Hormonal birth control isn’t for everyone. But that doesn’t mean that it’s part of a patriarchal capitalist plot to force women to work while menstruating (WORK WHILE MENSTRUATING?!?! IMPOSSIBLE). Yet that’s the argument from a feminist writer in her new book Sweetening the Pill: or How We Got Hooked on Hormonal Birth Control. Lindsay Beyerstein handily addresses her arguments in Slate:
There’s no question that some women experience side effects on the pill. Perhaps the best known and most serious of these is an increased risk of blood clots. The pill approximately doubles a woman’s risk of a blood clot, but her absolute risk remains low. On the pill, a woman’s annual risk of developing a clot rises from about 1 to 5 women out of 10,000 to 3 to 9 in 10,000. Bayer’s controversial Yaz and Yasmin pills probably push the risk of blood clots even higher (10 to 22 in 10,000). Even so, the risk of a blood clot on the pill is a fraction of the risk of a blood clot during pregnancy or the postpartum period. Are these acceptable risks? As a pill taker, they are to me, but every woman has to make up her own mind.
You might assume that women take the birth control pill for, well, birth control, but Grigg-Spall thinks she sees a more sinister agenda. “Women do not choose … hormonal contraceptives because these things are necessary or convenient for them or because they consciously need or want to,” she asserts. Instead, according to the author, “Women are encouraged to suppress their monthly ovulatory cycle in order to not miss any days of work or so as they can remain sexually available or experience only one-note moods.”
Sweetening the Pill frames hormonal contraception as a societywide assault on ovulation and menstruation orchestrated by the capitalist system and its handmaidens in the medical establishment and feminism. Grigg-Spall ascribes the pill’s popularity to a misogynist culture that expresses its contempt for the female body by squelching its natural cycles with artificial hormones.
If capitalism, medicine, and feminism sound like strange bedfellows, that’s because they are. Grigg-Spall makes a series of seemingly contradictory claims about the capitalist-medical-feminist bloc that is supposedly bullying women into taking the pill: 1) The pill is popular because it turns women into emotionally stable and industrious workers who never miss a day of work or bleed on the shop floor and because the economy needs women’s “passivity, anxiety and emotionality.” 2) The pill is the modern-day equivalent of the 19th-century practice of “female castration,” which was used to desexualize women, and the pill is promoted as part of a feminist scheme to make women more alluring and available to men. 3) The pill kills female libido, and the pill fuels the supposed epidemic of sluttiness known as “raunch culture.”
Does the pill masculinize, ultrafeminize, or unsex women entirely? Grigg-Spall claims all of the above!
I am one of the many American women who took the Pill for a while, didn’t like some of the side effects (mood swings, lower sex drive), went off of it and never went back. I found other birth control options that worked — and they worked in large part because I’m not financially or socially dependent on my male partners, and I have quite a bit of sexual negotiating power. That’s far from universal for many women. And most of my friends who are on the Pill don’t have the same side effects that I had, and are perfectly happy relying on it as their primary means of contraception. Also, one friend feels like she gets in her best shape by running, another by doing Barre classes and Pilates, whereas I prefer yoga. Shocking news: People are different, and our bodies work differently! The Pill works really well for a lot of women. It works less well for others. It’s intolerable for some.
That it didn’t work for Holly Grigg-Spall is a real thing. But that does’t mean that the Pill is terrible for all women, or that none of us should go to work while menstruating (for the record, I work just fine while menstruating). Other commentators point out that doctors shouldn’t dissuade women from using the Pill, and that too many of us are encouraged to choose hormonal birth control over all other forms. While I’m sure it has happened that doctors direct women one way or the other, part of a doctor’s job is to ask questions about why a medication isn’t working for you, and give you medically accurate information about risks and benefits. Which is why I think this is bunk:
Just as we who hold pro-choice values don’t judge or hassle women for the reasons they choose to have abortions, we should not judge or hassle women for the reasons they choose not to use HBC, nor try to deter them. Yet anecdotal evidence abounds that women who want to quit the birth control pill, have their IUDs removed, or learn fertility awareness based methods (FABM) are often actively dissuaded from acting on their choices. It takes extreme self-assurance to do what one young university student told me she did when her doctor questioned why she didn’t want to use HBC. Her response: “My reasons are none of your business.” She said she knew the doctor would try to overcome her objections to the side effects she refused to incur.
I believe that pro-choice sexual health advocates and care providers can and must find a way to do their work effectively within this birth control dichotomy. We must acknowledge the right of women to choose HBC or NHBC depending on which best serves their health and contraceptive needs. And it’s our obligation to help them use their chosen method effectively and confidently, without persuasion or dissuasion.
If you’re going off of any medication, it is in fact your doctor’s job to ask why. And of course women should have the right to choose non-hormonal birth control. But doctors also need to discuss realistic risks and benefits. The truth is, statistically, an IUD or hormonal BC will make it less likely that you’ll get pregnant compared to relying on fertility awareness. That doesn’t mean that fertility awareness is a worse choice than hormonal birth control for all women everywhere; it does mean that doctors need to lay out the facts and allow patients to weigh them. That isn’t dissuasion. It’s responsible medical care.
What’s not responsible medical care (or advice) is deciding that because something didn’t work for you, it’s not only totally useless but an evil corporate plot to keep sisters down.
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