Menstrual Health as a Constitutional Right in India

The recent judgment by the Supreme Court of India, recognising menstrual health and hygiene as intrinsic to the right to life, dignity, equality, and education, under Article 21 of the Constitution of India marks a decisive shift. The Court observed that treating everyone exactly the same can perpetuate inequality if biological needs aren’t addressed. 

For the first time, menstrual health in India has been placed squarely within the constitutional imagination of the Indian State. 

This moment did not arrive overnight. It is the outcome of decades of feminist legal advocacy, public health research, grassroots mobilisation, and everyday negotiations by menstruators who refused to accept that periods should remain private inconveniences.

Key directives issued

The Supreme Court has mandated specific measures, including: 

• Free sanitary napkins in schools (government and aided), to ensure affordability and access.

• Functional, gender-segregated toilets in all schools, with adequate water, disposal systems, and facilities for children with disabilities.

• Awareness and sensitisation programs on menstrual health and hygiene for students, teachers, and school communities.

• Menstrual Hygiene Management (MHM) corners in schools like spaces with water, disposal, and education materials.

• State accountability: Monitoring and implementation mechanisms to ensure these rights are realised on the ground.

This seems like a personal win to me as a menstruator. 

What does it enable next?

India is not starting from scratch. There is a substantial body of programmatic learning from school-based interventions, community-led menstrual literacy initiatives, and livelihood-linked production models that has demonstrated what works, where, and why. This judgment creates a policy window to institutionalise that learning rather than reinvent the wheel through top-down mandates. If taken seriously, it can encourage:

• inter-sectoral coordination across health, education, water, and rural development

• decentralised planning that reflects local realities

• accountability mechanisms that listen to menstruators experiences, not just dashboards

Time for the harder questions

As a public health professional, five questions emerge for me. These questions come from years spent working with menstruators across rural, tribal, peri-urban, and urban geographies.

First, in rural and under-resourced settings, the challenge has been material and structural: poor sanitation infrastructure, inadequate water access, weak waste disposal systems, uneven quality of service delivery, and deeply entrenched stigma around menstruation.

Without clear budgetary commitments, shared ownership across departments, and credible last-mile accountability, even a progressive judgment risks becoming a well-worded mandate that systems are not equipped to deliver. Ultimately, a right would not be exercised and riks to remain a moral statement.

Second, menstruators are not a homogenous group, and neither are their needs. A centrally interpreted right, if translated into standardised solutions, may unintentionally narrow rather than expand dignity. When implementation focuses primarily on sanitary napkins, we must ask: Are we overlooking the comfort and familiarity of safe cloth-based practices in many rural areas? Are we ignoring the growing demand for menstrual cups or tampons in urban areas?

As menstruators, we do not need a single prescribed solution, but complete information, safety, and the freedom to choose what works for our bodies and lives. Dignity lies as much in choice as in access. If menstrual health is reduced to pads alone, the burden quietly shifts back onto girls, now it may be framed as “non-utilisation” or “lack of need,” rather than as a failure of design.

Third, even if pad-based interventions continue, a critical question remains unanswered:Who bears the environmental and social cost of non-biodegradable menstrual waste?

In contexts where disposal systems are weak or absent, the consequences are borne disproportionately by sanitation workers, communities, and ecosystems. These challenges are often invisible in programme design and evaluation. A rights-based approach must grapple with sustainability, not defer it.

Fourth, this judgment also offers a moment to re-examine existing government programmes that claim to improve menstrual health and hygiene and to ask whether they are doing so meaningfully. Take Bihar’s Mukhyamantri Kishori Swasthya Yojana, which transfers ₹300 annually to school-going girls. Multiple reports and field observations suggest persistent gaps: lack of monitoring on how the money is used, limited awareness among frontline workers, delays in disbursement, and an amount that is insufficient to significantly influence menstrual practices. Bihar is not unique in this regard. Most states run similar schemes. The question now is not whether schemes exist, but whether they are adequate, accountable, and aligned with the realities they are meant to address.

Finally, implementation will inevitably vary across states. Where health budgets are constrained, as in poor states like Bihar, the feasibility to operationalise such judgments may be limited and will require sustained political and financial commitment. Without mechanisms that recognise and address these disparities, progress will remain uneven. When implementation is uneven, it is always the most marginalised who are left behind first.

This judgment is a significant victory. It reflects years of advocacy and collective effort. But its success will be measured far from courtrooms. It will be measured in schools where toilets function and in systems that respect choice at the last mile.

The highest court has spoken. Now we must work together to ensure that dignity is delivered.