In late 2025, Karnataka’s attempt to introduce menstrual leave was stalled following industry pushback, even as the Supreme Court offered mixed signals: recognising menstrual health as a fundamental right while cautioning against mandates that could reduce women’s employability.
This contradiction reflects a deeper policy confusion. The debate has centred on whether women should be granted leave, rather than whether they can work with dignity in the first place. Menstrual leave, while symbolically important, applies only to a narrow segment of women in formal employment. For the vast majority, the binding constraint lies elsewhere: the absence of basic sanitation at work.
The Informality Blind Spot
Nearly 80 percent of Indian women workers are self-employed or engaged in casual labour. For them, the challenge during menstruation is not negotiating leave; it is locating a functional toilet, accessing affordable menstrual products, and ensuring safe disposal. This creates a “biological tax”: a structural penalty imposed by the institutional failure to accommodate routine biological needs..
Leave policies operate where protections already exist; sanitation determines whether participation is possible at all.
Infrastructure Without Functionality
India’s sanitation investments have expanded infrastructure, but provision has not translated into usability. A toilet without privacy or disposal mechanisms does not meet the needs of menstruating women.
A recent audit of public toilets in Bengaluru found that only a small fraction were fully functional. Similar gaps are visible within state institutions themselves, where basic sanitation facilities remain inconsistent.
This points to a deeper design failure: policy has focused on construction targets rather than service delivery. The presence of infrastructure is treated as success, even when functionality is absent.
A Productivity Constraint, Not a Welfare Issue
Evidence from low-income urban contexts shows that inadequate sanitation leads to measurable absenteeism, with improvements in menstrual hygiene access directly increasing work participation.
These findings shift the framing of the issue. Menstrual health is not merely a welfare or health concern; it is a labour market constraint. Where sanitation is inadequate, participation becomes intermittent, productivity declines, and income loss follows.
Designing for Inclusion
Addressing this requires moving beyond symbolic policy gestures toward institutional design changes.
First, sanitation standards must be universalised across workplaces, regardless of size. The current thresholds under the Code on Occupational Safety, Health and Working Conditions, 2020 allow many informal worksites to remain outside regulatory coverage. This is where the need is greatest.
Second, policy must shift from building infrastructure to ensuring functionality. This requires clear accountability for maintenance, water access, and waste disposal, backed by regular monitoring mechanisms.
Third, sanitation provision must be treated as a shared responsibility across public infrastructure and workplaces. For workers in informal settings, access often depends on public facilities rather than employer-provided ones. Policy design must reflect this overlap.
From Symbolism to Structural Reform
Public policy must be judged by its reach. A debate centred on menstrual leave serves those already within formal systems, while leaving the majority to navigate work without basic facilities.
If improving women’s labour force participation is the goal, the starting point is not additional leave provisions but the removal of everyday barriers to working.
Any policy that claims to expand women’s economic participation must first answer a basic question: can women reliably access a functional toilet at work?