Browsing Tag

hormonal contraception

Feminism

reproductive coercion: Rhiannon's story

I am a feminist who supports contraception coverage for every person who needs and wants it. However, that does not mean that I will be blind to some of the ways that hormonal contraception can be used as a weapon against women; some have criticized the ever-growing expectation for women to be the one primarily responsible for contraception. Since hormonal contraception is a medication that is not right for every person, that expectation can harm women and needs to be discussed. This is Rhiannon’s story.

No one else from my high school was going to the same college as me, which was exactly what I wanted. As the youngest in a fairly large family, I always felt like I wasn’t allowed to be my own person. This would be just the fresh start that I needed. I bumped into a friend I’d lost touch with after middle school, and she invited me to an 18-and-older club. I walked into her dorm room before we left, and there he was.

Joey was a textbook bad boy – he had a mouth like a sailor, he smoked like a freight train, and he often had a flask of whiskey in his boot. He was every boy that I had never been allowed to hang out with at all, let alone date, and I was drawn to him because I was starving for adventure.

Things started out fairly innocently, I suppose. We danced at the club and ended up spending the night together a few nights later. Slowly, he started taking up more and more of my time. Things were always a little on the rough side. I cared about him and wanted to make him happy. He was afraid to commit but he would tell me that I was the first girl that ever made him feel the way he was feeling. His parents had been married for nearly thirty years and suddenly separated and got back together multiple times, and he was angry. He was always so angry. I was terrified riding in the car with him in traffic because I was afraid of his rage at simple things, like a traffic light turning red, or another driver forgetting to use a turn signal. If I got out of class and walked to meet him at the café with a male classmate he would get a sullen, resentful look on his face and ball up his fists until we sat down and our other friends arrived.

I never thought much of it because guys are jealous, right? He never got angry with me, so it was okay, wasn’t it? He’s just going through a lot right now, I told myself. He won’t always be like this.

Although he had never slept with anyone before we met, he still wanted me to perform sexual favors for him, with little to no reciprocation. We did begin a sexual relationship not long after we started dating officially. He was more paranoid about pregnancy than any person I had ever met. We always used condoms and he always pulled out as well, so I wasn’t concerned about pregnancy. He kept up with my menstrual cycle and when it was close to time for my period to start he would constantly ask me, to the point of harassment, if I had started yet. I thought maybe he would settle down after a while, but he didn’t. He just got worse. He started making threats, thinly veiled as jokes, about what would happen if I got pregnant. Most of his “jokes” involved coat hangers and flights of stairs.

I was too consumed with this relationship to see the warning signs of the depression I was falling into. I never had even a drink of alcohol before I went to college, but he and his friends all drank fairly heavily, so I started. And I liked it. I liked that it made me feel warm all over and I liked how it always felt like I was completely removed from my emotions when I was drunk.

He pressured me to get on birth control. At that point in my life, I was terrified of medication in general. I hated to even take an ibuprofen for a headache. The thought of taking artificial hormones and manipulating the natural processes of my body made me feel sick. He wouldn’t let up, though, so I made an appointment with the student health center to get a prescription. They prescribed me a $9 generic from Wal-Mart, which was more than I could afford at the time since I was in school full-time and living off of my financial aid. Joey wouldn’t help me. His reasoning was that I had better financial aid and therefore more money than he did.

That birth control made me feel awful. I was nauseous and I had heart palpitations and sudden, stabbing headaches. I stuck it out for a few months before I gave up. At that point, our relationship deteriorated pretty badly. I knew I wanted out but I didn’t know how. All of my friends were also his friends, because I had slowly cut my own friends out of my life.

One evening after a practice session where he was teaching me MMA-style fighting, we were sitting in the living room of the apartment he shared with some friends. There was a friendly but very lively debate going on about something in the Bible – I don’t remember what it was, exactly. I disagreed with something that Joey said and he got angry. Angrier than I had ever seen him. He had a mouthguard in his hand from our fighting earlier, and he threw it at my face. I was across the room and he was mad enough to mess up his aim. It didn’t hit me, but I felt the air rush past my face. Immediately, I calmly got up, walked to his bedroom, and started throwing all of my things into a bag. He ran to apologize, spewing a lot of total crap about how much he loved me and how “you just make me feel everything more strongly!”

I left.

I wish I could say that I left for good that night. In reality, it took a couple of months. But that was the start.

He never physically hit me (other than in the practice sessions), and he was very good at framing his manipulative words in a way that made me feel like I was being irrational and overreacting. Actually, his arguments followed a pattern similar to all of my parents’ tirades. My whole life, my parents told me that they loved me unconditionally, but then they turned around and screamed me into submission with implications of my sinfulness for “dishonoring my father and mother.” I didn’t have any kind of experience of a relationship without fear and emotional manipulation as the backbone, so how was I to recognize my relationship with Joey as abusive?

It was abusive. Abuse isn’t always sexual, although I do recognize some of my encounters with Joey as assault now that I know better. Abuse isn’t always physical. It’s not always bruises and black eyes and bloody noses. Abuse is often invalidation, emotional trauma, and power play. Joey figured out that I was vulnerable to being manipulated and he used that to keep me in his life when I should have been running far away from him.

August 1, 2014 by SamanthaField

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 two

Put in incredibly simple terms, hormonal birth control works thusly:

Step 1 : it prevents ovulation.

“Ovulation,” for the uninitiated, is when a mature egg is released from the ovary and become available for fertilization. “Prevents,” in this case, does not mean that the pill stops the egg from peaking its little head out of the ovary. It prevents because no egg develops to maturity. Simply put, there is no egg to come out of the ovary in the first place. This is one of the most important parts about hormonal birth control options, and something no one seems to pay attention to.

This is also the most important part for me. PCOS means that I get too many cysts developing at the same time, or they never stop developing, and I never experience a menstrual cycle. Ovarian cysts are normal– an ovarian cyst is where the egg matures. Hormonal birth control works to treat PCOS because it does not allow ovarian cysts to develop. An additional part of this process is that even if an ovarian cyst develops, there’s another chemical block in place that stops an egg from forming inside of it.

No ovarian cyst, no egg, nothing mature enough to be fertilized.

But, in the exceedingly rare case (if it wasn’t rare, it would be useless as a treatment for PCOS) where there is a cyst and an egg is developed, we move on to–

Step 2: eliminate the possibility of fertilization

This is pretty straightforward, and it comes in two steps. The progesterone in hormonal birth control options thickens the cervical mucus– makes it insanely more difficult for the sperm to reach the egg, which is already difficult– and it makes the egg harder to fertilize. So, even if a cyst develops, and if an egg develops inside of the cyst, and IF the sperm makes it up through the thickened mucus and all the way up the fallopian tube, when it reaches the egg, it’s going to have a hard time fertilizing it.

At this point in the process, the possibility of an egg being fertilized is so vanishingly small it’s not even really worth talking about, but I’m a-gonna, because it’s where the pro-life movement starts lying their little tooshies off.

“Supposed” Step 3: prevent implantation

At this point, the egg is a zygote, which is just the technical term for “fertilized egg.” For a lot of people this is where “conception” happens (which, problems), so this is where people start thinking that hormonal birth control is Just the Most Evil Thing those Evil Doctors have Ever Invented.

The most frequent term you’ll find in information about how this works is that the uterine wall is “hostile” for the egg. This is a misnomer. The uterine wall is exactly the same as it ever was, just thinner (hence, lighter periods). There’s no study that shows that the uterus becomes “hostile”– in fact, the scientific studies show that hormonal birth control options do not alter the uterine lining in any significant way except for making it slightly thinner, and are incapable of contributing to zygote failure (which I’ll explain).

This is the part where the pro-life movement lies. Because, at this point, they claim that this where the Pill murders babies. Literally starves them to death. Because it takes a baby (zygote), and then refuses it the opportunity to grow. It never grows, the woman’s body never receives the signal that she’s pregnant, and then the uterus expels the zygote and the uterine lining: therefore, MURDER.

Ok, folks, this is where I have All the Problems.

Let’s talk about the zygote, the supposed “great red herring” of the pro-choice movement.

The zygote is a single-celled organism, which through mitosis goes through stages (blastocyst, then embryo). Over fourteen days, it has to develop into an embryo, and the embryo has to develop the conceptus in order to attach to the uterine lining. The uterine lining, at this point, must transform from the decidua to the placenta.

Hormonal birth control methods are incapable of terminating a viable pregnancy. They are designed, in an unbelievable number of unnecessary steps, to prevent fertilization from ever occurring. Not by turning the uterus into a baby-killing machine. That’s patently false, and a bald-faced lie. If a woman’s body develops an egg, the uterine lining is unchanged. If there aren’t enough of the synthetic hormones present to prevent ovulation, there’s not enough of the hormones present to affect the uterine lining. If there’s no egg, then the uterine lining is thinner, possibly, and that’s the only real difference.

It’s a complete misunderstanding that in the case of supposed “breakthrough ovulation” that the uterine lining is still thinner. It’s not.

Here’s what the pro-life movement also refused to discuss:

All the medical studies I could scrounge up reveal that 60, 70, maybe 80% of all zygotes fail to implant on the uterine wall, when the woman is trying to conceive and is not on hormonal birth control.

Let me say that again: as many as 80% of all “babies” never implant in the uterus completely on their own.

For those that do manage to make it, another 30% don’t survive the first few weeks.

Let’s do the math again: 72% to 86% of all zygotes, which the pro-life movement refers to as babies, “die” without any outside interference whatsoever. When a woman is not on the Pill, zygotes fail.

When a woman is on the Pill, there’s rarely ever a zygote, and when there is one, it faces the exact same rate of zygote failure as a woman who isn’t on the Pill. The upside? When a woman is using hormonal birth control, there are less zygotes. Somewhere in the ballpark of 98% less zygotes.

Let me make this more clear: if zygote failure is “murder,” and hormonal birth control options drastically reduces the number of zygotes, the number of failed zygotes (i.e.: “murder”) is also drastically reduced.

Tell me again how the Pill is evil?

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*Edit*

I wanted to include some information I have that might clarify my basic argument in this post: that hormonal birth control options don’t interfere with implantation. I’ve already made it clear that hormonal birth control doesn’t make the uterus as “hostile” place for the zygote, but I thought it might be helpful to explain why, biologically, this is so.

A menstrual cycle is just that: a cycle. It goes through three steps, or stages. The first is the follicular phase, where the uterine lining is thin. Thin, in the same sense that it is thin while a woman is on hormonal birth control. It is not capable of of allowing the conceptus to attach.

However, part of the ovulation phase is that ovulation releases a trigger for the uterus to begin the luteal phase, where the lining becomes thicker and the conceptus is able to attach.

If a woman on the Pill ovulates, this releases the hormonal trigger, and the uterine lining thickens because it enters the luteal phase. If she does not ovulate, the uterus does not receive the trigger, and the uterine lining remains exactly the same as it ever was.

You can read about this on wiki. Seriously.

June 20, 2013 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