Disability and Menstruation

India is home to 9.3 million disabled girls and women who, like able-bodied women, menstruate and face menstruation-related challenges. But unlike other women, those with disabilities encounter added layers of struggle.

According to The Rights of Persons with Disabilities Act, 2016 "Person with disability" means a person with long term physical, mental, intellectual or sensory impairment which, in interaction with barriers, hinders his/her full and effective participation in society equally with others.

The voices of disabled women are largely marginalised and their obstacles remain invisible to the mainstream.

Firstly, those who are disabled are amongst the poorest of the poor in India. Moreover, they remain in poverty from one generation to the next, due to their inability to find stable and gainful employment. Secondly, the negative social attitude against those who are disabled leads to an increase in the risk of violence, discrimination, and neglect towards them.

Though the lived experiences of every disabled girl and woman varies due to the nature and extent of her disability, socio-economic status, region and environment, they have specific problems related to menstruation such as:

(1) For mentally or intellectually impaired girls and women, their inability to comprehend what menstruation is or how to take care of themselves during their periods means that they completely rely on their caretakers.
According to a study by the Oxfam Trust in 12 districts of Odisha which looked at 729 disabled girls, 6% of physically handicapped women and 8% of mentally impaired women were forcibly sterilised by their families.
In many cases, the parents opted to sterilise their disabled daughter because of two reasons: to avoid difficulties in managing their daughter’s menstrual hygiene and fear of pregnancy due to rape. In reality, sterilisation will not protect disabled girls or women from sexual violence but rather make her more prone to it — especially if she comes from an underprivileged background or lives away from home.

(2) For physically handicapped girls and women, they would need assistance to wear the menstrual products and dispose it after use. The most appropriate products to use would be period-proof underwear, disposable underwear and disposable pads.

(3) In the case of girls and women who are blind, they would need similar assistance as those who are physically handicapped including help in identifying when their period started and when to change their menstrual pad.

(4) For girls and women who are deaf and unable to speak, they would not face the same level of difficulty in managing their personal menstrual hygiene as seen above.

Beyond these issues, disabled girls and women face distinct problems like:

• The lack of information or educational resources for disability-specific menstruation issues and solutions — especially due to the stigma attached to both disability and periods
• Their exclusion from conventional menstrual hygiene management (MHM) education programmes
• The difficulties disabled girls and women face in accessing healthcare can compound into further health problems. Also, disabled girls or women need access to hormonal treatments to suppress or skip their periods or undergo medical procedures like stunting growth and sterilisation
• Like many women, disabled girls and women also experience the effects of Premenstrual Syndrome (PMS) or Premenstrual Dysphoric Disorder (PMDD) and if left untreated, can be negatively impact their quality of life
• The lack of disability friendly infrastructure in public buildings, transportation and washrooms shows the glaring disregard toward disabled persons and their needs

It should be noted that even today, there are not enough disabled women’s voices speaking out about their struggles when it comes to menstruation. There needs to be a growing recognition of the fact that disabled women are not given the proper resources and care they need to have healthy periods. This needs to change:

• We should treat disabled girls and women as equals to everyone else and create an inclusive space for them in MHM education
• Raising awareness about the roadblocks in disability-specific MHM and using creative tools to educate such as plays, comic books, sketches, cartoon videos, braille pamphlets, sign language communication , etc.
• Ensuring they have access to proper healthcare and trained professionals
• Training their parents or caretakers in disability-specific MHM, such as how to prepare their preteen daughter for menarche
• Having the access to disability friendly menstrual products
• And finally, ensuring that disability-friendly architecture and facilities are the norm and not the exception.