When I got my first period, I was in the most embarrassing place my then-11-year-old self could have imagined: my grandparents’ house. I wasn’t sure what to do, so I just put on extra pairs of underwear and threw them away one-by-one, scrunched at the bottom of the bathroom trash bin, as I bled through them. Finally, with nary a pair of panties in sight, I was forced to tell my mother. I have never been so thankful for pantyliners as I was for the ones she gave me.

But what if I’d been in school that day, like so many other girls are – without an extra pair of underwear or a quarter in my pocket to plug into the vending machine? Or what if my family’s weekly budget hadn’t been able to stretch far enough to accommodate replacing a few blood-soaked undergarments and those pantyliners?

I was lucky. For too many girls, the products that mark “becoming a woman” are luxuries, not givens. And for young women worldwide, getting your period means new expenses, days away from school and risking regular infections. All because too many governments don’t recognize feminine hygiene as a health issue.

We need to move beyond the stigma of “that time of the month” – women’s feminine hygiene products should be free for all, all the time.

Sanitary products are vital for the health, well-being and full participation of women and girls across the globe. The United Nations and Human Rights Watch, for example, have both linked menstrual hygiene to human rights. Earlier this year, Jyoti Sanghera, chief of the UN Human Rights Office on Economic and Social Issues, called the stigma around menstrual hygiene “a violation of several human rights, most importantly the right to human dignity”.

In countries where sanitary products are inaccessible or unaffordable, menstruation can mean missed school for girls (UNICEF estimates 10% of African girls don’t attend school during their periods) and an increased dropout rate, missed work for women and repeated vaginal infections because of unsanitary menstrual products. One study showed that in Bangladesh, 73% of female factory workers miss an average of six days – and six days of pay – every month because of their periods.

(Charities have picked up some of the slack in rural communities across the world – companies like LunaPads, for example, launched Pads4Girls, a program that provides in-kind donations of menstrual products. The organization She helps women start business to create and sell affordable pads, and in some countries like India, local innovators have come up with cheaper alternatives to store-bought products.)

In the United States, access to tampons and pads for low-income women is a real problem, too: food stamps don’t cover feminine hygiene products, so some women resort to selling their food stamps in order to pay for “luxuries” like tampons. Women in prison often don’t have access to sanitary products at all, and the high cost of a product that half the population needs multiple times a day, every month for approximately 30 years, is simply, well, bullshit.

Women in the UK are fighting to axe the 5% tax on tampons (it used to be taxed at 17.5%!), which are considered “luxuries” while men’s razors, for some baffling reason, are not. And in the US, though breast pumps, vasectomies and artificial teeth are sales tax-exempt and tax-deductible medical care, tampons are not even exempted from sales tax in some states (including California and New York, two of the most populous states).

But this is less an issue of costliness than it is of principle: menstrual care is health care, and should be treated as such. But much in the same way insurance coverage or subsidies for birth control are mocked or met with outrage, the idea of women even getting small tax breaks for menstrual products provokes incredulousness because some people lack an incredible amount of empathy ... and because it has something to do with vaginas. Affordable access to sanitary products is rarely talked about outside of NGOs – and when it is, it’s with shame or derision.

In 1986, Gloria Steinem wrote that if men got periods, they “would brag about how long and how much”: that boys would talk about their menstruation as the beginning of their manhood, that there would be “gifts, religious ceremonies” and sanitary supplies would be “federally funded and free”. I could live without the menstrual bragging – though mine is particularly impressive – and ceremonial parties, but seriously: Why aren’t tampons free?