j. marion sims, who is heralded as the father of obstetrics and gynecology, performed risky surgeries without anesthesia on enslaved women in order to experiment. a study performed through a series of interviews highlighted that for black and latina women, all the women in the study reported a normalization of pain by medical professionals. this was not surprising to the author of the study, given that women are proven to be less likely to report their pain when they are shot down in their attempts to seek out help. women in the study expressed atypical symptoms such as 47-day-long periods, excruciating cramps, and unrelenting constipation—and still were dismissed by medical professionals. these women, up to multiple decades later, were diagnosed with severe illnesses like pituitary tumors and polycystic ovary syndrome. the denial of pain for women of color does not stop at delayed diagnoses and daily pain, and rather has larger implications for mental health. negative relations and perceptions of one's uterus and uterine functions potentially may make many hesitant to call on their reproductive system in the future. especially considering high black maternal mortality rates, the connection between poor relationships with reproductive health and adverse consequences is glaring. a cat scan of a uterine fibroid fibroids are a particularly important condition to mention when discussing racial disparities in menstrual health. uterine fibroids are significantly more likely to occur in black women, with 9 out of 10 black women being diagnosed with fibroids before the age of 50. black women also face higher rates of adverse symptoms, like extreme pain and heavy menstrual bleeding. impacts on black women are further worsened by the fact that 42 percent of black women wait four years or more before seeking out treatment for fibroids, compared to 29 percent of white women. fibroids have immense consequences in terms of cancer risk, as black women who have fibroids have shown to be 40 percent more likely to have some form of endometrial cancer. analogously, it has been demonstrated that black women are equally as likely to have endometriosis, but are significantly less likely to be diagnosed with the disease compared to white women. all of the aforementioned health risks result in what physicians and activists alike label as "period trauma". dr. charis chambers, a board certified ob/gyn, explains that "i would define period trauma as any sustained psychological, social, or emotional injury/distress related to or caused by menstruation". almost half of black school-attending women reported that they are not able to do their best on school work because of their periods. especially considering the additional systemic burdens faced by black people, missing school and becoming further behind in the system worsens phenomena like the wage gap between white and black women. transgender people 66 percent of trans men feel uncomfortable or unsafe using their preferred restroom. correspondingly, 66% of transgender men thought people felt negative or very negative about masculine-presenting people who menstruate. menstruating on its own is difficult, when accounting for period stigma and period pain, but the added burden of gender dysphoria can be traumatizing for many. many trans men and trans masculine people feel uncomfortable with vaginal penetration, as penetration in itself is strongly associated with femininity and womanhood. period poverty disproportionately affects transgender menstruators, because these populations already face poverty, unemployment, incarceration, and underemployment at much higher rates. menstruation activism menstruation activism has become more prominent during third-wave feminism, with a range of arguments being made across global scholarship and cultures. much of the menstruation activism in the west has centered on arguments against what many feminists believe to be the misuse of menstruation to 'prove' female biological inferiority. while some feminists have argued that western patriarchy has used the inability for women to control their menstruation as evidence of the female body suffering from limitations, others have focused on historical works that deem menstrual blood 'dirtier' than other blood, because it results from the failed reproductive cycle. activists in literary fields and gender studies have noted a history of menstruation as being symbolic for evil or secrecy, and argue against the long standing stigmatization of menstruation in order to elevate masculinity. thus, menstrual activism has grown to include a variety of arguments, including, but not limited to: social, philosophical, political, and theoretical. all of these efforts make up the menstrual equity movement, which seeks to correct menstruation as a driving force for social and political inequality. one focus of activism has been to challenge high taxes on menstrual products, otherwise known as period tax. in recent years, activists around the world have turned their attention to lowering and/or abolishing the higher taxes placed on menstrual products, because some states and countries consider them "luxury items". in the us, the tax on menstrual products can reach up to 10%, depending on state legislature. in 2020, hungary had one of the largest, taxing up to 27% on menstrual products. still, some activists have raised concerns that the focus on period tax is halting broader, more important activism, like challenging the social and medical stigma that surrounds menstruation. still, the movement to lower period tax has persisted, and has been deeply connected to another movement against period poverty. period poverty is defined as a lack of access to anything dealing with menstruation, including hygienic products or facilities, education, and waste management. a global study conducted in 2021 showed that roughly 500 million women and girls experience period poverty. the effects of period poverty can range from physically not being able to attend school and/or work while menstruating, as well as negatively impact mental health. a us study conducted in 2021 showed that roughly 68% of women who reported experiencing period poverty monthly, also expressed having feelings of moderate to severe depression. this same study also revealed differences across racial lines in the us, as latinx women reported the highest rates of period poverty, followed by black women, and then white women, particularly from low-income communities. although research into period poverty has focused primarily on cisgender women in low/middle income communities and countries, other scholars have begun examining how period poverty affects non-binary and transgender individuals as well. menstrual pain and the lgbt community recent scholarship has argued that menstruation, although a strictly biological function, has been imbued with gender/sex identity. thus, as advocacy for, and awareness of transgender and non-binary individuals increases across the globe, menstrual activism is evolving as well. effects of the gendered perceptions of menstruation on the lgbtqia+ community differ, but current debates about the issue focus primarily on two key topics, transfeminine and transmasculine menstrual pain. transmasculine menstrual pain, like transfeminine, includes both physical and mental components. as trans men and non-binary individuals may still menstruate, they often experience the same negative side-effects of menstruation, like cramping. similarly some argue that the negative effects it may have on mental health have been underexplored. as menstruating conflicts with conventional ideas about masculinity, activists are concerned about the dysphoric gender identity that can arise from menstruating, after someone has chosen to transition or adopt a gender identity not linked to their sex at birth. some afab individuals (assigned female at birth) and non-binary individuals have expressed concern about the tension between menstruating and affirming their chosen gender identity. scholars have begun arguing for a non-gendered conception of menstruation in both social and medical settings, in an attempt to alleviate the discomfort afab and non-binary individuals feel during menstruation. examples of this can include but are not limited to: using clinical, non-gendered language to describe menstruation, saying 'cycle' rather than 'period', or 'menstrual products' rather than 'feminine hygiene products'. finally, researchers have also noted that many afab and non-binary individuals who menstruate encounter barriers in public restrooms, as men's restrooms do not have sanitary disposal bins in the stalls, and there are often few cubicles in comparison to urinals. this results in afab and non-binary individuals having to wait for access to stalls, and dispose of their menstrual products in the public waste bin. thus, advocacy for gender-neutral bathrooms has become a more recent part of menstruation activism.