The question of financial privilege does, however, make one enormous difference: If you’re poor, you may find it that much harder to escape the abuse, or to recover and heal.

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The reasons for this are myriad, complex, and mutually reinforcing, much like the causes of poverty itself, but they can be roughly assigned to two categories: Questions of power and questions of access.

Sexualized violence is a statement of power—harassment is not flirting, and assault is not sex. In both, the perpetrator is establishing themselves as having the right to treat another human being as they will. The victim’s right to safety is void; the perpetrator has the power to say or do what they wish, and the victim has no choice but to accept those choices.

Indeed, men who harass and assault women routinely prey on those who are clearly less powerful than their attackers. Harvey Weinstein consistently visited his depravity on Hollywood’s young and aspiring; R. Kelly has long been known for plucking girls from high schools on Chicago’s South Side. As Donald Trump said in 2005, “When you’re a star, they let you do it. You can do anything.”

One needn’t be a star to have relative power over a woman, though. In a society in which women are dehumanized in private, in public, in statute, and in practice, women as a class are axiomatically less powerful than men as a class. Poverty serves to exponentially increase that power differential.

Women in the lowest income bracket experience sexual violence at six times the rate of women in the highest. That statistic supports something poor women already know: The poorer you are, the more likely you are to endure a man’s unwanted attention. You can’t quit the job that barely pays, you can’t argue with the uncle in whose home you must live, and you can’t afford the classes that might allow you to leave both behind.

Poverty is not only a risk factor for harassment and assault, though—poverty is often the result of harassment and assault. The victim who leaves her job may have no other source of income, and more than one-third of women who leave their abusers’ homes end up homeless. Weinstein’s victims understood all too clearly that he ultimately held power over their ability to make a living, and a vindictive restaurant manager might be all that stands between a server and her ability to feed her kids.

Then there’s the question of access to medical or psychological support. Non-consensual sexual contact is often violent; rape can of course lead to pregnancy; studies have found that alarming numbers of harassment and assault victims develop PTSD; and even short-term experiences with shock and anxiety can be temporarily debilitating or permanently life-altering. But treating all of those things costs money. Even something as simple as transportation can present an obstacle—what if there’s no bus from your neighborhood to the nearest free clinic?

Every survivor’s experience is different, and trauma is not made untraumatic by a middle class income. Women of color, trans women, undocumented immigrants, and women with disabilities all face further hurdles, complications, and intersections, regardless of income.

Yet poverty places an undeniable additional burden on anyone who has survived sexual harassment or assault. Even as we reel from the unending revelations out of Hollywood or Silicon Valley, it’s worth remembering that even healing is a privilege.

A tax framework was released last week, so House Republicans are now primed to vote on the budget and set the budget reconciliation process in motion, which, if successful, will allow Republicans in both chambers to pass a joint budget by simple majority, thus skirting the threat of a Democratic filibuster. As confusing as all that may be for non-wonks (explainers here, here, and here), it’s all technically permissible under legislative procedure.

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Though it seems to have satisfied the Freedom Caucus (temporarily), there is considerable disagreement as to whether or not the White House’s nine-page framing document on taxes actually clarified much of anything. Trump and his various surrogates have done an awful lot of lying in the meantime—about who benefits, who doesn’t, and by how much—and no one seems to know how, exactly, the Congressional majority intends to pay for the trillions of dollars in tax cuts for which they’re calling. It seems to involve a fair amount of magical thinking.

Well, magical thinking, and shanking the poor. That much was clarified: The poor will, of course, be shanked.

Tax brackets, tax breaks, and just how the rich will become richer are all important details, no doubt, but among those details runs a single, shining through-line, a unifying message: Some people are worth investing in. Other people are not.

Every budget answers a question: Given a finite amount of treasure, on whom is it best spent? Should we, as a society, give $125 a month in food to people who can’t find a job, work in poorly-paid industries, or have fallen ill, or put an extra $129,000 into the pockets of people who make three-quarters of a million dollars a year? What’s better: Putting money into education initiatives and loan forgiveness programs that give those in poverty a tool with which to try to escape poverty, or helping the wealthy protect their wealth in off-shore tax havens?

Even for Trump and Congress, the calculus on who makes the cut is complex. It’s informed by race, by gender, by existing wealth, by proximity to power, by actual power. It’s informed by pettiness and greed. But at the end of the day—at the end of every single day—we still have a choice. The divide between poverty and wealth is a choice made by Americans who have arrived at a judgement about the fundamental worthiness of the lives of other Americans.

Contrary to how we usually discuss it, poverty is not a condition—it’s not dandruff, or cancer. Poverty doesn’t just appear at random, nor is it part of the natural order. Poverty is a choice, a series of choices, made and compounded across generations, by human beings. And as that choice is made by one group of people about another group of people, poverty is ultimately a relationship.  It is a direct outcome of how humans with power choose to relate to other humans.

The Ryan budget and Trump tax plan are blunt instruments with which to cement and extend the existing relationship between the extremes in American society—and the extremes are already more extreme than they’ve been in generations.

About a week before Trump unveiled his tax plan, the founder and chairman of Bridgewater Associates, the largest hedge fund in the world, made a startlingly frank comment about income inequality: At a fundraiser for Grameen America, Ray Dalio said that the United States effectively has two separate economies, and “the greatest issue of our time is the disparity of wealth and the problems that exist for the lower 40 percent of the population.”

Just days after Dalio made his comments, the Federal Reserve released a report about that very disparity, finding that the top 10 percent of American wealth holders already control 77 percent of the nation’s wealth. The top 1 percent of families control 38.5 percent.

Much of human suffering is beyond human control: Hurricanes and heartbreak will always come, no matter what we do. But poverty is a human relationship, in which humans decide who to value, and in whom to invest. Humans decide if the rich are going to get richer as the poor get poorer.

For all the commotion and legislative jargon currently swirling around the Congressional budget and tax plans, it’s important to remember that the poverty enshrined in both isn’t inevitable. It’s just that the wealthiest and most powerful people in America are doing all they can to ensure that people in poverty stay in their place.

Except that tampons are almost never mentioned.

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Americans have an abiding discomfort, bordering on revulsion, toward any discussion of menstruation. In discourse both public and private, this most human of bodily functions is treated as secret and shameful, a demi-illness that must be concealed if the sufferer is to have any hope of being taken seriously in functional society. God forbid a man catch you with a tampon in your hand.

Even as our generosity is called upon to help meet the daily needs of hurricane survivors, though, the specific needs of menstruating people are largely forgotten. Some organizations, such as food and diaper banks, include requests for period supplies in their appeals; a handful of menstruation-specific nonprofits exist; and there have been occasional media mentions, but these are by far the exception rather than the rule. For the most part, the parts of being a victim that are deemed unpleasant are studiously ignored.

Of course, for many Americans, it doesn’t take a natural disaster for the everyday to become tenuous. The poor, the homeless, the unemployed, and underemployed must regularly choose between school supplies or winter coats, diapers or tampons.

Depending on type, brand, and coverage, tampons and pads cost roughly $6 to $9 for a package of about 40, which any menstruator can tell you may not even last a month. Four weeks later that expense comes by again, to the tune of $70 to $110 a year before sales tax. For people who make $15,000 working full time at a minimum-wage job, that’s the kind of expense that can easily mean the difference between paying a bill or defaulting.

In recent years a movement has emerged to lessen this burden by eliminating sales taxes on period supplies; recently enacted laws to that effect are both hugely welcome and not remotely sufficient. What’s really needed, nationwide, is something akin to the law passed last year in New York City providing tampons and pads free of charge at schools, shelters, and correctional facilities—a move echoed by the federal government in late August, when it issued a recommendation that all federal penitentiaries do likewise.

Because lest we forget, period supplies are not optional. At the end of the day, pads and tampons serve one purpose: to contain menstrual fluid. With nothing to stop it, the combination of vaginal secretions, uterine lining, and (yep) blood can become a powerful mess. It’s a feature of the human reproductive system, not a bug—half of human bodies were designed to function this way. Forgetting that humans need period supplies is like forgetting that they need toilets (and then shaming them for urinating).

Girls and women (and some trans boys and trans men) who can’t readily meet this need are forced to make do however they can, often resorting to inappropriate or fundamentally unsanitary solutions that threaten their health, fertility, and basic ability to get things done—it’s hard to focus in math class or on the job if you know you’re bleeding all over your chair. That’s why Human Rights Watch recently released a report recognizing that menstrual hygiene is in fact not just a question of finances, but a human right.

We are right to open our hearts and our wallets to those who have had to watch as all they hold dear is literally washed away. No matter the weather, families always need food, babies always need diapers, and people who menstruate always need pads or tampons.

But what is true for the survivors of hurricanes is also true for the survivors of poverty. The deeply held misogyny that prevents us from treating female bodies as normal intersects with our dehumanization of poor people, and it prevents us from seeing that need (much less meeting it).

As we struggle to build a world that’s fairer for everybody who lives in it, it’s not enough to consider only the bodies we feel comfortable talking about. Whether rising to the challenge posed by natural disasters or acting to mitigate the unnatural disaster of poverty, we must begin to acknowledge the full humanity of all affected, reproductive organs included.