Spain’s plan for menstrual leave is good, but it can go further

Author: Leah Pattem (originally written for Al Jazeera Opinion)

Paid leave for menstrual pain should not substitute investments in health research for women and ethnic minorities.

In May this year, the Spanish cabinet approved a menstrual leave law – the first of its kind in Europe. If it passes in the country’s parliament, people suffering from painful periods will from next year be entitled to a minimum of three days of menstrual leave per month, with the possibility of extending this to five days if necessary.

A doctor must assess the patient monthly. Once they are satisfied that time off is needed, full state-funded sick pay will be granted. Sufferers of dysmenorrhea – severe menstrual pain – will soon be able to take time off work without worrying that other illnesses could leave them without sick pay.

It is unclear how the new law will affect freelancers, or how companies and sectors will need to reform in order to comply. Still, it presents a moment for Spain and the world to explore larger questions surrounding menstrual pain – and the health of traditionally disadvantaged segments of society more broadly.

According to the Spanish Society of Gynaecology and Obstetrics, about a third of women who menstruate suffer from dysmenorrhea. This means a significant proportion of Spain’s workforce could soon be offered menstrual leave, an important move forward for the country. However, menstrual sick leave is ultimately a short-term solution.

Some people entitled to menstrual leave will not take it for fear of missing out on promotions or being stigmatised at work. After all, many of those who suffer from painful periods have already normalised working in pain and discomfort. Meanwhile, Spain risks losing millions of people from the workforce each month and placing too much weight on self-care.

The move towards the new law, while progressive, must not serve as a substitute for longer-term medical solutions, investments in the investigation of potential treatments and cures and the funding to make those accessible to the public.

For as long as medicine has existed, women and non-white people have been marginalised from research. The result: healthcare systems made by white men for white men. As such, endometriosis – one of the major causes of severe menstrual pain – remains underfunded and underresearched, which greatly limits our understanding of the disease and slows much-needed innovation in diagnostic and treatment options.

Other female-specific health issues remain under-investigated too. The medical community needs more cardiovascular data on women. Women are also less likely to receive a diagnosis for chronic kidney disease or to receive recommended therapies. They also receive delayed dialysis treatment and lower rates of transplants compared with men. Similarly, type 2 diabetes is under-treated in women, who also receive less effective management of cardiovascular disease risk factors than men.

Spain’s proposed new law must serve as a catalyst for better investment in medical research into female bodies. And it shouldn’t stop there.

The debate sparked by this legislation should also be expanded to demand the decolonisation of medicine to ensure better research into the health needs of all marginalised groups, including ethnic minorities. For example, 96 percent of Spain’s domestic workers are women, but many are also from ethnic minority backgrounds. As such, they experience double discrimination within Spain’s healthcare system – just as their peers do in other countries.

In 2020, studies showed that African American women are significantly more likely to die of coronary heart disease and strokes than white or Hispanic women. The mortality rate from coronary heart disease was 22 percent higher in Black women than in white women and 55 percent higher than in Hispanic women. The divergence in death rates is even greater in the case of strokes. In the United Kingdom, members of South Asian communities are up to six times more likely to have type 2 diabetes.

Even in clinical trials for COVID-19 vaccine development, ethnic minority groups were underrepresented in the United States and the UK, despite being disproportionately affected by the virus.

So, instead of encouraging women and ethnic minorities to drop out of the workforce, or to live more cautiously than those with a lower risk of suffering from a myriad of diseases, we must be given the opportunity to live and function to our full potential.

Simply firefighting against biased healthcare systems by granting more sick leave will serve very few of us in the long term. People of all body types should enjoy equal access to healthcare and equal attention in medical research. That is the right thing to do for society – and for the economy.

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