It’s not just about the pill

It’s what it represents

I am a cisgendered*, heterosexual woman, and during my short lifetime I have tacitly absorbed the assumption that I and other cis-heterosexual women are expected, in this day and age, to take control of our sexual responsibilities and preclude the possibility of pregnancy.

It has come to my attention recently, however, that although I and others hold this expectation, the responsibilities we have are wholly subject to the amount of information we’re given by our educational systems, doctors, and the rights currently allowed us by the political system in which we live. From our induction into our potential to bear children, our hands are tied by sex education, doctor prescription bias, and the stance our government holds regarding women’s reproductive affairs.

From its medicalized, commercialized inception, contraception- has been available in very specific contexts. From the post-Victorian era to the sexual “revolution,” reliable forms of birth control were only available to women at their doctors’ discretion, and most physicians refused to prescribe it, particularly to unmarried women. The introduction of the Pill in 1960 was nothing short of magic, and though everyone quickly remembered it was just another drug and suffered from archetypical drug problems, it seems to have rediscovered its reverence in the eyes of young women and their prescribers. Steeped in wonder once again, the pill has been reclaimed as a solution to any teenage ‘problem,’ and that’s how doctors sell it. Or, at least, that’s how my doctor sold me Yaz.
Dual contraception and acne medications are dream drugs; brands like Yaz and Diane-35, originally oral acne medications converted to lower-dose hormonal birth controls, become a way for many heterosexual young women to covertly introduce contraception into their lives. They are incredibly popular, and are projected in ad campaigns as perfect for any ‘blossoming young woman.’ By my sophomore year of high school, every single one of my female friends was on a different pill. We all smoked, increasing our risk of blood clots or stroke; we all skipped it or took it irregularly, decreasing the effectiveness. We saw no problem, we’d done our part; we were medicated, and felt like full-fledged sexual beings because it was now ‘safe’ to have sex with us. But like our foremothers before the revolution, our physicians still controlled our access to contraception – just in a very different way. Instead of saying no, they said yes; but they only said yes to the Pill. Everything else was characterized as too painful (sub-dermal implants), too much upkeep (shots), too obvious (the patch), not right for women pre-childbirth (IUD), or too clunky/unreliable (barrier methods like the diaphragm or condoms); birth control pills were a first stop for prescription assignment, and every doctor I went to had first-month-samples of the bigger brands (like Yaz) on hand. When I wanted to ditch Yaz because of weight gain and chest pain, I was fought by multiple providers. I was told what I was looking for (a long-term non-hormonal form of birth control) didn’t exist, and I should just keep trying different pills. I have a ParaGard IUD now, but only because one day I happened to Google “non-hormonal contraception,” not because any of the brigade of doctors I visited ever told me it was even an option.

Doctors, ad campaigns, and young women turned the Pill into encapsulated maturity and responsibility. Instead of bringing us liberation, it introduced us to a perpetual and systematized crutch and kept us from fully acknowledging all of our new and important duties as sexual actors with the potentiality to bear children. In our hands, the Pill became a way for us to have everything we wanted without contextualizing these expectations and their origins. My friends and I just took them, because they made us feel like we were in control.

It’s hard to think critically about the Pill, particularly because it marked an important milestone in women’s liberation, and its acceptance was an integral part of second wave feminism. It allotted for choice, freedom, and many of the gains women made regarding their sexual spheres. But it was also one of the first ever ‘lifestyle’ drugs to be released, and one of the first medications to ever be initially tested on human subjects. The drug was prescribed to women who were not told about potential side effects, and some died from drug-related complications. There were hearings about the deaths, led by male researchers, with no testimony from women who had survived their prescriptions. A group of women calling themselves D.C. Women’s Liberation protested the structure, and garnered national attention. The result of this intersection was that the hormone levels in the Pill were lowered to a fraction of the original dose and, more importantly for my point and all of womankind, these women actualized informed consent as a national issue. They contextualized it, and made nascent consumer involvement a conceivable idea. But despite that, young women today are not acting on this informed consent because they are only able to be passive secondary participants within the current framework.

There is a blatant paradox within this system of assumed social responsibility. We cannot be given incomplete control, still expected to be fully responsible, and yet not be given responsibility to make choices for ourselves. This drug cannot do its job (allow us control) if we are not actively involved. From selective information in sexual education, to the continual contestation of a woman’s ability to make choices that are right for herself, to what birth control is most “us,” somewhere along the line young women need to stop being told what is best for them and realize that they can, and need to be, a member in their own process, but also that they cannot be the only member. Inter-generational and inter-sex discussion is a must in order to be informed of our true positions and the disproportionate liability women still hold.

Give me less acne, give me bigger breasts, give me lighter periods or fewer or less-painful periods or the ability to have spontaneous sex without worry; but it’s unrealistic to assume that taking one pill will do all of that, or that birth control in general will bring womanhood ‘glamour’ to every girl. We need to be aware about how young women are being taught to think about these drugs, and how these projections and expectations will play out later on in their conceptions of their gender or sexual roles.  
In 1988, surveys showed that continual research into birth control methods and safety were no longer on the list of the top 35 priorities in medical research. Our society has accepted and presumed that women are in charge of their own pregnancy prevention, and there is no immediacy in continual research to quickly add additional long-term, reversible options that allow for a same-level role of responsibility for men in prevention of pregnancy.  

For cisgendered heterosexual men and women, the concept of and role in pregnancy is differently and unequally conceived, and it colours the responsibility one assumes for the rest of their sexual lives. It contributes to a disproportionate sexually dimorphic conception of responsibility, and this is inaccurate. All sexual partners are equal actors in pregnancy, and pregnancy prevention, but those with uteri are assumed to be and therefore held disproportionately accountable.

The Pill is great for some people; they’re on it because they chose it and they have no side affects. But it is not right for every woman who is on it because she received incomplete information or choice, and it is not right for every woman.

A part of being informed is being aware, and so we need to make sure that just because we’ve become more active in our process we don’t just forget that, fifty years later, informed consent is still an [inter]-national issue. For all of humanity that identifies as female, cis or not, we need to make sure they know that they have options.

I completely and fully respect and encourage every single woman’s right to make informed, active choices about contraception and STI protection, and I fully and completely respect and encourage every man’s right to have access to long-term, reversible methods of birth control, and to continue to use condoms, but we need to make clear what the agenda of our birth control is, and the only way to do that is through discussion and a social recognition of mutual responsibility.

*a gender identity where an individual’s self-identification of their gender matches their sex