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Hobby Lobby

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