New Zealand's prime minister announced this week that free menstrual products will be available in all schools for the next three years.
Scotland became the first country to make pads and tampons available in schools, colleges and universities in 2018, and it has since expanded the effort to offer free products nationwide. England and Wales adopted similar measures.
But in the U.S., while a handful of states offer menstrual products at no costs to students and have exempted such products from sales tax, there has been little success in addressing period equity on a national scale.
Melissa Berton, the executive director of The Pad Project, a nonprofit that partners with organizations internationally to make period products accessible, said the U.S. is lagging behind some countries.
"This is a very new movement in the United States," Berton said.
California and Illinois became the first states to give public school students access to free menstrual products in early 2018, followed by New York later that year and New Hampshire in 2019. Georgia decided by budget, not legislation, that it will also provide pads and tampons at no cost in low-income schools starting the 2020 fiscal year.
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Similar laws were passed by state lawmakers early last year in Delaware and Virginia but await being signed into law.
Yet, one of the biggest barrier for those who menstruate in the United States remains the sales tax that is not exempted for menstrual products. Currently, 30 states have a "tampon tax," which experts say make period products more unaffordable.
A 2019 Reuters survey of low-income women found that more than 1 in 5 women struggle to afford period products every month.
"Menstruation is something that we can no longer afford to marginalize," said Jennifer Weiss-Wolf, co-founder of Period Equity, an advocacy and policy organization that focuses on advancing menstrual equity. "It will set us behind as a country if we don't own that reality."
With sales tax upward of 7% in some states, an average menstruating person will spend $100 to $225 in taxes on tampons in their lifetime, InStyle magazine estimated in 2018.
This means states are profiting around $150 million from taxing period products, Berton said.
"Leaving menstruation out of our laws leaves a lot of people behind," Weiss-Wolf said. "Everything we can do to make them more affordable and more accessible is something that benefits all of us because it impacts the full functioning of society."
Unable to afford period products, many people who menstruate are forced to miss school and work, Berton said.
A 2019 study sponsored by Thinx, a menstrual underwear company, and PERIOD, a nonprofit that works to eradicate period poverty, found that 1 in 5 teens could not afford period products, and 1 in 4 have missed class because they did not have access to pads or tampons.
Many women are "forced to make a terrible choice between buying food or menstrual products," Berton said, which leads to infections and other health effects.
"Access to menstrual care products is as important as toilet paper, clean water and food," she said. "It's not a privilege to manage one's period in a healthy manner. It's a basic human right."
Washington, D.C., and 14 states have passed legislation to exempt period products from state sales tax. (Of note, five states do not have sales tax to begin with.) California has a temporary tax exemption on menstrual products that lasts until next year.
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While sales tax and tax exemptions are up to states, some efforts to address period inequity on a federal level were attempted but have had mixed success.
Most recently, the CARES Act, a coronavirus relief legislation passed in March, expanded "qualified medical expenses" to include menstrual products, which allowed people to purchase these products using their health savings account, flexible spending account or health reimbursement arrangement.
Similarly, in 2018, the First Step Act, a criminal justice reform bill, included a provision requiring federal prisons to provide pads and tampons at no cost. But with most prisoners in state prisons, this effort did not have widespread impact.
The most comprehensive effort came in 2019 when Rep. Grace Meng, a Democrat from New York, introduced the Menstrual Equity for All Act. This bill would have required Medicaid to cover period products, and schools and homeless shelters to use federal funding to provide pads and tampons at no cost. However, the bill died in Congress without a vote.
But Weiss-Wolf believes local and state efforts are the "most effective way to impact most amount of people." And while many cities and states are joining this movement, menstrual equity needs "more urgency," she said.
"Affordable menstrual products are a necessity for half the population that use them and we should care about their ability to participate fully in everything from their education to the economy to daily life," Weiss-Wolf said.
"It should be a societal priority," she added. "We all do better when we all do better."
Follow Kaanita Iyer on Twitter at @kaanitaiyer_
This article originally appeared on USA TODAY: Period poverty: US lags behind New Zealand on free menstrual products