From Menstrual Hygiene to Menstrual Justice: The Promise and Limits of India’s Landmark Ruling

In a landmark judgment delivered on the 30th of January 2026, the Supreme Court of India declared menstrual health an integral component of individual fundamental rights, making India the only country in the world to constitutionally guarantee menstrual health[1]. The judgement drew on well-established jurisprudence under Articles 14, 15, 21, and 47 of the Constitution to situate the issue of menstruation management within the guarantees of dignity, equality, and substantive access to rights.[2] Acknowledging the substantial evidence linking menstruation to higher rates of absenteeism and school dropout among adolescent girls, alongside stigma, health risks, and the reinforcement of gender inequality, the Court reframed menstrual hygiene management (MHM) as a constitutional obligation of the State through two critical constitutional entry points: the right to education and the right to health.

First, the Court anchored MHM in the right to education, clarifying that this guarantee extends beyond the mere existence of schools to “meaningful, continuous, and non-discriminatory participation”[3]. In that light, the absence of functional, gender-segregated toilets, menstrual products, safe disposal systems, and supportive environments operates as a structural barrier to girls’ educational access. Second, the Court grounded MHM in the right to health under Article 21, read alongside Article 47 (which imposes a duty on the State to improve public health), linking it to reproductive health and bodily autonomy. It acknowledges that inadequate access to menstrual products and safe sanitation facilities forces girls into unhygienic practices and exposes them to avoidable health risks and harassment.

Building on this reasoning, the Court issued a set of far-reaching directives to all States and Union Territories mandating amongst other things (a) the provision of functional, accessible, and gender-segregated toilets in every school both private and public, (b) the free and regular supply of biodegradable sanitary pads in every school both private and public, (c) the integration of gender-responsive education on menstruation and related health concerns into school curricula.

The judgment is notable for a number of reasons. First, is its explicit recognition of some forms of intersectionality. The Court acknowledged that gender does not operate as a standalone axis of disadvantage when it comes to menstruation but intersects with poverty[4] and disability[5] to deepen exclusion. In doing so, it moves beyond a one-size-fits-all approach and affirms a substantive justice based approach that pays attention to differentiated needs. Second, and perhaps equally important is the Court’s acknowledgement that privacy, dignity, and bodily autonomy are outcomes that are directly linked to the availability of and access to menstrual-friendly infrastructure and commodities. Third, the Court recognized the importance of breaking the stigma and taboo associated with menstrual health by recommending the incorporation of a gender responsive curricula, that addresses menstruation, puberty, and other related health as well as engaging men and boys to address stigma and drive awareness to dismantle the myth that menstruation is only a ‘girl’s issue’. Finally, the Court also laid out clear architecture for accountability, including oversight for privately managed institutions, which are often left out of the policy conversation.

These aspects of the judgment are significant in addressing deep inequities in menstrual health across India. However, emerging scholarship demonstrates that menstrual discrimination is not experienced solely through lack of access to commodities or inadequate infrastructure, though these deficits have significant cascading effects on school attendance[6], workforce participation[7], and broader social inclusion.

To meaningfully advance menstrual equity, therefore, there is a need to shift from a narrow menstrual health framework toward one grounded in menstrual dignity. The menstrual dignity framework confronts the structural drivers of discrimination that fundamentally shape the lived experience of menstruation such as gender inequality, economic injustice, and environmental inequity, to name a few. This approach has long been championed across the Global South, from Latin America to Asia, and underpins the Sang pour Sang project led by Fòs Feminista.

A menstrual dignity and justice framework:

1. Enables women, girls, and gender-diverse people who menstruate to do so free from discrimination, and without fear of stigma, shame, or harmful taboos that restrict their participation in public, educational, and economic life.
2. Accounts for the diverse and intersectional needs of menstruating communities, recognizing how disability, caste, class, geography, migration status, and gender identity and sex characteristics shape access to information, facilities, and care.
3. Ensures access to a diverse range of safe, affordable, and environmentally sustainable menstrual products, supporting bodily autonomy, informed choice, and long-term sustainability rather than imposing one-size-fits-all solutions.

Adopting this lens reveals significant gaps in the judgement.

The judgment does not fully confront the behavioral, social, and informational barriers that shape menstrual practices. Menstrual hygiene interventions in India have heavily skewed toward products and infrastructure[8], and the judgement also largely operates within this paradigm. Evidence from the National Family Health Survey (NFHS-5)[9] shows that despite the existence of pad distribution programs, actual usage remains uneven, demonstrating that commodity distribution and built infrastructure alone does not translate into effective uptake. Even where there is a recommendation for mobilizing “social media, print media, radio advertisement, TV advertisement, cinema advertisement, and outdoor publicity”[10] this appears primarily directed at raising awareness about the availability of commodities rather than advancing large-scale normative change.

Second, the Court’s school-centric mandate is inherently limited, as it effectively renders invisible the needs of out-of-school adolescents, many of whom belong to the most marginalized communities in India. Adolescents, especially adolescent girls, from Dalit, Scheduled Caste (SC), Scheduled Tribe (ST)[11], and De-notified and Nomadic Tribe (DNDT) communities[12] are disproportionately affected by school exclusion. In addition, migrant adolescents especially those engaged in seasonal labor[13], adolescents who drop out from early marriage[14], and adolescents living in internally displaced or relief camp settings often remain out of formal schooling[15], meaning they are left without access to school-based menstrual hygiene interventions. By focusing almost entirely on schools, the judgment risks leaving these adolescent groups without meaningful support, reinforcing existing inequities and undermining the universality of its intent.

Third, efforts to address taboo and stigma appear largely confined to the recommended revisions to the NCERT school curriculum. This approach assumes that educators themselves are free from the deeply entrenched social stigmas surrounding menstruation, an assumption that is contradicted by existing studies in India[16]. It further assumes that the delivery of in-school education programs alone is sufficient to equip students with comprehensive information and to shift widely held social norms, another idea that has also been challenged[17]. Advancing menstrual equity, will require sustained, comprehensive, and rights-based education that goes beyond curriculum reform. Such efforts must explicitly confront stigma and taboo, promote gender equality, and provide accurate, inclusive information about the full spectrum of menstrual health needs, including the diversity of menstrual products, pain management options, recognition and treatment of menstrual disorders (such as endometriosis, PCOS, and dysmenorrhea), and accessible care pathways available across the life course. Crucially, this information must not be confined to classrooms or adolescents. It must be accessible to everyone, including parents, caregivers, teachers, healthcare providers, community leaders, and policymakers, and tailored to all stages of life, from menarche to perimenopause and beyond. Such approach ensures that menstruation is understood not as a one-time educational topic, but as an ongoing aspect of health, dignity, and bodily autonomy that requires continuous support and institutional accountability.

Fourth, despite its strong intersectional analysis of gender, disability, and poverty, the judgment remains silent on several other axes of vulnerability that compound menstrual inequity in the Indian context such as religion and caste for instance[18]. A particularly egregious gap is the silence on the needs of people with diverse gender identities and sex characteristics who menstruate. Menstrual inequity is implicitly framed as an issue faced by adolescent girls reinforcing a cis-normative understanding of menstruation and overlooking transgender, non-binary, and intersex individuals who menstruate and face distinct forms of menstrual stigma and exclusion. [19] This omission sits uneasily with the Court’s broader emphasis on dignity and bodily autonomy.

Fifth, the judgment also frames menstrual health as primarily an issue of adolescence, focusing on managing menstruation effectively during school years to avoid future reproductive health problems and providing information to school going adolescents. A dignity-centered approach would instead adopt a lifecycle perspective, recognizing menstruation, and its absence, as issues that shape the lives of women, girls, and gender-diverse people across all ages, not solely during schooling. For instance, the judgment could have more meaningfully acknowledged the complex ways in which menstruation shapes labour force participation[20] and reproductive decision making[21] in India, particularly within a sparse policy ecosystem that focuses almost exclusively on menstrual leave.

Sixth, the Court missed an opportunity to promote a wider range of menstrual management options, including reusable products, with its focus on single use, disposable, “oxo-biodegradable sanitary napkins”. Even if distributed free of cost in schools, a singular emphasis on one product type risks narrowing choice and failing to account for the diverse needs, preferences, and life circumstances of people who menstruate. Additionally, in the Indian context, where access to water, sanitation, and waste management systems varies significantly across regions, and where environmental sustainability is an increasingly urgent policy concern, centering single use menstrual products instead of a range of safe, sustainable menstrual products is insufficient.

Finally, despite its emphasis on accountability in the directives, the judgment is silent on the need for ring-fenced budgetary allocations to back the interventions laid out. Every element outlined, from expanding access to menstrual products to ensuring inclusive, education, strengthening infrastructure, and confronting stigma, is contingent on sustained and predictable public financing. Without direction on whether these measures will be backed by new resources or absorbed into already overstretched budgets allocated to existing programs, the directives of the ruling risks remaining aspirational. At the same time, this could opportunity to pioneer innovative financing models, leveraging blended finance, public–private partnerships, and catalytic philanthropic capital, to sustainably resource menstrual dignity initiatives while strengthening long-term health financing frameworks for public health.

Keeping these critiques in mind, achieving substantive equity in menstrual health will require a multisectoral approach that goes beyond the education system, leveraging community health infrastructure such as ASHAs, Anganwadis, Primary Health Care centres and integrating with programs like the Rashtriya Kishor Swasthya Karyakram (RKSK), while actively involving Panchayati Raj institutions and Urban Local Bodies, and social justice offices to reach marginalized and out-of-school populations. Menstrual equity will also need the engagement of ecosystem actors beyond teachers and parents and will need to involve healthcare providers, first line responders, community-based organizations, self-help groups, media and more.

In this sense, the judgment, while groundbreaking, stops short of the more radical structural reimagining that its own reasoning could have supported. It secures menstrual hygiene management within the language of rights but does not fully embrace the broader project of menstrual dignity. Nonetheless, as the first constitutional guarantee of menstrual health globally, it provides a powerful normative foundation for civil society, communities, and policymakers to build on to push India closer to an intersectional and sustainable vision of menstrual equity.

Authors:

Swetha Sridhar (Fos Feminista), Kemi Akinfaderin (Fos Feminista), Dr. Suchitra Dalvie (Obstetrician and Gynecologist), Prabhleen Tuteja (The YP Foundation), and Sonal Soni (The YP Foundation)

Footnotes:

[1] Although several countries, such as Botswana, Colombia, Ireland, Japan, Kenya, Scotland, and South Africa amongst others have adopted legal or policy measures addressing menstrual equity such as free product provision or menstrual leave, no other country has, to date, explicitly enshrined menstrual health as a constitutionally protected.

[2] Dr. Jaya Thakur v. Government of India & Ors, (2026), INSC97. https://api.sci.gov.in/supremecourt/2022/35023/35023_2022_7_1502_68117_Judgement_30-Jan-2026.pdf

[3] Supra, at 39

[4] Supra, at 65

[5] Supra, at 59

[6] Sivakami, M., Van Eijk, A. M., Thakur, H., et al. (2018). Effect of menstruation on girls and their schooling, and facilitators of menstrual hygiene management in schools: surveys in government schools in three states in India, 2015. Journal of Global Health, 9(1), 010408. https://doi.org/10.7189/jogh.09.010408

[7] Manhas, P. (2024). The influence of menstrual symptoms on women’s work productivity. The International Journal of Indian Psychology, 12(3). https://www.ijip.in

[8] Saxena, T. (2025). From Schools to Communities: A Critical Review of India’s Menstrual Health Policies. Social Policy Research Foundation India (SPRF India). https://sprf.in/from-schools-to-communities-a-critical-review-of-indias-menstrual-health-policies/

[9]  International Institute for Population Sciences (IIPS) and ICF. 2021. National Family Health Survey (NFHS-5), 2019-21: India: Volume I. Mumbai: IIPS. https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf

[10] Supra, at 173(iii).

[11] Bhagavatheeswaran, L., et al. (2016). The barriers and enablers to education among scheduled caste and scheduled tribe adolescent girls in northern Karnataka, South India: A qualitative study. International Journal of Educational Development, 49, 262–270. https://doi.org/10.1016/j.ijedudev.2016.04.004

[12] Kendre, R. (2025, December 10). Why are NT-DNT communities still excluded from education? | IDR. India Development Review. https://idronline.org/article/inequality/why-are-nt-dnt-communities-still-excluded-from-education/

[13] Ralli, S. (2025, December 19). Education in Motion: Addressing the hidden crisis of migrant children in India. AIF. https://aif-india.org/education-in-motion-addressing-the-hidden-crisis-of-migrant-children-in-india-2/

[14] Yadav, R., Dhillon, P., Kujur, A., et al. (2022). Association between school dropouts, early marriages, childbearing, and mental health in early adulthood of women: Evidence from a cohort study in Bihar, India. International Journal of Population Studies, 8(1), 27–39. https://doi.org/10.18063/ijps.v8i1.1280

[15] IDMC, IMPACT Initiatives, Consortium for Street Children, & PLAN International. (2020). Becoming an Adult in Internal Displacement: Key Figures, Challenges and Opportunities for Internally Displaced Youth. https://api.internal-displacement.org/sites/default/files/publications/documents/internally_displaced_youth_final.pdf

[16] Sharma, S., Mehra, D., Brusselaers, N., et al. (2020). Menstrual Hygiene Preparedness among Schools in India: A Systematic Review and Meta-Analysis of System-and Policy-Level Actions. International Journal of Environmental Research and Public Health, 17(2), 647. https://doi.org/10.3390/ijerph17020647

[17] Muralidharan, A. (2017). Comprehensive programming for menstrual health in schools in India. WaterAid. https://washmatters.wateraid.org/blog/comprehensive-programming-for-menstrual-health-in-schools-in-india

[18] International Institute for Population Sciences (IIPS) and ICF. 2021. National Family Health Survey (NFHS-5), 2019-21: India: Volume I. Mumbai: IIPS. https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf

[18] Supra, at 173(iii).

[19] Tibrewala, M. (2024). Transgender persons and structural intersectionality: Towards menstrual justice for all menstruators in India. Indian Journal of Medical Ethics, 9(2), 142–146. https://doi.org/10.20529/ijme.2024.015

[20] Jha, M. (2025). Left Behind: The Women Missing from India’s Period Leave Conversation – The Wire. The Wire. https://thewire.in/labour/left-behind-the-women-missing-from-indias-period-leave-conversation

[21] Parent, D., & Kumar, R. (2025). Outrage as sugar cane workers in India still being ‘pushed’ into having hysterectomies. The Guardian. https://www.theguardian.com/global-development/2025/jun/12/outrage-as-sugar-cane-workers-in-india-still-being-pushed-into-having-hysterectomies