Few states have taken the step to not tax women for buying essential menstrual products. Minnesota is among a list of 11 states to drop the sales tax. It did so in the early 1980s, when North Dakota lawmakers enacted the adult diaper tax exemption.

A pad and tampon exemption bill was considered by the North Dakota Senate in 2017, but it was shot down 43-3. Some plan to revive the bill in 2021.

"It’s a little telling that we’re willing to exempt it for a certain population but not for another," said Sen. Erin Oban, D-Bismarck.

The reason for not supporting a tax exemption came down to money, because around $1.1 million would have been lost in sales tax revenue. Yet exempting adult diapers adds up to an estimated loss in sales tax revenue between $3 million to $6 million per year, according to Kathy Strombeck, director of research and communications for the North Dakota Office of State Tax Commissioner.

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But it's not only a tampon tax that underlines the inequality. The "pink tax," as it's been coined, is the theory that products and services for women typically cost more than those for men.

RELATED: 'Pink tax' means women pay more than men

"The premium that women pay for the same products and ones women are predominantly using creates a very unfair dynamic," said Amanda Savitt, president-elect of the Fargo-Moorhead AAUW.

The American Association of University Women opposes discrimination against women in any form and works to "make sure women's financial power is equal to men," Savitt said.

Considering the gender pay gap of women earning 85% or less of what men earn on average, according to the Pew Research Center, women are paying more while also getting paid less.

"It just exacerbates that women are charged more for the same goods and services," Savitt said. "I think that it’s really staggering when you think about the effects of the gender pay gap."

Ax The Pink Tax, an online campaign bringing awareness to gender-based pricing disparities, reports that women pay as much as 13 percent more than men. That includes personal care products and services like dry cleaning and auto repair.

"Sometimes it's as explicit and obvious as the pink item is more expensive than the blue item," Savitt said. "It's made fun of at the national level, like BIC pen For Her. Do women really need a specific pen marketed toward them?"

Yes, the BIC pen example is real. It came out in 2012, and comedian Ellen DeGeneres exposed the product then that still sells for $10 on Amazon today.

Signs of the pink tax across Fargo-Moorhead in big retailers such as Walmart, Target, Walgreens and CVS aren't so obvious. Though marketed for men and women, products like vitamins, razors and body wash are comparable in price.

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But an adjustable knee support brace at K-Mart in south Fargo was $13, while the same product marketed for women was $17. At Cash Wise Foods in Moorhead, a pack of 10 pairs of earplugs was on sale for about $4.50, originally priced $5.29. Despite having only seven pairs, the same brand in a special "Dreamgirl" pack of pink earplugs was about $8.80.

The financial impact of gender-based pricing disparities adds up to $1,351 per year, according to the Ax the Pink Tax. That means by the time a woman is 20 years old, they've spent an extra $27,020. By age 50, that's an extra $67,000.

Herstory

Nineteen-year-old Bridget McManamon facetiously calls her period "Shark Week."

She dealt with painful periods, but what made the often unexpected start to her cycle worse was realizing she didn't have a pad or tampon in the middle of the school day.

She would then have to go to the nurse's office where there is a limited supply of free menstrual products. "That's where you go when you're sick," she said.

But the Moorhead High School graduate said periods aren't a sickness.

This experience sparked inspired McManamon in 2016 to create Herstory , a charitable organization promoting the accessibility and affordability of menstrual products.

More than a dozen businesses in downtown Fargo have signed on to McManamon's cause to have free products in restrooms. She also partners with local homeless shelters and some schools in the area have followed suit, like Jefferson Elementary School, where girls as young as third grade get their periods, she said.

"We need to empower more women, make them feel more confident (and) promote equality through access to menstrual hygiene products," she said. "But it's hard to access them because they are expensive."

Though some can afford the monthly expense, she said families on free and reduced lunch in school can't afford food, so how can they be expected to have funds for tampons and pads?

McManamon wants a federal mandate for public schools to supply these resources rather than make periods a stigma and something for young girls to be embarrassed about.

She also supports a sales tax exemption on these products so they're more affordable. States making money off of periods is "blatant sexism," she said.

"I think a lot of it stems from it being a partisan issue and a lack of women in politics (and) conservative women in politics not defending the rights of low-income women or women of color," she said.

Now studying political science at Creighton University with focuses on women's studies and public health, McManamon said she aspires to run for public office in the future to tackle issues like this.

'These aren't some luxury items'

Oban said menstrual products are a reality and necessity.

"Unfortunately, I think it's something that makes people uncomfortable," she said.

Of the 47 senate members serving during the 2017 legislative session, nine were women, but only two voted in support of the tampon tax exemption: Oban and Carolyn Nelson, D-Fargo, along with Sen. Tim Mathern, D-Fargo.

The only other Democratic female senator, Joan Heckaman, voted against the measure. But she and Oban both agreed to bring the bill up again next legislative session.

"I think it’s something we need to revisit again," said Heckaman, D-New Rockford. "It’s a health issue for women, and it think it’s an important issue that should be considered by legislators."

Heckaman and many of her colleagues argued the definition of what was being exempt was too vague. Language of the one-sentence bill is "a sales and use tax exemption for sales of tampons and sanitary napkins."

In a video recording of the 2017 session, there is little discussion on the bill. Two men and a woman spoke against the proposed exemption and no lawmaker gave any remarks in support.

Sen. Larry Luick, R-Fairmount, authored the bill after people from his district presented him with their concerns about taxing menstrual products. But on the floor, he laughed and said he was "at a loss for words."

"I understand the issues with this — it's just something that I left in the hands of the tax committee to iron out," he said. "Vote as you wish."

Chuckles are then heard throughout the chamber.

Sen. Judy Lee, R-West Fargo, was the last to grab the mic and said, "We don’t exempt toilet paper and we wouldn't even be being gender specific in that, so I do urge a do not pass vote."

Oban said the bill had little chance of getting any legs "when you don't even have a bill sponsor who is fighting for the issue they introduce." She also rejects the idea that the bill language was ambiguous.

"I know what feminine products are used for — women’s menstrual cycles — and I don't think they should be taxed," she said. "That’s a million dollars that women are paying for things they have to buy. These aren't some luxury items I walk around Target and fill my cart with."