WED-028 - Bleeding Through Sports: Period Poverty’s Impact on Psychological Safety Among Menstruating Athletes

Brief Abstract Summary: In 2022, Hawai‘i passed SB2821 requiring public and charter schools to provide free menstrual products, reflecting the state’s commitment to addressing menstrual stigma and period poverty (MSPP). MSPP, linked to lack of knowledge, comfort, or access, negatively affects school attendance, mental health, and participation in academics, sports, and activities. This research explored how MSPP impacts adolescent girls’ sports participation in Hawai‘i. Despite the proven benefits of sports, menstruation is a barrier; girls leave sports at twice the rate of boys by age 14. Using mixed methods, the study examined experiences of menstruating athletes in two of Hawai‘i’s independent schools. Surveys measured MSPP prevalence and psychological safety, while photovoice captured student perspectives on stigma, inclusion, and legislation. The study hypothesized that MSPP reduces inclusivity, psychological safety, and retention in sports, informing recommendations to support equitable participation.

Detailed abstract description: In 2022 Governor David Ige signed into law SB2821 requiring Hawai‘i’s public and charter schools to provide free menstrual products to all students. This signaled the state’s priority to address menstrual stigma and period poverty (MSPP) defined here as issues with knowledge, comfort discussing needs, and access to products. Studies have documented the negative impacts of period poverty on school attendance, mental health, and full participation in regular curricula, particularly physical education, and extracurricula, such as sports.

This research investigated the role of MSPP in sports participation among adolescent girls in Hawai‘i. Despite the known benefits of sports for health and well-being, menarche and menstruation as barriers remain underexplored. By age 14 girls drop out of sports at twice the rate of boys. The study focused on MSPP and its potential to hinder sports participation and impact psychological safety in sports. Psychological safety is highlighted as crucial for ongoing participation, promoting inclusivity and help-seeking.

To explore these impacts, the research employed a mixed-methods approach, combining photovoice focus groups and surveys. The initial set of participants were adolescent girls who had experienced menarche and participated in sports, recruited from two private schools in Hawai‘i with diverse student bodies. The second phase of the study aims to recruit students from a cross-section of public schools to build upon the initial pilot data. Survey data described MSPP prevalence using the validated Menstrual Practice Needs Scale (MPNS-36) and measured psychological safety in sports using the Sport Psychological Safety Inventory (SPSI), alongside additional questions. The photovoice methodology used participant-led photography and dialogue in focus groups (n=15-20) to document community concerns and discuss menstrual stigma, sports participation, and the impact of relevant state legislation. Data from both methods were analyzed using grounded theory and statistical techniques respectively, and then synthesized to generate a comprehensive theory of drivers and barriers to sports participation among menstruators.

The project hypothesized that MSPP reduces inclusivity, psychological safety, and leads to sports discontinuation. It aimed to develop actionable recommendations to support adolescent female sport access and on-going participation.