‘Ain’t I a Woman?’ – UCL Institute for Global Health dumbs down for IWD

Note the faux folksy language and the cutesy drop of blood.

About this event

For IWD 2022, UCL’s Institute for Global Health will be hosting a virtual panel discussion exploring the taboos surrounding menstruation.

International Women’s Day (IWD) is a global international day celebrated annually on March 8th to commemorate the cultural, political, and socioeconomic achievements of women. It is also a focal point in the women’s rights movement, bringing attention to issues such as gender equality, reproductive rights, and violence and abuse against women.

To mark IWD 2022, UCL’s Institute for Global Health (IGH) will be raising awareness of taboos surrounding menstruation, and its absence, to explore ideas of ‘womanhood’. Whether it’s menstruation or menopause, talking about periods or the absence of them has often been a taboo subject. IGH will be hosting a virtual panel discussion to explore taboos around period poverty and conditions such as endometriosis, and the absence of menstruation, including those experiencing menopause and women who do not menstruate. IGH aims to raise awareness of the variety of research and experiences globally and join this important conversation. 

The discussion will open with a short video story from IGH’s Asma Ashraf sharing their personal experiences and close with a reading of the winning poem from IGH’s student poetry competition running alongside this discussion to mark the international day. The discussion will include an opportunity for audience Q&A.


Chair: Dr Shema Tariq 
Shema is a Clinical Research Fellow at UCL’s Institute for Global Health, and a Consultant HIV/Sexual Health Physician at Mortimer Market Centre. She is a Medical Anthropologist and Epidemiologist whose work focuses on the health and wellbeing of women living with HIV. Shema is the Chief Investigator of the NIHR-funded PRIME Study, one of the largest studies internationally exploring HIV and menopause, and is a passionate advocate for intersectional approaches in post-reproductive health

Tara Akindele 
Tara is a Biomedical Science graduate currently studying a masters in Global Health and Development at UCL. She is the founder of Flo Haven, a non-profit organisation aimed at tackling period poverty and the stigma attached to menstruation in Nigeria. Through Flo Haven, she aspires to provide menstrual heath education to underprivileged girls and women in Nigeria, create and cultivate local and global partnerships to end period stigma and empower girls and women worldwide.

Susan Cole-Haley
Susan is an award-winning HIV activist, broadcaster, writer and public speaker. She has been advocating for the rights of people living with HIV for almost 20 years. She leads the community engagement & broadcasting activities for the HIV information charity NAM aidsmap and is a member of the Global HIV Collaborative & 4M Network of Mentor Mothers. She’s particularly passionate about issues affecting women and people from Black communities living with HIV, writing and presenting about the health inequities they face. Susan is also contributing to Bloody Hell! And Other Stories, Adventures in Menopause from Across the Personal and Political Spectrum by Mona Eltahawy.

Dr Catherine Conlon
Dr Catherine Conlon is Assistant Professor in Social Studies at the School of Social Work and Social Policy, Trinity College Dublin (TCD). Her research focuses on the social politics of reproduction and sexuality. An expert in qualitative research methods, she has published widely on abortion and crisis pregnancy, sexual socialisation, and inter-generational relations. She has completed research with Irish women attending abortion services in England in 2004-2006 and has previously explored parents’ accounts of talking with their children about sexuality, the body and growing up. An experienced teacher, Dr Conlon teaches across undergraduate and postgraduate programmes, supervises both Masters and PhD students, and is Director of TCD’s Bachelor of Arts in Sociology and Social Policy. She serves on the Board of the Centre for Gender, Feminisms and Sexualities at University College Dublin

Suzanna Hopwood 
Suzanna is a lay member of the Royal College Of Obstetricians and Gynaecologists Women’s Network which advises the College and is also a Lay Examiner for the College. She has also contributed to a Green Top Guideline on Gender Care which will shortly be published by the College. In addition she has served as a member of NHS England’s Gender Identity Programme Board and has extensive experience of delivery of health care to both trans masculine and trans feminine people. She has recently joined the newly established team which will deliver lower gender surgery for trans women at St Georges Hospital.

From the Eventbrite blurb

High alert

I almost didn’t attend but then received a background note prepared by the man on the panel, Suzanna Hopwood, in which ‘Menstruation and Trans People’ was explained. Here are the first couple of paragraphs.

A Short Background Note about Menstruation and Trans People

Prepared by Panel Member Suzanna Hopwood

In discussing how to approach this subject we agreed that it could be perceived as inappropriate and insensitive for a man (albeit a trans man) to contribute to what is an International Womens Day discussion about menstruation. However, the fact remains that Trans Men and Non Binary people do experience the impact of Menses and we would therefore assert that in this context it is valid to address it.

In order to manage this conundrum appropriately I have been asked to contribute to the Panel discussion in order to provide a trans masculine perspective in as far as that is possible as a woman with a trans history but with some observed experience of the subject.

So we couldn’t have any women cosplaying as men on the panel, but a man who cosplays as a woman? Perfectly fine.

IGH’s public engagement pledge

Rich conversation

The chair, Dr Tariq, began by telling us the panel would be discussing what it was like to have a period, or not have a period, but also abortion, which also has nothing to do with menstruation.

UCL had recently ditched Stonewall and the chair wanted to acknowledge that ‘gender’ was a contentious issue in academia currently. The panel wanted to openly state that the definition of woman was ‘trans-inclusive’ and that ‘trans women are women’. She urged any lurking terfs to behave themselves and to read the etiquette to ensure that there would be a ‘rich discussion’. A trigger warning was given for the fact that ‘trans men’s periods’ would also be discussed and acknowledged that this might be ‘uncomfortable’, but that the Institute was committed to improving the ‘health and well being of people regardless of ethnicity, gender and sexuality’. But essentially, even in holding this discussion, the Institute had tacitly approved the idea that women who do not conform to sex stereotypes should be medicalised, possibly sterilised, many of whom will be lesbian.

Trans men are one of the most marginalised groups, she told us, and if we don’t discuss their periods here, then when will it be discussed? Not on International Men’s Day for sure.

A little film about not having a period

Asma Ashraf’s video was introduced as being about ‘not having a period’ and being intersex, but the video, produced by the University of Derby, is entitled ‘Forced Marriage and Honour Based Abuse’. Frankly, I find it a stretch to believe Ashraf was really a candidate for forced marriage, given she talks posher than the Queen. When we hear that she was allowed to read voraciously throughout the night as a teen, it doesn’t fit in with what we know about women oppressed by the ‘honour’ and clan system.

The story goes like this: Asma at 16 was diagnosed as infertile and taken to Pakistan to be seen by some priests, they held her wrist for a minute and mumbled something about a bone obstructing her. Then she returned to England. Dramatic stuff.

Ashraf was thanked for ‘courageous sharing’. I remember Ashraf from a UCL event she hosted in December 2019, at the UCL Institute of Child Health.

‘I went to school because we had to school, because we lived here’ (54 seconds in) – sad story

The student’s presentation

Tara Akindele had set up a non-profit organistion, Flo Haven, to end ‘period poverty’ in Nigeria. There really is no such thing as ‘period poverty’, but regular poverty just isn’t fashionable. Akindele explained she was also involved in an adjacent project to provide clean water to the community of ‘menstruators’ she was helping. Akindele gives out a range of products to her ‘menstruators’, including pads and moon cups, the risk of infection with the latter being incredibly high unless you have hot clean water to sterilise them between each use, and I wondered what the point was of giving these out to women who didn’t yet have access to clean water. One wonders how many have ended up with serious infections, but not to worry moon cups are climate friendly.

The bloke’s presentation

Hopwood had sought the help of Dr Michael Toze in preparing for the presentation. Toze is a trans-identified female and a Senior Lecturer in Public Health and Social Determinants of Health at the Lincoln Medical School and full-on trans activist – see here. There’s a very peculiar thing in which ‘trans men’ tend to be described as ‘trans masculine’, whilst ‘trans women’ are often just referred to as ‘women’.

Hopwood has wormed his way onto a working group of the Royal College of Obstetricians and Gynaecologists and apparently the College will shortly be producing guidelines on ‘gender variant people’.

Hopwood told us that it was a very complex issue, because there were all the different sorts of people who menstruate. Women in different states of transition. But of course, as always, it was not explained clearly that women on a regular dose of testosterone do not menstruate, or that high doses of testosterone can instigate chronic bleeding. Such chronic bleeding, of course, is not normal menstruation, it is a sign that the body is highly distressed. But no one wants to talk about that, or the necessary hysterectomies which ensue.

Both men and women had ‘gender dysphoria’ over the issue of periods. Hopwood took great pleasure in stuttering over the subject of tampon wrappers and male lavatories. He was ‘well beyond’ being in them any more, but from his recollections he never saw the ‘er, the er, what do you call it, the things where you can put the sanitary towels and tampons inside the cubicles’. (They’re called bins mate, and you should get in one.) This bought up the thorny topic of privacy in men’s spaces, which we know is close to heart of all trans activists. It meant women had to go ‘stealth’ instead.

One bullet on the slide said ‘More men electing to retain the ability to menstruate (Does it strengthen the case for gender neutral lavatories?)’. He wanted us to think about this.

‘There is no conflict between trans men and women’s spaces,’ he told us. It was imperative that we acknowledge the issue and that there would be increasing numbers of women who would claim to be men having periods. It was their civil right to take testosterone and pursue child birth. So there.

Dr Tariq pretended that she was ‘aghast’ that this was the first time somebody had bought her attention to the issue of ‘trans masculine periods’ in her 20 year career.

The pro abortionist

I wondered how abortion could be really be a menstruation issue, but Conlon told us: When absent menstruation means unexpected pregnancy – the title of her presentation. Abortion had been illegal in Ireland for a very long time but the Republic of Ireland repealed in 2018 and Northern Ireland followed suite in 2019. She spoke about ‘home abortion’, i.e. pills which medically induce an abortion which are taken outside of the hospital setting.

Conlon didn’t say, but these pills are a hormone-blocker called mifepristone, which blocks progesterone. She talked about the home abortion as allowing women to be in space where they felt comfortable with people they loved. One woman took the day off, and her boyfriend also, and it sounds like they had a duvet day, cuddling and watching TV in bed. Not mentioned though was any possible side effects of the drug. The reality of what it must be like to bleed profusely and discharge clots of tissue, and ultimately a foetus, with no medical supervision, with no idea if the haemorrhaging were too serious, was lightly glossed over. Conlon did not mention if there were any long term impact on future fertility or if the women in her study were worried about that.

Conlon said that the women in her study talked about a ‘continuity’ between periods and termination in the language that they used, as if this were evidence that the two things were in fact the same. Just for reference, a period is when the womb naturally sheds its lining as a result of not being pregnant, it is not a medically-induced termination, nor a miscarriage, nor bleeding bought on by high dose testosterone. The muddying of language is now so widespread, but no doubt when Conlon finally publishes her study this will be one of the conclusions; having an abortion is just like having a heavy period.

The HIV activist

Susan Cole-Haley, the last speaker, talked to us about HIV and the menopause and definitely deserves the most screws loose out of the panel that day. Cole-Haley has been living with HIV for the last 25 years following a routine immigration test in America, which was a big shock, especially as she had young children. She bemoaned the fact that there was ‘stigma’ around the fact that people were still scared of blood infected with HIV. (It’s because people don’t want to die Sue, they don’t want to end up on life-long medication, we’ve seen in the Ukraine how quickly sands can shift.)

Cole-Haley told us that sometimes having sex can make your periods start (erm, that shouldn’t really happen) and that sometimes men get freaked out by seeing blood. Some even worry that they might get HIV, which seems a reasonable worry to me, but Cole-Haley was very keen to ridicule such a fear. Cole-Haley is on the look out for her ‘fourth ex-husband’. A moment’s silence please, for that guy.

Cole-Haley said that having periods for HIV positive women was very traumatic, but also not having periods was equally traumatic, because they might be childless. Research had shown that women with HIV experienced the menopause a little bit earlier and that symptoms were a little worse, she didn’t mention whether that was because of antiretrovirals, but it’s difficult to think of another reason.

Cole-Haley thought it was ridiculous that HIV positive women were discouraged from having children, but again failed to mention that preventing HIV infection involved a number of measures, not least prescribing a new born antiretroviral drugs for the first four weeks of life. She has four children, two of whom she had after her diagnosis, all of whom are HIV negative. She described the chance of a mother passing HIV onto their baby as ‘absolutely tiny’ and failed to mention anything to do with how transmission was prevented. Though she did mention when she was pregnant she did a naked cover shoot for a magazine. A woman contacted her when she saw the photograph and decided not to have a termination and went on to give birth to a HIV negative baby.

The PRIME study, which stands for ‘Positive tRansItions through Menopause’ is a UCL study which looks at HIV positive women and the menopause. Cole-Haley said that it was essential that activists were involved in such projects.

Dr Tariq told her that she had been very successful in getting us to think about what it was like ‘to have periods and not have periods’.

So in a webinar which was supposed to be addressing the taboos around menstruation we had had a period poverty activist, an intersex activist, a trans activist, an abortion activist and a HIV activist. It notable that no one gave a definition of what normal menstruation was, since that would spaff up the loony presentations.

Question and Answer

What does it mean to you to be a woman in 2022?

Akindele – being powerful and assertive yet kind.

Hopwood – arrived at womanhood in a slightly different way. Spent first 64 years of life as a man. He didn’t regret the years he spent as a man, since he had a wife, children, and grandchildren. However, coming into womanhood was a ‘very rich experience’ and his relationships with women had changed. The relationships were much ‘richer’ and there was more ‘sharing’. It was more deeper and more profound. He is now 74 years old and enjoying this ‘rich’ experience.

Conlon – was conscious that she was bought up as a cis white able-bodied woman in a developed country with access to education, yet there were so many ways in which women were still oppressed. We still needed International Women’s Day and feminism.

Dr Tariq told us she had looked at Instagram that morning and found a woman who felt IWD not necessary. Dr Tariq then listed all the things she felt the woman was: cis gendered, white, straight and not in academia or providing services to people, therefore implying that her opinion was not valid.

Cole-Haley wanted to talk about intersectionality, and enthusiastically told us she was a woman with some of the right intersections (e.g. black, HIV positive) she was experiencing a lot discrimination. HIV positive people faced ‘abhorrent discrimination’.

Question from Chair to Cole-Haley – Tell us more about what it’s like to experience the menopause with HIV

Cole-Haley – We don’t know what to expect. Will it be earlier and worse? Also clinicians don’t know. When we speak up about our symptoms we aren’t believed. We are told we can’t have HRT when we have HIV.

Question from Chair to Conlon – Compared heavy periods, medical abortions, and miscarriages and asked about the ‘silencing of our bodies’

Conlon’s said that the research was incomplete because the language didn’t exist and that her participants and herself didn’t like using ‘clinical’ words. Descriptions then were ‘inchoate’. Often women wanted to sit with their ‘products’, others didn’t want to see it. It was all about ‘power and control’ Conlon told us, presumably alluding to the ‘patriarchy’.

Question from Chair to Hopwood – How do we build better sexual reproductive services for trans and non-binary people?

General services should be respectful of their identities and lifestyle choices, or else they should have a specific service tailored to them. Commissioners should be aware of the issues. Hopwood admitted that he had given a very superficial answer to the question. No, no, not at all, the Chair reassured him.

Question from chair to Akindele – What is the impact of period poverty in Ukraine?

Make sure women and girls have access to menstrual products was the answer. Partner with NGOs who can help. It sounded like she was going to say ensure women and girls have safe spaces but she swerved last second.

Questions from the audience – Contraceptive methods for controlling bleeding in Nigeria

Akindele told us the use of contraception was quite low and women weren’t educated about the issue (what wasn’t mentioned, and what I assumed was being alluded to, is that bleeding almost disappears to nothing if you regularly take the OCP).

Question from queer woman of colour with two non-communicable diseases to Cole-Haley – Tell us about your experience

We just aren’t believed when we talk about pain. When Cole-Haley had breast cancer she wasn’t believed when she reported that she was experiencing pain. She switched hospitals after a doctor tried to take what sounds like a clinical history from her regarding her HIV history and treatment. It was rooted in institutional racism.

Happy International Women’s Day!

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