DC schools first with statewide menstrual health standards, officials say

For Liv Birnstad, much what she’s learned at school about reproductive health has been about preventing sexually transmitted diseases. She learned about sex and how babies are made, but there was scant information on periods — how to prepare for them or why they happen.

“For some people, it’s taboo,” said Birnstad, a senior at Capital City Public Charter School in Northwest Washington. “Folks may not have parents who are willing to teach them about these things.”

Next school year, however, that will change. Starting in the fourth grade, every student in the District’s traditional public and charter schools will have to take classes on menstrual health — regardless of gender — making DC the first jurisdiction in the country with specific universal standards, officials said.

Students will cover topics such as how the menstrual cycle works, where to find sanitary products and the stigma that often accompanies menstruation. The standards come as the State Board of Education prepares to approve new social studies standards designed to increase representation for marginalized groups and more directly examine racism and white supremacy. The updates reflect a broader effort to modernize what is taught in city schools, officials said.

“From menstrual standards to social studies — up next, you’re going to hear us pass standards in financial literacy. Down the road, we’re working on standards in environmental literacy,” said Christina Grant, the District’s state superintendent of education. “It’s the role of a state education agency to always reflect, revisit and then align on standards adoptions that reflect the dynamism of education, that reflect what students should be learning in an age-appropriate way, and for us to grapple with topics and frame them out to our community in service of our children.”

The menstrual health standards have been in the works for at least a year, since the DC Council passed legislation requiring the school board and the office of the state superintendent of education to develop guidelines that ensure students “have the information, support, and enabling school environment to manage menstruation with dignity, safety and comfort.” The law also required schools to put free pads and tampons in women’s and gender-neutral bathrooms. If a school doesn’t have gender-neutral bathrooms, period products should be available in at least one men’s restroom on campus.

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But with a few examples nationwide, city education officials drafted the standards from a “blank canvas,” they said. Leaders sought feedback from experts including teachers, community organizations and pediatric health-care providers.

The curriculum includes more than two dozen standards spread across grade levels. In the upper-elementary years, students will gain an understanding of the menstruation cycle, the physical and emotional changes that can come with a person’s period, and how to maintain personal hygiene. By eighth grade, young people should know what causes irregularities in the menstrual cycle, how to compare different types of period products, and identify safe and reliable ways to track one’s period, along with other standards.

In high school, students will explore topics including how the use of contraception can affect the menstrual cycle and when to discuss a menstrual health concern with a doctor. They will also critique the way their communities are, or are not, supporting menstruators.

“These are important things that all students need to know about, regardless of whether or not they menstruate or will menstruate at some point,” said Birnstad, who is a student member of the State Board of Education, which had to approve the standards. “We know that people who menstruate menstruate at very different ages, so it’s important that we talk to younger students about this.”

The standards are designed to provide some uniformity to a subject area that has little consistency nationwide. What a child learns about periods varies by state, district and even individual school, said Melisa Holmes, an OB/GYN and co-founder of Girlology and the Period Education Project, which focus respectively on adolescent wellness and training medical students to deliver menstrual health education.

Few states require students to be taught about menstruation products or how to manage their periods, according to an analysis of education standards conducted in 2020 Meanwhile, lawmakers in Florida have passed legislation that limits discussions of sex education in schools and bans discussions of gender identity before high school. The law takes effect July 1.

Florida bill would ban young girls from discussing periods in school

“Traditionally, all that [students] learn about, as far as menstrual health, is how to use a pad or a tampon,” Holmes said. Lessons are centered on basic hygiene and menstruation in the context of pregnancy. Comprehensive menstrual health education, henceforth, is rare.

“Menstrual health is a much broader topic that really covers what’s normal, what’s not normal, when seeking medical attention. It’s destigmatizing. It’s for all genders,” Holmes said. She added that having menstrual health education in schools could prevent some of the issues she had seen in more than two decades of caring for women who did not understand how their bodies worked.

“That’s why it takes an average of seven to 10 years to be diagnosed with endometriosis, because we write off period pain,” Holmes said of the condition in which tissue similar to the lining of the uterus grows outside of it and causes severe pain. It affects about 10 percent of reproductive-age women and girls globally and can lead to infertility. “When we educate all genders, we are decreasing that stigma. We are normalizing the process as being vital and part of the human experience.”

While the standards have been largely lauded in DC, their implementation could pose challenges, said Amita Vyas, a professor at George Washington University and director of the school’s Center of Excellence in Maternal and Child Health.

First, there is little research on the efficacy of a handful of menstrual health programs that have been in schools, Vyas said. Officials will need to make sure educators feel equipped to teach these standards and make the content interesting for all students regardless of whether they are menstruating — including boys, nonbinary and trans students. The city has already hosted at least one day of training for educators.

“It’s a diverse group of adolescents that we need to be able to engage with,” Vyas said. “I think that these competencies and these new guidelines are excellent, but I think the real test is going to be in its implementation.”

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