“Hi there, Miss…” he checks the form in front of him, then finishes, “O’Malley. You’re here for a physical?”
“Yes, sir,” I answer the doctor.
“Okay. I just need to enter some information into the system.” Using his heels, the doctor drags himself over to his computer. “Can you give me your name and date of birth?” I answer. We go through the questions, one by one.
Then, he asks, “When was your last menstruation?”
Title X, or the National Family Planning Program, was launched in 1970 by President Richard Nixon and is, to this date, the only federal program specifically dedicated to family planning care (read: reproductive autonomy). The initiative is designed to fill the gaps in coverage experienced by populations historically (and currently) excluded or blocked from receiving safe reproductive care, particularly low-income individuals, people of color, and those who are enrolled in Medicaid (but do not receive full coverage of reproductive services) or are insured. Among those receiving care from Title X clinics, 50 percent of patients are uninsured, 38 percent participate in Medicaid, and a little over one-half are people of color.
When it comes to topics of sexual, genital, or reproductive health my family – like many others – simply doesn’t like to talk. My first introduction to the topics of menstruation and sex was an American Girl maturation book – The Care & Keeping of You – quietly slipped under my door when I was nine years old. This first exposure set the tone for the remainder of my future childhood inquiries about sexuality and health, with my mother’s discomfort in talking to her own daughter sending a clear – albeit unspoken – message that these issues were not matters to be discussed or brought up. From that initial moment, reproductive and sexual health remained mystified and shrouded in secrecy, never something we openly talked about with each other. It was not until my mother faced her own health struggles that we, as mother and daughter, were forced to confront our shyness around the issue and actually communicate with one another about our bodies and the ways in which our medical systems have failed to support them.
Uterus- and vagina-owners have always been the special target of medical and technological advances designed and advertised to help overcome the “embarrassments” inherently tied to our bodies, offering to solve problems we didn’t know we really had through the purchase of things we didn’t really know we needed.
In the realm of menstruation, these “innovations” are nothing new. In fact, they practically drive sales within the industry, as menstrual product companies introduce an assortment of upgrades devised to make you a better, more-discreet menstruator, from scented products (to mask those “pungent, putrid, and musky smells”), to quiet, crinkle-proof pads (so no embarrassing sounds are emitted from your public bathroom stall), to “smart tampons” that inform menstruators when it’s time to remove their tampon (it’s a real thing!). These products, marketed as crucial aid to the hassles of everyday life, usually create more problems than they actually solve, exploiting insecurities and reinforcing ideas that certain natural processes – and, by extension, the bodies attached to them – must be changed, hidden, or passed over to some external or technological control (because they’re just too gross for you to deal with them yourself, dammit).
From the age of 14 I have been a recipient of Medicare. Since neither of my parents worked in the United States, this was the only affordable option provided to us and – given my various health conditions – we utilized the benefits. At the age of 20, I was no longer eligible to receive Medicare – after I became employed and declared an income to the State, my full Medicare was pulled, and I now had to pay for my appointments and prescriptions in full. In order to continue my care, I opted to be seen by a doctor at Community Health Center’s—a center that specializes in low income care.
I have almost never had a bad experience with a doctor. I have had more than my fair share of medical issues moving in and out medical facilities and thus far, I have had almost no complaints. I was fortunate to have the most compassionate, intuitive, and competent health care providers. My providers would speak to me frankly and walk me through their rationale as to why they were doing what they were doing. They were empathetic. They were kind. They were capable.
The disregard for the health and safety of non-cisgender males hold a historical legacy that has pervaded nearly all aspects of society, from politics and economics to medicine, including, most severely, reproductive and genital health. Since the emergence of disposable menstrual products — such as pads and tampons — alongside other products touting vaginal care, “FemCare” industries (a widely-used label that, derived from the sale of “feminine hygiene” products, represents the general gender normativity of the industry and ignores the wide spectrum of genders amongst product users) have taken advantage of genuine biological needs and already-present body insecurity in order to generate enormous and continual profits.
One of the biggest barriers against making the switch to a menstrual cup is the information gap. Many menstruators still don’t even know about menstrual cups or, if they do and are interested in using them, don’t know how or where to look to find out more. Given the mystification surrounding menstrual cups, I wanted to compile a list of easy-to-read, all-in-one-place guide that addressed some of the curiosities and questions I most often hear. The end result is this post, which covers the benefits, insertion, care, and fitting of menstrual cups. Welcome to Menstrual Cup 101!
CW: Mention of body dysphoria
My relationship with my period has always been uncomfortable. For starters: I am very nonbinary and even though my period is something I have to deal with, I do not identify as a woman, just as a uterus-owner. For me, being nonbinary is sometimes a little “weird,” because I don’t feel like I should have a full-fledged vagina, uterus, etc., nor do I feel like I should be able to get pregnant or give birth. On the other hand, I don’t feel like I should have a full-fledged penis, either. Instead, I feel like I should have something in between. So, you can imagine how uncomfortable my period makes me.
Almost everyone with a vagina knows that periods suck eggs. Majorly. But for me, the challenges that accompany the tidal wave of bodily fluids flowing from my uterus are compounded.
I got my first underwhelming, tiny brown smudge of a menstrual event in middle school, and I was… conflicted. Amidst battling the wildly pulsing hormones being pumped to every single chemical receptor in my body and navigating the general shit-show that is sixth grade, I had yet to notice the symptoms of what would be the wild card of my life. It wasn’t until I turned thirteen that the studious, polite, kind, and all-around logical Amanda was diagnosed with obsessive-compulsive disorder.
The first time I felt my cervix, I thought I was dying. The incident occurred during a particularly vigorous masturbation session when my fingers, desperately searching for more depth, suddenly felt a medium-sized bump inside me. As someone who had only just started masturbating, I had never experienced or become familiar with the innards of my own vagina and was baffled by this oddity inside me: a round, hard-ish nub with a small dent or dip in the center (known as the os – or as I prefer to call it, the gateway to your uterus). Left to the throes of my imagination, I began to convince myself that the peculiar lump was some sort of life-threatening disease, almost certainly a tumor.