Special Episode: Dr. Kate Clancy & Period

research today. And we have got so many more exciting books on our schedule over these next few months to keep you informed and entertained. We'd also love to hear from you about how you're liking these book Club episodes, what lingering questions you have that we didn't cover, and if there are any books that you'd like to add to the list. Just send us a message through our contact ust form on our website This Podcast will Kill You dot com, or through our email This Podcast will

Kill You at gmail dot com. All right, podcast business over. Now, let's get to what we're going to be talking about today, and that is menstruation. Despite the fact that about half of the people on this planet have menstruated or will menstruate at some point in their lives, and that, as UNICEF tells me, one point eight billion people across the world menstruate each month. There remains an aura of mystery

surrounding this completely natural biological function. Conversations about periods, about flow duration, cramping, color, or consistency of discharge, they take place in hushed tones. Tampons or pads or panteliners are passed surreptitiously like sleight of hand style. TV commercials advertising menstrual products somehow managed to not mention periods or menstruation at all, and instead show people pouring a mysterious blue liquid distinctly not menstrual blood, onto various pads or in

a beaker where it's absorbed by a tampon. The list of euphemisms for periods is seemingly never end, and I bet you can think of at least three or four right off the top of your head that time of the month, aunt flow on the rag. These were just the first three that popped into my head. And if someone does dare to speak openly about menstruation, they are often told that they are gross, that periods are disgusting

and don't make for polite conversation. This widespread shame regarding periods so often leads to silence, a silence which serves only those who actively want to exert control over menstruators, who want to take away their bodily autonomy, and in a recently proposed bill in Florida, this silence would be legally enforced, with children and their teachers forbidden from talking about menstruation in school until sixth grade, at which point

many of these children would have already started having periods. In period The Real Story of Menstruation, published just last week, author doctor Kate Clancy, explores the complex origins of these attitudes to menstruation and considers their role in the perpetuation of period myths, menstruation taboos, and widespread myths and disinformation that reveals that what little science does know about periods

is often less than correct. Doctor Clancy, who is a professor of anthropology at the University of Illinois at Urbana Champaigne and has worked extensively on the issue of pervasive sexual harassment and higher education, presents a compassionate, clear and thoughtful examination of menstruation that is at once informative and inspiring.

Informative for the thorough debunking of long standing period myths and clear explanation of biological processes, and inspiring for demonstrating that knowledge is power, that knowing the sources of and reasons for shame and disinformation is a crucial part of

imagining a better period future. Doctor Clancy joins me on this bonus episode to discuss a bit about these period futures, the inspiration behind her book Period, some of the ways that different cultures vary in their perceptions of periods, why the concept of a quote unquote normal period is both untrue and can be harmful, but the sars kvy two vaccine revealed about scientific attitudes towards periods, some of the different hypotheses for why human's mens street, and so so

much more. Period is sure to become an instant favorite among listeners, and as a longtime admirer of doctor Clancy, who has kicked myself for never taking one of her classes while I was at the University of Illinois, I am so excited for today's episode. If you can already tell so On that note, let's get right to the interview after this shortbreak. Thank you so very much for

being here. I was incredibly thrilled when I learned that you were writing a book about periods, and that excitement was totally justified because period the real story of menstruation, is absolutely fantastic. What made you decide to write a book about periods and why focus on the aspects you did well?

So that's wonderful to hear. Part of the reason that I wanted to write a book about periods was that I really noticed a lot of menstrual stigma in my field. And when I would discuss menstruation or periods, there would be these interesting body language changes in the way I spoke to people. They would start to wrinkle their nose, that was the big one. They would start to lean back. There was a lot of just sort of changes that made me realize that even in a scientific context, we

are often not ready to discuss it. And it's interesting to me because my field talks endlessly about menstrual cycles, and we have no problem talking about ovaries and eggs and estrogen and progesterone, but you start to talk about mensis and it suddenly becomes well, let's see if we can sort of scientifically talk our way around this being unnecessary or of no real consequence to the science of menstrual cycles. So I just, I mean, really, I just leaned into that.

Like sort of the health class version menstrual management. So how to actually do that concealing is something we're not really taught. We're taught that tampons exist, that pads exist. Now we have cups and underwear and other options. But you know, I don't know. I mean, maybe you have a different experience, but my experience of health class was definitely not that my male health teacher, who was also the basketball coach, was going to be explaining tampon insertion

to any of us. And yet research has shown that that is what people most desperately want to learn when it comes to actually learning about periods. So, on the one hand, there's all this enforced concealment, and there's this shame when we fail to conceal. On the other hand, because of the stigma, nobody talks to us about how to do that concealing. So, I mean, just imagine how

many issues are wrapped up in that. Right. Then, in terms of activity, there are you know, there are sort of these long standing assumptions that during mensis you're more tired, or that you might want to withdraw from society or do less physical activity. Certainly, when I was younger, it was one of the ways you could get out of pe or physical education class was to tell your instructor

you have your period. You know. On the one hand, you could see it as a nice thing because it's a way of honoring Hey, maybe my body's doing something a little different today, maybe it would be nice to rest. On the other hand, though, it also is a way of withdrawing from society, and so so sort of this issue of activity, I think is a big one because of the ways that since you're never telling anybody why you're doing it, you're just because we're not supposed to

be talking about when we have our periods. It's sort of this secret thing that we just sort of like exempt ourselves from the world a little bit more around this time. And then again, communication kind of ties these all together, because issues of communication mean that even though we somehow get this vibe that we're supposed to be concealing, we're supposed to be removing ourselves. People aren't supposed to

know that we have our period. The how and the practicalities of it completely escape us, which means many of us go through all sorts of rounds of not concealing mencies and having very embarrassing stories. You know, I bled through my clothes multiple times in middle school and high school, and I actually really enjoyed the solidarity of being supported by other menstruating people in those moments of people bopping shirts with me so I could wrap things around my waist,

finding tampons or pads when I ran out. I actually think that we can notice the broader structural problems here while also appreciate that menstruating people have found some very clever ways to subvert or undercut these structural problems and still support each other.

find out one of them got her period. And then it's this whole educational thing where the mom is then teaching these three girls all about periods. And it's actually one of the only ones I've ever seen that even talks about like the quantity of menstrul blood or anything.

So the really like, the really funny scene for me that I will just remember for the rest of my life, even though it's thirty plus years ago, is the moment she's holding up some pancake batter and she says, you know, a girl will menstruate about half a cup over the course of her period, and then she pours out the batter into the shape of the uterus and then starts explaining, you know, the functions of the uterus and menstruation on this pancake.

So I think a lot of that universality misconception comes from the fact that Westerners, particularly white Westerners, and to center themselves and everything and just assume that we are the norm. To me, that's the biggest piece of it.

I and that's very tied to settler colonialism. You know, the whole practice of settler colonialism is going in where people already live, pretending now that this stuff belongs to you, and then you know, extracting resources, committing genocide, taking over, and often there's you know, there's some cultural appropriation, but there's also a ton of cultural erasure, and that's a lot of colonialism is about dominance, and so it's not surprising then that, you know, we just come to assume

that a lot of the cultural practices that occur in a lot of our societal contexts are universal. I think the other thing is that as our ideas of menstrual stigma and menstrual taboo have changed over time, I think there have been a lot of folks who have at first pushed for a more scientific understanding of periods and then have expressly tried to neutralize a lot of the language and even sometimes create a positive spin in thinking

about menstruation. And as we've moved in that direction, it becomes very comforting to Westerners, again, especially white Westerners, to conceive of menstrual stigma as something in the past, or even to use really problematic language like this mus be a primitive way of thinking because we are modernizing it. And then that continues to reinforce this idea. Well, since this is in the past, I bet this is what happens to those other cultures that are less modern than ours.

So I think there's a couple different things going on, where again, it's all about colonialism, and it's all about these ways in which we are just trying to believe that wherever we're at is the best place to be in the most sort of evolved or modern take on things.

meant functionality. It began to be co opted and thought of differently, in particular among people who liked to start to imagine some people are better than other people, or some processes are better than other processes. And so again, these concepts of normality came directly from people who had who believed in eugenics, promoted eugenics, wanted to believe that some people fell within a normal range or were statistically average, and that to be statistically average is the desired trait.

And I think that's kind of it's kind of a weird concept, right, because in some ways we have these concepts of ideals, and we also have these concepts of average, But what happens really often is that they get really conflated and we start to see the average is ideal. How does that happen because when we create this idea of average, we only include some people in the calculation.

So you know, if you're trying to figure out the ideal body type and you only include thin, white, able bodied, cisgender women between the ages of eighteen and twenty, you're going to get an average of that group. That then if you try to say that that's the average for everybody, is really not going to seem right at all. So

that's how those things start to get conflated. So with the menstrual cycle, it's the same sort of an issue where the way that we've calculated or assessed normal and average has been from a very limited understanding of menstrual cycles. This idea that the best menstrual cycle to have is one that is twenty eight days long and always ovulates that it's really not the right notion. Menstrual cycles should vary. They should be really variable and long and largely in

ovulatory when you're a teenager. Even in your twenties, they should still actually be the hormone should probably be on the lower side, and you're still going to have some n ovulations. Thirties are when the body really kind of hits its stride, and so like mid twenties to mid thirties, maybe even into late thirties, is when you're seeing something closest to what we often say is sort of the

normal cycle. Even then, up to a third of the time you're not ovulating, so it doesn't look anything like the norm, and then things start to shift, you know, late thirties into forties, and as we head into menopause, we start to have a completely different range that you

can see among completely healthy people. So again I use age as this one example, but there are so many other ways we can also sort of parse these different patterns and start to learn that this textbook that we keep being shown doesn't actually represent a whole lot of people.

And in fact, when we look at menstrual cycles in our lab, it's really hard to ever find anybody who looks like that, even among people in our rural Polish population who've had twelve children, who clearly have no problem getting pregnant, superfertile, but their menstrual cycles don't look like that.

of style. Can you take us on a brief tour through some of these ideas about the evolution of menstruation, and do you think it's likely that there's a one size fits all hypothesis that will eventually come to light or do you think it's just going to be difficult because there are so many different drivers for the evolution and persistence of menstruation in humans.

have these ideas of the quote prime mover hypothesis so much in evolutionary biology is that people want to stake their professional claims on being the one who figured out the answer. But the reality is that most of these traits are operating under a number of different competing forces.

So I'm going to give the punchline of where I of what I think is going on, which is that I think there are two main really three main hypotheses, all of which have some truth to them in terms of why humans, in particular killer menstruate as copiously as they do. We have Beverly Strassman's hypothesis on energy economy

that came through in the nineteen nineties. I think what was really important about it is that, in addition to the fact that she did some work to discount a hypothesis i'll talk about in a minute, we also use it as an opportunity to say, you know, there is a lot of energy expenditure that goes into creating, so proliferating the lining of the uterus and then differentiating it.

And that's like hundreds of calories. And so rather than maintaining that indefinitely for some possible implantation, really we should get rid of it when we don't need it and start over. So the energy explanation, I mean energetics rides through so much of evolution that I think it's it would be silly to say that that has absolutely no bearing. The next one is terminal differentiation, which is the one. This is Colin finn. This is the one people like

the best. But I think again. Is one of really three great hypotheses that are all all valuable, and point is really just like a physiological inevitability one, which is that you know, if you're going to grow this endometrium, you're going to differentiate it into this particular set of cells, this particular structure that's great for implantation. It probably has an expiration date right most cells that once they differentiate.

That's where that term terminal differentiation comes from. Once cells sort of get to a certain point, they can't really like back up and do something else. So once they've hit that point and you've kind of passed some receptive window by which it's maybe not going to be as effective for implantation to work, it makes sense for these cells to die so that you can kind of start over again. So that's where the terminal differentiation idea comes from.

Once it differentiates, you know, if it's not used, we kind of have to just start over. The third one, which is a newer idea that I think is incredibly valuable, is from Brozens and others looking at what's called preconditioning, which is basically this idea that menstruation is practice when

you grow and differentiate that endometrium. What you see is that the more and more you do it, the better those structures get, and potentially the more receptive the endometrium is for implantation, it means that the implantation process might go better. And we have some really interesting lines of evidence to support this, in particular around preeclamsia. So preeclamsia is a condition of pregnancy that is a hypertensive So

it's a blood pressure disorder, and it's incredibly dangerous. It has killed many people, many pregnant people, and you know, as your heart, as your blood pressure starts to go up, really the only fix is to give birth, so it can lead to premature birth, and even then that may not be enough if you don't catch it early enough. And there we now do have some drugs that will

help people survive preeclamsia. But I mean, if you're a down to an Abby fan, you know that one of the beloved sisters dies of a clampsia, which is the you know, the downstream version of preclamcy. So we know now that part of what causes preeclamsia is likely sort of not good enough invasion of the trophoblasts. So basically

like the maternal fetal contact isn't quite as good. And increasingly we also know that one of the means by which preeclamsy is more common is in younger people, the people who have had fewer menstrual cycles, people for whom it's their first birth, you know, they haven't had a lot of implantations. There's other mechanisms too, but that's one of the really big ones is it's more common in sort of first timers and people who just tend to

be on the younger side. There's also some evidence that people who are longtime contraceptive users who also have fewer periods that way, are also at slightly higher risk. So all of that said indicates that you know, when you remove menstruation as practice, you increase the risk for some

of these pregnancy conditions. So to me, that's like a really compelling reason for preconditioning being a great explanation for why we menstrate is that we need it in order to build up the actual deellular architecture to make it an effective place for implantation to happen. There are so many people now who are starting to sort of move in that direction and try to understand the function of menstruation.

Now that we understand that it actually has a purpose, I think, to me, the problem with the terminal differentiation hypothesis is where it's led a lot of people to go is to say menstruation is non adaptive and useless because it's just this thing that comes out of the body because of these other functions, because of cycling itself

being adaptive, but like periods itself aren't. But menstrual blood and menstrual tissue are crucial to the component to endometrial cycling and are necessary for the healing processes to be occurring simultaneously with the removal of menstrual tissue. So to say that that stuff's not important is kind of weird, Like, of course it's important. It's part of the whole process, right. You can't just decide when part of the process is an important because you think it's gross. So that's sort

of like the big picture where we are today. But I think what's interesting to think about. I'll give a briefer version of how we got there in terms of how we got there, and I think the reason that the terminal differentiation one became so compelling, and again the title of it was literally a non adaptive consequence of uterine evolution or something, and people really leaned into that non adaptive consequence. Is that some of the early ideas

about menstruation being adaptive were pretty crummy. We have the menotoxin, which really just you know, came straight out of a lot of Christian beliefs that menstruation's dirty and so you have to get the dirty stuff out of you because women are dirty. You know. That's where a lot of that came from. Those beliefs persist today, but they aren't studied all that much anymore, thankfully. But the menotoxin throughout the entire twentieth century was considered a significant means of

understanding menstruation. And my favorite counter to that was margie Profits hypothesis of sperm borne pathogens. So she says, yeah, sure, menstruation's dirty. The reason it's dirty actually is that dudes are dirty and they send their dirty sperm in here, and then we got to clean it all up because we don't want to get those pathogens. We don't want to get sexually transmitted diseases. So menstruation, in her hypothesis, is to remove the pathogens that sperm are sending up,

not that mensies itself is dirty. And so part of the reason that I think the terminal differentiation idea in particular was seen as so refreshing is it was trying to get out of that adaptation evolution conversation at all and say, look, it's not any of that stuff, It's just this basic biological phenomenon. So I think it made

an important contribution in that way. But it also did what happens all the time to things that we gender feminine or that are more common in female bodies, which is that we call a lot of those functions useless.

and bleed. Right. There are lots of reasons that it causes gender dysphoria, that it causes pain, that it messes with our schedules, and can we look at these broader structural these broader structures and say, why is the world set up so that it's so hard for us to bleed? Of course, you know, I'm menstruating right now. I'm on day two, So I am like, very heavily menstruating as we speak, and I am kind of at that stage

where I'm having to swap out pads. I'm wearing period underwear and I have to swap out pads pretty regularly, and so it's one of those things where like I'm having to look at my schedule, look at my back to back meetings and figure out how can I run in between multiple meetings to make sure I'm swapping out so I'm not, you know, bleeding onto my pants, which I have done at work multiple times in my life because my meetings have gone too long and I haven't

gotten a chance to swap things out so you know, in anticipation of that and not wanting that to happen. You know, Like, I've been running around quite a bit to like swap out pads between meetings. So I share all of that, and you know, I try whenever I am menstruating to be public about when I am. But I share all of that to say, like, still, it's

a giant pain in the butt. Right, and again, even if it were, if that's the only reason you don't want to do it, that's a good enough reason to not want to do it, to the point of, like, is suppressing periods bad for you? I think it's an

open question. I think this pre acclampsia and this question of pregnancy practice, it does open up a question of if you are someone who wants to reproduce in the future, should we be studied doing a better job studying menstruation, process of menstruation, and frequency of menstruation to see whether some of these hypotheses that we have that are indirectly supported by the evidence can actually be shown to be

like a real causal thing. Right, And so I'm unwilling to tell any one person you need to get bleeding if you want babies, right, because we just these are inferences that we can make from the literature that I think are strong. But the thing is is that the

research hasn't been done to establish this causality. The one last point I'll make about this is one of the really frustrating things around hormonal contraceptives and IUDs is that far more people have unpleasant experiences with it than often admit it, and even IUDs have a fairly high discontinuation rate, possibly as high as fifty percent depending on the study.

And discontinuation of an IUD is challenging because the coercive pressure of medical doctors to keep you on IUDs is so strong that it can be very hard to find someone who will remove your iod for you, and so you can be having months of distress, lost libido, just continuous spotting, not feel like you have whatever the peer you know, the experiences that makes you say, I want to get this IUD taken out, and you can't find

someone who's going to do it for you. It is a real problem that we make it so hard and that we prioritize efficacy over lived experience every single time

when it comes to these contraceptives. So I'm excited about the fact that there are people now starting to think about this and say maybe we should care about lived experience and side effects as well, and start to think about and develop new technologies that allows people to have their contraceptive needs met, their suppressive needs met, but without

having to endure so many other side effects. And again, half the people who take them don't have any of these problems, right like, So to be clear, there's plenty of people I know, plenty of them who are like you will take away my IUD from my cold dead hands. You know, I never want this thing removed or I you know, I'll keep it in as long as I possibly can, and then I'll swap it out for a

new one, which is fantastic. I'm so glad for them, But I also know a lot of people are who've been miserable, and we just need to make sure that we're tending to all of the different people who have different experiences.

is outside of the norm for them. And one recent instance of this on a wide scale was breakthrough bleeding after getting the Stars Kobe two vaccine. Can you talk about your incredibly fascinating research into this pattern, how you got interested, what you found, and what sorts of reactions you got from the press and public.

you have? What did I have? And a few of them were like, weird periods, different, wonder what that's about, and you know, and it was sort of from there that we began to have this conversation and I'm not an IUD user. So for me, I didn't have breakthrough bleeding, but I noticed my first period after my first shot, I had one of the heaviest periods I've had in my life aside, like the only heavier period I can think of is after my embryo. Like I had two

failed embryo transfers before I had my second child. Those were incredibly heavy periods, but they were because they were, you know, stimulated with hormones and stuff. But like that level of heaviness. So I just asked Twitter, you know again, one of the reasons that I love and hope I will never miss Twitter, hopefully it will stare around in some form is that you can learn from and listen to so many people by using that space, and it

went viral. By the end of the day. Katie and I were already talking about and mocking up a first survey because we thought, you know, we have to look at this. There are people who are in distress, there are people who are equating it with infertility issues, and we immediately were like, you know, we know the biology of it enough to be very confident that that's not what's going on. But we also knew that just saying

that wasn't going to be satisfactory. So we thought, we really need to do some kind of project that, you know, that like gathers this information and allows us to critically assess what's going on while also creating opportunities for listening and validation. As anthropologists. That's how we create our science. That's we also build in reflexive practices so that we are discussing our projects and thinking about and adding to

things based on what our participants say. So we got an IRB exemption, and in our little IRB exemption form, it was like, you know, how many people do you think will participate? And we said, oh, maybe five hundred, and we thought that was a stretch, like that would be so cool if our survey we got five hundred people. I think we had five hundred in the first hour it was open. By the time we closed, we had Once we did all the data cleaning, I think I

want to say one hundred twenty thousand individuals. We had one hundred and sixty five thousand separate responses, but then removing some of the dual ones and stuff, I think it went down to about one hundred and twenty thousand, and then our first paper, we focused just on the first couple of months of data collections, so that was thirty nine thousand participants, just numbers that I don't normally

work with. We had to like try to beg for emergency funding from the university, which they were kind enough to give us in order to get some RAS to help us with all of the data cleaning and so this little fun project. Then Katie and I were like, maybe we'll get an honors thesis out of it and we'll just have our own set. You know, curiosity satisfied

turned into this ginormous international phenomenon. The other thing I want to point out is that, in part because of the attention our research was getting, the NIH came up with supplementary funding in order to fund people looking at this phenomenon, and so then five more projects in addition

to ours. Ours was never funded by NIH. We've tried four times now, but the NIH funded five other projects, so that you know, we knew we were not alone in doing this, which was really another form of validation in many ways. It was great to have multiple people looking at this with different data sets and different methodologies.

And now the papers have all started coming out and we're all having all the same findings, which, again, given that the initial criticism of our work was you know that we were doing it in this way that centered participants, and was yes it was snowball sampling. Yes it was self selective. It's not a random sample. We aren't comparing to people who aren't vaccinated. We didn't do the kinds of things that people like to hold up as methodological

gold standards. But when you're trying to do things as it's happening, and you feel you have ethical obligations to not create a condition that might encourage people or incentivize them to not get vaccinated, you're going to do it the way we did it. And again, our find ended up being the same as the folks who did perspective work, which is that heavier and longer periods did happen in a subset of participants who got any of the mRNA vaccines.

In particular, I can't remember the name of the commission, but a European commission has just released a requirement that in Europe, at least the two mRNA vaccines must now disclose that a potential side effect is heavy menstrual bleeding. Again,

it's still really validating to see that. Because we were able to get that narrative out there, we were able to push back on the there's no real biological mechanism to explain it, which was what a lot of mds were being quoted as saying, and we were able to push back on the idea that it was connected to fertility. So this is an immune process. It's an immune it's a downstream immune effect. Part of immune function is hemostatic,

is related to changes in bleeding and clotting. So what's an organ that does a lot of bleeding and clotting the uterus? So in some portion of people, a giant immune response is probably going to invoke downstream effect on

an organ that bleeds in cloths. And in fact, the participants that had it happen more so of the heavy bleeders, they tended to be a little bit older, and tended to be more likely to have already had children, So again they had more of that endometrial architecture, so you know, we're kind of more primed for something bleedy happening to them.

So again, our hypotheses were in a lot of ways supported by who it seemed to happen to more and so it's less about fertility and more about just you're just going to have that architecture being like capitalized on a little bit more if you've got all this bleedy clotdi stuff happening prior to it.

how do you still talk about vaccines being safe? And I feel like part of it has to do with just talking about periods and period variability and so on. But yeah, I was wondering if you could talk a little bit more about that potential issue.

a hormonal contraceptive for a good reason. Right. They don't want a potential fetus exposed during this testing period, because that's not the purpose. The purpose is probably in this case testing an adult and looking at the effects on

an adult. But what this does then is that if they're potentially masking effects with a contraceptive, and if they are then asking no their questions, then they never are gathering in of these data about well, what does happen to your period after these drugs or vaccines or whatever. So the fact that it's not even in the trial design is a problem because it means we just don't know what's going on. And I think that there are sort of three things to think about when we're thinking

about a new medical treatment of any kind. There is efficacy, there's safety, and then there's also just like side effects or what I've been calling lived experience. Right, it is worth noting that chemotherapy can be very effective for treating many cancers and seriously affect quality of life. And if it has a really high chance of being effective, you will still go through it. Most people are still going to say, you know what, this is going to be miserable,

but it's better than being dead. I am going to make this choice, right. So, I think there's this medical paternalism that often seems to say, well, we should probably not fully inform the ladies of how this might affect them, because then they might not do it, and that is not what our data supports. So our data support that our participants felt incredibly betrayed by not knowing ahead of time what to expect. They were not betrayed by having

side effects like breakthrough bleeding or heavy bleeding. They are betrayed by never being told and never being studied. They also shared with us many stories of having this heavy or breakthrough bleeding and going to their doctors or other medical providers and then being mistreated in those sessions where they were told it's in your head, you're stressed out, it's not real, there's no biological mechanism, or whatever the

story was, and it was really distressing. Something that we have in preparation right now that is really relevant to this is that one of my grad students, Uruba Fatima, who's just a brilliant qualitative researcher, has been looking at doing a sentiment analysis of people's descriptions of their vaccine experiences or their post vaccine minstrreul experiences, and she was noticing that a huge proportion of the participants had what

looked like negative and then positive effect appearing, and always in that order in their description, and so she didn't dive in to figure out, well, why is this happening with most people? It's not all negative or all positive, and it's never positive then negative, it's negative then positive. The negative effect terms were all describing the negative symptoms that they were experiencing with their periods. I'm fatigued, I'm tired, i don't feel good, you know, various types of negative

framed experiences of their heavy period. And then the positive words were all but I am so grateful to have this vaccine. I am so happy to be vaccinated. I am so glad that I got the vaccine. I feel so lucky. Like all of these incredibly positive words, the negative experiences of the vaccine were not driving them to have negative sentiment toward the vaccine. What we saw instead were the people who had negative experiences with medicine had

negative sentiment about the vaccine. So this idea that like we shouldn't bother looking at this, or we should only wait until post emergency authorization to bother to look at these adverse effects. I think is really deeply problematic and again points to this bigger question of why are we so paternalistic towards patients, particularly patients with uteruses.

And in general it is just like a feminist and black feminist concept that says, why do we keep believing in this Cartesian dualism thing that says, we have a brain, we have a body, and we can ignore the needs of the body in the pursuit of a life of the mind. People that don't have bodies that have a lot of needs that might not be a challenging dualism

to live in. People that have bodies that are tended to by other people also might not have too much of a problem living with this dualistic life soo In particular, white men who maybe have lived their whole lives being served by other people, experiencing medicine that allows them to be able bodied for longer, perhaps do not ever have to menstruate, lactate, or gestate, or recover from any of those processes, or be at more risk of conditions that

come from any of those processes, are going to have a much easier time living a life of the mind. Like if someone is making me lunch every day and typing up all of my notes every day and I never have to care for children or just state or anything, it's going to be pretty easy. So I think the intervention is really we have to do a better job acknowledging that there are bodies and working to create communities

that love and support lots of different bodies. And you know, I'm in many ways I'm borrowing from disability justice here as well, And I'm saying this in a way that acknowledges like this is not me coming up with this idea. This is me noticing the work largely of black feminists and other women of color working in many activist spaces who've been making these points for decades, and so I just I'm just sort of trying to bring that to an audience that might might not be as familiar with

that work. But to say that that's I think who we should be paying a TENI to and what we should be doing is again that we should be creating communities of care, acknowledging that we have needs that we have. You know, we do these now, Oh everyone gets a five minute bio break between Zoom meetings. You can't heat up your lunch, eat your lunch, hydrate, use the bathroom, swap out a tampon, and also perhaps like pump breast

milk in a five minute biobreak. And so you know, there's starting to be some acknowledgment that we have bodies that need to be tended, but we're not going nearly far far enough, and so to me, it's more just like starting to imagine what are the kinds of futures not just for people who have periods, but people who have lots of different types of bodies, all of whom deserve to be tended so that all of us can

be present. One of the places I find this most distressing is the complete removal of hybrid options and masking across most university settings and most other public settings. Now, even among scientists who should know the science and know that we are living in an airborne pandemic, are still walking around unmasked all the time. And what that tells people who are immune, compromised, or disabled or would prefer to avoid long COVID is that their lives just really

aren't worth protecting. We're not going to do this minimal thing and put this scrap of fabric over our face to just make you not just feel more comfortable, but be more safe and be made to feel welcome. So what are the ways that we can think about that when it comes to all the different ways that we can protect each other. We can be masking, we can be filtering. We can create more time and space for

people to get places we can create hybrid options. There are some people that I know who menstrate so heavily that they spend a decent portion of their period just sitting on the toilet because they're like, what's the point of swapping out tampons? I could just sit here and

let it come out. Hybrid option would be kind of nice for those folks, right, Like, we don't need to enforce these ablest returns to work when instead we could try to imagine a different future instead of a return to a really problematic past.

years I spent writing revising. I went through two rounds of peer review for this book as well, one of which took over six months because it was during the pandemic and it was really The second one took almost as long too, actually, and so you know, it took a really long time. It took literal years of my life. But we're more mostly book perplexed, like why would you do that?

And I think once I sort of talked through, well, here's why I care, and here's the sort of the big idea of the book, that I think people were supportive. I think the main thing I was surprised by is that I could do it, honestly, because it's you know, it's six chapters. It was six really long papers, and so thinking through argumentation and stuff when you're trying to write six long papers all by yourself is a lot.

But in terms of, like topically the kinds of things that surprised me, I would say a lot of the menstrual preconditioning was really exciting and interesting to think through. I mean, I think probably the most surprising piece, or the most rewarding thing to do in this book was how I think in many ways it got to remain a feminist book and a book that came from a

place of what's called feminist objectivity. So trying to expose and think about histories, biases, assumptions in play in the literature. And when you strip those things away and you move away the menotoxins and the terminal differentiation and the eugenic concepts of normal and you know, when you pull all of that away and you look at what menstruation is, it is just one of the coolest things that the

body does. Like it creates an opportunity for your body to practice a thing that it has to get good at later. It is simultaneously remodeling and sloughing off at the same time, like it is doing all of these repair processes that would if anybody gave a crap and actually paid attention to in the tissue engineering space, we would have already solved so many tissue regeneration questions in that discipline. But ew menstruation, so people haven't paid attention

to it. I mean, I have a collaboration where that is something we've been doing for almost ten years. But that's because the collaborator is my husband. You know, nobody else is going to listen to me about this stuff, And so I think for me, that's the thing is that, like, it is an incredibly cool process. It is an incredibly

cool function of the body. And if there hadn't been so much bias baked into our understanding of it for multiple centuries, this would be a thing taught alongside dinosaur bones, This would be a thing taught alongside the planets, Like it would be one of those basic functions that everyone would be like, Hey, have you guys learned about this?

Because this is this cool thing that is like all of us were in a womb at some point, right, we should be really fundamentally curious about what happens in there. And how is that's not one of the like that there's not an entire high school class just devoted to it, you know. So I think that's for me, the sort of surprising amazing thing is that, of course I already loved this stuff because this is what I do. But I think it became even more obvious with feminist objectivity

that it's even cooler than I thought it was. And I think that's my biggest hope for this book is that other people will arrive at that same conclusion.

don't forget. You can check out our website for all sorts of other cool things, including but not limited to, transcripts, Quarantini and Placebrita, recipes, show notes and references for all of our episodes. Link to merch our bookshop dot org, affiliate account, our Goodreads list, a first hand account form and music by Bloodmobile. Speaking of which, thank you to Bloodmobile for providing the music for this episode and all

of our episodes. Thank you to Leana Squalacci for our amazing audio mixing, and thanks to you listeners for listening. I hope that you liked this bonus episode and are now so excited to be part of the TPWKY book Club. A special thank you, as always to our fantastic, generous patrons. We appreciate your support so very very much.