(This article is dedicated to the women of Puerto Rico who, unknowingly, were the test subjects of the first birth control pill in the 1950’s. Some of these women were given placebo pills and told that they would not get pregnant. Some of these women died from contaminated pills. None of these women were in control of their medical decisions. Every woman who takes the pill is indebted to these women. Find out more about this here.)
After taking the birth control pill for almost half my life, I took my last pill today. I’ve looked forward to this day for years, but now that it’s here, I feel an odd sense of loss instead of the euphoria I had expected. Could it be that I feel my youth receding into an ever more distant past? Not likely. Youth for me was high school, minimum wage customer service jobs, and bad sex with people I didn’t really like. So what is it? Am I mourning the loss of control that comes with more permanent methods? There is something comforting about the tangible aspect of popping a pill each morning, but then again it’s also a pain in the ass. I think the pill is so hard for me to let go of because it was so fucking difficult to get.
You can buy condoms at drug stores, grocery stores, gas stations, even liquor stores. I haven’t checked hardware stores, but it wouldn’t surprise me to find them on an end-cap next to some ridiculously large stainless steel screwdrivers. Yet, birth control pills must be prescribed by a physician and purchased from a drug store. You can get pills at most low-income clinics, such as Planned Parenthood or county health offices, but you cannot walk into a gas station at 3 am and buy a pack of pills.
All those years of waiting in line at Planned Parenthood, listening to the screaming toddlers and the woman with the yeast infection pleading with the receptionist for an immediate appointment, gave me ample time to ask myself: Why is the pill a controlled substance? Why isn’t it an over the counter medication? Other drugs are controlled because they are addictive or dangerous if used incorrectly, but birth control is neither. If used incorrectly, you get pregnant and end up in the same damn clinic getting booster shots for your toddler. I suppose there could be dangerous side effects if you overdosed on your pills. If you were really nervous and took the entire pack in one morning, maybe you’d grow a third breast or lose one. Even if the pill was dangerous, there are plenty of dangerous medications available over the counter. An overdose of acetaminophen (Tylenol) can be, and often is, fatal. The pill is not addictive or dangerous, but it is controlled. Why?
More to the point, why are some forms of birth control (condoms) readily available while others (the pill) are controlled? They both prevent pregnancy and are the two most effective methods of birth control available. So what is the difference? Any guesses? I’ll give you a hint: who uses each one? That’s right, men use condoms—well sometimes we help put them on—and women use the pill.
Now before you discount me as a conspiracy theorist, consider the reaction to birth control on the shelves of your local Rite Aid. What do you think people would say? I imagine, and have heard, statements similar to, “well anybody could go and buy it, even minors!” Minors can already buy birth control, so what are we really afraid of? We are afraid young girls will go buy birth control because when we think of condoms we think of men and when we think of the pill we think of women. I think a discussion of our cultural attitudes about sex, youth and gender is necessary if women, of any age, are ever to gain easy access to birth control.
We have some calamitous expectations about sex, youth and gender. It is generally acceptable and expected for young men to experiment with sex, but it is inappropriate, obscene in some circles, for young girls to think of participating. Yet our society does not condone homosexuality, so there is a problem here. Now of course this is not everyone’s opinion on the matter, but it might as well be because we condone young men’s sexuality by having their method of birth control readily available to them. While simultaneously forcing our young women to make appointments and wait in clinics just to gain control over their bodies. This isn’t fair, and it certainly isn’t smart if we want to reduce teenage pregnancy.
I know that young women can also buy condoms, but I used to be a young woman, and I know that very few of us had the self-confidence to buy condoms, ask our boyfriends to wear them and make sure they put them on and took them off correctly. What do you suppose a teenage girl is more likely to do: pop a pill each morning in the privacy of her bedroom, or hand her boyfriend a condom and demand that he put it on?
Youth is so overrated. At least the pill was much easier to get once I was an adult, right? Wrong. Even as an adult, I had to go to Planned Parenthood for my pills. There were two reasons for this. First of all, for a long time I didn’t have health insurance or the money to go see a doctor. So I went where I could get them for free. I dreamed of the day I would be a fully-insured adult! Once I had a decent health insurance plan, I learned a new term: “medically necessary.” That’s right, my wonderful health insurance plan, which paid for dental, vision and even $100 for smoking cessation treatment, refused to pay for my pills. When I looked further into the details of my plan, I found that they would pay for me to have a baby or an abortion, but they wouldn’t pay for birth control unless it was deemed medically necessary by my doctor.
Back at Planned Parenthood, I explained my situation and the frustrated receptionist finally whispered over the counter to me “just lie and say you don’t have any health insurance.”
After years of pursuing the pill, I guess it shouldn’t be any wonder that I have a hard time giving it up. I know I should be happy, and I would be if I knew I could just swing by the gas station and get more should I ever need it again.
Autumn,
ReplyDeleteI think your recent essay is very insightful. It's true, who is it that teenage boys are learning about sex with if not girls their own age.
While reading though, I had another thought about why condoms are so readily available and birth control isn't. Could it be a very backhanded (and fucked up) compliment for women implying that while men apparently can't keep it in their pants longer than a trip to the local gas station women have more self-control? Yes, I am being funny, but maybe partly serious. With this setup, long term responsibility (rather than the more immediate one night stand) is ultimately placed on the woman. This point in itself could be an argument for making birth control over the counter, and, while it is much more practical to do so, wouldn't it be interesting to deprive men of their quick fix and force them to wait in line in the same clinics? Or would that just mean more unplanned pregnancies? If not for the almost immediate satisfaction purchasing condoms at the local gas station can bring (to both man and woman, correct?), a man might even come to feel insulted by the insinuation he lacks the same self control a woman is assumed to have. And, on the other hand, a woman seriously frustrated by the ammount of self control she is being assumed to have and forced to exercise.
It's shocking that insurers wouldn't consider the pill medically necessary. As if sex without procreation isn't necessary.
ReplyDeleteHowever, I imagine Viagra would be paid for, being that it takes care of a 'dysfunction.'
But wait, is sex really necessary?
I've long thought that birth control pills should be available over the counter for the same reasons you raise in your article. But there are a number of different pills out there with different types and amounts of hormones, and I'm inclined to think that women should speak to their doctors about which one is "right for them" rather than purchasing it without any advisement. I don't know what the solution to that is, other than suggesting that the initial purchase be permitted only after offering proof of having met with a doctor first. It would be lovely to purchase refills over the counter for less than $75 for a month's worth! (Which is how much they can cost without insurance.)
ReplyDeleteAlso, I don't think the importance of condoms should be underestimated. While the pill offers young girls the privacy they may desire, it doesn't protect them from STDs, including HIV.
Yes, my insurance, and most insurance companies, do cover the cost of Viagra. In one draft of this essay, I said that if I had had a penis, they would have paid for my erection :)
ReplyDeleteI suppose it isn't so shocking that they won't pay for birth control. They won't pay for my mother's MRIs each year even though she had a tumor that was removed, which only an MRI can detect, and that type of tumor typically grows back after it is removed, and her doctor's deem it medically necessary--thanks Blue Cross!
But there is something about the term "medically necessary" that is particularly insulting to me in the case of needing birth control.
you wrote: "While simultaneously forcing our young women to make appointments and wait in clinics just to gain control over their bodies."
ReplyDeleteDo women need to have birth control to "control" themselves???
I think that is outrageous!
Self control is what is MISSING!!!!
And those that have none suffer greatly!
I am assuming that by "self control" you are referring to abstinence, and that your argument is that women should practice abstinence as a form of birth control.
ReplyDeleteIf this is indeed your argument, I agree that for some women abstinence is the best option. I also agree that all women, especially young women, should have the self respect and the self confidence to wait until they are ready for sex. I certainly don't want anyone to rush into or be pressured into sex before they are ready.
However, I know that many young women also choose to be sexually active. Just as I support a woman's right to wait, I support a woman's right to engage. If a woman wants to have sex, I see no reason why she should not be able to. While I do encourage women to practice safe sex by using condoms in most circumstances because they are the only form of birth control that also protects against STDs, I see no reason why other methods should not be readily available as well. Why should an 18-year-old, or a 38-year-old, who has been in a monogamous relationship with her boyfriend for 6 months not have easy access to the pill?
(And by the way, your equivocation with the word "control" is a logical fallacy.)
Does self-control/abstinence also apply to married women who are postponing motherhood for various reasons, including health or finances?
ReplyDeleteExcellent essay. There was much debate and argument several years back in Connecticut over the fact that the state required viagra to be covered by al health insurances, but not the pill or other forms of hormonal birth control for females. Birth control coverage became part of state legislation. Some even argued that with the advent of viagra, birth control pills were even more necessary.
ReplyDeleteI agree with Amber on the issue of a doctors consultation, although perhaps trial and error would be best for those of us who cannot readily see our physician. Advertisements and pamphlets informing us of hormones and their levels, and which types of pills work best in different situations, should be enough for us to make informed decisions. I've told my doctors which BCP I wanted for the past several years because of doing such research. It would have been easier for me to just have it dispensed at my leisure than going about the current system.
As far as self control goes, I'm controlling my body. I don't take this medication for sexual purposes. One does not need to be a promiscuous woman to require BCP, but those of us with multiple partners may especially want the pill. Amber's reasons above are also quite warranted. If we begin to question a woman's reasons for protecting her reproductive organs, then we must also question the men with whom the majority of us have sex.
I am a married woman who could not possibly afford to have kids as I just recently graduated from college and my husband still attends. We have no health care and no way of supporting a family. I also suffer from hereditary intense pain with my monthly cycle, and birth control regulates that. Having this medicine is absolutely necessary for me, my quality of life, and that of my family. Thank goodness for planned parenthood where I can get it for free, after waiting ten hours in line. I'm mainly writing to say thanks though, your piece was very thought provoking and has spurred some great discussion!
ReplyDeleteThanks for the comment! It is situations such as yours that only further my belief that birth control needs to be an over the counter drug.
ReplyDelete