February 6, 2024
By Angeline Nguyen, Drexel University College of Medicine

Period poverty is the lack of accessibility or affordability of menstrual hygiene tools and educational material, such as sanitary products, washing facilities and waste management. Within the United States, around 500 million people have inadequate access to menstrual products and an estimated 16.9 million menstruating people in the United States (U.S.) live in poverty, two-thirds of whom are low-income and food-insecure women who cannot afford basic menstrual products. The National Organization of Women estimates that the average woman spends about $20 on feminine hygiene products per cycle, adding up to about $18,000 over her lifetime.

As of December 2023, 21 states in the U.S. charge sales tax and some counties and cities even impose additional local sales tax. Sales tax on menstrual products range between 4.7% in Hawaii and 9.9% in Louisiana.⁴ The most recent state to end tax on period products is Texas. The Texas Senate Bill 379 went to effect on September 1, 2023, and exempts “feminine hygiene products [meaning] a tampon, sanitary napkin, menstrual cup, menstrual sponge, menstrual pad, or other similar tangible personal property sold for the principal purpose of feminine hygiene in connection with the menstrual cycle… from the taxes imposed by this chapter.”

Criticism of this “tampon tax” stems from the fact that items that are deemed nonessential necessities, including Viagra, Rogaine, and even gold club memberships, may qualify for value-added tax (VAT) exemption.⁴ However, individuals who menstruate must pay sales tax in these 21 states that view feminine hygiene products to be a luxury and not a necessity. As the majority of those who menstruate are women, this tampon tax increases the disparity in financial burden between women and men. Additionally, women in low socioeconomic communities and those with heavy flow are disproportionally negatively affected by sales tax on these products, which can cause some to skip work or school because they cannot afford tampons or pads.⁵

Having a menstrual product tax exacerbates period poverty and impacts the quality of life of women by decreasing the accessibility of menstrual products. Period products are not a luxury good. They are items that meet the natural physiological needs of those who menstruate. In resource-limited areas, women can be driven to turn towards unsanitary alternatives such as rags, toilet paper and old blankets, which can increase the risk of infections.

Although $20 a month on period products may seem affordable to some, the amount of added sales tax can make a big difference over time for those who live below the poverty line. Currently, government programs for low-income individuals like Medicaid or Supplemental Nutritional Assistance Programs (SNAP) do not cover the cost of these products. However, a bill called the Menstrual Equity For All Act was introduced in Congress this May and proposes to mandate Medicaid coverage of period products. Ending the tampon tax is one step in the right direction to combat period poverty, which impacts the physical, mental and socioeconomic reproductive health of menstruating individuals.

Sources/Resources:

• Alvarez A. Period Poverty. American Medical Women’s Association. Published October 31, 2019. Accessed December 8, 2023. http://www.amwa-doc.org/period-poverty/
• Vardapetyan A. Period poverty: the belittling of a basic need. American Medical Women’s Association (2021). Available at: https://www.amwa-doc.org/periodpoverty-the-belittling-of-a-basic-need/
• Kim. Female Homelessness and Period Poverty | National Organization for Women. now.org. Published January 22, 2021. https://now.org/blog/female-homelessness-and-period-poverty/#:~:text=The%20average%20woman%20spends%20about
• Rodriguez L. The Tampon Tax: Everything You Need to Know. Global Citizen. Published June 28, 2021. https://www.globalcitizen.org/en/content/tampon-tax-explained-definition-facts-statistics/#:~:text=The%20tampon%20tax%20is%20a
• Singh, Bhuchitra MD, MS, MPH; Zhang, Jiahui BA; Segars, James MD. Period Poverty and the Menstrual Product Tax in the United States [29F]. Obstetrics & Gynecology 135():p 68S, May 2020. | DOI: 10.1097/01.AOG.0000665164.05365.d0
• Julie Hennegan, Inga T. Winkler, Chris Bobel, Danielle Keiser, Janie Hampton, Gerda Larsson, Venkatraman Chandra-Mouli, Marina Plesons & Thérèse Mahon (2021) Menstrual health: a definition for policy, practice, and research, Sexual and Reproductive Health Matters, 29:1, 31-38, DOI: 10.1080/26410397.2021.1911618
• US Congresswoman Introduces Bill for Menstrual Equity in the US | MHDay. https://menstrualhygieneday.org/us-congresswoman-introduces-bill-for-menstrual-equity-in-the-us/