Photo of Alhelí Calderón-Villarreal. Courtesy of The Herbert Wertheim School of Public Health and Human Longevity Science
A Q&A with Public Health Doctoral Student Alhelí Calderón-Villarreal, MD, MPH
Since 2012, 10 countries and territories in the Americas — Jamaica, Canada, Saint Kitts & Nevis, Trinidad & Tobago, Guyana, Colombia, Puerto Rico, Mexico, Ecuador and Barbados — have eliminated taxes on menstrual products such as sanitary pads and tampons. However, 63 percent of countries in North, Central and South America continue taxing menstrual products, with an average tax rate of 11 percent that ranges from 1.0 percent in Costa Rica to 22 percent in Uruguay.
Alhelí Calderón-Villarreal, MD, MPH, a doctoral candidate in the San Diego State University Joint Doctoral Program in Public Health at UC San Diego, recently described what many consider a discriminatory taxation against people who menstruate, which is half the world’s population, in the journal The Lancet Regional Health – Americas.
Following, Calderón-Villareal shares what she learned from analyzing data from 57 countries and territories, and 78 states in the United States and Brazil.
Q. Why did you study taxation of menstrual products?
A. Many women around the world experience what is known as menstrual poverty, meaning they have limited access to menstrual products and other goods and services needed to manage their menstruation, such as clean water, private toilets, bathing facilities, etc. There is a growing sense among advocates, governments, researchers and the public, that taxing menstrual products is discriminatory and unfair, and also an economic barrier to good health among people who menstruate.
Q. What impact does taxation have on people who menstruate?
A. Menstrual product taxes promote symbolic and economic discrimination against women and other people who menstruate. The cost of menstrual products can be a burden for many families. It has been documented that low-income families in many areas often have to decide between menstrual products and food or other basic needs. Ideally menstrual product access should be universal, but eliminating taxes on these products can a least help decreasing the economic burden.
Q. What does elimination of taxes on these products accomplish?
A. The elimination of taxes can decrease the final cost of menstrual products, reducing barriers to menstrual health access. These changes are especially beneficial when implemented together with other policies to promote menstrual health, including menstrual health education, communication campaigns against stigma, universal access to menstrual products in schools, hospitals and prisons.
Q. Why do taxes on these products vary so widely from country to country?
A. Different campaigns promoted by feminist groups have been advocating for changes at various points in history over the past several decades in the Americas. For example, the U.S. started eliminating these taxes several decades ago, while other countries such as Mexico and Ecuador have seen more recent advocacy campaigns linked with the rising feminist wave in Latin America in recent years. Additionally, different countries, and even different states within the U.S., have very different approaches to generating funds from taxing goods vs. taxing income and other revenue streams.
Q. What caused countries and territories to end taxation of feminine items?
A. There are several factors, but two recent elements that have worked together in a critical way have been the increasing participation of women in governments, as well as the growing power of feminist groups in the Americas. Together women lawmakers, and all lawmakers who work from a gender perspective, and civil society groups have successfully advocated for the elimination of menstrual products taxes and similar policies. Very often these changes are implemented as part of a wider set of bills promoting gender equity, including menstrual dignity.
Q. In the United States there is no national tax on menstrual products. How do individual states handle these taxes?
A. The United States has no national sales tax, and therefore no national menstrual product taxes. However, at the national level menstrual products used to be classified as luxury products, which resulted in much higher sales tax rate in many states. This has since been changed to “medical devices,” which started a wave of menstrual product tax elimination in many U.S. states. However, in 2022, almost half of U.S. states (21) still had taxation on menstrual products.
— Yadira Galindo