Agents of change

Hong Kong female social entrepreneurs are opening up new avenues to fight for women's rights, tackle ingrained social bias toward their menstruation and bodies, and address breast cancer patients' needs for comfortable undergarments. Oasis Hu reports from Hong Kong.

There is an average of 2,500 days in a woman's lifetime when she has to bear with it - menstruation. She has to put up with the discomfort of having to change pads almost 15,000 times during up to 500 menstrual cycles.

Social entrepreneur Zoe Chan Yuk-lam, 30, was dead set on offering women a better deal with products that would cushion their misery. She founded Happeriod - the first social enterprise in Hong Kong to address menstruation-related problems through a diverse range of products that go beyond traditional disposable pads, such as menstrual cups, plates, cloth pads, tampons and period panties. Since its inception, the company has been organizing lectures, workshops, exhibitions and courses to destigmatize menstruation, and promote sex education, as well as gender equality.

Chan's career aspirations date back to her days at university when she was pursuing a degree in social sciences, and developed a keen interest in promoting gender equality. After graduation, she worked with nongovernmental organizations focusing on women's rights. In 2014, after participating in a workshop on handmade cloth pads, Chan began using alternative menstrual products personally, and found that many preconceived notions about them were misconceptions.

Many people fear menstrual cups will cause discomfort but, if properly inserted, they provide a more comfortable experience compared to pads by not irritating the skin. The higher capacity of menstrual cups also alleviates concerns about leakage, enabling Chan to engage in exercise and fitness without worries.

After the menstrual cup is removed, she found that the menstrual blood in it was odorless. Following research, Chan knew that menstrual blood is actually odorless and its discoloration and odor often stem from the plastic substances in disposable pads. These new findings led her to discover that pads had become the default option when it came to menstrual products, and women were not given much room to choose or even talk about them.

Through her research, Chan knew of a subtle but ubiquitous social phenomenon - menstrual shame. Although it's a normal physiological process in which a woman's uterine lining is regularly expelled from the body, menstruation is often seen as a shameful thing in life.

For example, menstrual products are often hidden away in corners of supermarkets, and are discreetly packed in black bags when sold. Furthermore, menstruation is so taboo that more than 5,000 code words are used to refer to it in more than 190 countries, such as "shark week", "bloody Mary", "lady business" and "M".

Tip of the iceberg

Menstrual shame leads to many negative consequences, and it's always women who have to bear them as they often lack a general understanding of their bodies and menstrual products, says Chan. "Some women with skin illness feel uncomfortable using plastic pads, but they never know that menstrual pants and tampons exist."

On average, women experience their first period at the age of 12, and generally reach menopause between 45 and 55, which means women have about 40 years of menstruation in their lifetime. Given 12 periods per year, each lasting about 5 days, a woman can expect to experience her menses for around 2,500 days.

Women who find pads intolerable have no alternatives, and have to endure decades of unnecessary suffering, says Chan.

The negative impact of menstrual shame extends to society at large, from which a menstruation-friendly environment is absent.

It's common for women to have their periods unexpectedly at work or at school. However, few companies or institutions provide emergency menstrual products or provide women with ways to purchase menstrual products.

In major public crises like earthquakes, floods or epidemics, affected people are typically provided with supplies like food, water, and masks. Unfortunately, the needs of women for menstrual products are often overlooked.

Due to menstrual shame, many menstruation-related issues are not up for discussion, such as menstrual leave. Many women endure pain during menstruation, but few companies offer them time off for menstrual-related issues. "Whether to provide leave for menstruation is a topic that can be further explored but, at the very least, women should have room to express their discomfort," says Chan.

Another example is period poverty, whereby poor families cannot afford menstrual products. In Hong Kong, to save money, some women on lower incomes may use a single pad for a long time, jeopardizing their well-being.

Many regions have taken steps to address this issue. Scotland, for instance, passed legislation in 2020 to offer free menstrual products to women, and New Zealand decided that all local schools would offer free menstrual products to students from 2021. Yet, Hong Kong lacks similar policies, as well as discussions, about them, notes Chan.

Menstrual pollution also lacks attention, she says. Research shows that a woman uses about 15,000 disposable pads in her lifetime, and pads are mostly composed of chemical fibers and plastics, with a pad equivalent to four nondegradable plastic bags. It's unfair to condemn women for pollution since they have to use menstrual products. The prevalence of disposable pads and the lack of a diverse range of options should be blamed, says Chan.

To encourage greater adoption of alternative menstrual products and draw attention to menstruation-related issues, Chan started Happeriod in 2017.

She says entrepreneurship brings many challenges, such as marketing, finding collaborators, and negotiating with buyers, but the biggest obstacle is always facing deeply ingrained societal attitudes.

"These unappreciative voices made me recognize the significance of my business more profoundly," says Chan, adding that she has organized more than 100 initiatives, including art exhibitions, workshops, and book publishing, to destigmatize menstruation since launching her business.

Years of experience have accustomed her to situations that might be perceived as embarrassing by others.

She talks about menstruation with people during meals, and keeps samples of menstrual cups with her at all times. She shares menstrual experiences during open speeches, holding new period panties that resemble underwear in her hands, persuading audiences to feel their fabric. "Many may not understand what I'm doing, but the potential for changing society for the better, even if it's to a minimal degree, keeps driving me to persist in my career."

Fanny Cheung Mui-ching, a psychology professor at the Chinese University of Hong Kong, who set up the city's first gender research center, says menstrual shame is a deeply ingrained social norm that has persisted for thousands of years.

One reason for menstrual shame is its association with women's reproductive organs, which are a private matter. But, more importantly, the phenomenon stems from patriarchal social structures, with menstruation having been regarded as spiritually and physically impure by most religions or traditional cultures.

Despite the transition to modern society, the notion that menstruation is indecent has been perpetuated through family, schools, media and various facets of society over many generations, and has been internalized as a social norm, notes Cheung.

In recent years, the rise of women's economic power has helped promote gender equality across various aspects of society. However, social norms, consisting of concepts and consciousness, are often harder to change compared to these substantive transformations, such as education, employment, law, and politics, she says.

Deep understanding

But, as more women become influential, avenues have opened up to challenge social norms. Social enterprises have emerged as a new way forward in this respect, particularly when they're founded by women to address women's needs.

Kwan So Chiu-yan founded Comfort Me Health Wear - the city's first social enterprise dedicated to producing bras for women with breast cancer. In 2013, a family member's breast cancer diagnosis exposed Kwan to Hong Kong's serious issues. On seeing the lengthy queues at overcrowded clinics with her family member, Kwan realized numerous women in Hong Kong were plagued by breast cancer for the first time.

Breast cancer has been the leading form of cancer affecting women since the 1990s, with cases tripling to nearly 5,565 by 2021, meaning around 15 diagnoses daily.

While supporting her afflicted family member, Kwan recognized those patients' shared struggle to find suitable post-mastectomy undergarments, as most rehabilitation bras available in the market were imported from Europe and the United States, and their designs do not take into consideration the body shape of Asian people. Additionally, these products are expensive.

To improve the situation, Kwan teamed up with a friend, Lin Lai Ka-wah, a seasoned lingerie maker with more than 20 years' experience, to launch Comfort Me in 2015. Breast cancer patients undergoing radiation or chemotherapy have delicate skin, so Kwan designed post-mastectomy bras without rigid steel rings or tight fabrics that could bruise their skin.

Breast cancer patients may also need to have sentinel lymph nodes located under their armpits removed, which can be affected by the spread of cancer, in addition to losing their breasts. Consequently, they may find it hard to reach behind to fasten their bras. Kwan addresses this challenge through designs featuring front-facing buttons, allowing garments to be easily put on and taken off when sleeping, bathing, or visiting doctors.

According to Kwan, most underwear products offered by Comfort Me are priced from HK$200 ($25.60) to $500 - about 40 percent lower than most options available in the market, enabling support to be extended to low-income groups.

Kwan has also partnered with the Hong Kong Research Institute of Textiles and Apparel to develop a 3D printing technology to customize the most suitable underwear for breast cancer patients.

Recovered patients always need to wear prosthetic breasts to restore balance. Ill-fitting underwear can cause the prostheses to shift, leading to embarrassment and inconvenience. This technology begins with a body scan and a breast density test for the patients, then utilizes 3D printing technology to produce breast pads and underwear which are highly customized to meet the unique needs of each patient, thus ensuring that prostheses do not move, eliminating inconvenience and restoring confidence.
In 2022, Kwan's technology won a gold medal at the Geneva International Exhibition of Inventions. A product incorporating that technology will be launched by the end of this year.

Norms in question

Comfort Me's mission extends beyond business, as there are around 50,000 breast cancer patients in Hong Kong. Since its inception, the company has served more than 10,000 customers, many of whom have to struggle with emotional distress while choosing lingerie. "I want to use our lingerie to convey a message: women's beauty is not solely defined by their sexiness, but by their health and confidence," says Kwan.

According to Cheung, societal beauty standards are another form of social norm. They are shaped by the "male gaze", where women are often seen as hypersexualized objects of desire, and are often portrayed as such in the media. These portrayals reinforce the idea that women must conform to certain body types, influencing their identity perception.
For breast cancer patients, losing breasts can feel like losing femininity and beauty. What's more, this issue extends to other women, who may feel pressured into harmful behaviors, such as extreme dieting or excessive exercise to conform to narrow beauty definitions, says Cheung.

Whether menstrual shame, or a stereotypical definition of beauty, gender social norms are so ingrained that they are assumed to be normal by society.

Luckily, female social entrepreneurs are providing powerful ways to change the situation. Only women have firsthand experiences and understanding of these issues, so they can bring a unique perspective to the issues faced by women, which have often been overlooked or ignored in the past, says Cheung.

As more women reach decision-making positions, more social norms can be shaken. The road ahead may be long, but where there's action, there's hope, says Cheung.

Contact the writer at oasishu@chinadailyhk.com