Normalizing the Natural A study of menstrual product destigmatization Klintner, Louise 2021 Document Version: Publisher's PDF, also known as Version of record Link to publication Citation for published version (APA): Klintner, L. (2021). Normalizing the Natural: A study of menstrual product destigmatization. MediaTryck Lund. 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LUND UNIVERSITY PO Box 117 221 00 Lund +46 46-222 00 00 LOUISE KLINTNER LOUISE AN ECOLABEL 3041 0903 Normalizing the Natural NORDIC SW A study of menstrual product destigmatization Natural the Normalizing Normalizing the Natural In this thesis, I develop our understanding of the destigmati- A study of menstrual product destigmatization zation process to include product destigmatization. Previous ryck, Lund 2021 research on destigmatization has primarily focused on that of LOUISE KLINTNER | DEPARTMENT OF BUSINESS ADMINISTRATION | LUND UNIVERSITY individuals, groups, organizations, and industries. However, there is an abundance of empirical evidence showing that a Printed by Media-T product stigma has a significant bearing on market logics, in- cluding legal classification of products, marketing challenges, as well as a lack of innovation and entrepreneurship. Around 300 million people menstruate on any given day around the world, yet the market for menstrual products consists predominantly of homogeneous products that have been around since the late 1800s or early 1900s. Simultaneously, there is a surprising lack of regulations and standards, in particular on a global level, ensuring a widespread safety for so many users around the world. Other products used on or intimately with the body are generally heavily regulated and/or standardized. In a pilot study investigating these seemingly contradicting notions, I found that one of the most fundamental reasons for the status quo is grounded in the stigma on menstruation and menstrual products. Through a multi-method approach, combining aspects of case research, action research, and document studies, I examined the menstrual product field from a synthesis of theory including stigma, destigmatization, and neo-institutional. I de- veloped a framework through which product destigmatization can be understood. Therein, I emphasize three primary mechanisms driving product destigmatization, and how they act on all three levels of society. The mechanisms comprise reclassi- fying, framing, and claiming agency. My main contributions are threefold. First, I deliver a comprehensive study on destigmatization that includes different dynamics and levels, which has not been done previously, in particular regarding menstrual products. Secondly, I find that in contrast to what previous research demonstrates, destigmatization processes do not only occur from the top-down, but also through bottom-up initiatives. Finally, I advance our understanding of the role of organizations, including entrepreneurs, and their innovative capacities to affect institutional change. 957798 Department of Business Administration 789178 Lund Studies in Economics and Management | 150 ISBN 978-91-7895-779-8 9 150 Normalizing the Natural 1 2 Normalizing the Natural A study of menstrual product destigmatization Louise Klintner DOCTORAL DISSERTATION by due permission of the School of Economics and Management, Lund University, Sweden. To be defended at Ekonomihögskolan. Date: April 16, 2021, 13.00. Faculty opponent Sara Louise Muhr 3 Organization Document name LUND UNIVERSITY Ph.D. Dissertation School of Economics and Management Date of issue April 16, 2021 Author: Louise Klintner Sponsoring organization Title and subtitle Normalizing the Natural - a study of menstrual product destigmatization Abstract In this thesis, I develop our understanding of the destigmatization process to include product destigmatization. Previous research on destigmatization has primarily focused on that of individuals, groups, organizations, and industries. However, there is an abundance of empirical evidence showing that a product stigma has a significant bearing on market logics, including legal classification of products, marketing challenges, as well as a lack of innovation and entrepreneurship. Around 300 million people menstruate on any given day around the world, yet the market for menstrual products consists predominantly of homogeneous products that have been around since the late 1800s or early 1900s. Simultaneously, there is a surprising lack of regulations and standards, in particular on a global level, ensuring a widespread safety for so many users around the world. Other products used on or intimately with the body are generally heavily regulated and/or standardized. In a pilot study investigating these seemingly contradicting notions, I found that one of the most fundamental reasons for the status quo is grounded in the stigma on menstruation and menstrual products. Through a multi-method approach, combining aspects of case research, action research, and document studies, I examined the menstrual product field from a synthesis of theory including stigma, destigmatization, and neo-institutional. I developed a framework through which product destigmatization can be understood. Therein, I emphasize three primary mechanisms driving product destigmatization, and how they act on all three levels of society. The mechanisms comprise reclassifying, framing, and claiming agency. My main contributions are threefold. First, I deliver a comprehensive study on destigmatization that includes different dynamics and levels, which has not been done previously, in particular regarding menstrual products. Secondly, I find that in contrast to what previous research demonstrates, destigmatization processes do not only occur from the top-down, but also through bottom-up initiatives. Finally, I advance our understanding of the role of organizations, including entrepreneurs, and their innovative capacities to affect institutional change. Keywords Destigmatization; menstrual products; stigma; institutional change; institutional entrepreneurship; standardization; normalization Classification system and/or index terms (if any) Supplementary bibliographical information Language English ISSN and key title ISBN 978-91-7895-779-8 (print) 978-91-7895-780-4 (PDF) Recipient’s notes Number of pages 317 Price Security classification I, the undersigned, being the copyright owner of the abstract of the above-mentioned dissertation, hereby grant to all reference sources permission to publish and disseminate the abstract of the above-mentioned dissertation. Signature Date 2021-03-05 4 Normalizing the Natural A study of menstrual product destigmatization Louise Klintner 5 Copyright pp 1-317 Louise Klintner School of Economics and Management Strategy | Lund University ISBN 978-91-7895-779-8 (print) ISBN 978-91-7895-780-4 (PDF) Printed in Sweden by Media-Tryck, Lund University Lund 2021 6 To my grandmother, who probably would have been as horrified as she would have been proud of this 7 Table of Contents 1. Introduction 13 1.1. Empirical problem 15 1.1.1. Testing and knowledge about the safety of menstrual products 16 1.1.2. Innovation and development of menstrual products 17 1.2. Theoretical perspective 19 1.2.1. Stigma 19 1.2.2. Product stigma 21 1.2.3. The menstrual stigma 22 1.2.4. Neo-institutional Theory 24 1.2.5. Studying a field setting 26 1.3. Conclusion of background, purpose, and structure of the thesis 27 1.3.1. Conclusion of background 27 1.3.2. Purpose and structure 28 2. Literature Review 31 2.1. Stigma 31 2.1.1. Defining the concept of stigma 31 2.1.2. The four components of stigmatization 32 2.1.3. The Stigma Turbine 35 2.2. Stigmatized products 38 2.2.1. Positioning stigmatized products 38 2.2.2. Defining the concept of stigmatized products 39 2.2.3. Product stigma’s effects on fields 42 2.2.4. Stigmatization of menstrual products 44 2.3. Destigmatization 52 2.3.1. Defining the concept of destigmatization 52 2.3.2. A framework of destigmatization 54 8 2.3.3. The process of destigmatization according to Clair, Daniel, and Lamont (2016) 56 2.3.4. The process of destigmatization, according to Mirabito et al. (2016) 57 2.4. Institutionalization, deinstitutionalization, and institutional change 60 2.4.1. Institutionalization 60 2.4.2. Deinstitutionalization and institutional change 62 2.4.3. Institutional entrepreneurship 63 2.4.4. Social movements as change agents 65 2.5. Summary of literature review 66 3. Methodological and Epistemological Considerations 69 3.1. Case study research 69 3.2. Methods of data collection – a multi-method approach 71 3.2.1. In-depth interviews 71 3.2.2. Action research 73 3.2.3. Document analysis 74 3.3. Research design 74 3.3.1. Study questions and propositions 75 3.3.2. Unit of analysis and theory selection 76 3.3.3. Method for data analysis and theorization 79 3.4. Trustworthiness 84 3.4.1. Reliability 84 3.4.2. Validity 86 4. The Mechanisms of Destigmatization 87 4.1. Overview and structure of the findings 87 4.2. The menstrual product stigma and first steps toward destigmatization 91 4.2.1. Cultural variations of the menstrual product stigma 91 4.2.2. The menstrual product stigma in Sweden 95 4.2.3. Lack of knowledge, regulations, and standards regarding product safety 100 4.2.4. Lack of pressure from consumers to regulate 103 4.2.5.