A/HRC/33/49 menstrual cycle by showing a photograph of a tampon on the cover.27 A letter to the chief executive officer of Facebook from a student in New Delhi asking him to introduce a “on my period” button on the world’s largest social network has received significant online attention.28 Awareness-raising campaigns to inform and change the mindsets and attitudes of both men and women should be designed using all available means, including the media, at the community level and in schools, with the participation of civil society. C. Gender-based violence and sanitation-related psychosocial stress 26. Gender-based violence can be defined as acts that “inflict physical, mental or sexual harm or suffering, threats of such acts, coercion and other deprivations of liberty”.29 It is a widespread issue rooted in power differences and structural inequality between men and women, although men and boys can also suffer gender-based violence. As the SecretaryGeneral has pointed out: “Violence against women and girls makes its hideous imprint on every continent, country and culture”.30 27. Women fear violence by men in public toilets and open defecation sites, and along the routes leading to both. Some women and girls looking for a place to defecate have reportedly been exposed to rude remarks, brick-throwing, stabbing and rape. Gender-based violence also occurs at places to collect water, bathe and wash clothes. Abuse of boys is reportedly a common and underrecognized phenomenon, and one that receives even less attention, as shame and cultural restrictions or taboos concerning homosexuality deters boys from reporting such abuse.31 28. In addition to risking physical violence, women and girls may also experience sanitation-related psychosocial stress, including fear of sexual violence. Women and girls who have limited access to sanitation facilities experience environmental barriers when they engage in water, sanitation and hygiene practices, including carrying water, managing menstruation, defecating and bathing, that contribute to that kind of stress. Examples include the fear of encountering snakes and mosquitos when walking to a defecation site, or the stress caused by social norms that view the fact of being seen by men while bathing as negative, among other issues. A better understanding of the range of causes of stress and adaptive behaviours is needed to inform context-specific, gender-sensitive water and sanitation interventions.32 29. The fact that in many instances women and girls risk being harassed when they relieve themselves in the open or in public facilities is partly due to the structural and systematic use of stereotypes and stigma. The promotion of awareness-raising campaigns, targeted education programmes and discussion groups, among other measures, to transform both men’s and women’s perceptions of gender roles is therefore encouraged. Genderbased violence must be prevented and investigated, and those responsible must be prosecuted, in order to break patterns of societal acceptance of exclusion and violence 27 28 29 30 31 32 See www.vivala.com/womens-issues/newsweek-cover-period-stigma/4062. See www.indiatimes.com/news/india/this-girl-s-open-letter-to-mark-zuckerberg-asking-for-an-onmy-period-button-deserves-a-reply-252396.html. Committee on the Elimination of Discrimination against Women, general recommendation No. 19 (1992) on violence against women. See www.un.org/en/women/endviolence/pdf/pressmaterials/VAW%20Press%20Release.pdf. Louisa Gosling and others, “Nowhere to go: how a lack of safe toilets threatens to increase violence against women in slums” (WaterAid). Krushna Chandra Sahoo and others, “Sanitation-related psychosocial stress: a grounded theory study of women across the life-course in Odisha, India”, Social Science and Medecine, vol. 139 (August 2015), pp. 80-89. 9