity entails comprehensive and multiple approaches to menstrual care. Menstrual care must be redefined and adapted to the intersecting experiences that we embody. Menstrual care should also consider situations of vulnerability such as homelessness or (im)mobility (Vora, 2020). It also has to accommodate diverse bodily experiences such as living with disabilities (Steele and Goldblatt, 2020), or living with premenstrual distress, to address different manifestations of our menstrual cycle and how we make sense of them (Usher and Perz, 2020). It should be des-individualized or collectivized, because menstrual experience is relational and we often learn about it generationally (McCarthy y Lahiri-Dutt, 2020). It should aim for a transformation of the narratives to eradicate menstrual stigma and taboo which indicate we cannot inhabit the public space with a stain on our clothes. Such transformation needs to be done through menstrual education or awareness-raising programmes. And it should foster menstrual autonomy^[6] through the development of self-care and self-knowledge as emancipatory and subversive practices.  

Menstrual care is political, and it should be both material and sociocultural. It is complex and it must be inclusive and placed at the core of other structural changes that we need as humanity. These structural changes may include, for example, sexual and reproductive health education, eradicating violence against women and girls, ending poverty or even enhancing access to sanitation and a dignified place to live. In this sense, menstrual activisms play an important role in challenging hegemonic narratives, reductionist views on menstrual care, and manifestations of oppressive systems.

Menstrual activisms nowadays are often linked to feminisms. According to Chris Bobel, back in the days, in the United States of America, for example, three standards were woven to produce menstrual activism around the 1970s: the movement for the health of women, the movement for the environment, and the critique of consumerism. Many feminists back then reclaimed menstruation and refused to remain silent about this crucial aspect of women’s health (Bobel, 2010). As part of menstrual activism’s diverse manifestations, some activists as well as social entrepreneurs started to use empowering^[7] languages and shift the term from “‘female hygiene” to “menstrual health”. Replacing “hygiene” with “health” entails an empowering shift since it turns away from the idea that there is something that needs to be “hygienized” in our cyclic bodies. The notion of hygiene sustains the narrative that our bodies, including our fluids, are dirty. As Punzi and Werner (2020) notice: “their messaging is meant to inspire body positivity and encourage women to become knowledgeable about their menstrual cycle and overall health” (p.843). The notion of menstrual health also links us to the idea of menstrual care. This shift has also taken place in contexts such as therapeutic-spiritual, and also offer, as Guilló-Arakistain (2020) sustains, “different ways of experiencing corporeality, highlighting the importance of self-care” (p.876). On the other hand, replacing “female” with “menstrual” opens the door to recognize the diversity of menstruating persons since not only women menstruate. Visibilizing this diversity and shifting the narratives locates the diversity of menstruating persons as subjects of menstrual dignity, justice and rights.

In Latin American contexts, menstrual entrepreneurship started back in 2011 in México. And in 2012 Guatemala Menstruante, in Guatemala, emerged as the first collective entirely dedicated to menstrual activism (Bean, 2021). In previous research I conducted with menstrual activists who integrated Guatemala Menstruante, I found menstrual activism emerged from the activists’ own experiences, traversed by silence, disgust, fear and shame for the most part. Becoming menstrual activists transformed the experience of our own body and the experience of the collective. Being menstrual activists also means being consciously menstruating, in the sense of being aware that the menstrual experience, and the experience of the body, is permeated by power relations, by culturally constructed emotions and by the contexts/cultures in which we have to live (Aguilar Ferro, 2021). 

Menstrual activisms are plural, and most of them recognize the patriarchal wounds related to menstruation and position themselves from (diverse) feminist approaches. Specifically speaking from my own experience as a menstrual activist, I would say that I aim to heal my own menstrual experience. Understanding healing is a political path to reclaim our body-territory, as proposed by territorial communitarian feminists from Guatemala (Cabnal, 2018). The strategies, narratives and practices that are being created collectively in the arena of menstrual activisms in Latin America, as political tools to dismantle oppressive systems, include taking care of ourselves, our bodies, our planet and our cycles. Self-knowledge and self-care are strategies we weave collectively as part of our paths to menstruate, autonomously, in dignity and justice. In the following pages I will discuss the research I conducted with menstrual activists regarding these topics and present their voices and views. 

Methodological process

I conducted research with five feminist menstrual activists and educators from Latin America, specifically from Guatemala (3), México (1) and Perú (1). I invited participants directly based on my own personal encounters with them and knowing them for being menstrual dissidents^[8]. They carry on actions and processes linked to foster and enhance emancipatory menstrual experiences in different regions of Latin America. Since we are distant in a geographical sense I contacted them through social media, mainly Facebook and WhatsApp. I explained my curiosity to explore menstrual self-knowledge and self-care in the context of their menstrual activism practices. I contacted seven possible collaborators, but due to time restrictions and other responsibilities, only five of them agreed to participate. I would like to clarify that I have a personal bond to my participants. We have actively collaborated in previous programmes concerning menstruation in our regions, which brought me to the idea of contributing, through this paper, to a systematization and analysis of their practices and voices^[9].

The method I used to obtain the data consisted of a self-filling survey with 16 open-ended questions^[10]. The survey was in Google Forms and took them around 30-40 minutes to complete. Since we all speak Spanish and identify ourselves with that language, I decided to design the survey in Spanish so that participants would feel more comfortable. I then translated their answers into English for analysis as well as for this publication. Participants answered between the dates of February 12th and 18th, 2022. The main objective of the survey was to explore the concepts of menstrual self-care and self-knowledge, how they are practiced and incorporated into menstrual activism/education, and what is the relation they have with feminisms and menstrual health/justice/dignity. I established this objective out of my own experience working as a menstrual activist in Guatemala, and my knowledge of menstrual activisms that have multiple origins and manifestations which echo and weave into our bets to contribute to menstrual justice, dignity, and health.

I retrieved the participants’ answers with an Excel table, where I created a double-entry matrix to organize data. The data were then analyzed through Dedoose software.  In the following paragraphs I will present the results of the research.

Results

To situate the results of the research I would like to briefly introduce the participants who collaborated in this research experience, whose ages range from 27 to 35 years old. 

• Mariel Soledad Távara Arizmendi (she/her) is a psychologist, menstrual activist, and educator from Perú. She is a member of a project named Somos Menstruantes, which aims to foster menstrual education in Perú.
• Andrea Reyes (she/her) is the Executive Director of The Period Movement Guatemala’s Chapter, which seeks to eradicate the menstrual taboo and bring menstruation to public debate.
• Anahí Rodríguez Martínez (she/her) is a menstrual activist from México. She is involved in #MenstruaciónDignaMéxico movement, which promotes free access to menstrual products in México City, as well as quality menstrual education. 
• Adriana Gómez (she/her) is an anthropologist and a menstrual activist and educator from Guatemala. She is part of Guatemala Menstruante, a feminist collective dedicated to foster the material conditions and narratives to menstruate in dignity, health, and rights. 
• Gabriel Álvarez (he/him) is a transgender man, researcher, psychologist, and human rights advocate in Guatemala.

All the participants of this study identify themselves and their practices with feminisms (ranging from decolonial perspectives to communitarian and trans-feminisms). In the following paragraphs I share the narratives and reflections from these menstrual activists and educators. Exploring participants’ experiences, approaches in their menstrual activism/education practices, and how they understand their own activisms/practices, this article aims to examine the connection between menstrual self-care and menstrual self-knowledge, and their relations with feminisms and menstrual health/justice/dignity.

Experiences with menstrual activisms and education

Participants have shared some common topics when addressing their experiences with menstrual activisms and education. They recall how important it has been to their experiences having all the inspiration from other collectives, persons and initiatives that address menstruation in Latin America. 

Mariel Távara (participant): in 2018 I met menstrual education, from the proposal of the companions of Princesas Menstruantes^[11]. I fell in love with their work and began my journey to promote menstrual education in Peru more intensely. 

Gabriel Álvarez (participant): I really got closer to the subject in a time when I was joining women’s collectives where I felt for some reason very identified.

Most of them mention that their experience and participation in menstrual activism comes from the outrage they feel regarding the menstrual taboo and the desire to change this reality. 

Anahí Rodríguez (participant): my fight for dignified menstruation was born from indignation, anger, and disbelief that a merely biological issue which is not a choice for us to make, would lead us to pay a tax or not have access to rights as basic as education.

Adriana Gómez (participant): since 2014 I have been part of the Guatemala Menstruante collective in which we carry out various manifestations of menstrual activisms (red tents, research, collaborations with other collectives, exhibitions, etc.). We work to dignify the experience of menstruation for everyone, specifically we want to contribute to the construction of new narratives around menstruation that lead to a dignified life.

Menstrual self-care and self-knowledge

When it comes to defining menstrual self-care, participants share a diversity of aspects. They mention how important change in the perspective they had about menstruation was in their experiences. 

Anahí Rodríguez (participant): I shifted from hating my period to starting to see it positively as a sign that my body is healthy.

Self-care for them also implied other aspects that may be regarded as not necessarily related solely to menstruation in the strict or “traditional” sense. These aspects include changes in diet, symptom relief (specially cramps), setting boundaries (mainly related to productivity and work), flowing with the menstrual cycle, and emotion management practices. 

Mariel Távara (participant): for me, menstrual self-care is the set of practices that each menstruating person develops in relation to their cyclicity: from what we choose and use to manage bleeding, to what we eat or drink.

Anahí Rodríguez (participant): I started to pamper myself those days. I started to let my body flow with my menstrual cycle and began to practice free bleeding which connected me more with my body. 

Participants also linked menstrual self-care practices to self-knowledge, not only related to menstruation but to their bodies and needs. Most of the self-care practices they recall are self-knowledge based.

Adriana Gómez (participant): for me, it is knowing/understanding my body, understanding it from its particularities and from there taking care of it so that it is healthy, to live a menstrual cycle in dignity with my own terms.

Andrea Reyes (participant): self-care also includes knowing how to recognize myself, my body, and my cycle, and reconcile myself with the processes of my body.

Mariel Távara (participant): menstrual self-care implies self-knowledge.

When addressing menstrual self-knowledge, companionship, sharing knowledge between women (mostly), and learning from others is key. Menstrual self-knowledge, then, even though can be thought as something individual, is rather a collective process. This process can begin within family circles and mother figures.

Mariel Távara (participant): I think that each one can develop tools to accompany this process, among women we share practices: since I was a child my mother taught me about the phases. Together, we marked on a small calendar the days of my bleeding, as she did on hers. She also asked me about how I felt. Now that practice continues with me in the form of a menstrual notebook or diary in which I record not only the days I menstruate, but also the days I ovulate, how I feel, what I do, etc. I believe this practice has its essence in that first experience with my mother.

Another key aspect for menstrual self-knowledge for participants is related to their abilities to recognize how cyclicity manifests itself in their bodies and experiences. 

Andrea Reyes (participant): for me it is to know our cycle. Knowing how to identify through our cycle that everything is fine with our body or that there are warning indicators.

Adriana Gómez (participant): it is to identify my own cycle. In this way, the self-knowledge of the menstrual cycle is the possibility of recognizing this cycle in me, of embracing each phase that makes me who I am and taking care of it to experience well-being.

Mariel Távara (participant): for me, menstrual self-knowledge is the process through which we allow ourselves to know our own body and recognize how our own cyclicity moves (when we ovulate – when we menstruate and how we feel in each phase).

To be able to recognize cyclicity in them, participants usually carry out practices such as menstrual diaries, as Mariel mentioned, or tracking their cycles through technologies and apps developed for that purpose. This practice does not limit to physical manifestations of cyclicity, but also includes emotional and psycho-social self-explorations.

Menstrual self-knowledge has been a fundamental part of their activism practices. It has allowed them to challenge hegemonic menstrual narratives.

Mariel Távara (participant): I think it implies freeing ourselves from the stereotypes of “regularity” and the homogenizing mandate of our diverse menstrual experiences.

Anahí Rodríguez (participant): self-knowledge also allows us to see that our blood is not dirty and that helps us to remove stigmas and taboos.

Menstrual self-care and self-knowledge into practice

Participants recognize how the topic of menstruation, despite being addressed by different projects and collectives, remains invisible, has been a privilege or does not reach all menstruators. They share different approaches they have taken in their own practices as menstrual activists and educators to change this, a change that is not absolute but rather a continual process.

Anahí Rodríguez (participant): the first thing that we put on the table was the word, it is no coincidence that in the name of the collective is the word menstruation, we knew that it was powerful and that it would cause reactions. So first I would say that we named it because “what is not named does not exist”. The first step is to change the narrative into a more positive one. The second thing is to let them know that these processes are not easy or linear, there will be times that you will continue to hate menstruation because we have been with a negative narrative for many years, it requires practice.

Specific practices related to menstrual self-knowledge and self-care are linked to make information and tools accessible, thus contributing to processes of empowerment of menstruators. 

Mariel Távara (participant): from the Somos Menstruantes proposal, we share information and experiences hoping that this will help other menstruating persons to approach their cyclicity in new ways. Both concepts allow us to break with colonial ideas that are imposed in our territories in relation to our bodies. Both concepts are a source of collective and individual empowerment. Generating a narrative from the menstrual self-care proposal is essential to change the hygienic, sexist, and patriarchal perspectives of menstruation that have historically limited the experiences of those of us who menstruate.

Adriana Gómez (participant): the general idea, I believe, is to get menstruation out of silence so that each one has the tools and information necessary to experience it from their own terms, in dignified conditions.

Andrea Reyes (participant): we have tried to speak freely and knowledgeably, constantly educating ourselves from various spaces to be able to replicate this information with groups that may have never heard of the subject, of menstrual management alternatives, of the social and political importance of this topic.

Another important aspect is related to the recognition of how menstrual self-care and self-knowledge practices are diverse. One important aspect that all participants share is that they enunciate themselves and their activisms from feminist perspectives. Especially since menstrual activisms and feminisms often have shared political aims and horizons.

Adriana Gómez (participant): feminisms are also diverse, but they seek to build conditions for a dignified life for women, among other populations, and that is where they coincide.

Mariel Távara (participant): talking about menstrual self-care and menstrual self-knowledge is highly revolutionary and feminist.

Anahí Rodríguez (participant): from feminism we have fought for all the rights that we have, and we will continue in the fight for those that we lack. Ensuring that no woman or menstruating person is hindered from exercising rights because of menstruation is a feminist motto.

Participants share the idea that menstrual self-care and self-knowledge is also linked to ending the oppression and control over women’s (and menstruators) bodies.

Gabriel Álvarez (participant): feminisms and menstrual self-care and self-knowledge are linked, and a lot because in the end what they all seek is to recover the wisdom in our bodies.

Andrea Reyes (participant): linking feminisms with menstrual self-care and self-knowledge is a way to vindicate ourselves from our bodies that have constantly been invalidated and subdued.

Adriana Gómez (participant): oh yes, all that we do is linked to the autonomy of women’s menstrual body (although not only women menstruate). Menstruation has been relegated to silence and this oppressed (rather: oppresses) the life of bodies with a uterus by not having information and conditions necessary for a dignified menstruation in several cases (such as water or products for menstrual management).

Mariel Távara (participant): menstrual self-care and self-knowledge are definitely linked to feminisms because they start from breaking with control devices of our bodies.

And lastly, addressing menstruation from a feminist perspective can also nurture feminist practices.

Andrea Reyes (participant): talking about menstruation is a form of sorority. Helping menstruating people understand their processes is necessary for their emancipation.

Mariel Távara (participant): everything related to menstrual education allows us to break with adultcentrism and necessarily connect with the experiences of menstruating childhoods and adolescences, a challenge for our feminisms.

Self-care and self-knowledge as practices that bring menstrual justice, health, and dignity

Participants share how their personal practices of menstrual self-care and self-knowledge have contributed to their subjectivation as menstrual activists and educators, situated in their local contexts in Latin America. 

Mariel Távara (participant): menstrual self-knowledge brings us closer to recognizing our experiences and from there thinking about the concept of menstrual dignity for our territories.

Adriana Gómez (participant): menstrual self-care and self-knowledge result in a greater empowerment of the bodies with a uterus, of the same body that contains it, and most of the time, I believe, it entails tools to identify health and knowledge to build the conditions of menstrual dignity in our own terms. It is in this way that when we delve into the subject, the need to work for menstrual justice becomes visible, since most bodies with a uterus in different territories do not have the necessary conditions for a dignified menstruation.

Anahí Rodríguez (participant): menstrual self-care and self-knowledge help us to revalue, rethink and resignify our relationship with menstruation and this leads us to have greater menstrual care in health issues, and to become aware of the conditions that surround us around the experience of the period. They allow us to detect conditions that are not fair that impact the way we experience menstruation. And in the long term, this awareness can lead to activism.

Participants also mention that menstrual self-care and self-knowledge contribute to experiencing menstruation from well-being, which they connect with menstrual health, justice, and dignity. These topics should be addressed from an intersectional perspective, especially in territories such as Latin America, where inequality prevails. 

Anahí Rodríguez (participant): dignity and menstrual justice, in my opinion, go hand in hand. Menstrual justice brings dignity. In societies with so much gender inequality, menstrual justice is an important step for women’s rights and the minimum dignity that we as human beings deserve.

The notions and definitions participants have regarding the concepts of menstrual justice, health and dignity are diverse. Menstrual health is associated with experiencing menstruation in well-being, with access to medical care (pain relief as well as gynecological checkups), and self-knowledge about the cycle. Menstrual health should be responsive of different systems of oppression as well.

Mariel Távara (participant): when we talk about menstrual health, we refer to the desirable well-being of every girl, adolescent, woman and menstruating person in relation to the experience of their menstruation and cyclicity; according to their development and identities

Another aspect participants link to menstrual health is self-knowledge of the cycle as well as other bodily manifestations. 

Adriana Gómez (participant): menstrual health implies knowing my body and understanding the cycle that happens. This allows me to identify what is health for me and what things are happening that may need attention, so that I can respond to them to seek health.

Andrea Reyes (participant): it is to know our cycle. To know how to identify through our cycle that everything is fine with our body or that there are warning indicators.

The notion of menstrual health is also linked to menstrual care, as Gabriel Álvarez notes, it implies taking care of our body as a territory^[12].

When addressing specifically the concept of menstrual justice, my participants share some common topics such as access to menstrual management products, including reduction in taxes as well as free access for some less privileged menstruators. Participants advocate that seeking menstrual justice also includes having access to quality medical care and menstrual education. 

Adriana Gómez (participant): menstrual justice refers to the construction of conditions for a dignified menstruation for everyone, approaching it from a comprehensive perspective; that is, to include education, infrastructure, health services, products for the management of menstrual blood, social and cultural narratives about it, among other aspects. All those edges that collide so that we can all live a dignified menstruation; edges that must be modified, since currently menstruating in dignity is not a right for everyone.

As Adriana notes, menstrual justice is one of the paths that helps menstruators to gain menstrual dignity. Menstrual dignity is signified as a human right. It is linked to access to information that enables menstrual self-knowledge and autonomy that leads to menstrual self-care practices. 

Mariel Távara (participant): menstrual dignity for me is a right. This concept links the recognition of cyclicity-menstruation with equality and human rights. It implies that menstruating persons can live our menstrual experiences without feeling restricted from accomplishing achievements in our life projects and daily actions. Therefore, menstruations must be freed from all stigmas, genderstereotypes and acts of sexist, patriarchal, heteronormative violence. We have a right to receive diverse information (considering both “scientific” and ancestral or traditional) that dignifies all experiences. Menstrual dignity is the major goal of the menstrual education practices that I undertake, personally and collectively.

Menstrual dignity is also thought as a condition for wider dignified conditions of human experience. Participants link it to infrastructure, both in public and private spaces, and how it can contribute to the dignification of menstrual experiences.  

Anahí Rodríguez (participant): it requires that they have the adequate infrastructure for the management of menstruation both in the private (home) and in public spaces (work and other establishments).

Adriana Gómez (participant): dignity is related to living the menstrual cycle with information, infrastructure, and products for the management of menstrual blood, comprehensive conditions of dignity, in which I can decide on my terms how I want to live it and that it is respected.

Discussion

The results show that there is plurality when we think about menstrual self-care and self-knowledge. Menstrual activists and educators do not necessarily share the same concepts/propositions, but rather construct them out of their situated experiences. Nonetheless, some of them echo one another. The consistency of the participants’ reflections in my research is the feminist link between the practices of menstrual self-care and self-knowledge as practices of resistance to defy menstrual injustice.

Results also show that menstrual self-care and self-knowledge are two interwoven concepts. Menstrual self-knowledge is knowing how each phase of the menstrual cycle manifests in each one of us, both in our body languages (getting to know our vaginal flows and discharges, for example), and in our emotions. It is the one that enables self-care since it allows menstruating persons to know what they need to take care of their cyclic bodies and their manifestations. We embody this knowledge as we menstruate, in diversity. Menstrual self-care practices are diverse, and they are often linked to living the menstrual experience in dignity, comfort and with accurate information. Self-knowledge is (un)learned through non-linear processes such as overcoming the stigma/taboo around menstruation, accessing emancipatory information through menstrual education, and sharing our menstrual experiences with other menstruators, which confirms that menstruation is relational. As Mariel shared about the practices she used to have with her mother when she was young, it is common that we only engage in the topic of menstruation within inner circles of trust. This can sometimes result in a complete absence of menstrual education, which is necessary for menstrual self-knowledge. However, at the same time, these inner circles of trust consolidate as safe and brave spaces to discuss and learn about menstruation.

The idea shared by Anahí about the importance of understanding that our blood is not dirty as a key to eradicate menstrual stigma and taboo finds an echo in my own experience. It was until I was able to smell, touch, and see my blood using a menstrual cup (which was a recommendation from one of my closest friends) that I was able to grasp that my blood did not smell bad or that it was not dirty. Rather, I started to question all the previous ideas I had learned about it. The contact with blood, for me, was an important aspect to pursue menstrual self-knowledge. It opened the possibility to ask other questions about other aspects of my cycle that were neglected or misinformed. Such questions included exploring my other cyclic manifestations, such as identifying when I was ovulating or understanding the emotional processes that occurred to me due to hormones. I did not go through this self-exploration alone, rather I did it with close friends. Therefore, I often share that collectivizing our experiences is fundamental. Self-knowledge is key to challenge menstrual stigma and taboo, both at individual and collective levels since it defies hegemonic narratives and discourses. 

Self-knowledge-based self-care practices also challenge discourses that normalize pain and menstruating in discomfort. Other discourses that are challenged are the ones that suggest using disposable products is the only option available to manage menstrual blood. Menstrual self-care is political in the sense that it enhances autonomy and challenges the power that runs through our cyclic bodies. 

Results also echo Chris Bobel (2019), as she states that when menstruation is freed of its (gendered) stigma, spaces are opened up. These open spaces allow diverse practices that may include information seeking, resource sharing, and healthy critique of menstrual care practices. In this sense, an information-rich context enables menstruators to experience our bodies with the confidence and support we deserve (Bobel, 2019). It also allows us to create and embody new menstrual narratives and conditions to menstruate in justice, in rights, which are also mediated by the contexts and the intersectionality we embody.

Participants position the menstrual experience as linked to other aspects related to the contexts where they activate. Recognizing the diversity of needs related to achieving menstrual dignity and justice entails the acknowledgement of multiple levels of inequalities that are characteristic of most Latin American contexts. Therefore, diverse menstrual activism projects respond to different needs, contexts, and menstruating persons. Menstrual activists and educators that participated in this research, as well as many others, aim to transform these realities and bring dignity, justice, and health to diverse menstrual experiences. Aspects such as gender, class, ethnicity, education level, among others, directly affect our menstrual experiences, possibilities for self-care and self-knowledge, and as Johnson manifests, intersectional approaches when speaking about menstruation are necessary to understand how different systems of oppression manifest themselves (Johnson, 2019). In societies with so much gender inequality, menstrual justice for all is an important step to live in rights. 

In many countries, including México, Argentina, Guatemala, and Colombia in Latin America, new laws, law initiatives and policies have been created to address menstrual injustices. Three of the participants of this study were actively engaged in the creation of policy and law instruments related to menstruation in their countries. For Johnson, structural intersectionality can strengthen these efforts that also aim to challenge the cultural narratives of menstruation that often represent menstruating persons as shameful, impure, and incompetent. These narratives often result in exclusion, essentialization, discrimination, and harassments against menstruators (Johnson, 2019). Therefore, challenging hegemonic narratives is also a systemic process.

It is my perception that this study opens the door for new research questions and maybe deeper approaches to further understand the political practices of menstrual self-care and self-knowledge as pathways to resist heteropatriarchal, colonial and hegemonic narratives and material conditions that deprive us, menstruating persons, from experiencing menstruation in justice and autonomy. There is also an important highlight, that leads me to raise the question of how these practices that are often constructed as “individualized” (even though they’re not necessarily so, as this study shows) can contribute to dismantling other oppressive systems and structures, such as neoliberalism. 

Final (and cyclical) reflections

We must not confuse the practices of menstrual self-care and self-knowledge with our struggle to dismantle hegemonic colonial and patriarchal material conditions and narratives around our bodies that sustain inequalities, in which menstrual injustice resides. As Asam Ahmad (2016) stated, it does not matter how often we tell people to love (and care for) their bodies (or their menstrual cycles), because some of us will be daily reminded that our (cyclic and changing) bodies (and fluids) need to be hidden, silenced, oppressed (Ahmed, 2016). We must recognize the need to continue to confront, challenge, and resist oppressive systems through different pathways, of which menstrual self-care and self-knowledge are key. Finally, I also consider it relevant to remember that the recovery of our body-territories can also be done from joy (as the territorial community feminist companions of Ixim Ulew-Guatemala teach us) and from radical tenderness as the engine of our rebellion.

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^[1] Margaret E. Johnson (2019) defines menstrual injustice as “the subordination and oppressive treatment of menstruators” (p.79). She proposes that menstrual injustice is sustained through cultural narratives of menstruation that often represent menstruators as incompetent, impure and shameful.

^[2] In the following pages I will use the term “menstruating persons” and/or “menstruators” to refer to women, girls, adolescents, non-binary, queer, and diverse persons who experience menstruation. 

^[3] I would like to disclose that the context I am presenting in this paper has no intention to be generalizable or encompassing. Rather it is situated, following Donna Haraway’s proposal (Haraway, 1988), in my own body and experience as a mestiza young woman, mother, feminist, menstrual activist, researcher, and educator from Guatemala.

^[4] “The “evil eye” is a traditional disease that generally presents itself under the symptoms of a severe headache, tiredness, difficulty opening the eyes and annoyance towards light. In the case of children, the recurrent symptoms are constant crying and the inability to fall asleep” (Gracia, 2014).

^[5] Menstrual Hygiene Management is defined by Sommer and Sahin (2013) as the process where: “women and adolescent girls are using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required, and having access to facilities to dispose of used menstrual management materials” (p.1557). This definition is cited by Tomson et al. (2019) and they also reflect upon how this definition has “become the central way in which work around menstruation is framed and measured” (p.12).

^[6] Menstruating in autonomy, for me, includes (but does not limit to) bleeding in comfort, managing our blood as we decide, with information, knowing our cyclic bodies, and identifying/fulfilling our needs of care, including emotional and relational aspects of it.

^[7] I use the notion of “empowering” even though it is a very disputed concept since, for me and many activists, it means to reclaim power over ourselves and our bodies. Power that has been exercised from patriarchal and misogynistic social locations and positions. 

^[8] This is a concept I am starting to explore to create a category for those of us, menstruating persons, that are critic and question the hegemonic narratives of menstruation as something dirty, something to be ashamed of and something to be hidden from public debate, spaces and conversations.

^[9] Participants actively mentioned to me that they wanted to be named in this publication. 

^[10] Survey questions included in the appendix. 

^[11] Princesas Menstruantes or “Menstruating Princesses” in English is a project from Colombia dedicated to menstrual education with girls, mostly in school environments, aiming to build emancipatory menstrual narratives. 

^[12] The notion of body as a territory is one of the main contributions of communitarian feminism, especially from Lorena Kab’nal (Cabnal, 2018).

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Acknowledgements

I would like to express my gratitude for Alessia González for her help in my writing process.

Mariel, Adriana, Andrea, Gabriel and Anahí, thank you for your collaboration to make this research possible but also for everything you do to bring menstrual justice and dignity in our territories. 

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Appendix

The survey I used to collect data with participants included the following questions (including consent).

1. Do you consent to collaborate in this research effort? Your participation will consist in answering the following questions, which will be analyzed and integrated in the process of creating knowledge about menstrual self-care and self-knowledge. 
2. What is your name, country, and activism space?
3. Do you want to be named in the final text or do you prefer to participate anonymously? 
4. How old are you?
5. What is your gender identity?
6. Tell me a little bit about you and your experience regarding menstruation and menstrual activism/education.
7. What is menstrual self-care for you?
8. What is menstrual self-knowledge for you?
9. How do you put into practice these concepts within your processes related to menstrual activism/education in your territory?
10. Do you consider that these concepts are linked to feminisms? Why?
11. Do you relate these concepts to health, dignity and/or menstrual justice? How and why?
12. What is menstrual justice for you?
13. What is menstrual health for you?
14. What is menstrual dignity for you?
15. Do you have any additional reflections or comments that you may want to share about menstrual self-care and self-knowledge? Perhaps a personal experience or something you would like to share that was not addressed in the questions?
16. Please provide your e-mail to share with you the results of this research.