Passage of the Affordable Care Act provided a major benefit to women of reproductive age: Employers with religious or moral objections to birth control weren’t allowed to exclude those benefits from health plans just because they thought birth control was wrong. When Trump rolled back that mandate — effective immediately — he removed that protection, meaning that women whose prescriptions had been covered could now have to pay out of pocket for medication crucial to their lives. And it can be crucial — hormonal birth control is essential to treatment of conditions like endometriosis, polycystic ovarian syndrome, fibroids, and debilitating periods.
It’s also good for other stuff.
According to the Guttmacher Institute, 58 percent of women who use birth control pills do so for medical reasons. And leaving those conditions untreated can have devastating consequences for women — not only are endometriosis, PCOS, and fibroids intensely painful, they can lead to a loss of fertility for women who really do want to have children someday. The cramps and nausea that accompany PMDD can make women miss days of work or school every month. Hormonal birth control allows them to live normal, productive lives and protects their future.
It also allows women to safely fuck, which is a thing women get to do.
It’s not a matter of women wanting “free birth control,” as it is so dismissively characterized. Women are still paying their share for employer-sponsored health plans. The ACA mandate does remove a co-pay for those birth control methods — not just pills but also injections, implants, patches, and IUDs — but otherwise, coverage is basically the same as any other medication. The regulation just says that employers can’t exclude that coverage on religious grounds, any more than they could prescription allergy medicine or epilepsy medicine. And for women who are in and out of the hospital for treatment of their endometriosis, or trapped in bed because of severe symptoms during their periods, that birth control is just as crucial.
And if women want to fuck — like, really get it in there and go at it — without making a baby, birth control is the way to go.
Yes, one of those arguments might be, purely on the surface, a little more compelling than the other. But women deserve to enjoy a great quality of life from a personal/medical and an interpersonal/recreational standpoint, and affordable access to birth control — via mandated insurance coverage — is an essential component of that.
From a purely utilitarian perspective (because God forbid a woman’s life should be viewed from any other perspective than utility), women’s healthcare generally has better optics than family planning. It’s not fair, but it’s an observable phenomenon. A woman with health problems that can only be addressed with hormonal birth control has an undeniable, physician-diagnosed problem that is hard even for ultraconservatives to dismiss.
Fucking, on the other hand, is easy for them to dismiss — their right to judge women for their personal choices by the standards of religion-based morality is an easy claim, and their right to dictate a woman’s choices on the basis of that religion, while asinine, is something they’re happy to cling to against all logic. “Fucking is for procreation, so if you’re not open to the idea of making a baby, just don’t fuck.” Not financially capable of raising a child? Don’t fuck. Pregnancy could be life-threatening? Don’t fuck. I mean, even if it’s with your husband — he’ll be totally cool with having a completely celibate marriage all the way up through menopause, despite the existence of safe and reliable medical methods to prevent pregnancy. Just don’t want to have a baby? Burn in hell, slut; it’s nothing more than you deserve for denying your God-given job as a woman. And definitely don’t fuck.
Since passage of the ACA, giving women reliable and affordable access to birth control like pills and IUDs, women’s health has improved dramatically. The U.S. is currently experiencing the lowest rate of unintended pregnancy in 30 years, the lowest-ever rate of teen pregnancy, and the lowest abortion rate since Roe v. Wade. Worldwide, access to reliable family-planning methods is associated with lower infant and maternal mortality, lower mother-to-baby HIV transmission, and lower abortion rates. The positive effects of readily available birth control, not just for health purposes but also for family planning, are undeniable. And in theory, people who claim to be pro-life should also be supportive of easy, affordable access to something that has been proven to reduce the number of abortions performed in the U.S. But when that abortion reduction comes without a reduction in women fucking, for some reason it isn’t good enough.
To try and hide that contradiction — against abortion, but also against things that reduce abortion — opponents have to reduce the issue to a farcical image of out-of-control slutbags who just want to fuck without negative consequences. Of course, the truth is, women do want to, and should be able, to fuck without negative consequences. The choice to engage or not engage in sexual intimacy shouldn’t be dictated by fear. That’s why access to family planning is so important. But a legislator who defaults to “keep your knees together, slut” is obviously unwilling to see reason.
And that’s why the debate over insurance coverage for birth control pills tends to focus on the health benefits rather than the family-planning benefits: because opponents don’t care about women getting to fuck. Women shouldn’t be fucking. If unintended — or even potentially life-threatening — pregnancy is the result of women fucking, that’s a feature, not a bug.
I’m not going to criticize the focus on women’s health needs during this debate, because it’s a valid argument within a critical debate that affects women’s lives. Even people who don’t agree with the ultraconservative position that women shouldn’t be fucking are more easily swayed by, and thus more likely to throw their support behind, images of women with severe health problems that can be solved by hormonal birth control. I’m a propagandist by trade — if I were concepting an ad campaign in support of the contraceptive mandate, that’s the primary messaging strategy I would take.
But as a feminist with a blog, I also have to argue in favor of women’s right to fuck. I have to argue against the idea that there’s something wrong with women fucking, that women fucking should automatically come with consequences, or that women are somehow less deserving of accessible healthcare on account of their fucking. I have to point out that lots of women fuck, that there’s nothing morally or ethically wrong with women who fuck, and that for women to fuck with the protection of birth control is more responsible and less “risky” than fucking unprotected. I have to point out that across the world, fucking is a way of life, and the ability to protect oneself whilst fucking improves, and even saves, lives.
Yay for women having access to the treatments they need to live full lives despite serious medical conditions. Yay for women having access to the medication that allows them to manage their fertility and have — or not have — children on their own terms.
Yay for medical care.
Yay for gettin’ down.
Yay for birth control. Yay for legislation that guarantees that employers can’t limit women’s affordable access to birth control because slut. Boo for removal of that protection, leaving women vulnerable without the demonstrable benefits that said access provides.
Yay for health, family planning, and better lives for women in practically every way. (And seriously, yay for fucking.)
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