-Ramphal Kataria
Biology, Stigma and the Republic: Menstrual Health as a Constitutional Question
Abstract
Menstruation, a foundational biological process essential for human reproduction, has historically been marked as impure across large sections of Indian society. This stigma—rooted in patriarchy, ritual purity norms, and male control over household economics—has produced systemic exclusion, silence, and preventable ill-health among women and adolescent girls. Despite incremental improvements in awareness and product availability, access to safe menstrual hygiene remains deeply unequal, particularly in rural and marginalised communities where sanitary napkins continue to be treated as dispensable luxuries. Drawing on public health research, social history, and constitutional jurisprudence, this article critically examines the lived realities of menstrual exclusion, the psychological trauma faced by adolescent girls, and the structural barriers created by gendered economic decision-making. It situates the Supreme Court’s recent recognition of menstrual health as integral to Article 21 of the Constitution as a transformative yet fragile intervention, cautioning against the fate of earlier socio-economic rights such as the Right to Education. The article argues that without sustained financing, social sensitisation, and judicial monitoring, menstrual health risks becoming another symbolic right divorced from lived dignity. Menstrual justice, it contends, is not welfare policy but a constitutional obligation central to public health, gender equality, and democratic accountability.
I. Introduction: Biology as Social Crime
Menstruation is among the most basic facts of human biology. It enables reproduction and ensures the continuity of life. Yet, in India, this process has long been transformed into a site of social exclusion, moral anxiety, and institutional neglect. Across regions, castes, and classes—albeit with varying intensity—menstruation is still associated with impurity, pollution, and restriction. Women are barred from kitchens and temples, excluded from social interaction, and rendered invisible within their own homes during their menstrual cycles.
This paradox—where the biological foundation of life is treated as contamination—reveals the deep entanglement of patriarchy, culture, and governance. While urbanisation, education, and media exposure have weakened some practices, menstrual stigma remains stubbornly persistent in rural and economically marginalised settings. The costs of this persistence are borne not only in social humiliation but in measurable losses to health, education, and dignity.
The Supreme Court’s recent recognition of menstrual health as an essential component of the right to life under Article 21 marks a constitutional rupture with this history. Yet constitutional recognition alone cannot undo centuries of social conditioning. The gap between legal declaration and lived reality remains the central concern of this article.
II. The Historical Construction of Menstrual Impurity
The stigma surrounding menstruation is not a product of biology but of social power. In pre-modern societies, bodily processes associated with reproduction were regulated through ritual norms that prioritised male authority and lineage control. Over time, selective interpretations of religious texts and customary practices framed menstruation as disorderly and dangerous, necessitating segregation.
This construction served multiple functions. It disciplined women’s mobility, regulated sexuality, and reinforced domestic hierarchies. Menstrual restrictions were internalised as moral duties rather than recognised as social impositions. Crucially, impurity was never applied to childbirth or motherhood—only to the process that signified women’s autonomous reproductive capacity.
Colonial modernity did little to dismantle these norms. While public health discourse expanded, menstruation remained confined to the private sphere, insulated from policy attention. Post-independence India inherited this silence, embedding it within welfare approaches that addressed maternal health while neglecting menstrual hygiene.
III. Pain, Silence and Adolescent Trauma
Menstruation is not merely a physiological event; it is a deeply embodied experience shaped by social context. For many women, menstruation involves pain, fatigue, and hormonal fluctuation. In settings where menstruation is stigmatised, these physical challenges are intensified by fear and shame.
For adolescent girls, the experience of menarche is often marked by confusion and psychological distress. In countless households, menstruation is not discussed openly. Girls encounter bleeding without prior explanation, accompanied only by warnings, restrictions, and secrecy. The absence of conversation produces fear rather than understanding, reinforcing the idea that their bodies are sources of embarrassment.
Schools, rather than offering refuge, frequently reproduce this silence. Inadequate toilets, lack of water, absence of disposal mechanisms, and unsensitised teachers make menstruation a source of anxiety. Fear of staining clothes or being ridiculed leads many girls to miss school during their periods, contributing to cumulative absenteeism and eventual dropout.
IV. Sanitary Napkins and the Economy of the Household
Access to sanitary napkins remains deeply stratified. For a significant proportion of women, particularly in rural areas, sanitary products are viewed as non-essential expenditures. Household economics are overwhelmingly controlled by male decision-makers, and menstrual needs are frequently deprioritised.
As a result, millions of women rely on old or discarded cloth, often reused without adequate washing or drying due to lack of privacy. Medical studies have consistently linked such practices to reproductive tract infections, urinary tract infections, and long-term reproductive health complications. These outcomes are not accidents; they are the predictable consequences of structural neglect.
The framing of sanitary napkins as a luxury rather than preventive healthcare reveals a deeper political economy of gender. Women’s health needs are accommodated only when they align with reproductive outcomes valued by the family or state. Menstrual health, by contrast, is rendered invisible because it challenges male control over resources and demands recognition of women’s bodily autonomy.
V. Girls Outside Institutions: The Invisible Majority
While recent policy interventions have focused on school-going girls, a vast population of menstruating women remains outside institutional coverage. These include school dropouts, child labourers, domestic workers, early-married girls, and women engaged in informal agricultural and urban labour.
Biologically, menstruation spans roughly from ages 10 to 45. Any serious approach to menstrual justice must therefore extend beyond schools and colleges to community-level provisioning. Limiting access to educational institutions risks reproducing exclusion by design.
The invisibility of out-of-school girls mirrors earlier failures in child welfare and education policy, where institutional presence became a proxy for entitlement. Menstrual health cannot afford a similar narrowing of scope.
VI. Constitutional Intervention: Menstrual Health under Article 21
The Supreme Court’s recognition of menstrual health as integral to the right to life and dignity represents a significant expansion of constitutional meaning. By directing the provision of free oxo-biodegradable sanitary napkins, functional gender-segregated toilets, safe disposal mechanisms, and comprehensive sensitisation programmes—including for boys and male teachers—the Court has foregrounded menstruation as a public obligation rather than a private inconvenience.
Importantly, the judgment situates menstrual health within dignity rather than charity. This framing compels the state to treat menstrual hygiene as non-negotiable, akin to food, shelter, and basic healthcare.
Yet constitutionalisation also raises expectations that governance structures may be ill-equipped—or unwilling—to meet.
VII. The Shadow of Article 21A: Lessons from the Right to Education
The trajectory of the Right to Education under Article 21A offers a sobering lesson. Enacted through the 86th Constitutional Amendment, the RTE dramatically increased enrolment but failed to deliver substantive educational quality. Learning outcomes stagnated, teacher accountability weakened, and child labour remained visible across urban and rural landscapes.
The lesson is not that rights-based approaches are futile, but that they are vulnerable to bureaucratic dilution. Infrastructure replaced pedagogy; compliance replaced commitment. Menstrual health risks a similar fate if implementation is reduced to procurement statistics and utilisation certificates.
VIII. Implementation, Finance and the Question of Political Will
Unlike civil liberties, socio-economic rights require continuous expenditure. Sanitary napkins, toilets, disposal systems, water supply, and awareness programmes demand sustained public investment. This is precisely where political commitment often falters.
There is a real danger that menstrual health will be treated as a one-time scheme rather than a permanent obligation. Governments may comply formally while underfunding implementation, particularly in fiscally constrained states. Without accountability, menstrual justice risks becoming another entry in policy documents rather than a lived reality.
IX. Comparative Perspective: India and Western Societies
In many Western societies, menstruation is discussed openly within families and schools. Parents prepare girls in advance, provide menstrual kits, and educate boys alongside girls. Sex education includes discussions of consent, contraception, and bodily autonomy. Menstruation carries no ritual stigma; it is treated as a normal aspect of health.
This openness is not cultural accident but political choice. It reflects long-standing investments in public health education and gender equality. The contrast with India highlights how stigma is socially produced and therefore socially dismantlable.
X. Conclusion: Menstrual Justice and the Test of the Republic
The Supreme Court has opened a constitutional door by recognising menstrual health as a fundamental right. Whether this recognition transforms everyday life for millions of women depends on what follows. Rights without monitoring risk becoming rituals; dignity without resources remains abstraction.
Menstrual justice is not a marginal concern. It is a test of constitutional morality, public health governance, and democratic seriousness. A society that venerates motherhood while stigmatising menstruation reveals a profound hypocrisy. The challenge before the Indian state is to ensure that constitutional promises do not end where women’s bodies begin.
Without sustained funding, social transformation, and judicial vigilance, menstrual health may join the long list of rights honoured more in law reports than in lived experience. The cost of such failure will be paid not in statistics, but in the bodies, minds, and futures of girls and women.
References
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