In Michigan, the city of Ann Arbor recently passed a law to stock all public toilets with menstrual products.
In Florida, legislation that would require free products in school restrooms has been introduced twice, but has yet to pass.
Recent studies have shown that about a quarter of menstruating students struggle with access to period products, and that many teens still feel a stigma around menstruation.
"This country already expects schools to provide toilet paper and soap," says Damaris Pereda, the national programs director of PERIOD, a nonprofit advocacy group. Why, she asks, shouldn't students who menstruate have the same access to basic supplies? "So that if something happens, they just go to the restroom and get their things and continue to live their lives."
Access to period products has an impact on learning loss
Currently, many schools keep menstrual products in the school nurse's office.
At those schools, "while you can get a period product, you often have to walk across the campus while you're still bleeding through," Pereda says. "What happens in that case is that a lot of students feel ashamed and like they've lost some of their dignity."
Right now, there is little national data about teenagers' access to menstrual products. But what little information there is suggests the lack of access is worse for poor students. The only publicly available study tracking the impact of period poverty among U.S. teenage students, which was funded by PERIOD, found that 23 percent of students have struggled to afford period products.
California addressed this lack of access in 2017 by requiring schools in low-income districts to provide free period products in schools. The legislation passed in October expanded that access to all schools and requires products to be in half of a school's bathrooms.
"It becomes a barrier to education," says Christina Garcia, the Democratic state assemblywoman who introduced the legislation, which was signed by Gov. Gavin Newsom (D) in October. "These are our most vulnerable kids, who already have a lot of barriers. This should not be one of them."
Nicky Dawkins, who runs PERIOD's Miami chapter, is hoping the recent legislative win in California will help mobilize educators, students and health professionals across Florida.
"We don't want to continue to Band-Aid this problem," Dawkins says. "We want to solve the issue, which is done through passing bills."
The study also found that 70% of students felt that their school environment made them feel self-conscious about their period.
At Miami Arts, Amani feels like the stigma can be seen everywhere. They told NPR that there isn't a nurse that students can go to when they need period products or have questions about their period.
"There are people who think they're dying because they started bleeding," Amani said. "They freak out and don't know what to do, and if schools were more open about menstruation, we could lessen the stigma."
Alfredo de la Rosa, the founder and principal of Miami Arts Charter, told NPR that while the school does not employ a nurse, students can go to an administrator's office if they need menstrual products. "A female assistant principal (or delegate if she is absent) is assigned to provide menstrual products to any young lady who requests them," he said in an email.
Activists see period products as a medical necessity
Advocates say the issue goes beyond stigma, to affect the quality of education as well. The study found that 4 in 5 menstruating teens said they have either missed class time, or know someone who missed class time, because they did not have access to period products.
Pereda says this learning loss often happens when students need to go home because they are unable to find products they need: "Then, they don't want to come back to school, or if they do, they've already lost that time, all because they didn't have access period products at school."
Like Amani, Margaret Schedler approached her school about stocking the bathrooms with period products. She's a junior at The Altamont School, a private college prep school in Birmingham, Ala. Schedler says the administration was receptive to the idea, and agreed to her plan to have her school club raise money for the project. The school provides, and pays for, menstrual products to students in the front office and nurse's office.
Now, Schedler's club, Ladies of Lavender, relies on student donations to provide menstrual products in Altamont's restrooms. Even though the club receives a lot of donations, Schedler says it still feels unfair that the students bear this responsibility, especially because they have to hold donation drives every month, and students often complain that they've already donated supplies in the past.
"Schools should realize that [menstruation] isn't a choice," Schedler argues. "And if they want to support menstruating citizens, they should do the bare minimum and make sure that public- and state-funded places have period products that people can use."
Cost is often cited as a factor when considering whether to provide widespread access to these products. Free the Tampon, an advocacy group focused on getting period products in state budgets, estimates that it costs $5-7 per year per student to supply period products. Advocates working with the Office of Legislative Services in New Jersey are estimating the cost of the recent law requiring schools to provide period products to students in public schools at about $750,000 per year.
Advocates say the costs bring benefits for students. A pilot program in New York City found that attendance increased by 2.4% among girls at a city high school after making tampons and pads available in its restrooms.
Others argue that the question of cost sidesteps a larger point.