Episode 069: Menopause Policy Playbook

Menopause is getting louder in the culture, but the law is still whispering. We sit down with attorney, author, and policy leader Jennifer Weiss-Wolf, widely known for helping lead the campaign to end the tampon tax, to ask a bigger question: what does real menopause support look like when you move past awareness and into rights, coverage, and protections?

We trace the through line from menstrual equity to menopause advocacy and why the policy path is so much more complicated. Jennifer explains how menopause touches everything at once: medical education, clinical guidelines, health insurance coverage, workplace culture, and the chronic underfunding of women’s health research. She also shares why the “stigma and silence” story is incomplete and how a century of messy debate has shaped today’s gaps in care.

Then we get practical about menopause workplace accommodations and the legal guardrails that are missing in the United States. We talk ADA limitations, how the Pregnant Workers’ Fairness Act and EEOC guidance hint at possible pathways, and why anti-discrimination protections may matter as much as employer benefits. We also zoom out to the state-level surge: dozens of bills across many states focused on provider training, public education, insurance and Medicaid coverage, and emerging attempts to define menopause discrimination.

Jennifer’s new book, “When in Menopause,” lands as a user’s manual and citizen guide, showing how advocacy can start at the doctor’s office and scale up to community action and legislative change. Listen, share this with a friend who needs it, and please subscribe and leave a review so more people can find the show.

Website: https://jenniferweisswolf.com/

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MiDOViA is dedicated to changing the narrative about menopause by educating, raising awareness & supporting women in this stage of life, both at home and in the workplace. Visit midovia.com to learn more.

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Transcript

Welcome And Guest Introduction

SPEAKER_02 0:00

Welcome to the Medobia Menopause Podcast, your trusted source for information about menopause and midlife. Join us each episode as we have great conversations with great people. Tune in and enjoy the show. Welcome back, everyone. Our guest today has been called the architect of the campaign to squash the tampon tax, which tells you she does not do this work quietly. Jennifer Weiswolf is an attorney and author and the executive director of NYU Law's Burn Baum Women's Leadership Center. She leads partnerships and strategy at Ms. Magazine. She's testified at the White House and before Congress on menstruation, menopause, and the law. And her 2017 book, Period's Gone Public, got called The Beginning of Liberation for Us All by Gloria Steinem herself. She has a new book coming this October, which we're really excited about, called When in Menopause. And she is exactly the person we want walking us through where this movement has been and where it is going. Jennifer, welcome.

Why She Entered Menopause Advocacy

SPEAKER_02 1:06

Jennifer, take us all the way back. What pulled you into this work in the first place before it was a movement with a name?

SPEAKER_00 1:15

Well, thank you for asking that. In part because my origin story, I think, in the menopause space looks a lot different than other folks who are, you know, such important voices for improving menopause care in this world right now. I did most times I think I feel like people are either physicians or clinicians who understood, you know, on the front lines what was missing from people's, you know, their patients' experience, or it was patients, people themselves who were having um, you know, challenges in navigating menopause because there was there was no vocabulary, there was no, you know, formal framework for what it looked like to understand the challenges and forge solutions. I had a perfectly fine and kind of unmemorable menopause experience, but it's that I am an advocate who's in the space of been in the space of menstruation and public policy for quite some time that I became really curious what this next chapter looked like in the realm of public policy. It was in 2020, actually, and I it was the pandemic, and I was experiencing some symptoms of menopause myself, and I was sharing them with a friend with whom I do menstruation-related advocacy. And she asked me, what's the what's the landscape for menopause policy? And I said, I don't know. And she said, I would think you would want to know. And I was like, hmm, I would, I would think I would want to know too. Um, so there it was. Um, that was November of 2020. And um I decided that after five or six years at that point of being deeply embedded in menstruation-related public policy around things like the tampon tax and um free period products in public facilities, um, that it was time to turn my attention to what was inevitably the next chapter.

SPEAKER_02 3:01

Yeah. Well, you've been an advocate for menstruation for a long time. I loved your first book, Period's Gone Public. And I was sitting in the menstrual health space at that time too. So it's interesting that you're moving into the menopause space and advocating for that as I am in a completely different way too. I think uh, you know, that's what happens through conversations like you just mentioned. But you um, there's a through line here with menstruation to menopause. And I think a lot of people don't understand that. Um, the that that through line.

The Link Between Periods And Menopause

SPEAKER_02 3:34

How does the fight over periods actually connect to the fight over menopause? And I I use that that term fight loosely, but it is a fight.

SPEAKER_00 3:43

Um this is a political and public sphere, and these are needs that haven't been met. So advocating for them is making a demand that hasn't ever been considered. So it is a fight. Fight doesn't have to mean, you know, it's a bloody brawl, um, even it's a little bloody, but um, it it is part of, you know, the energy we bring to this. You know, in some ways it's there's a lot of similarity because it's, you know, when you think about just bodily functions, we're not accustomed to talking about in the public sphere, that's a big hurdle to have to, you know, to get through. Um, although I found in the menstrual space, people, it was a pretty quick one to chip away at. If, if, if, you know, people in the media or legislators or other people in positions of influence weren't willing or interested in talking about it, they only looked foolish. You know, it's a natural body bodily function and occurrence. And by not talking about it, we'd left, we society had sort of left open a wide array of challenges and problems that had fairly simple solutions that could be applied, at least in terms of public policies. Um, I understand and appreciate that breaking down stigmas and all of the um baggage that comes with that is not a simple path, but the policy solutions themselves weren't that complicated. I was really surprised when I first started exploring menopause how different it actually was, at least in terms of what public policy could offer. Um I assumed that the stigma and the silence was the main culprit. And I was really um, I think, surprised to find out one, that there hadn't been as much silence over the past century, um, especially in halls of power and politics around menopause than I might have guessed. Um, it's been actually a pretty robust conversation and debate and fight, even though it hasn't always gone in directions that were purposeful or useful or that didn't actually set us back, which is you know where this last chapter has left us. Um, but also that there is so much when it comes to science, there is so much research that has been unstudied, there is so much investment that has been um ignored or certainly undermade, um, that there was there was an entirely different um set of circumstances to have to wade through to come up with what the policies that could create improvements would be. Whereas for menstruation, I think they were much lower hanging fruit.

SPEAKER_02 6:29

So so menopause is more complicated. Um, it's not as simple as having your your period tamp on tax.

SPEAKER_00 6:37

Um at least in terms of the the correlating policies, yes. I would say that there is a lot more complication to wade through. Yeah.

Why Menopause Policy Gets Complicated

SPEAKER_00 6:46

So what surprised you the most? That is what actually surprised me the most. Um when I started this work, I mean, I'm not a doctor, I don't play one on TV. Um I got to know a lot of doctors and medical experts and people who either had scientific expertise or saw patients. So I really did start to learn this world through their eyes. Um and I guess that threading that needle, the way I describe it often is um the analogy I use or the visual I try to bring is like a ball of yarn. If you had a ball of yarn and you threw it across the floor and then you wanted to wind it back up, it wouldn't be very hard to do. Like you would just roll it back up. But if you had a ball of twine, it would get all like sticky and kinked out and you know, pull in different directions, and it would be a lot harder to put back together. And that was how I felt about menopause. Every time I thought I unfolded something, I would discover something else that was exacerbating it. There's not a single like deficit in the menopause space, whether it is education, whether it is research, whether it is funding, whether it is um, you know, how we consider the workplace and the important work that you do, that doesn't come with a flip side or another consideration or another challenge all the way across, you know, all the way across the room, that when you fix one thing, you maybe inadvertently trigger another. Um, so that was what was so, I don't know that I was surprised by that, but it was, it is so complicated. And it's really hard to boil down to a single talking point or a single op-ed or a single, you know, policy proposal, or a single, you know, uh proclamation of what it is we want because everything has a catch. Um and everything has a counterpoint. Um, and I know that might sound vague for listeners and we can unpack what some of those are, but that has been my experience is that nothing was nothing had just a simple linear path.

SPEAKER_02 8:48

Yeah. Well, we find the same thing. I mean, there's triggers on the other end. Every time you pull a lever, there's something on the other side that you have to consider, including um varying opinions. So there's very

Workplace Pushback And Ageism Reality

SPEAKER_02 9:00

strong opinions that we are seeing with individuals, both men and women, who would say, why are you bringing this up? Why are you talking about this? There's enough ageism that I faced in the workplace, specifically in what we do and our focus. Uh, why are you adding this to the mix? Why are you calling it out? So I'd love, I'd love your opinion on that.

SPEAKER_00 9:25

Yeah, I, you know, I I get that, I get that feedback too. And um, it's interesting because when I think about the workplace in particular, um, and I'm eager to have the conversation because I know we have like a lot of very we even among us, we have a lot of varying thoughts and opinions and ideas about it. I I do think that we have to plow through uncomfortable pieces of it, or it's where it's it's more than uncomfortable. It's the aspects of it that that make our lived experiences stand out. I mean, surely the the people who fought for protection from discrimination on the basis of pregnancy or other um attributes or characteristics that were specific to women received the same blowback. But the idea that our bodies are are distinct and workplaces and the economy um have an obligation to um have an obligation for all kinds of reasons, for you know, social justice reasons, but for economic reasons too, to ensure the the the I don't know, the most practical and and pragmatic and manageable workplace. I don't know if I'm I'm getting lost in my words here, might need to edit out this piece of it. But the idea that our our distinct needs need to be met is really important. Um, the thing about the and I'll say that the thing about the workplace um and the idea of workplace benefits, which I know are becoming more and more popular, and it's um really important that there are organizations like yours ensuring that they are pragmatic, that they are thoughtful, that they are meaningful to a wide variety of employees. Um, all of those things are true. I think at the same time, what is also true in this country, and this is where the lawyer, the kind of wonks like me come into play, is that our anti-discrimination protections in this country are so insufficient that I worry deeply about navigating a space of accommodations or acceptance or acknowledgement before or while we're still figuring out what those discrimination protections should and must be, that that's the piece I think that I'm pretty hung up on.

SPEAKER_02 11:43

Yeah. Unpack that a little bit more, Story. Yeah, tell us

Protections Versus Accommodations At Work

SPEAKER_02 11:48

more.

SPEAKER_00 11:48

Um when when we think about um the various accommodations, for example, on the basis of pregnancy that have been forged in this country and the agencies, the Department of Labor, the um the EEOC that have been responsible for for thinking through and managing what those accommodations are. We've had a pretty robust movement, legal movement as well, to ensure protection from the on the basis of you know discrimination on pregnancy. Um, so we've been successful as a country in plowing forth with um laws like first the Pregnancy Discrimination Act, um, and now the Pregnant Workers' Fairness Act, more recently, um, that can balance the need and demand and scope of accommodations with assurance of protection and a classification on from discrimination. We don't have any such thing for menopause right now and where it might even squarely fit. So in my book, I look at things like the Americans with Disabilities Act, I look at the Pregnant Workers' Fairness Act, um, there has been legislation that uh on the basis of discrimination on the basis of age that is part of you know traditional civil rights legislation and new bills that have been introduced too. Um, menopause doesn't fall squarely in any of those and might be well served to find its own, you know, its own home, or some creative lawyers might think very strategically about which pieces of each of those um legislation menopause could fit. Lawyers in the UK have been doing that work, and they have created and and codified uh discrimination protections. They haven't really tested them that fully yet. Um, and theirs fall somewhere between gender, age, and disability. Okay. Um and I think that we'll probably be headed in a similar direction, and there is definitely an appetite in Congress to tackle this. You know, I don't think there's a clear path at this moment in this political administration to see this through, but this is certainly the time to be seeding, SEED seeding um that kind of either standalone legislation or reads of currently existing legislation. But right now, what I truly worry about is somebody who has a very menopause forward organization, and perhaps they've worked with Medovia or others to get there and in the wrong hands taking advantage of those benefits could find somebody on the receiving end of harassment or discrimination and that they would not have adequate protection under the law.

SPEAKER_01 14:38

Yeah, yeah. Let's talk about the law

Menopause In Courts And Federal Rules

SPEAKER_01 14:40

a little bit. I'm curious, like when did menopause specifically show up as a legislative issue? And like, you know, when does that actually begin? Because we've been watching other countries, UK being one of them, Australia, another one, like having this happen. But when what do you see in terms of where specifically it's showing up and and what what's the future look like?

SPEAKER_00 15:00

Yeah, you know, so it's shown up in in random court cases that have either been on the basis of menopause or where menopause at least played a central role where um somebody uh a person argued they were fired or you know, otherwise discriminated against because of their menopausal status. Um for, and I I can't rattle off case names, sorry, they're in the book. Okay, but um it's not that I can't do it for any reason other than that they're not coming to my head right now. Um but in one case um for an employee who was going through premature menopause, the court did find that the Americans with Disabilities Act would apply because it wasn't a normal menopause for normal. Um for other employees, and and really there's I can count them on one hand how many cases there have been. So it's not like there's been you know heaps of of judicial um opinion to to parse through. But by and large, menopause as a normal condition of um you know our bodies has not been afforded protection under the laws that were brought to bear. In 2017, I think it was, um, there was a case of an employee, I think she was a telephone operator in Georgia who was perimenopausal and was having extremely heavy uh menstruation and bleeding and bled on her chair and stained her chair and was fired for that. Um, and while the argument around menopause was raised, it was never adjudicated. So we're really left with um very little. Legislatively speaking, the Pregnant Workers' Fairness Act, which is the newest piece of legislation, at least that we as a country now have access to, was signed by then President Biden in 2023. Um it does not mention menopause overtly, um, but it does address conditions related to pregnancy. And menstruation has been um acknowledged as a condition related to pregnancy. Many people stepped up and argued that menopause or perimenopause, both of them should be included similarly as menstruation as a condition related to pregnancy. The EEOC did not weigh in on that when it issued its rules for the uh implementation of the Pregnant Workers' Fairness Act, but they provided a bunch of hypothetical scenarios in which the law could be leveraged, and menopause was an example in one of those hypotheticals. So at least that indicated that the leadership at the EEOC at that time um saw a pathway or an open mind to including menopause, but it's not it's not written in it in any concrete or overt way. And you know, the current leadership of the EEOC obviously um has very different priorities. So I wouldn't I wouldn't hold out much hope, at least in the here and now. Um, but I think what the future looks like is folks like all of us in this really robust emerging movement of everybody from clinicians to um uh celebrities to the media um being really clear and concrete about the need for those um protections, um, especially, especially as we see um state legislature, yeah, uh state legislatures, and we can talk about that for a bit as well, the what's what's happening in the states and why there's been so much momentum and interest and energy towards a wide variety of of legislative, you know, protections or um uh what would be the word, like interventions

State Bills Insurance And CEO Pressure

SPEAKER_00 18:45

to improve menopause care. Um we've seen at least one state, Rhode Island, and one municipality, Philadelphia, um call for both menopause accommodations as well as um protections or that pregnancy-related discrimination protections should be um stretched to include menopause. So I think it's really important that they did both, not just one. Um, and we'll probably see more of that. Michigan put out a memo from the governor's commission on women to explore um more robust menopause workplace accommodations and protections. And Virginia passed the law as well, although Governor Spanberger did not um sign it. She vetoed it and called for more research. So I think it's a really open road right now. And what would be really important, vital, as far as I'm concerned, is to make sure we're talking as much about the discrimination protection as we are the scope of accommodations.

SPEAKER_02 19:43

Yeah. Yeah. I think it's it's um, it's never siloed, right? Uh we have to look at the big picture. And there are many, we always say there's many levers that you have to pull. You can't just look at one piece of the puzzle because they all fit together to your point. Um, do you feel like the um statewide movement, I guess I will call it, um, and municipalities, do you feel like that will drive organizations to implement change? Because right now, I mean, if you the conversations that we had several years ago with organizations was really building that business case and it was um convincing organizations that there was a return on investment and this is a real thing, and you need to look at your bottom line. Um, but now we're moving more towards conversation um that that includes legislation, right? Am I gonna have to do this? Um, you know, because I mean a lot of organizations just sit in.

SPEAKER_00 20:41

Most companies in this country probably don't worry about, shouldn't have to worry about having to do it. We are not there yet. In the UK, they will have to do it in 2027, at least companies of a certain scope and size. That's right. Um, I don't think we're quite there yet here in the US. And I think that um I think that companies, I'm sure they're in part driven by bottom line, and you obviously have front row seat access to what to hearing them, you know, engage on what that looks like for them. I think that many of them, honestly, this might sound a little cynical, might be swayed by the media and the kind of public attention they could get for doing it. It's certainly in vogue. Menopause is very popular and it gets very popular, you know, public attention. Um, I I think that I would be thrilled to see more legislation and the best legislation in more in more states and potentially federally at some point in time. Um, I think that from my perspective, I also want to see CEOs do more than bring that perspective to bear inside their workplace. I want them to use their platform and their voices to push all of the reforms that are on the table. Of the state legislative reforms, for example, we just named the handful that. Engaged in workplace, but um 26 states have introduced more than 60 bills over the past you know two sessions, um, focused on everything from improving education among providers and clinicians as well as the general public about menopause to ensuring um that menopause care and treatments are covered by insurance, including public insurance, Medicaid, um, including private insurance, whether through employers or otherwise. Um and I would like to see um CEOs and people who have platforms of that scope and size use their voice and their resources to push the full agenda. At some level, people will argue that if we solve some of the broader issues about access to care and treatment, we perhaps diminish the need for workplace information and accommodation because people will be better treated and better cared for and and and be you know burdened less by aspects of menopause that might, you know, otherwise now benefit from support in the workplace. We're probably pretty far, it's hard to imagine anything that black or white or either

The Research Funding Gap

SPEAKER_00 23:10

or. It's you know, it takes a long time for change to happen. Um, in particular, um, and the thing we haven't talked about and we haven't really seen yet in the state legislatures, um, is a commitment to research. Research might may be sort of the the number one, you know, smoking gun and and unaddressed matter and the the lack of commitment we've had, both because of you know some of the certain circumstances that apply to menopause, but also because women's health research is is chronically and dramatically underfunded in this country by the major vehicle for for research support, the National Institutes for Health and other federal agencies. One reform that I'm really eager to see is for states to start stepping up and using their own state university uh oversight and influence to fuel um research that the federal government might not or will not fund at the moment, um, and whether that could bolster it, whether that could set an example, whether that could, you know, create a new future for research going forward. Um, I think that would be really exciting. And taking it back to the CEOs, that's the kind of thing I'd really like to see them supporting. Um, that's where they can have deep influence. I'm gonna take a pause until my 11:30. I'm gonna be five minutes. Yeah, I was gonna say let's uh we can wrap it up. But let me just let her know.

SPEAKER_01 24:38

Time goes fast.

SPEAKER_00 24:39

I know it does. Are you getting okay stuff here?

SPEAKER_02 24:42

Yeah, no, it's great. Thank you. This is great. Yes, no, this is great. Thank you. Okay, okay.

SPEAKER_00 24:47

Stop at 1135.

SPEAKER_01 24:49

Okay, perfect.

Her New Book And How To Advocate

SPEAKER_01 24:50

Um, let's talk about your book because I think that's yeah, okay. Let's get that in. Yeah. Uh a user's manual and citizen guide comes out in October. Let's what who did you write it for? What did you want them to, you know, close the last page thinking about? What was what was your thinking on that?

SPEAKER_00 25:07

Thank you for that question. Right. Here it is. I'm gonna hold it up just because we do. Um, I wrote it for everybody. Um, it's it's interesting. I started writing it thinking it was gonna be more of a piece that would appeal to policymakers um and people who think about shaping policy. But actually, what the book ended up being is an everyday user's guide. Um, and it breaks down really what advocacy is as much as what menopause is. Um, and I joke or or or sometimes you know call it lovingly a choose your own adventure book, um, like the kind We Gen X read when we were little. Maybe kids today still do too. Um, but I think the word advocate can sometimes dimey people or or you know um sway them in the other direction, thinking, oh, if I don't know anything about policy, I'm not political, I don't want to step in. That sounds big, that sounds scary, that sounds, you know, public. Um and it's really intended to show how so much of what we do in our everyday lives, especially when it comes to treating and caring for and being our menopausal selves, can be advocacy. Um, and sometimes it can benefit us personally, how we're interacting with our doctor, how we're navigating the shopping aisle, how we're maneuvering the internet, how we're dealing with our family members, older, younger partners, everybody. So that's advocacy. So that's really the whole first section of the book is um advocacy for yourself and you know, within your within your own orbit. The second section is advocacy and community, and it highlights all kinds of communities, making menopause the center of discussion. Um, I feature advocates or community, you know, members, people, um, just people all over the country who are doing this through everything from public library initiatives to film screenings, um, to bringing people together to have, you know, interesting, hard, um, enlightening conversations. And the workplace is actually where I focus on community also, um, thinking about the workplace as a really inevitable and necessary community for most of us for what are you know likely our menopausal years, um our perimenopausal, menopausal, postmenopausal years. And then the final section of the book is is maybe like my deepest heart and where I originally started, but that is um advocating for the future, what it looks like to really step up into halls of power and halls of influence and make this demand. Um, because so much of this is happening at the state level now, I think there's something really um inviting about that. And advocating for state legislative change is a lot less intimidating, perhaps, to folks than thinking about, you know, Mr. Smith goes to Washington or walking up the steps to the halls of Congress. I always joke, my state representative is my neighbor. I see her in the grocery store all the time and you know, over the frozen food aisle. I will ask her what's going on with the menopause bills. She introduced four of them. Um it's they they're really leaders, local and state leaders are really eager to hear from you. You are their lifeblood. Um, this is how they have their job and keep their job and make their mark. Um, and so I know that my um state representative is so proud of the bills that she's championed, and people like me help, you know, keep making that a reality for her. So um this the final part of the book really and gives all kinds of um hands-on, user-friendly tools to how to do this in every every avenue. So for the for the for the self, for the community, for the halls of government, the book is really practical. It features lots of stories and storytelling of people who've been doing this or people who've you know had this experience and wanted to share, um, whether it was how they engaged with their mom or their daughter or their partner or their workplace or their PTA, you know, or their book club or their state legislator, you name it. This book really gives a lot of you know three-dimensional, colorful energy about what it looks like to do that.

Preorder, Speak Up, And Closing

SPEAKER_02 29:20

I love to read it. Colorful energy. I really love that. Well, Jennifer, thank you for spending the time with us today. And really um for your book and breaking down advocacy in in a tangible way that we can all advocate for ourselves in many different ways and aspects of our life. Thank you for that. I think this is the kind of conversation that turns the um that's just how it is, to that's about to change. And that's about to change. I love it. That is about to change. It's all about to change. Thank you for all the work you both do too. I'm so happy to be here with you. Thank you. Yes, and until we meet again, everyone, you can go pre-order the book. Yes, Jennifer, you can pre-order the book right now. Okay, fine. Go pre-order the book, find out what's happening in your own state, advocate for yourself because odds are that there's something happening already. And you'll make it happen if it hasn't yet. And go make it happen. Use your voice. Yeah, speak up. Um, and until we meet again, everyone, go find joy in the journey. Thank you. Take good care. Thank you for listening to the Medovia Menopause Podcast. If you enjoyed today's show, please give it a thumbs up, subscribe for future episodes, leave a review, and share this episode with a friend. Modovia is out to change the narrative. Learn more at Medovia.com. That's M I D O V I A.com.