Compared to the average non-vampire person, I’ve consumed more than my fair share of blood over the years. This is because my favorite food of all time is black pudding (otherwise and way more accurately known as blood sausage), a menu item whose main ingredient is clotted hemoglobin syphoned from the arteries of pigs.
I get why, for many people, the idea of this is beyond gross. I can’t resist it, though, having become accustomed to its crumbly, delicately spiced, high-in-iron umami from a tender age, on regular trips to visit my grandparents in Glasgow, Scotland. (Which, by the way, is where the finest examples of coagulated pig drainage in world cuisine can be found.)
As a child, I had little inkling of what black pudding was or how it was made; had I known, I’m pretty sure I wouldn’t have let it anywhere near my face. But by the time I’d been informed, it was too late: Its sheer deliciousness had me hooked, and now, thanks to the happiness it brings to my mouth and an overriding sense of nostalgia I feel whenever I smell it on the grill, I see breakfast food while you might see a gore-smeared abattoir floor.
I confess my appetite for steamed scabs here as an illustration that people’s relationship to blood isn’t a simple one. Plenty of people will claim they can’t stand the sight of it, even while tucking into a steak done rare and watching dismemberment for fun on Game of Thrones; the point is, ichor isn’t straightforwardly icky in all circumstances — not as much as most other bodily expulsions you might prefer not to think about.
What’s especially weird about our various reactions to it, is that it’s blood in its most benign, everyday form that seems to cause us the most psychological difficulty. Because menstrual bleeding is going on everywhere, all the time. For around 26 percent of the population, it’s a routine and unavoidable feature of their personal lives, and on paper at least (or perhaps some sort of more absorbent material), it should be the kind that provokes the least visceral reaction in all of us.
Of course, the exact opposite has been the case throughout all of human history. Today, in liberal, increasingly gender-conscious Western societies, the cultural dial seems like it’s been nudging away from verboten and toward visibility. Efforts from pro-period voices like Thinx — manufacturers of pioneering menstruation-undies — to normalize conversations about “people who have periods,” are starting to bear fruit: Apple’s recent rollout of a palette of menstrual emojis could be seen as a big step in that direction.
For all that, though, any period-positive moves that place actual images of menstrual blood directly in the public’s eye-line still tend to be met with a tide of antipathy. When pad brand Libra aired ads in Australia this September that showed scarlet fluid on their products, rather than the blue dye of sanitary-marketing gentlemanly convention, it prompted the highest number of viewer complaints for the year so far — although Aussie broadcasting regulators ultimately ruled that its accompanying images of blood running down a model’s legs in the shower didn’t breach advertising standards.
The visceral reaction online and in the press to photos of crotch stains on an American musician running in the 2015 London Marathon, as well as Instagram’s widely condemned censorship of Canadian artist Rupi Kaur’s spotted-bedsheet photography, suggest that while tolerances are slowly shifting, visual contact with the reality of menstruation is a red line society has been all too hesitant to cross. Other people’s periods should be none of our business — a maxim that’s particularly, and almost literally, true for men. So why do so many of us get our panties in such a wad over them?
Negative Blood Types
“I don’t think all blood is created equal,” says Debra Lieberman, associate professor of psychology at the University of Miami, who spends much of her time thinking about how mechanisms of disgust and aversion have evolved in human psychology, and has co-authored a book on how they’ve shaped our society, Objection: Disgust, Morality and the Law. “The idea that there’s regular blood, coming out of your arm when you’ve got a cut, versus menstrual blood — those are quite different things.”
While the source of the blood makes a big difference in modulating our reaction to it, according to Lieberman, any sense of disgust it might trigger stems from the same basic evolved instinct for self-preservation. “Aversions to contact with blood arise from concerns about pathogens,” she explains. So our issues with blood in general are a species-wide defense mechanism, as built up and compounded, generation after generation, in the psyches of survivors of diseases and epidemics — also known as our ancestors.
As recent research by the London School of Hygiene & Tropical Medicine has elucidated, it’s the same reason we’re repelled by other disease risks, such as poop, pus-seeping lesions and rotting carcasses, and the reason so many of us struggle with insects. But in the case of blood, our disgust-driven avoidance system has had to evolve a crucial bit of headroom. “Let’s call it flexible,” says Lieberman, who points out that in our distant hunter-gatherer past, an uncompromising aversion to blood would have put early humanity at a distinct disadvantage. Hunters, for instance, wouldn’t have got very many things slaughtered if they were constantly having to down spears to throw up.
As Lieberman illustrates: “We’re going to be killing this thing and now we’re going to have to bring it back and cut it up, and there’s going to be a lot of blood, guts and gore.” In the context of prehistorical meat processing, we can expect contact with blood “shouldn’t necessarily be disgusting at all.”
In modern food handling, recent cross-disciplinary research points to the fact that butchers often have to overcome a repugnance toward blood early in their careers. Explaining how ingrained blood aversion can be managed and overcome by circumstance, a 2016 study of workers in the British meat trade quotes a butcher reminiscing about his brutal initiation: “All of a sudden you come into a workplace like this, and you’re thrust in with blood, guts and gore — basically it’s the stuff of horror movies.” A common emotional progression for butchers and slaughterhouse workers, the authors argue, means that “over time the initial aversion to the unpleasant sights, practices and sensations lessened and tolerance levels increased. Many butchers referred to ‘getting used to’ the dirtier aspects of the job.”
“You also tend to find that nurses have lower disgust sensitivities,” adds Lieberman, though this profession’s prevalence of steelier stomachs might not be “through anything that happened during nursing school — it’s just that people who aren’t as sensitive to disgust tend to find nursing as an appealing type of position.”
What’s going on when we’re confronted with any given blood-smeared thing, she says, is that our disease-avoidance system is performing a sometimes complicated bit of background calculation. “It’s assessing the probability that pathogens are present,” first and foremost — but that’s not the only element that’s being weighed into the situation. For our ancestors, says Lieberman, the determining question was: “What considerations would have been important to weight against pathogen presence when making decisions about contact? One of those would be hunger; another of those would be kin and the social value of the target” — which is to say, if a member of your family is badly wounded, does a close social bond sufficiently outweigh your fear of their blood to allow you to walk up and help them? Or might you be ostracized by others if you refused to go near an injured member of the community? “So you have all these things that factor in to what I’ve termed an ‘estimated value of contact.’”
How we feel about blood in general, then, is regulated by a sort of primordial cost-benefit analysis — and while periods might be a special-case blood-type in terms of the heightened degree of disgust it can arouse, its cost can be subject to fluctuation too. Qualitatively, menstruation inspires the same type of aversion in women as in men, thinks Lieberman: “It’s just that when it’s coming out of your body, it produces slightly less disgust — and that’s how it is for everything. If I saw a friend’s dirty tampon, I’d vomit. That’s disgusting, right? Or blood in the toilet — sometimes you go to the bathroom and someone hasn’t flushed, and it’s just, ‘Oh my God, I’m going to puke.’ It’s awful. But here’s the thing: If it was my daughter and she was struggling with a tampon saying, ‘How do you do this?’ I’d help her. Would I help a stranger do it? Noooo…”
Against the Flow
Whether a man would have anything remotely useful to offer in this situation is a whole other matter. It’s not true of all men, of course, but the assumption that guys are, on average, significantly more freaked out than women in the presence of periods is backed up by science.
“I ran a study a long time ago asking about, oh my gosh, so many different acts,” says Lieberman. “And across all these acts, women found all of them far more disgusting than did men. Except two: One was having sex during your or your partner’s period, and the other one was changing a baby’s dirty diaper. And men really didn’t rate many things disgusting; other things were just not as disgusting. But menstrual blood and baby poop? That seems to do it.”
Just why a woman’s discarded endometrial tissue should carry such a high disgust tariff compared to other types of bleeding continues to be the subject of much debate, in feminism, in anthropology, in psychology, in sanitary-towel marketing-department meetings. But the fact that down the centuries it’s been men who have written the rules on periods’ moral status and how feminine hygiene should be conducted — from Pliny the Elder infamously informing fellow Romans in the first century A.D. that menstruation could poison crops, cause bees “to forsake their hives,” rust metal and turn dogs rabid, to whichever ancient scribe wrote the notorious passages in Leviticus that suggest anything a woman touches on her period becomes “unclean” — can’t be a coincidence.
Nor can the injunctions to avoid women who are menstruating in the Quran; nor the Hindu tradition of chaupadi, still practiced today in parts of Nepal, in which women are isolated in special huts for the duration of their bleeding; nor a litany of superstitions embedded in cultures across the globe, such as those that prevent women on their periods in parts of India from preparing food or entering temples, or the one in Burundi that leads people to believe that menstruation that occurs around kitchen utensils might poison family members. In world-historical terms, it’s the taboo that keeps on giving.
From the point-of-view of evolutionary psychology, these sorts of proscriptions are precisely what happens when a well-honed adaptation for pathogen-avoidance expresses itself at scale — through cultural and behavioral norms — and when it’s placed almost exclusively in the hands of people who don’t have the remotest clue about the thing that’s freaking them out.
“Just like men have no idea what the world of pregnancy is,” says Lieberman, “men have no idea what the world of menstruation is, so to them, it just seems incredibly foreign; extraterrestrial, even.” She points out that in the modern world, most men are shielded from menstruation. “They’re none the wiser about it, because it’s always behind a bathroom door with some pads or tampons and women take care of these things. But ancestrally it was a very public event, when women bled. It wouldn’t have been often, because women typically weren’t getting very many periods.” (Why? It’s complicated.) “But when they did, [for the men] it would have been like, ‘Holy hell, what’s that?!’ To male minds, when you have a thing that bleeds for a long time and doesn’t die, it’s strange!”
Compounding this basic lack of hands-on understanding, the fact that menstruation is inescapably entwined with sex and reproduction has helped push male squeamishness up into an even higher register. Recall that psychologically the source of blood is always important in framing our gut response to it — and where a potential mate’s set of genitals are the provenance, for men it all feels a little too close to home. Unconsciously, “men are probably like, ‘I’m going to put my penis in where?!?’” suggests Lieberman, “while women are just like: ‘Yeah, that’s gotten on me before.’”
On some base level, men’s helplessness when confronted by all matters menstrual could well be a case of, as she puts it, “being slightly more resistant to putting things that you care about in places where there are clear signs of pathogens.”
Given that pathogen-aversion seems such a deeply embedded element in our collective psyche, how likely is it that it can be overcome by ever greater menstruation representation on our screens and in public discourse? After all, culture has been trying to tell itself that having periods is normal and nothing to be afraid for decades now with limited success — like in the below Disney educational film from 1946, which even back then takes a matter-of-fact line and stresses “menstruation is normal and natural” throughout (although some of its other takeaways sound a little more dated, such as the advice to teenage girls on how to regulate their cycle: “Try not to throw yourself off schedule by getting over-tired, emotionally upset or catching cold…”)
By itself, a TV commercial that swaps blue dye for red blood might be equally unlikely to reverse centuries of cultural baggage, plus millennia of evolved aversion strategy — in fact, as Lieberman points out, graphic ads like the Libra one might even run the risk of “making women more disgusting in some minds,” because of the associations it may imprint on them. But if people, and men in particular, somehow could get over their bleedy-heebie-jeebies, there’s little doubt it would be a healthy thing for society all round — both in further addressing inequalities within Western cultures, and in making us all perhaps more willing to turn our attention to parts of the world where the shame associated with menstrual taboos, and/or a lack of access to sanitary products, amounts to a global crisis affecting millions of women’s health, education prospects and social status.
“It’s important to better understand the full role of women in our culture and society,” says Lieberman. “And that includes all of the things that happen biologically. Understanding the trauma, and getting used to, and dealing with the extra things women have to deal with — and having a common understanding of what both sexes go through — is important in having that dialogue.” But to wedge those lines of communication open in the first place, she contends, “we have to understand our disgust psychology primarily, if we’re going to deal with some of these moral and taboo issues.”
If normalizing menstruation in mainstream culture is the goal, there’s a chance that simply splashing more blood around might not be the way forward — even if those images are intended to transmit just a fraction of the contact that women are experiencing on a regular basis. And if we accept that pathogen-avoidance psychology really is driving our reactions from unfathomable depths, in getting both men and women to confront their hang-ups, “tell, don’t show” could prove more of a winning strategy in getting the message across, at least to begin with.
There might be other ways of harnessing the vivid reality of periods to defuse the stigma, too. The next time you encounter a discarded tampon by the side of the road or on the cubicle floor, you could stifle any rising distaste by attempting to see the blotches for what they really are: Parts of the endometrium, the lining of the uterus where an embryo embeds itself at the commencement of a pregnancy. It’s the place, therefore, where nearly all of us began; our earliest nurturing environment. As such, it’s basically the exact opposite of something that’s threatening or alien — if you squint a bit, you might almost see it as home. Menstrual blood “is the absence of a Big Bang,” says Lieberman, “but nevertheless still contains some of the starter materials for life. If you tie it to physics, and the idea that self-assembly begins here, I think it does turn it into a slightly different picture.”
And if it feels like it’s taking an insanely long time for culture to embrace the idea of periods as a normal, non-menacing bodily function, perhaps it’s because the deprogramming process many of us have to go through is so much bigger than we thought.
It’s a lot to absorb.