Browsing Tag

birth control

Feminism

hormonal therapy: medical treatment and birth control

On Monday, Rachel Held Evans ran “Why I Use Birth Control,” which featured my story with ten other women. What I wrote for her focused on the fact that I use the NuvaRing to manage my PCOS/endo and painful periods. I focused on that part of my story for a few reasons; first, it’s the only reason I’ve really had to use the NuvaRing up until recently, and second because the time in my life when I couldn’t afford it and had a cyst rupture was extremely relevant to what’s happening with the Hobby Lobby decision.

However, I’ve been married for a year and a half, and both I and my husband would prefer not to use condoms, especially since I’m allergic to latex and the non-latex options tend to be more expensive. We don’t have to, fortunately, because I have hormonal contraception that I tolerate fairly well. This reason is also important to talk about, because I don’t want to have children right now. I’m not even sure I want to have children at all, and I figure as long as we feel that way it’s probably a good idea to wait.

Handsome and I are in the position where having a child would be fine if I unexpectedly became pregnant. It would interrupt a lot of our plans and I wouldn’t be happy having a baby so far away from our families (I grew up away from my extended family, and I don’t want that for my children), but unlike Darlene Cunha, having a baby wouldn’t send us spiraling into poverty. But … we really don’t want kids right now, and we’re lucky that our health insurance covers the NuvaRing.

Jessica Valenti argued in The Guardian that “women like sex” and asked us to “stop making ‘health’ excuses for why we use birth control,” and she has a point. I want to have sex and I don’t want to have a baby: hormonal contraception is the perfect option for me, and I shouldn’t pretend that’s not at least half of the reason why I use it, and why I would continue using it if my PCOS/endo miraculously disappeared. The fact that most of the women who shared their stories on RHE’s blog focused on taking hormone therapy for medical reasons instead of as contraception also received some criticism, and I believe that is valid. If I could write my section again, I’d include “not wanting to have a baby” as one of the reasons why.

Conservatives, especially conservative Christians, the Religious Right, and the Christian fundamentalism that is so deeply integrated into the culture that Hobby Lobby is a significant financial supporter of are completely horrified at the idea that women might have sex without “consequences”– because that’s all a baby really is to them, a consequence and a punishment for a woman enjoying her sexuality outside of male control. They have no right whatsoever to assert their patriarchal system onto me and make my sexual choices for me, but oh do they ever desperately want to. For that reason, I believe that Valenti is right– saying “oh, but virginal, good women need BCPs for medical reasons!” isn’t going to do much when the conservatives and social regressives are obsessed with controlling what a woman does with her body.

However.

I don’t think we need to stop talking about the legitimate medical reasons why a woman or trans man might need to use hormonal therapy. It’s not a “health excuse”– it was the only thing that allowed me to function for the bulk of my life. And, personally, I am horrified that so many “Christian corporations” (I’m still in shock there is such a thing now, the whole idea is so essentially anti-Christ) are willing to sacrifice the health care of their female employees because of a completely unfounded belief about how hormonal contraception functions. That so many women desperately need hormonal therapy doesn’t affect them. Conservative Christian culture could not care less about women, and this proves it.

Conservative Christians want to make sure that women are punished, controlled, and enslaved by their uteri, and they are willing to sacrifice the health of every single woman who needs hormonal therapy to do it. They do not care about me, about the millions of other women like me. My pain, my suffering, means nothing to them when compared with their “deeply held religious belief.”

That’s why I think we need to talk bout both. Women deserve to think about if and when they want to have children, and they also are people with a specific medical need that deserves treatment options. That conservative Christians want to refuse us both says more about what their priorities are more than anything else– and loving Jesus and his children isn’t among them.

Update 7-17-14: Some have asked what I’m referring to when I say “conservative Christian.” Here on my blog I have chosen to use the terms “traditional theology” or “Protestant orthodoxy” to refer to theological conservatism, and distinguish between that and the theology of fundamentalism and evangelicalism. “Conservative Christian,” in the context that I have chosen to use it, refers to religiously-motivated social conservatism, as typically defined by socially conservative (and usually evangelical) Christians. If you identify yourself as a conservative Christian but you do not agree with those who would deny women necessary medical treatments and procedures, than the statements I’ve made here do not apply to you; feel free to disregard.

July 16, 2014 by SamanthaField

Feminism

hormone therapy and abortifacients aren't the same thing

I have a problem with the fact that Hobby Lobby was able to get away with this because pro-life advocates are either a) misinformed about hormone therapy or b) they knowingly lie about it.

So I’m writing about how hormone therapy functions in the bodies of people who have vaginas, uteri, and ovaries. In order to know how hormone therapy works, we have to understand how the ‘female’ reproductive system works.

Menstruation is a cycle, which begins when the ovaries do what they do and ovulate. This happens through the development of an ovarian cyst, which creates an oocyte that will eventually mature and become an ovum. This part of the cycle is the follicular phase. During the follicular phase, the uterine lining (the endometrium) is not conducive to implantation.

Once the ovum has matured, the ovary releases it to travel through the fallopian tubes to the uterus. This begins the luteal phase, and the endometirum begins forming secretions and blood vessels in anticipation of implantation. Once the ovum has been released, it can be fertilized by sperm, and this is when it becomes a zygote; the fertlized ovum begins going through stages until it eventually forms a conceptus that attaches to the uterine lining, which at this point must transform the base endometrium into the decidua and placenta. This is when pregnancy officially begins. Many pregnancies fail during the first few weeks– this failure is known as a miscarriage or spontaneous abortion, and most women do not even know they were ever pregnant. If the ovum is not fertilized or the zygote fails to implant, the uterus begins to shed the luteal phase lining. In humans, this is menstruation (some mammals absorb the lining instead of excreting it through the vaginal canal).

Hormone therapy– which has many uses– can be used as an effective form of birth control because it prevents ovulation. It also has the secondary effect of thickening mucus, making it more difficult for the sperm to travel beyond the cervix, through the uterus, and into the fallopian tubes. On top of that, it changes the outer portion of the ovum, making it slightly more resistant to penetration by the sperm.

Every single step of hormonal birth control prevents ovulation, which is why it is an effective treatment for some people who suffer with PCOS, like me. In the event that ovulation has occurred (which rarely happens, otherwise it would be a useless treatment), the secondary effects prevent fertilization.

If the ovary releases a mature ovum, it has also released a hormonal trigger for the endometrium to begin forming the luteal phase secretions. Without a mature ovum, nothing happens to the uterine lining, which is why hormone therapy is said to “thin” the uterine lining, although that description is misleading and deceptive. Hormonal birth control– even emergency contraception— cannot affect implantation for this reason.

This information is not controversial. It is well established, and can be found in any medical textbook concerning reproductive biology.

Hobby Lobby argued that four of the HHS-mandated contraceptives violated their religious beliefs (which is hypocritical and deceptive in the extreme, since they fund the manufactures of these contraceptives and their health plan covered all 20 FDA-approved contraceptives up until two years ago); they argued this based on outdated information concerning how emergency contraception and other forms of hormonal therapy operate that manufactures were required to place in their inserts.

Considering that the hormonal contraception Hobby Lobby opposed– Plan B, ella, and Mirena– functions exactly the same way as all other hormone contraceptive options, their opposition to these in particular is largely ridiculous. The only possible exception is the copper intrauterine device. The copper it releases acts as a spermicide and inhibits sperm mobility. I could find no medical study concerning copper IUDs and its ability to affect implantation– just a lot of speculation– but it is within the realm of how the device works. If you believe that a blastocyst is fully human (a position I believe involves a lot of cognitive dissonance and a lack of intellectual honesty and rigor), then the copper IUD might not be a good option for you.

That doesn’t mean any employer has the right to dictate what their employees use their healthcare for. Healthcare, typically classed as a “benefit,” is part of the financial contract between corporations and employees; laborers agree to sell their labor in exchange for taxed financial compensation as well as non-taxed “benefits” such as healthcare. The reason why healthcare is a separate area of compensation is that the United States government incentivizes employers to provide mass-negotiated sponsored healthcare to their workers without that part of the financial compensation being taxed. Healthcare benefits appear as a subtraction on the employee’s paycheck: it is a service I am contractually guaranteed (part of the reason why I agreed to labor for a particular corporation was to receive it) as well as a service I pay for. Employers have no business telling their laborers how they spend their own money. There is no difference from me handing my insurance card or my credit card to my pharmacist.

The lack of information concerning the cisgender female body is the single most important reason why Hobby Lobby was able to argue for their position. The Supreme Court majority decision specified that it wasn’t the medical legitimacy of the belief, but merely having the belief that made the HHS mandate a “burden” on Hobby Lobby and the hundreds of other companies that are affected by this decision; however, Hobby Lobby is capable of having this “sincerely held religious belief” (coughbullshitcough) because people do not understand how hormonal therapy works. At least part of the reason why this can be considered a “sincerely held religious belief” at all is that so many people are so wrongly informed. Without this traction, Hobby Lobby could never have made an argument in the first place.

I find that particularly laughable, especially since there is more research that says Advil can prevent implantation and cause abortion than hormonal therapy options.

July 1, 2014 by SamanthaField

Feminism

how I learned to stop worrying and love the Pill, part one

When I was fourteen, I was diagnosed with Poly Cystic Ovary Syndrome (PCOS). To cut a very long, and a very awkward, story short, hormonal birth control (also known as “the Pill”) is the only known treatment for it. It’s not a cure, but it works to mitigate the suffering for a lot of women who suffer with PCOS. But it’s the only treatment [edit: occasionally, blood sugar problems can be a part of PCOS, but not always, in my case it is not], because of how it works and what it does, but I’ll get to that in a bit tomorrow.

I had to start taking it at fourteen– the doctor said that if I wanted any chance of ever having children, I would need to take the Pill. And even then, she warned me, I’d probably still need to have a full-blown hysterectomy before I was thirty. If I didn’t take the Pill, everything would get continually worse and I’d need to have multiple surgeries just to keep it under control.

So, I went on the Pill, and I took it faithfully for the next three years. It got my hemorrhagic cysts under control, even though it continued to cause persistent nausea and daily headaches that could blow up into migraines at a moment’s notice.

I also didn’t tell anyone, not even my best friend, that I was taking it.

When I started college, I was faced with a pretty significant dilemma: how was I going to hide taking the Pill everyday from roommates and suite mates? My solution was to put the pills into a regular prescription bottle, but that only worked for about a month, until I got my prescription in the mail. Then I had to figure out ways to get the Pills into the bottle and then hide the packaging– it had my name all over it, so I couldn’t just throw it away anywhere. I got pretty creative, coming up with means to hide what it was.

The fact that I was worried about people finding out about me taking the Pill every day should tell you something. What in the world was I expecting them to think?

Well, for one thing, I was absolutely positive that if someone who didn’t know me very well found out about it, they’d just assume that I was a slut. And secondly, if the administration found out about it (which was not outside possibility, they cared an awful lot about intimate details concerning their students), if something happened, my character would automatically be in question. They’d be suspicious about me.

Because I had PCOS, and was taking the Pill to treat it.

But, I knew that having a “legitimate” medical reason for taking the Pill wasn’t going to change the way anyone had already decided to perceive me. If they found out I was taking it, I knew they would label me a slut, and there would be nothing I could do about it. I was on the Pill– it would be all the proof they needed.

~~~~~~~~~~~~~~~~~~~~

A whole bunch of years later, when I’d figured out that I didn’t give a damn about idiots who would judge me for taking the Pill, I was talking to a woman about some of the pain she’d been suffering. During the course of our conversation, I realized that she probably had PCOS, and when I asked her about it, she agreed– that’s what the doctor had diagnosed her with. For her, it had caused her to lose her job, and she’d been hospitalized several times because of cysts rupturing. The pain had caused her to miss church, to constrain her to her bed for days on end.

I asked her what the doctor had suggested for treatment, and her response was that he’d given her pain killers, but she was trying not to depend on them too much.

“You aren’t on any medication?”

“There’s not any real medication for this, though.”

“There’s the Pill,” I blurted out. “It can help.”

She stared at me, her eyes widening in horror. She leaned in close, and dropped her voice to a whisper, even though we were in my house and the only people around were friends. “You mean, the birth control pill?”

I nodded. “Yes. I’ve been on it for years.”

Again, silence, and her wild eyes boring into me. I watched her think about what I’d said, and I watched terror form. She was completely horrified by my suggestion. “Oh my goodness, no, I couldn’t. I just couldn’t. That would just be so . . . wrong.”

It was my turn to be horrified.

~~~~~~~~~~~~~~~~~~~~~

I should make it clear that this wasn’t in my fundamentalist church-cult. This was from a woman who had grown up in “regular” Christianity. There was nothing extreme about the religion she’d been surrounded by. It was all pretty typical, run-of-the-mill Baptist stuff. And she was still so horrified at the very idea of taking the Pill that she refused to even consider it as an option, even though it is the only medical recourse for her condition.

This is One of the Many Reasons why I have a Serious Problem with the Pro-Life Movement.

Because, and not to put too fine a point on it, they lie to people, especially women. They have spread so many lies for so many years that when a woman could take the Pill to treat a medical condition, she won’t, because the only thing she knows about the Pill is poppycock and hogwash.

So, I present a Crash Course in What the Pill is, For Realsies.

First, the Pill is a really limited concept of birth control. There are so many different kinds of birth control, including Natural Family Planning (NFP), barrier methods (condoms, sponges, vaginal condoms, diaphragms), vasectomy, tubal litigation. For hormonal birth control, there’s oral contraception (the Pill), hormonal and copper IUDs (intrauterine device), Depo-Provera (the “shot”), OrthoEvra (the “patch”), and now things like the NuvaRing.

Some of these are long-term, like the shot or an IUD, lasting from a few months to a few years. The patch and the NuvaRing last for the month, usually. You leave it on or in, and take it off/out for a week to have your period. The Pill you have to take every day, which is a bit of a nuisance.

All of these methods work a little differently, but the one that the pro-life movement has spread the most lies about is hormonal birth control, so I’m going to focus on that tomorrow.

June 19, 2013 by SamanthaField

Feminism

I was pro-life until I need an abortion, part 2

I rarely think of that week, now. For years afterwards I tried not to think of it at all– the guilt and shame I carried were debilitating when I let myself dwell on it. I had been so close to crossing an absolute line– the line, the only line that really mattered to most of the people I knew. Before, there was always the comfort of comparison– at least I wouldn’t do that, I could tell myself.

Not anymore.

I would do that, and I had made my decision in a little less than twenty-four hours, not even knowing if I was pregnant. Sometimes I ask myself if I would really have gone through with it– maybe, if I’d known . . . if it hadn’t been some unsettling fear of the unknown driving me to desperation . . .

One thing has been clear since then: my “beliefs” about pro-life weren’t as cut and dried as they were. They couldn’t be.

When I was in highschool, I once argued in favor of mandatory trans-vaginal ultrasounds for women considering abortions. I defended a position I now see as a disgusting, hideous form of legal rape. When I think back to that blind teenager who had no idea what she would someday be facing, I shudder– and I feel pity for her– and I feel envious of her. To her, the world was so simple, so clear, so black and white.

Learning that it is a messy, complicated place has been a difficult process, but I’m glad for it.

I don’t even have a name for where I stand in the pro-life/pro-choice debacle.

But, for political clarity, I’m pro-choice.

I’m pro-choice because I believe that the goals of the pro-choice platform align better with what I could describe as pro-life-ish beliefs. I believe that lowering the abortion rate is the right thing to do– for the health of women, because medical and surgical abortions carry risks, like any other medical procedure. The American abortion rate is double that of any other first-world nation, and I find that troubling.

I believe that making birth control methods freely available to the women who need them–the women who are statistically more likely to have an abortion and are also the women who, statistically, don’t have as much access to birth control–should be a priority. I also believe that the rhetoric surrounding birth control in many pro-life circles is … well, asinine, idiotic, misinformed, deceptive, and ridiculous–to be blunt. The Pill isn’t a “Baby Killer,” as I’ve heard it called– it actually lowers the rate of zygote passage, which a woman’s body does naturally, by the way.

I believe that teenagers should have access to real sex education– a sex education that is focused on delivering all of the facts while focusing on giving young men and women a informed idea of sexual health, and a healthy environment to discuss a holistic approach sexuality– including that, girls, you have a right to say no, ALWAYS, and you also have the right to experience pleasure. And boys, grabbing a girl’s vagina through her pants isn’t funny– it’s a violation.

And I believe that it would be horrific to reverse Roe vs. Wade, or to outlaw abortion federally, simply because that just makes abortions more dangerous, more fatal, to the women seeking them.

I also believe that it is a very, very bad idea to require a woman to have “permission” from the father. A young man I was speaking to, recently, brought up this point. He felt that it “takes two to make one,” and as the father of the baby he should have a “right” to decide whether or not the fetus is terminated. He feels that the current laws paint men as “assholes” that “don’t care” about the possible outcomes of having sex, that men are irresponsible jerks. I understand his feelings, and I get how he can feel that way . . . but that idea, which I’ve heard discussed plenty of times, misses the point.

The laws aren’t there to make men seem irresponsible– they are there to protect women. To protect young girls, like me, who face possible beatings, or possibly death, at the hands of their abuser. They protect women from having to go through the ordeal of proving their abuser a rapist in order to have the right to make decisions concerning her own body– which may or may not even happen.

The “rape exception,” that a lot of pro-life people talk about, is clouded by a lot of misinformation in pro-life circles. There’s an impression that rape is rare, when it is not rare at all, and that pregnancy from rape is also rare, which it is not. This murkiness is in part due to what Mr. Akin called “legitimate rape”– a rape that is so horrific, so violent, so clearly and obviously rape that it can’t be questioned. When, in fact, most rape is not that way. Most rape may not even “look” like rape at all to a fundamentalist– it will look like a sexual encounter where the woman is clearly responsible for leading that poor man on.

Ick.

I’m confused why so many in the pro-life campaign refuse to consider any realistic method the could actually lower the abortion rate– unless their goal isn’t to lower the abortion rate, but to control women, especially to control a woman’s sex organs, which it absolutely is.

I will be gathering links and source material over the next few days, and I will continue to post it here, but, for now, here is Libby Anne’s amazing article on how she became pro-choice.

Photo by Greta

February 15, 2013 by SamanthaField