There are approximately 170,000 people incarcerated in women’s jails and prisons across the country. While some identify as trans and gender-nonbinary, they all have similar reproductive health concerns. 90% of people in women’s jails and prisons are below the age of 55, and for them, those concerns include monthly periods. This means that every month, every time they menstruate, they face an additional layer of humiliation and dehumanization.

As a criminal-justice reporter and an oral historian, we collected first-hand accounts from prisoners as part of a global oral history project about menstruation. What we discovered, from correspondence with multiple writers incarcerated in different states, is a system that weaponizes menstruation as a form of punishment and oppression.

One such incarcerated writer is Kwaneta, a woman imprisoned in Texas. She told us that each month, her allotment of pads and tampons isn’t enough.

“In prison, we’re strip-searched often. Before we leave our cell. Before and after work. Each time we must remove our pad or tampon,” she wrote. “We’re assigned one pack of pads and five regular-size tampons monthly. If you’re one of the heavy bleeders, women who have fibroids or are premenopausal, the state will not provide you any extra items. You must purchase them. We aren’t paid to work in Texas. And nothing is free in prison.”

She continued, “I’ve had guards open every single pad and tampon to check for contraband. Now the tampons are contaminated. There’s no need to open a sealed package, but they do. I’m just so thankful I can afford the box of tampons to replace them.”

If Kwaneta, or any woman, needs more supplies, she must purchase them from the commissary, the prison’s sole store. But Texas prisoners are not paid at their prison-assigned jobs, and a box of tampons in Texas prisons costs $15 (In contrast, the average cost of a box of tampons in drugstores outside of prison is from $5 to $8).

Read More: Florida Politicians Want Less Talk About Periods. We Need More of It

Many incarcerated women don’t have family members who can send money. That leaves them little choice but to stuff their panties with wads of toilet paper (which is also rationed behind bars) and hope that they don’t bleed through onto their white jumpsuits. Often, the best solution, Kwaneta explained, especially for the most desperate and poor, is to eliminate their period through birth control, which is oddly more available in Kwaneta’s prison than basic menstrual care items.

But a lack of supplies isn’t the only assault on dignity. While collecting testimonies, we also heard the following:

A guard can supply a woman with her allotment of pads, but deny her the underwear she needs in order to wear the pad in the first place.

Someone on their period may be given supplies, but denied trash cans to dispose of soiled items.

During strip-searches, women are corralled into one area where a guard will order anyone menstruating to remove their tampons. One woman described routinely stepping onto other women’s menstrual blood on the floor.

A menstrual blood stain on a prison uniform becomes a reason to be singled out, called “lazy” and shamed by guards.

There is no privacy behind bars. Even changing your pads or tampons is an occasion for guards to watch.

Lawmakers have made some attempts to introduce legislative protections around menstrual care for incarcerated people. In 2017, Senators Cory Booker and Elizabeth Warren introduced a bill called the Dignity For Incarcerated Women Act, requiring that federal prisons supply menstrual care products. Two weeks later, the federal prison system announced that it would provide period products free of charge, a change that was later codified as part of the First Step Act.

However, this federal legislation affects only those in federal jails and prisons, who make up less than 10% of the nation’s 173,000 women behind bars. Those in state prisons are dependent on state laws. Over 35 states currently lack menstrual care protections, leaving women incarcerated in those state prisons at the mercy (or cruelty) of their jailers. The voices in this article come from people incarcerated in states without legal menstrual care protections.

In some states, the indifference and the indignities around reproductive health extend from the monthly experience of periods all the way to birth. In Arizona, prisons have induced women into early labor against their will. Between 2005 and 2013, California sterilized over 850 people in women’s prisons, frequently without their knowledge or informed consent.

No matter what you believe about serving time, we need to question why we permit this kind of control and abuse over anyone’s most basic bodily functions and needs.

What’s needed as part of the push for state-level regulations that guarantee the access to menstrual care products (and that the federal government has already acknowledged are necessary), is for us to first open our eyes. We must let the inhumane conditions of bleeding behind bars be known. Menstruation has been taboo for so long that the topic has remained in the shadows. But we are in a new era; we are ready to speak up. Perhaps on the deepest level, the inhumane conditions of bleeding behind bars provokes the question: Why are we locking up so many people in these torturous institutions in the first place—and how does subjecting people to abuse make anyone safer?

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