More than one manifestation of agency: Relinquishing and/or retaining menstrual practices in Nepali migrant communities in the United States.

Menstruation is a physiological process imbued with socio-cultural meaning. In the scholarship on menstrual health, culture is almost exclusively portrayed as oppression, limitation, and restriction, with cultural and religious practices in Nepal receiving growing attention. Our study aims to complement this body of literature by exploring menstrual practices among women of Nepali origin living in the United States, as migrant communities offer deep insights into cultural meaning-making but have been largely neglected in menstrual health literature. Drawing on feminist conceptions of agency, this study seeks to develop a nuanced understanding of Nepali immigrants' relationship with menstrual practices. In 2022, we conducted 22 semi-structured interviews and explored women's menstrual experiences and the tensions they navigate between the United States and Nepali contexts, investigating the role of identity, religious beliefs, cultural norms, societal expectations, respect for tradition, and sense of community. Our findings indicate that women largely relinquished menstrual practices that reach into the social sphere and everyday life. However, regarding practices in the religious sphere, women demonstrated significant variation: some abandoned these practices for pragmatic reasons or because they considered them discriminatory, whereas other women deliberately held on to religious practices motivated by their religious identity, respect for tradition, and sense of community. Thus, menstrual agency not only manifests in resisting cultural practices, but also in retaining them. Our findings challenge monolithic understandings of agency and acknowledge the nuance, complexity, and constraints that shape women's lived realities. These insights have significant implications for strengthening culturally responsive support for migrant women's health.