Menstrual inequality and the welfare benefits system: the case of PMDD

Menstrual health conditions, particularly those that fluctuate in severity, are often inadequately recognised within the welfare benefit system. This systemic failure creates significant disparities in access to financial support, reinforcing broader menstrual inequalities in resources, opportunities, and well-being. Our study focused on one such condition: Premenstrual Dysphoric Disorder (PMDD), a severe cyclical mood disorder associated with heightened risks of suicidality and self-harm. We conducted four focus groups to explore the lived experiences of individuals applying for Adult Disability Payment (ADP) or Personal Independence Payment (PIP) with PMDD. Three focus groups involved individuals with PMDD, providing insight from 17 participants, while one included three professional stakeholders who assist applicants through the process. Participants shared their experiences of navigating the benefit system, highlighting barriers to access and support. Our interim analysis revealed four key themes that exacerbate menstrual inequality in disability benefit assessments:
1. The absence of trauma-informed assessment practices.
2. Inconsistent decision-making, leading to disparities in outcomes.
3. The challenge of evidencing a fluctuating menstrual-related condition.
4. Limited awareness and availability of application support services.
We will explore how these findings have contributed to the Scottish Government’s ongoing Independent Review of Adult Disability Payment, highlighting the urgent need for a more inclusive and equitable approach to assessing menstrual health conditions within the welfare system.