Period products like pads and tampons are considered an essential public health need, but access for women and trans people held in federal custody — from prisons to immigration detention centers — remains inconsistent. While specific figures for women held in immigration detention have not been reported for President Donald Trump’s second term, the detention population broadly reached record highs in 2025, growing from about 40,000 to nearly 70,000 people.

A report published Monday by the Government Accountability Office (GAO), a nonpartisan arm of Congress, found that federal prisons and immigration detention centers generally make menstrual products available. But investigators also discovered inadequate oversight: Some facilities do not follow federal policy that mandates specific types of menstrual products and how often they must be replenished.

The watchdog office suggested recommendations to the federal Bureau of Prisons (BOP) and to Immigration and Customs Enforcement (ICE). “GAO recommends that (1) BOP ensure its oversight activities monitor adherence to its policy on providing menstrual products, and (2) ICE clarify requirements related to providing menstrual products in its detention standards.” The report noted that while BOP committed to taking steps to address the recommendations, ICE declined, stating that its standards are intended to provide “guidance” and “flexibility” to facilities.

“Menstrual products aren’t a luxury, they are a basic need for half of the population,” Rep. Grace Meng, a New York Democrat and one of six congresswomen to request the GAO report, wrote in a statement. “This is why I first requested this report from GAO in 2022: to investigate whether our own government is meeting that basic need. And this report now could not be more timely, as we see news reports from federal prisons and immigration facilities about women who have been denied pads and tampons and forced to sit in blood-soaked clothing.”

Women and transgender individuals behind bars receive substandard reproductive health care, including insufficient access to menstrual products in local, state and federal facilities around the country.

Many facilities limit the number of tampons or pads menstruating people may receive each month, in some cases providing 12 to 20 products per month that are often much lower quality than standard store-bought items. Outside of prison, people will typically go through three to six tampons or pads each day during a menstrual period, which can last for seven days.

Currently and formerly incarcerated menstruating people have described prison pads as “not much more than a panty liner,” as one woman told The 19th last year. Some need to use six pads at a time to prevent leakage. 

Others are forced to either bleed through their clothing or make their own tampons out of whatever they can get their hands on: toilet paper, dirty rags or even filling from their mattresses, said Miriam Vishniac, the founder and director of the Prison Flow Project, a database focused on access to menstrual products in U.S. prisons.

The GAO launched its investigation of products in federal facilities in response to a request from nine members of Congress, all Democrats. Between July 2024 and February 2026, GAO investigators conducted site visits to five federal prisons and three ICE detention facilities, conducted interviews with staff and officials at the facilities as well as incarcerated or detained women. The office also sent web-based questionnaires to all 29 BOP institutions that housed women in fiscal year 2024 and all 52 ICE facilities that housed women in fiscal year 2024.

About 60 percent of prisons and ICE facilities that responded to the survey listed the quality of the menstrual products they provide to be an “important” or “somewhat important” consideration. About 70 percent listed the “timeliness of delivery” of the menstrual products as either “important” or “somewhat important.”

The 2018 First Step Act requires BOP to provide free tampons and sanitary napkins that meet industry standards, “and in a quantity that meets the healthcare needs of each prisoner.” All menstrual products must be made available in common areas, such as bathrooms, and incarcerated individuals must have access to these items at all times of the day and may keep them in their cells, according to the GAO report. But the office found that some institutions do not provide all five of the required types of products in common areas, or replenish menstrual products within the required 24 hours.

For ICE facilities, the agency assigns one of three different sets of standards that guide requirements for providing food, medical care and hygiene items. But these standards are inconsistent and lack detailed directives for providing menstrual products.

“For example, of the two sets of detention standards that explicitly mention the provision of menstrual products, one set specifies that the facility must replenish products at no cost to detained individuals, while the other does not,” the report states. “The third set of detention standards does not mention menstrual products at all.”

In response to the GAO recommendation that ICE clarify its requirements related to the provision of menstrual products, the Department of Homeland Security (DHS) declined to follow the suggestion. GAO recommendations are not legally binding and do not have to be implemented. DHS stated that the language of its current requirements allow different facilities to customize based on their individual operational needs, “strategic constraints” and geographic locations. The DHS letter added that the recommended changes “would create undue burdens on facilities that currently address these types of issues in accordance with local policies.”

The other women lawmakers who requested the GAO inquiry did not get back to The 19th’s requests for comment by the publication of this story.

Vishniac, from the Prison Flow Project, called DHS’ reasoning “ridiculous.”

“When you do not document these procedures, menstruators in confinement are left at the mercy of their captors,” Vishniac wrote in an emailed statement. “In the best circumstances, this may lead to people who do not menstruate making uninformed decisions that have significant negative impacts. In the worst circumstances, it creates an opportunity for abuse.”