Running head: HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG

Health Policy Analysis: Menstrual Equity at UNCG

Ariel Everett, Stephanie Sistare, Nicole Thomas, Danielle Vega
HEA 645: Health Policy
The University of North Carolina at Greensboro
HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 1

I. Problem Statement

How can The University of North Carolina at Greensboro provide menstrual equity for
all of its students?

II. Background

Menstrual equity is a public health initiative that would increase health, education,

economic prosperity, and quality of life for girls, women, and transgender men. According to

H.R.972 - Menstrual Equity For All Act of 2017, menstrual equity is defined as, “...increas[ing]

the availability and affordability of menstrual hygiene products for women and girls with limited

access, and for other purposes” (Menstrual Equity, 2017). Menstrual hygiene products can cost

from $7.00 to $10.00, excluding the sales tax in most states (Weiss-Wolf, 2016). In addition, the

products are not reimbursable through medical insurance or covered by flexible spending

accounts or food stamps (Rabin, 2016 & Pearson, 2015, p. 9). Therefore, obtaining menstrual

hygiene products can be a monthly financial burden for many people living at or below the

poverty level or in vulnerable populations, creating a barrier to health.

Menstrual equity is taking root as an allocative, educational policy to help alleviate

physical, economic, and societal barriers to education for at-risk students by supplying necessary

menstrual hygiene products for free. Providing menstrual hygiene products for students allows

for increased student health, student attendance, educational opportunities, and reduced stigma of

menstruation (Weiss-Wolf, 2016). Menstrual equity policies and pilot programs have been

enacted at higher education institutions such as Duke University, Brown University, Emory

University, Harvard University, Columbia University, Dartmouth University, and the University

of North Carolina at Chapel Hill. These institutions are placing free menstrual hygiene products

in public bathrooms on campus, including gender neutral bathrooms, for students (Doan, 2017;
HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 2

Lowe, 2017; The Crimson Editorial Board, 2017). According to The New York Times, “...the

ability to manage menstruation falls squarely at the intersection of health, economic and

education policy” (Weiss-Wolf, 2016). By enacting menstrual equity policies, higher education

institutions are setting a policy precedent that establishes menstruation as an important part of

student health.

III. Landscape

There are many individuals and groups who serve as the key stakeholders for this policy

initiative besides just our group who is advocating to make the change on the UNCG campus.

The key stakeholders consist of the students, especially those who are women and transgender

men, faculty and staff of UNCG, especially the director of the Elliott University Center, and

groups around Greensboro who work with women, girls, and transgender men.

The students serve as a key stakeholder because they are the people who use these

restrooms most often and may have a need for a menstrual product at a time they are on campus.

Not only does this help the students who begin menstruating on campus and do not have a

tampon with them, but it also helps those students who are unable to afford menstrual products.

Both women and transgender individuals will be able to feel a sense of inclusion and care by the

University offering these necessary services. Faculty and staff are included in the woman and

transgender men on campus who may have easier work days knowing the their needs are being

met and that they have a place on campus to receive free menstrual products.

Although the woman and transgender men will benefit tremendously, many students

might be opposed to the policy due to the fact that they do not want their student fees to go to

this type of service. Some people may not see this as a need and feel that women and transgender

men are receiving special treatment by having free products given to them.
HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 3

William Parrish and Kathleen McGirty, the directors of the EUC, serve as key

stakeholders as they are the ones who can make the decision to provide this service and make the

center a place of inclusion and care for the needs of a population. This will also enable them to

be the changemakers in the community and make UNCG place that certain populations are more

welcomed and cared for, attracting more and more students. Because of these practices, more

groups around Greensboro will also feel like they are welcomed in the UNCG community and

will be more willing to support the University as well as creating partnerships for activities and

events throughout Greensboro.

As some students may feel that we as a University cannot afford a service as such, many

students may feel a serious need for such an initiative. In 2012 Washington Monthly ranked

UNCG as 8th overall in social mobility considering the recruitment and graduation of low

income students. UNCG’s student body is diverse in a number of ways, including socio-

economically. 15 percent of all UNCG undergraduate students are from families at or below the

federal poverty level. 25.7 percent of all undergraduate students are at or below a 150 percent

poverty level, a common low-income benchmark. 33 percent of undergraduate financial aid

applicants are at or below the 150 percent poverty level mark(Harris,2012). Not only is UNCG

diverse financially, but also shown to be open to anyone. In the Fall of 2014, The American

College Health Association National College Health Assessment II found that .5% of students at

UNCG identified as transgender (University of North, 2014, p. 17). With a high percentage of

women and transgender students, a initiative like this will be able to provide access for a great

deal of students. This will then lead to more students of these populations continuing to attend

UNCG and creating a supportive alumni base for the future.

HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 4

IV. Options1

The following are options for ways to supply free menstrual products at the EUC at

UNCG for an academic year. Similar to the plan at UNC Chapel Hill, we propose that the year

supply for products be 2,500 tampons and 1,250 pads for a total of 3,750 products (Lowe, 2017).

The average cost for tampons and pads is $0.18 making the yearly cost for the products $675.00

(Lowe, 2017). The number of products yearly will remain the same while the amount in each

restroom will vary based on the number of bathrooms stocked Options vary in the types of

restrooms they supply and how the products are distributed.

Option one is to supply all women’s, men’s, and single occupancy restrooms in the EUC

with menstrual products and have them in baskets on the counters. The baskets are

approximately $5.05 each resulting in a one time cost of $80.80 to place one in each restroom.

With products at $675 yearly, the total cost for initiation is $755.80. This plan would allow for

20 tampons and 10 sanitary napkins in each restroom every month.

Some pros to this option are that it promotes menstrual equity by providing menstrual

products cost free similar to the way toilet paper and soap are provided. Since products are

available in men’s restrooms it also promotes trans equality and recognizes that some men have

periods. A benefit to using baskets is the significant decrease in cost and simplicity in installation

of the program. Possible cons to this option include added cost of providing products cost free,

sanitary issues resulting from the baskets with the products residing on the counters with water

and soap, and resistance to menstrual products being placed in men’s restrooms. Brown

University provided menstrual products in all non-residence restrooms on campus and did

1
More specific information about the costs mentioned in the options section will be included in
the references.
HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 5

experience some push back for providing them in men’s restrooms but stated “people generally

understand when we explain it,” (Jones, 2016).

Option two is to supply all women’s men’s, and single occupancy restrooms in the EUC

with menstrual products and distribute them with dispensers. Free hygiene product dispensers are

approximately $234.99 each resulting in a $3,759.84 cost to place one in each restroom. With

products at $675 yearly, the total cost for initiation is $4,434.84. This plan would allow for 20

tampons and 10 sanitary napkins in each restroom every month.

Some pros to this option are that it promotes menstrual equality by providing menstrual

products cost free, similar to how the university supplies toilet paper and soap. Since products

are available in men’s restrooms it also promotes trans equality and recognizes that some men

have periods. Benefits of dispensers are that they do not present any sanitation hazards by being

placed on the sink and can prevent hoarding of the products. Some cons include the added cost of

providing these products, the extra expense of the dispensers, and the added time to install

dispensers in each restroom.

Option three is to supply only women’s and single occupancy restrooms with menstrual

products in the EUC and distribute them in baskets on the counters. The baskets are

approximately $5.05 each for the cost of placing one in each restroom would be $40.40. With

products at $675 yearly, the total cost for initiation would be $715.40. This plan would allow for

35 tampons and 17 sanitary napkins in each woman’s and single occupancy restroom every

month.

Some pros to this option are that it promotes menstrual equality by providing menstrual

products cost free, similar to how the university supplies toilet paper and soap. A benefit to using

baskets is the significant decrease in cost and simplicity in installation of the program. Possible
HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 6

cons to this option include added cost of providing products cost free, sanitary issues resulting

from the baskets with the products residing on the counters with water and soap, and possible

critique of some trans exclusivity by not providing products in men’s restrooms.

Option four is to supply only women’s and single occupancy restrooms in the EUC with

menstrual products and distribute them with dispensers. Dispensers are approximately $234.99

each so the cost for placing one in each woman’s and single occupancy restroom would be

$2,114.91. With the products at $675 yearly the total cost for the first year would be $2,789.91.

This plan would allow for 35 tampons and 17 sanitary napkins in each woman’s and single

occupancy restroom every month.

Some pros to this option are that it promotes menstrual equality by providing menstrual

products cost free, similar to how the university supplies toilet paper and soap. Benefits of

dispensers are that they do not present any sanitation hazards by being placed on the sink and can

prevent hoarding of the products. Some cons include the added cost of providing these products,

the extra expense of the dispensers, and possible critique of some trans exclusivity by not

providing products in men’s restrooms.

Option five is to supply only women’s and single occupancy restrooms with menstrual

products in the EUC and distribute them with dispensers. Dispensers are approximately $234.99

each so the cost for placing one in each woman’s and single occupancy restroom would be

$2,114.91. This plan would allow for 27 tampons and 10 sanitary napkins in each woman’s and

single occupancy restroom every month. The remaining tampons and sanitary napkins would be

packaged in amounts of six available upon request at a designated office or desk in the EUC with

11 packages of sanitary napkins and 11 packages of tampons each month. Signs would be

present in all women’s, men’s, and single occupancy restrooms in the EUC indicating where to
HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 7

retrieve the package of 6 products. The packaging and signage should cost approximately

$35.35. With the products remaining at $675 yearly the total cost would be $2,825.26.

One pro to this option is that it promotes menstrual equality by providing menstrual

products cost free, similar to how the university supplies toilet paper and soap. Benefits of

dispensers are that they do not present any sanitation hazards by being placed on the sink and can

prevent hoarding of the products. Providing items in bulk could offer some additional protection

from hoarding of products and offer an option for students who have a greater need and can’t

afford to purchase their own products. Some cons include the added cost of providing these

products and the extra expense of the dispensers. While there could be some critique of trans

exclusivity by not placing products in the men’s restrooms, having signs detailing that products

are available in single occupancy restrooms and in bulk supply offer some protection. However,

having a designated desk or office where supplies are available upon request decreases

anonymity.

V. Recommendation

Although there are several options available to address menstrual equity on UNCG’s

campus, ultimately option five provides the most needs for UNCG students in the most efficient

way. By putting menstrual products in women’s and single occupancy restrooms and signs in all

restrooms, we begin to set a tone of both female and trans-inclusivity. Providing in bulk on

counters in both female and male restrooms can result in hoarding and can leave transgender

men as a target in male restrooms which is why option five would be a more ideal solution. A

drawback to this option is for trans men and their inability to have a menstrual product in a

men’s restroom. To best make this initiative mainstream and inclusive would be to install a
HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 8

dispenser in every bathroom. In the future this could be something to improve upon, however,

for the initial purpose of this initiative and safety of transgender inclusion, option five will best

provide menstrual equity. Although dispensers have a larger initial expense, they amend both

issues.

Option five is also the only option that allows for students with extended needs to have a

resource to turn to. This option can be adjusted as time goes on to further fit the student

population. However, doing nothing is always an option. Doing nothing allows students who

suffer from menstrual inequality to continue to pay the price academically, economically, and in

health. Key stakeholders can take pride in the health and equality being provided and understand

that an investment of $2,825.26 is worth the health and well being of our student population. It is

a service that can be priceless for those who have no other option or resource to turn to. While

several similar solutions have been implemented in other institutions, UNCG can best utilize the

successes of these institutions and serve as a precedent for many others in the state of North

Carolina and United States.

HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 9

References

The Crimson Editorial Board. (2017, March 29). Expand campus access to feminine hygiene

products. The Harvard Crimson. Retrieved from

http://www.thecrimson.com/article/2017/3/29/feminine-products-harvard/

Doan, I. (2017, January 13). New initiative to provide free tampons in the Bryan Center. The

Chronicle. Retrieved from http://www.dukechronicle.com/article/2017/01/new-initiative-

to-provide-free-tampons-in-the-bryan-center

Harris, M. (2012, September 25). UNCG ranked No. 8 nationally in social mobility, by

Washington Monthly. Campus Weekly. Retrieved from

http://ure.uncg.edu/prod/cweekly/2012/09/25/no8insocialmobility/

Jones, A. (2016, September 15). Free Tampons and Pads are Making Their Way to U.S.

Colleges, High School and Middle Schools. Retrieved April 4, 2017, from

http://www.newsweek.com/free-tampons-pads-us-schools-496083

Lowe, B. (2017, January 11). Free pads, tampons available in Student Union restrooms. The

Daily Tarheel. Retrieved from http://www.dailytarheel.com/article/2017/01/free-pads-t

ampons-available-in-student-union-restrooms

Menstrual equity for all act of 2017, H.R. 972, 115th, 1st. (2017). Retrieved from

https://www.congress.gov/bill/115th-congress/house-bill/972/text

Pearson, T. (2015). The other risk factor for diabetes and its complications. The American

Association for Diabetes Educators, 3(2), 8-10.

http://dx.doi.org/10.1177/2325160315572597

Rabin, R. C. (2016, March 21). New York City bill to call for free tampons in public school
HEALTH POLICY ANALYSIS: MENSTRUAL EQUITY AT UNCG 10

restrooms, shelters and jails. The New York Times, Well Home. Retrieved from

http://well.blogs.nytimes.com/2016/03/21/new-york-city-bill-to-call-for-free-tampons-in-

public-restrooms-shelters-and-jails/?_r=0

2012 comprehensive annual financial report (Controller’s Office, Comp.). (2012, June).

Retrieved from http://www.unc.edu/finance/fd/c/docs/2012_cafr.pdf

UNCG: The financial report 2012-2013. (2012-2013). Retrieved from

https://sys.uncg.edu/wp-content/uploads/2014/04/FR-2012-13web.pdf

University of North Carolina Greensboro executive summary: American college health

association national college health assessment II. (2014).

Weiss-Wolf, J. (2016, June 21). New York makes history, with tampons and pads. The New York

Times, The Opinion Pages. Retrieved from

http://kristof.blogs.nytimes.com/2016/06/21/new-york-makes-history-with-tampons-and-

pads/?_r=0

*All cost information was calculated using the vendor amazon.com. Specific product descriptions and

prices will be displayed below.

Product Description Product Price Link to Product

https://www.amazon.com/gp/produ

ct/B016P977RI/ref=ox_sc_act_titl

$10.09 e_1?ie=UTF8&psc=1&smid=A1K
Ikea Salnan seagrass basket, 2
pack (small) ESWQI1T3KZ0

https://www.amazon.com/gp/produ
$234.99
Frost 608-1-0.50 Napkin and ct/B00AUZG1OE/ref=ox_sc_act_t
Tampon Dispenser, White
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itle_2?ie=UTF8&psc=1&smid=A

TVPDKIKX0DER

https://www.amazon.com/gp/produ

ct/B002YUEYK6/ref=ox_sc_act_ti

Stayfree Folded Sanitary $60.98 tle_3?ie=UTF8&psc=1&smid=A1

Napkins w/ Wings, 250/CT,
White UEW3GW612BDQ

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Tampax Tampons for Vending $60.98 title_4?ie=UTF8&psc=1&smid=A

Dispenser in Vending Tubes
(Case of 500), Hospeco T500 TVPDKIKX0DER