Looking For a Bathroom

How one Columbia Public Health student rediscovered her own city through the lens of menstrual equity

October 24, 2019

The farthest distance one can travel on Earth – roughly 12,000 miles from Rosario, Argentina to Xinghua, China – can also be journeyed on over 12,000 miles of sidewalks in New York City. For those who move here from other cities, states or countries, it can be overwhelming and shocking to take in the density and multitude of experiences that exist here. It’s also all too easy to become immune to the hardship that surrounds us. When confronted with ambient suffering, we often pop in our earbuds, switch subway cars, and hasten our step—even when our destination may be to a classroom to discuss these very inequities.

As an MPH student, I’m interested in the social determinants of sexual and reproductive health. For example, the way people experience menstruation is shaped by all kinds of social factors including everything from policy to stigma to physical infrastructure. Difficulty managing one's period as a result of those factors can have ramifications for physical, mental, and economic well-being. These challenges can be particularly pronounced for people facing heightened vulnerability in other aspects, such as those who are dealing with a lack of stable housing. For my practicum, I had the opportunity to examine some of these important drivers of menstrual health inequity as a Lerner Research Fellow with the GATE Center at Columbia Public Health. Together, my colleagues and I worked to understand the unique needs and barriers that homeless people face when managing their menstruation—an often-overlooked burden among the myriad challenges people endure while homeless.

This summer, I walked close to one hundred miles of New York City sidewalks in an attempt to better understand and highlight the reality of the world that so many of my fellow New Yorkers live in — that of sleeping on the street or in shelters and having to manage getting your period, too.

As part of my practicum, I spent a good portion of the summer assessing the city’s public restrooms while keeping in mind how someone with their period might experience them.

Public restrooms are an important spatial element of the dual experience of menstruation management and housing insecurity. They are crucial and often overlooked public spaces, particularly for people without regular access to safe, clean and private places to use the bathroom or manage their period.

So what might a period-friendly public restroom look like? I walked innumerable city blocks, and into parks across the city in order to learn about the experience of using public facilities. I was reminded that public bathrooms are more than just physical spaces, they’re also social ones. In addition to considering the physical components of menstruation management, I also spent time listening to and getting to know the custodians, security guards, and bathroom attendants who experience the social fabric that makes up a New York City bathroom. Collectively, I was able to get a better sense of how people use these spaces and what they actually need from them.

One hundred miles of walking is nothing compared to the 12,750 miles of sidewalk surface area that constitute this city. However, even in pacing the streets downtown where I was born and raised, I spun off my usual orbit. I saw just a sliver of what it’s like to have to rely on public facilities for the most basic human need: using the bathroom. Collecting data, I was, at times, repulsed, encouraged, questioned, laughed at, shooed away, and blistered. For the first time, I found myself inside of a subway station bathroom (yes, they exist!). While it may sound less than pleasant, as a person who passes as not being homeless, I had the ability to move through these often dirty and rundown spaces with relative ease. At the end of the day, I had the privilege of coming home to my own bathroom, a long soak for my sore feet, and clean clothes—comforts which many of my fellow New Yorkers who’ve been on their feet all day do not have.

Many recent initiatives and attention from the media (domestically and globally) have slowly started to open up the conversation about menstrual equity by focusing on the importance of providing products like pads, menstrual cups, and tampons to people with periods. Through my practicum experience, however, I’ve seen that equitably supporting people with periods requires more than that, especially for the most vulnerable among us. Access to safe, clean, and functional infrastructure for managing menstruation is absolutely essential and in many cases, sorely lacking. Access to products is crucial, but so is a functioning bathroom door, a disposal bin, and running water-- basic needs that require attention in any city in the world, including this one.

Maayan Jaffe is an MPH candidate in the Department of Sociomedical Sciences and a Lerner Center Research Fellow. She earned her Bachelor's Degree in Science, Technology, and International Affairs from Georgetown University. 

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