Hello everyone. I am Anupriya Tuli, PhD candidate at IIIT-Delhi, India. Today,
on behalf of my team: Surbhi Singh, Rikita Narula, Neha Kumar, and Pushpendra Singh, I am presenting
our work on Rethinking Menstrual Trackers towards period-positive ecologies. According
to the great German philosopher Immanuel Kant, all persons,
regardless of rank or social class, have an equal intrinsic worth or human dignity,
which is an innate worth or status that we did not earn and cannot forfeit. However,
menstrual hygiene and management advocates across the globe assert on focusing on the
safe management of menstruation to avoid shame, embarrassment, and the loss of menstrual dignity,
where menstrual dignity means menstruators do not have to compromise their basic human rights
on the pretext of menstruation. The question arises if menstruation is normal and healthy,
why must it be managed to ensure dignity? It is this social construction of menstrual dignity that
views the menstrual body as a site of reform that needs to be controlled. The HCI literature has
critiqued the design of current menstrual tracking technologies for re-enacting androcentric ideals
by focusing on providing solutions to the same longstanding problem of the uncontrolled female
body. In this work, we take a stance against the social construction of menstrual dignity
by revisiting the purpose of menstrual trackers from being a tool to 'control the body' to a tool
to challenge unjust social structures by promoting a shift towards period-positive ecologies. We
situate our work in the urban settings of Delhi, India, where menstruation has
historically been a conversational taboo resulting in negative period experiences,
low self-esteem, and fear of embarrassment among menstruators.
Our research investigates. How do menstruators engage in menstrual tracking at different points
along their menstrual journeys? What factors affect these choices? Do these tracking practices
evolve as menstruators transition from menarche to menopause, making different life choices?
And finally, what are the experiences with and aspirations from digital menstrual trackers?
To answer these questions, we take a long view of the menstrual journey by engaging with
menstruating women between the ages of 12 and 65 yrs. We began by conducting a preliminary survey
to develop a basic understanding of prevalent menstrual tracking practices in our study context.
Corroborating insights from the survey and existing literature informed our overall
study design. Next, we conducted detailed surveys with adolescents and adults at scale
and concurrently reviewed available menstrual tracking apps to curate a
set of functional features that were later used in remote interviews as probes. The features
included fertility tracking mode, symptom logging, parental control, reminders, notifications, forums, etc.
Given that we were conducting remote interviews on a taboo subject, these functional features served
as a starting point for discussion while offering a vocabulary to our participants. Additionally, to
understand how adolescent menstruators practice, visualize and relate to menstrual tracking,
we conducted a cultural probe investigation where we used an in-house designed period journal as
the probe. The data was collected in both Hindi and English in the form of 457 survey responses,
field notes, photographs, and more than 19 hours of audio interview recordings.
The qualitative data were analyzed using inductive thematic analysis
and the rest by calculating percentages and cross-tabulation.
The data collected through different methods were analyzed using the triangulation-convergence model
to outline our findings that are structured in four themes, namely tracking through the
menstrual journey, where we unpack evolving associations with menstrual tracking through the
menstrual journey, which is then followed by discussing
the innovative methods menstruators leverage to track and interpret their cycles. Next,
we unpack the relationships that influence and shape a menstruator's associations with their body
and menstrual tracking practices throughout the menstrual journey.
Finally, our last theme presents aspirations of digital menstrual trackers that emerged
in our data, as participants discussed their experiences with available digital trackers.
Due to time limitations, we will briefly present the first theme.
We observed that the menstruators during adolescence viewed tracking as
"unimportant" and "did not take their periods seriously." While reflecting on their menstrual
journey, the majority of the adult menstruators acknowledged that tracking should be practiced
since menarche. However, in practice, the adult menstruators adopted formal tracking if they have a specific reason
like a medical diagnosis, cycle irregularity, embarrassing experiences (like that of stain stigma),
or once they are sexually active. Jasmine, one of our participants, shared, "except for pregnancy,
I don't think there is any value [in tracking]. In the sense of pregnancy, I mean who wants to
conceive and who does not want to conceive. That is the only reason. Else, I don't see any logic
for it [tracking]. It is normal, it is going to happen, and your body will alarm you definitely."
We also observed that menstrual tracking has a deeper value and meaning in our context.
It is seen as a means to an end where the end is more than just menstrual wellbeing.
Some menstruators use it as a guide to be period 'prepared' to avoid stain stigma, as evident in the shared
quote. While some track to feel more empowered in making decisions about their body and life
while co-existing with the prevalent cultural stigma. For instance, we observed that unmarried
menstruators relied on menstrual tracking as a natural birth control technique. We observed that
the menstrual tracking patterns did not change much with transitioning into menopausal years.
33% of menopausal survey respondents mentioned forgetting to keep track of their cycle,
and 16% said they did not feel the need to track their cycle at all. The ones who tracked
their cycle continued with their tried and tested tracking methods and did not track any additional
parameters other than the date, given the sporadic nature of periods during menopausal years.
We analyzed our findings using Martha Nussbaum's capabilities approach,
where she proposes a set of ten central capabilities as a social minimum for an
individual to live a life that is worthy of human dignity, making it a fitting choice
for our study. This approach served as an ally to our participants as it made their struggles
of navigating life as menstruators visible in a context with deep-rooted menstrual stigma.
We now present a consolidated version of our takeaways from the paper.
Our data shows how menstrual tracker as a capability-building tool call for
designing to support menstrual journey instead of designing trackers for a specific transition
like menarche, fertility, and menopause in isolation.
Taking this approach will entail designing for the subjectivity at multiple layers throughout
the journey while accounting for messy and diverse associations with menstrual tracking.
Thus we propose that the design should empower menstruators to first design
and later tailor their tracker through their menstrualjourney in accordance
with where they are in their journey, experience with menstruation, and life choices.
Facilitating self-designing will offer a new site for intervention, i.e., the process of designing,
assembling, and tailoring itself. For instance, the process of engaging the user in designing
a tracker for themselves can be structured as a co-designing activity while preserving the agency
of the user to include or exclude stakeholders(s) in the vicinity as co-designers of their trackers.
In this case, the design process can facilitate conversation on the subject by serving as an
ice-breaker, offering vocabulary, and an avenue for activism by facilitating
positive body association with one's body and creating body awareness of others. Please
consider reading our paper, where we present our findings and arguments in much more detail. Thank
you. I would love to take questions now, over email, or over a cup of coffee! Thank you!