Book Review: The Pill Problem

 

Before I started reading The Pill Problem by Ross Pelton I had just finished Drugs for Life by Joseph Dumit. I was slightly apprehensive about the message of the book, thinking that Pelton would promote solving one problem by perhaps encouraging the use of various drugs, but I was wrong. Pelton acknowledges the fact that the pill plays an important role in the lives of women, but states that the side effects are many and varied. Pelton’s mission with this book is to educate women on the side effects of the pill and hope that they will switch over to safer, healthier forms of contraception.

We often hear about side effects associated with the pill, but we are rarely told why women taking the pill are more likely to have blood clots for example. Pelton states that research has shown that nutrient depletion is common for the majority of women taking the pill, and that nutrient depletion can cause a range of undesirable symptoms and illnesses, such as cardiovascular disease, heart attacks, depression, birth defects, cancer, osteoporosis and more.  [Read more...]

Emergency Contraception Restrictions Overturned!

This morning, Judge Edward Korman of the District Court of Eastern New York overturned the Obama administration’s ban on allowing women under age 17 to purchase emergency contraception without a prescription. Judge Korman has ordered the FDA to make Plan B available over the counter to all women “within thirty days.”

In late 2011, the administration overruled a decision by the FDA to allow teenage girls to purchase Plan B without a prescription. The administration’s move came as a surprise and was blasted for being politically motivated. In the decision released today, Judge Korman seemed to agree with that assessment, writing that the restriction was “a strong showing of bad faith and improper political influence … The decisions of the Secretary with respect to Plan B One-Step…were arbitrary, capricious, and unreasonable.” (The full decision can be read here.)

Plan B has been available to women ages 17 and older without a prescription, and to younger women that have a prescription. But keeping the medication behind pharmacy counters meant that women could only buy the pill when the pharmacy was open, and many pharmacies are closed on evenings and weekends. Since Plan B is most effective if taken within 72 hours of having unprotected sex, such delays matter. Women have also reported encountering pharmacists that refused to sell them Plan B, because the medication violated their own personal beliefs.

Today’s decision is great news, and a great way to start the weekend!

Getting Over the Pill

I know when the romance started for me. I was at summer camp, where all the best romances begin, getting a windbreaker or a jean jacket–some outerwear-oriented excuse for busting in where I wasn’t supposed to be. contraception_591At the sink, I saw my counselor, older, cooler, and in my memory, always blonde, popping a candy necklace pill out from a plastic flip-top compact.

I knew I wasn’t supposed to know what I was seeing. But I did. She was on the pill. Having sex. Which somehow made me feel a few steps closer to having sex myself. Inside that pink clam shell was the secret of adult life. Everything I needed to know about sex and men in its own handy dandy carrying case.

Now, of course, I realize she might not have been having sex, and I want to swaddle my younger smartypants self in a thick blanket, knowing when and how she’ll have the easy answers bruised out of her.

But there was no reasoning, then. And no reason to reason … I was in love with the pill, and as I grew up, I could see I wasn’t alone. It was the hot girl’s one and only punchline in Sixteen Candles and Roseanne’s cool-mom badge of honor, and long before that, Loretta Lynn was singing its praises for good reason. The lyrics make it clear how much the pill could change the fundamental facts of a woman’s life.

You wined me and dined me when I was your girl
Promised if I’d be your wife you’d show me the world
But all I’ve seen of this old world is a bed and a doctor bill
I`m tearing down your brooder house ’cause now I’ve got the pill

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No Better Time for Plan B

I have a package of Potassium Iodide tablets in my Go Bag, and I’m happy most days not to think about either, but I feel better knowing that they’re there. For those of you unfamiliar with either, or both–Potassium Iodide protects the thyroid from radiation poisoning, and a Go Bag is an emergency preparedness kit with enough supplies for a person to survive without outside help for at least three days.

If you didn’t know, consider yourself lucky. Or blissfully ignorant. I suppose it’s all a matter of perspective. That–and what the future happens to bring to yours.

Me, I decided back in the days of the dirty bomb scares that I’d rather have a package of ominously-packaged pills in the house than to one day wish I had bought some as an invisible deadly force fried my body. Same goes for the Go Bag. I put the pills in the bag, put the bag behind the couch, and honestly, including today, I can count on one hand the number of times I’ve thought about either in the past ten years.

Isn’t that how worst case scenario preparation should work? Prepare for the worst, hope for the best, and try not to scare the bejesus out of yourself in the meantime. Anything less would be irresponsible when it’s a matter of life and death, right?

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Good News in New York

Teens at thirteen New York City high schools have had access to emergency contraception for over a year–but it wasn’t news until the New York Post got wind of it in an “exclusive” report on Sunday. In other words, the program did not make any of its critics’ wildest fears come true. No crazy rise in teenage sexual shenanigans. No rash of teens stricken with any of Plan B‘s side effects, real or imagined. The Post and fair-weather parental advocates like Cardinal Timothy Dolan would never have passed up the opportunity to fan even the slightest concern into a full-blown controversy.

Now the belated hand wringing has begun, and as long as the schools keep following the state law that allows doctors to prescribe emergency contraception pills to women fourteen or older without parental consent–yes, once again, New York state is ahead of the curve–I don’t mind in the least.

Okay, maybe I do mind, but I can also hope that the special provision included to protect parental rights (how I want to put quotations around that phrase), will force the parents who are really only fighting for the right not to think about teenage sexuality at all, to consider the possibility that their child may have the same feelings that have been making adolescents infamous for ages, even if only for the moment it takes them to ”opt-out” of the program. Best case scenario, it starts an honest dialogue between parent and child. Worst case scenario, at least the child knows where his or her parent stands, if and when the poor kid needs to talk to a grown-up.

Elsewhere in New York state, the news in teenage reproductive health hasn’t been good. A recent investigation by the NYCLU revealed “glaring inaccuracies about basic anatomy, reinforced negative gender stereotypes, and stigmatized LGBT students and families” in Sex Ed classes statewide. In one district, the ignorance reaches Todd Akin proportions: definition of vagina–”a sperm deposit.” No word on whether it shuts down or not. (Maybe it has bankers’ hours? Get it?)

I have every sympathy in the world for parents, and the argument about school nurses needing a parent’s permission to dispense Tylenol is at least as old as I am. But I’m still pretty sure teenage girls don’t use Tylenol (or aspirin, anywhere) to prevent pregnancy. (“Not now, I have a headache,” comes much later.) Maybe today’s parents are less hung-up about sex than my parents were back in the day. It wouldn’t take much. But I have a hard time believing even the coolest parents in the world have figured out how to make their children believe they’re always “easy to talk to” about sex. (I’d be impressed and probably a little creeped out, but I wouldn’t believe.) I’m too uptight to say I think the taboos we have about sex are a good thing; but I do think they’ve survived thousands of years because they’re powerful. If loosey goosey New Yorkers with all their culturally elite street cred can still get tongue-tied–or willfully blind–about teens and sex, I, for one, am glad city teens have professional health care providers looking out for them while their parents work out their feelings.

 

Feminists for Choice Fundraiser in NYC

On September 7, 2012, Feminists for Choice will celebrate New York’s historic role in protecting women’s reproductive rights at a happy hour fundraiser for the New York Abortion Access Fund (NYAAF). With the Republican National Committee drafting what committee member Russ Walker boasts is “the most conservative platform in modern history”–a document that promises more rights to a zygote in a petri dish than to the living, breathing, thinking woman who might hope to carry that zygote to term–there’s no better time to support the grass roots efforts of the NYAAF to ensure that New York remains the safe haven for women it has been for generations.

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De-Queering the Fetus

recent article by Alice Dreger, Ellen K. Feder, and Anne Tamar-Mattis documents the controversial application of prenatal dexamethasone in pregnant women. The impetus for this pharmacological therapy is to stop virilization in female fetuses that may be affected by a form of congenital adrenal hyperplasia (CAH) called 21-hydroxylase deficiency or 21-OHC CAH.

Don’t allow the medical jargon to turn you away from what’s taking place here: the steroid is administered to pregnant women with the goal of stamping out intersexed bodies while ultimately minimizing the likelihood that a female will grow to be butch, lesbian, bisexual, and/or transgender. Yes, you read that right. This is an ongoing medical project that is motivated by homophobia, transphobia, sexism, and cissexist ideals. Let’s back up a bit and unpack some of the medical jargon that complicates our understanding of systemic hate.

CAH is a disease of the endocrine system (the hormone regulating mainframe of the body). There are variations of CAH and the one of interest here is 21-OHC CAH. 21-OHC CAH leads to an over production of androgens, which could lead to a genetic female fetus “developing along a more masculine pathway neurologically and genitally” (5). The term for this masculinization is virilization, which manifests in many ways but can lead to masculinized female genitalia, of which is a surface motivation (e.g. justification on grant applications) for the use of prenatal dexamethasone. CAH is a serious disease and as such, every U.S. state requires that newborns be screened for it. However, at case here are fetuses that may be affected by CAH, not newborns that are affected by it. The authors expose that 87.5% of those fetuses that are exposed to prenatal dexamethasone stood no chance to benefit from the therapy at all.

Prenatal dexamethasone is a steroid that is theoretically used to stop the effects of 21-OHC CAH. However, the drug is experimental and there is no substantial support for its use. In the U.S. it is categorized as “off-label,” which means that it is not FDA approved. As it stands, there is very little known about the impact of the therapy but it may alter “fetal programming,” which can result in serious metabolic problems that may not be apparent until adulthood. For 30 years, the steroid has been used to combat virilization in female fetuses and yet, little is known of its impact because there are few long-term studies that explore its impact—of those, the populations are not representative and the protocol does not meet national or international scientific standards. In fact, the Endocrine Society set up a task force to look at the effectiveness of the pharmacological therapy. The task force found very little support for the use of the steroid and “could not even say with confidence whether prenatal dexamethasone works to reduce genital virilization” (2).

Nonetheless, it has been administered to pregnant women on false pretenses. The pregnant women were/are not informed that the “off-label” steroid is experimental, that benefits and risks have not been established due to lack of adequate testing and scientific protocol, and that exposed fetuses are studied retrospectively effectively rendering moot any correlation between the drug and the fetus born one way and/or raised another.

The “most prominent promoter” of this therapy is Maria New, a pediatric endocrinologist at Mount Sinai School of Medicine. By 2003, New has “treated” more than 600 pregnant women with dexamethasone in order to prevent virilization in CAH-affected female fetuses. That number is as high as 2,144 fetuses. This is where the story turns sour and scary—or more sour and scarier.

Despite a lack of support for prenatal dexamethasone Maria New insists that it “has been found safe for mother and child” (15-16). The authors of the article do some bold investigative work and turn to New’s grant applications discovering some interesting motivations for the continued use of the steroid.

Those few studies that do exist show that girls affected with 21-OHD CAH exhibit “behavioral masculinization.” These girls are on average “more interested in boy-typical play, hobbies, and subjects that non-affected females, less interested in becoming mothers, and more likely to grow up to be lesbian or bisexual” (6). Some clinicians find that of those females with 21-OHD CAH, 5% may ultimately identify as male. “Behavioral masculinization” is a euphemism for non-traditional gender performance or expression in women, females, and/or girls. It seems that the underlying motivation has less to do with ambiguous genitalia (which is problematic itself) and more to do with minimizing “tomboyism,” non-heterosexuality, and trans* embodiment.

Interestingly, the U.S. National Institutes of Health have funded Maria New’s work in figuring whether or not prenatal dexamethasone works to stop “behavioral masculinization.” Said another way, the U.S. government funds New’s work in stopping queerness and/or trans*ness in those potentially affected with 21-OHD CAH. Please, read that again for the sake of letting it sink in.

One justification for using prenatal dexamethasone is to minimize the chances of having a child that is intersex so that “corrective” surgeries will not be necessary. However, such “corrective” surgeries are elective and yet this reason is used as grounds to administer this potentially dangerous drug.

The unknown effects of prenatal dexamethasone are as potentially damaging and traumatic to intersex bodies as invasive “corrective” surgeries that claim to “fix” a problem when the problem isn’t the fetus at all. The inspiration for this pharmacological therapy is stigma and anxieties surrounding intersexed and/or queer bodies. It is a medical intervention that works to ensure the production of relatively normative bodies no matter the cost to those that are at risk of teetering between cissex and intersex embodiment. The anxiety/fear-inspired application of prenatal dexamethasone points us to the intersection of sex, gender, and sexuality and those systems that work to keep them aligned more nicely.

Speaking to parents of children with CAH, Maria New “showed a picture of a girl with ambiguous genitalia and said: The challenge here is to see what could be done to restore this baby to the normal female appearance which would be compatible with her parents presenting her as a girl, with her eventually becoming somebody’s wife, and having normal sexual development, and becoming a mother. And she has all the machinery for motherhood, and therefore nothing should stop that, if we can repair her surgically and help her psychologically to continue to grow and develop as a girl” (italics mine 6).

For New, the prominent cheerleader in prenatal dexamethasone therapy, girl/female/woman are one and the same and are heterosexual desiring motherhood and marriage. For New, queer variation is inconceivable. For New, prenatal dexamethasone is the ultimate in conversion therapy because it gets at the “problem” before it is a problem. It does so even though the long-term impact is unknown and potentially fatal. New, and her supporters, will do whatever it takes to ensure that queerness is squashed at every chance. For the record, you can contact Maria New at maria.new@mssm.edu.

Ladies! Get Your Slut Pills Free Starting Today!

If I had a wacky waving arm flailing inflatable tube man, I’d put it up in front of my apartment complex today. It would have a really cool sign that said:

“FUCK YEAH! FREE SLUT PILLS! THANKS OBAMA!”

Or something like that.

Dubbed “No Copay Day,” today is the day when seven key preventive reproductive health services are now covered without copay. I really think that the Obama Administration could’ve come up with some better names for today, considering that it’s a milestone for women’s health and feminism. My suggestions include “The Day Freedom Died,” and “Slut Pills Liberation Day.”

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Political Science: Plan B and the Implantation Debate

Want to know how effective a bully the anti-abortion lobby is these days? When it comes to labeling emergency contraception pills, the Italian equivalent of the FDA–yes, that Italy, home to the Pope and umpteen Catholics, where, in contrast to the U.S., it actually is illegal to use contraceptives that prevent implantation of a fertilized egg–is less timid. The Italians have accepted evidence the F.D.A has been reluctant to place on emergency contraception for years, even though there appears to be little doubt about its validity.

This week the New York Times reported that there is ample scientific evidence proving that emergency contraception such as Plan B and its generic equivalents does not prevent the implantation of a fertilized egg. It delays ovulation, which means it prevents the egg from meeting that sperm altogether. This of course negates the argument abortion opponents use to attack the medication, but why let a little truth get in the way of a good story about bad scientists and the bad women who love them?

The Times’ investigation shamed one federal health agency into admitting the truth: [Read more...]

The Little Blue Party Pill: Sex, Boners, and Lots of Viagra


Editor’s Note: Today’s guest post comes from Saira Khan. Saira currently works in publishing but dedicates her free time to social commentary on her personal blog. She is a soon to be Master of Science candidate at Columbia University. Follow her on twitter @sairakh.

In the past two years we’ve seen an onslaught of Republican led bills to limit women’s access to safe and affordable abortions, cheap birth control, and health care. A recent Kansas bill allows doctors to lie to women in order to prevent abortions including lying about breast cancer treatments. They’re also trying to add a 6.3% tax to abortions even for rape victims. This is just one in a slew of bills we’re seeing red states draft in order to deny women the right to choose and deny them access to affordable contraception.

But it’s not just birth control and abortion that are under attack. Women and their sexuality are now in the spotlight. After the whole Limbaugh-Fluke fiasco, Bill O’Reilly went ahead and aligned himself with the likes of Limbaugh by stating “You Want Me To Give You My Hard-Earned Money So You Can Have Sex?” To sum it up: they don’t want women getting abortions, they don’t want to help women who choose not to have an abortion, and they don’t want women using birth control. Basically, they don’t want women having any sort of sex whatsoever unless it’s to procreate. What’s interesting about all these discussions is: where the hell are the men? Somehow conservatives make it sound like women get pregnant all by their slutty selves and then recklessly get abortions. Seriously though, where are the men in this equation? Oh yeah, they’re out there having lots of sex and getting cheap and easy erections…

Not only are men entirely excluded from this whole we’re not paying for you to have sex conversation, men and their overuse and abuse of Viagra is actually defended! The common excuse I hear in defense of the little blue pill is “well, Viagra is life-giving.” So, really what it comes down to is that they seem to believe men can have as much sex as they want because, you know, they’re men. And somehow birth control promotes sex and Viagra promotes, what, abstinence?

Let’s clear a few things up here about Viagra. [Read more...]