Despite a year filled with crisis and uncertainty, one thing has remained constant for many of us. During the pandemic, women in particular have been disproportionately hit economically and socially. Not only do they face the most unemployment (opens in new tab), but they are also weighed down by caregiving responsibilities (opens in new tab) and mental health challenges (opens in new tab). Another new burden has been added to the list: the cost of menstruation."

The good news is that there are major policy reforms for menstrual equity around the world in 2021. On New Year's Day, the tampon tax was abolished in the United Kingdom (opens in new tab). Scotland made history as the first country to mandate free sanitary products for those in need (opens in new tab).

Notable progress has also been made here in the United States. Namely, sanitary products were reclassified as a qualified medical expense and can now be purchased on a pre-tax basis through an employee's health savings account or flexible spending account. Prior to this new designation, items like contact lens solutions and sunscreen were included, but tampons, pads, cups, and sanitary underwear were not.

In April, Washington State (open in new tab) repealed its tampon tax, joining 19 other states (open in new tab) that have already done so. Also, when schools closed last spring, New York City lawmakers were persuaded by two teens (open in new tab) to provide sanitary products at emergency feeding sites for low-income students and their families.

These may sound like baby steps compared to the news of sweeping national change across the pond, but a winning national agenda requires a mix of federal, state, and local interventions that intertwine and unfold just like this. I am more optimistic than ever that the stage is set for change this year.

Following are five menstrual equality policies we must fight for in 2021.

Thirty states (open in new tab) still do not exempt menstrual products from sales tax. Together, these states take in more than $125 million (opens in new tab) annually from our menstrual product purchases.

Since 2016, 10 states (open in new tab), along with Chicago, Denver, and Washington, D.C., have eliminated the tax by passing legislation, adjusting their budgets, and even initiating citizen-initiated ballot measures. Because the sales tax is levied on a state-by-state basis (and in some cases on a city, town, or county-by-county basis), it cannot be directly ordered by Congress or the White House. Nevertheless, the passage of the federal CARES Act sends a compelling message: first, that sanitary products should be treated as medical necessities. Second, that tax exemptions are an important and appropriate means of providing meaningful economic relief and addressing inequities.

The tampon tax is an issue that has garnered rare bipartisan support; in 2018, I teamed up with Republicans to shed light on this phenomenon. In these acrimonious political times, the opportunity for both parties to share a victory is one we should all support.

There is also a cutting-edge movement underway in the courts to get this tax withdrawn. My organization, Period Equity, has formed a coalition of leading constitutional scholars, private attorneys, and law students to argue that the tampon tax is sex-based discrimination. Last summer, we filed a class action lawsuit against the State of Michigan on behalf of three women. (We filed a similar lawsuit in New York State in 2016, successfully pressuring the legislature and the governor.) ) The complaint begins: "The devastation wrought by the coronavirus pandemic has only amplified the impact of this unfair and regressive tax.

This federal omnibus bill (open in new tab), sponsored by Rep. Grace Meng (R-NY), would promote broad access to menstruation through the judicious use of federal spending and oversight. Among its provisions: requiring Medicaid to include menstrual supply purchases; directing emergency shelter funds to provide menstrual supplies to emergency shelters and homeless populations; requiring the Department of Homeland Security to do the same for detainees; leveraging federal education law to provide pads and tampons in school budgets include them; utilizing labor regulations to mandate the provision of free menstrual products in workplace restrooms. [ME4ALL's criminal justice provisions are also worth noting. It is based on prior recommendations from the U.S. Department of Justice and a 2018 law called the "First Step Act" (opens in new tab) that requires federal prisons (opens in new tab) to provide free sanitary products. Given that the majority of female inmates are housed in state prisons and local jails rather than federal facilities, the bill would tie state federal justice funding to the requirement to provide sanitary products in all correctional units. While a stunning demonstration of the power of the purse strings, it is also a sobering reminder that national interventions do not always affect the greatest number of people.

In recent years, six states (open in new tab) have passed laws requiring the provision of pads and tampons in schools and 13 states (open in new tab) have passed laws requiring their provision in prisons, detention centers, and shelters. Many cities and communities are doing the same, extending to places like public benefits offices, libraries, and parks. The entire country should follow this lead.

At the same time, we have a greater obligation to those whose menstrual costs extend beyond dollars and cents to their safety, including transgender people, people in police custody (opens in new tab), and survivors of domestic violence (opens in new tab). We have a duty of care that goes deeper. Many people in need of assistance exist outside the social safety net to which sanitary products are currently available. While doing so, both activists and lawmakers should use gender-neutral language as a default when advocating and promoting menstrual policies to be inclusive of trans and non-binary (open in new tab) individuals.

Scotland's new law sets an excellent example in terms of expanding the paradigm of the public sphere. The law allows individuals to confidentially request assistance, receive payments in the form of special cards or vouchers, and obtain menstrual products in the easiest way for them.

After a century of work, the United States is on the precipice of full passage of the Equal Rights Amendment (opens in new tab). Beyond the symbolic significance of enshrining equality in the U.S. Constitution, there are myriad legal and policy inequities that the ERA can help correct. Menstruation must be one of them (opens in new tab). Congresswoman Carolyn Maloney (R-NY) was the first to propose menstrual equality as part of her platform: "The ERA means we no longer have to fight the pink tax on a per-product basis or the gender wage gap on a per-job or employer basis.

An estimated 6,000 GenXers like myself (open in new tab) are going through menopause every day. We are welcomed into this stage of life by legions of powerful Baby Boomers. Millennials are now the largest cohort in the United States and are known as the menopause that precedes menopause and can last up to 10 years. This means that three generations are affected in real time.

As we have shown in our campaign for menstrual equality, menopause can also be a compelling impetus for better and more representative legislation.

However, there is a vast information vacuum regarding this chapter of our lives. In addition, public interest in policies centered on menopause is virtually nil. Workplace accommodations and protections for employees experiencing menopause, development of educational curricula ranging from secondary sex education to health professional training on the mechanisms of menopause, increased transparency regarding drug treatment to alleviate the most debilitating symptoms of menopause, and the link between plummeting hormone levels and specific health risks Urgent research on (including the recently raised concerns about the severe symptoms and outcomes of COVID-19).

The time for change is now. Menstrual equity is essential to creating a fair and just society for all. Join the fight here (opens in new tab).