Deaf women in higher education face barriers to menstrual health support

Deaf women who use British Sign Language (BSL) face significant barriers accessing information and support about menstrual health in UK universities, according to what researchers believe is the first study of its kind.

The report, Accessing information and talking about menstrual health: Perceptions of deaf women who use BSL and work in UK universities, found that many deaf women struggle to discuss sensitive health issues because universities and healthcare services rely on hearing-centred systems of communication.

Professor Jemina Napier from Heriot-Watt’s School of Social Sciences led the study, which involved interviews and co-design workshops with 12 deaf women who use BSL and work or study in UK universities.

Professor Napier said: "Our findings show that deaf women face many of the same menstrual health challenges as hearing women, but they also encounter additional barriers because information and support are rarely designed around their language and communication needs.

"The burden of constantly adapting to hearing-centred systems can leave deaf women feeling excluded from conversations about their own health."

Barriers to information and support

Participants described a lack of accessible information about menstruation, endometriosis, fibroids, perimenopause and menopause, despite working in highly educated environments.

They also reported feeling excluded from informal conversations where hearing colleagues often share experiences and learn about menstrual health.

The researchers identified four main issues affecting participants: communication, access to information, interpreter dynamics and the impact of other factors such as ethnicity, geography and additional disabilities.

Many participants said they preferred discussing menstrual health directly in BSL but rarely had the opportunity because managers and healthcare professionals did not sign.

Instead, they often had to communicate through interpreters or written English, which some said reduced privacy, comfort and confidence when discussing personal health issues.

The “deaf tax”

Professor Napier said: “A recurring theme was that of the “deaf tax”, which refers to the additional emotional and practical effort deaf women need to continually undertake to explain their needs or secure support.

“It’s ongoing emotional labour and fatigue and reduced participation in menstrual-health related activities.”

BSL interpreters were seen as essential, but participants said their involvement could have consequences about confidentiality, trust and accuracy, particularly when discussing sensitive topics. Several highlighted that male interpreters appeared to be uncomfortable discussing menstrual health.

A need for BSL-first material

The researchers also found that existing menstrual health information is largely produced in English and then translated into BSL, rather than being created in BSL from the outset.

Abigail Gorman, deaf independent facilitator, health policy consultant and co-author of the report, said: “To be in charge of your own health, you need to be able to recognise when something’s wrong, name it, and ask for help - in an appointment where you can actually be understood. That’s the whole chain.

“But if the information was never accessible in the first place, deaf women can’t even get to step one. If the appointment itself isn’t accessible either, that breaks the chain all over again, when it matters most.

“BSL-first health resources aren’t a nice-to-have; they’re how deaf women get to be equal participants in decisions about our own health.”

Professor Napier said: “The deaf women we interviewed want more visual, culturally appropriate resources designed specifically for them - not a crude translation of existing material.

“BSL accessibility should be the default for menstrual health information and events.

“We need improved interpreter policies and BSL-first educational resources.

“The university sector should also establish a UK-wide, deaf-led health and wellbeing network.

“All these changes would reduce communication barriers and improve access to menstrual health support for deaf women working in higher education.”

The research is part of the Equality, Diversity and Inclusion Caucus (EDICa), a research group led by Heriot-Watt’s Professor Kate Sang to improve equality, diversity and inclusion in the research and innovation sector. EDICa is funded by UK Research and Innovation (UKRI), the UK’s national funding agency for investing in science and research, with support from the British Academy, which supports humanities and social sciences research in the UK.