Next school year, however, that will change. Starting in the fourth grade, every student in the District’s traditional public and charter schools will have to take classes on menstrual health — regardless of gender — making D.C. the first jurisdiction in the country with specific universal standards, officials said.
Students will cover topics such as how the menstrual cycle works, where to find sanitary products and the stigma that often accompanies menstruation. The standards come as education leaders in the city prepare to adopt new social studies standards designed to increase representation for marginalized groups and more directly examine racism and white supremacy. The updates reflect a broader effort to modernize what is taught in city schools, officials said.
“From menstrual standards to social studies — up next, you’re going to hear us pass standards in financial literacy. Down the road, we’re working on standards in environmental literacy,” said Christina Grant, D.C.’s state superintendent of education. “It’s the role of a state education agency to always reflect, revisit and then align on standards adoptions that reflect the dynamism of education, that reflect what students should be learning in age-appropriate ways, and for us to grapple with topics and frame them out to our community in service of our children.”
The menstrual health standards have been in the works for at least a year, since the D.C. Council passed legislation requiring the city’s school board and education superintendent to develop guidelines that ensure students “have the information, support, and enabling-school environment to manage menstruation with dignity, safety and comfort. The law also required schools to put free pads and tampons in women’s and gender-neutral bathrooms. If a school does not have gender-neutral bathrooms, period products should be available in at least one men’s restroom on campus.
But with few examples nationwide, city education officials drafted the standards from a “blank canvas,” they said. Leaders sought feedback from experts including teachers, community organizations and pediatric health care providers.
The curriculum includes more than two dozen standards spread across grade levels. In the upper-elementary years, students will gain an understanding of the menstruation cycle, the physical and emotional changes that can come with a person’s period, and how to maintain personal hygiene. By eighth grade, young people should know what causes irregularities in the menstrual cycle, how to compare different types of period products and identify safe and reliable ways to track one’s period, along with other standards.
In high school, students will explore topics including how the use of contraception can affect the menstrual cycle and when to discuss a menstrual health concern with a doctor. They will also critique the ways their communities are, or are not, supporting menstruators.
“These are important things that all students need to know about, regardless of whether or not they menstruate or will menstruate at some point,” said Birnstad, who is also a student member on D.C.’s State Board of Education, which had to approve the standards. “We know that people who menstruate at very different ages, so it’s important that we talk to younger students about this.”
The standards are designed to provide some uniformity to a subject area that has little consistency nationwide. What a child learns about periods varies by state, district and even individual school, said Melisa Holmes, co-founder of Girlology and the Period Education Project, which both focus on adolescent health.
Few states require students to be taught about menstruation products or how to manage their periods, according to an analysis of education standards conducted in 2020 by researchers. Meanwhile, lawmakers in Florida have passed legislation that limits discussions of sex education in schools and bans discussions of gender identity before high school. The law takes effect July 1.
“Traditionally, all that [students] learn about, as far as menstrual health, is how to use a pad or a tampon,” Holmes said. Lessons are centered around basic hygiene and menstruation in the context of pregnancy. Comprehensive menstrual health education, meanwhile, is rare.
“Menstrual health is a much broader topic that really covers what’s normal, what’s not normal, when to seek medical attention. “It’s destigmatizing. It’s for all genders,” Holmes said. She added that having menstrual health education in schools could prevent some of the issues she has seen in more than two decades of caring for women who do not understand how their bodies work.
“That’s why it takes an average of seven to 10 years to be diagnosed with endometriosis, because we write off period pain,” Holmes said about the condition in which issues that line the uterus grow outside of it and cause severe pain. It affects about 10 percent of reproductive-age women and girls globally and can lead to infertility. “When we educate all genders, we are decreasing that stigma. We are normalizing the process as being vital and part of the human experience.”
While the standards have been largely lauded in D.C., their implementation could pose challenges, said Amita Vyas, a professor at George Washington University and director of the school’s Center of Excellence in Maternal and Child Health.
First, there is little research on the efficacy of the handful of menstrual health programs that have been in schools, Vyas said. Officials will need to make sure educators feel equipped to teach these standards and make the content interesting for all students regardless of whether they menstruate — including boys, nonbinary and trans students. The city has already hosted at least one day of training for educators.
“It’s a diverse group of adolescents that we need to be able to engage,” Vyas said. “I think that these competencies and these new guidelines are excellent, but I think the real test is going to be in its implementation.”