By Tasnia Shahjahan

This op-ed was first published on BrownGirl Magazine on May 28, 2020.

Tasnia Shahjahan is a graduate student in the Human Rights Studies program at Columbia University.  Her research explores violence against women, gender justice and legal advocacy, amongst South Asian communities. Beyond her academic career, she has worked as a domestic violence and sexual assault crisis response advocate and peer educator. She envisions a world free of interpersonal violence. Find her on Instagram @wordswithnia

“Period” and “menstruation” are still words that cause discomfort in our communities today. While menstrual stigma is not unique to our South Asian community, it may be intensified by the deeply rooted patriarchal traditions that our immigrant ancestors brought over many moons ago. Buying menstrual pads back home in Bangladesh meant coming home with a newspaper wrapped box in a translucent bag or a black opaque plastic bag. This exemplifies the social stigma around a natural process of the human body, experienced by around 50% of the world’s population at some point in their lives. But what better day than today to talk about periods? It’s Menstrual Hygiene Day – a day to break silences, raise awareness and challenge the stigma. 

If menstruation talk makes our community uncomfortable, “sex” especially “pre-marital sex” can cause outrage. At the intersection of these two topics (and thus taboo to the point of being forbidden) lies a pack of tiny, round capsules, 28 of them, to be exact (i.e. birth control pills). As an unmarried Bangladeshi-Muslim woman, the fact that I take birth control pills is an eyebrow raising concern for many people in my own community. Even though one might argue that the choices I make about my body should be solely my own concern, this often is not the case in family oriented communities. While the denial of the existence of pre-marital sex presents a massive issue, let us consider here, the public health dimension of the use of contraceptives.

Why does the contraceptive pill not necessarily indicate sexual activity? Contraceptive pills are an important, widely used form of medication for menstrual health management that only a low number of South Asian women have access to before marriage due to the association of the pill with sex. Menstrual pain is treated as a state of normalcy that we as menstruators must learn to deal with – or perhaps may treat with Ibuprofen. The possibility of the contraceptive pill as a form of menstrual management is a wild thought, a pill that women and girls like me, unmarried, should not even be thinking about. As a result, the non-contraceptive uses and benefits of the birth control pill are rendered invisible in and by our society.

There are a number of non-contraceptive health benefits of birth control pills. According to research, “Approximately one in three women experiences a heavy period, also known as menorrhagia.” Women who have a healthy uterus and heavy periods are commonly prescribed the birth control pill as an effective form of treatment. The estrogen from the pill can increase clotting to decrease flow, shorten cycle or even provide relief from menstrual pain. Despite the widespread criticism of the use of hormonal birth control as a “go-to’ option to fix all things “period” it is important for women to have the choice and the access to the knowledge, through their doctors to make informed decisions. Among other known medical benefits of the contraceptive pill, is treating gynecological disorders such as Polycystic Ovarian Syndrome (PCOS) and Endometriosis. Hence, the use of hormonal birth control may simply indicate a treatment of gynecological health problems. 

This stigma in our community not only puts unmarried women at a higher risk of being pregnant, but takes away their chance at addressing other health concerns. Research in South Asian on women’s use and choice of contraceptive methods focus extensively on married women. This alone indicates stigma around premarital sex and sexual desires in the larger South Asian society. Little research is available on the premarital use of contraceptives. A Research that studied nine countries in the region found that only two countries, India and Nepal, had any data on sexually active unmarried women. Even in these two countries the use of the pill was very low with less than 30% in Nepal and fewer than 16% in India. The stigma around the use of contraceptives before marriage due to its association with sex overlooks the other health benefits and results in the minimal use of the pill before marriage.

While I could argue that women and girls should be able to access contraceptive pills for the purpose of birth control and pregnancy prevention, the chances for this argument to prevail in South Asian communities are slim. This argument calls for a cultural shift and challenges the deeply rooted traditional beliefs of many people in the region. Therefore, I am suggesting an alternative way to approach the issue. A health based approach focused on the alternative uses of a rather controversial pill can create bigger waves. This is a call to re-educate society, from health professionals to mothers on the benefits of birth control pills, so that it is readily available to women and girls, and stigma around the premarital use of the birth control pill can be combated, so that we have the choice to use it, if needed.  

Happy Menstrual Hygiene Day!

In Spring 2020, Columbia students and faculty had the opportunity–for the first time ever–to spend a full semester exploring menstruation through many different angles in the course “Menstruation, Gender, and Rights: Interdisciplinary Perspectives.” Students engaged in writing OpEd style short pieces that draw attention to various facets of menstruation neglected in the mainstream discourse. Leading up to the worldwide day celebrating menstruation, we have the honor to present a selection of emerging menstrual voices. If you’re interested in joining, please stay tuned–we plan to offer the course again in Spring 2021. — Professor Inga Winkler