Birth Control

Despite the wide range of birth control methods available to people with gynecological systems, the majority of these still have strong effects on hormones and overall health.

While contraceptive methods in the past were often bulky contraptions, modern science has allowed birth control to be much less invasive, albeit not invisible. The pill, the patch, and the shot (also known as Depo Provera) all rely on hormones that are pushed into the bloodstream to alter the hormonal balance of bodies with uteruses and stop the process of ovulation. The pill is taken daily, the patch is changed weekly, and the shot is typically re-injected every three months. While these forms of birth control seem simple, they wreak havoc on the bodies they inhibit. Weight gain, mood swings, spotting, headaches, and nausea are common side effects of all hormonal methods. Blood clots are also a dangerous long term side effect of the pill. These impacts are not to be taken lightly.

Hormonal Intrauterine Devices (IUDs) release small amounts of the hormone progestin into the uterus. The side effects may be less severe than with other hormonal methods because the hormone is localized. There are also copper IUDs available, which prevent pregnancy because of sperm’s aversion to the metal. IUD strings need to be checked every month, because the device can perforate the uterus if it becomes dislodged. This is a personal self-examination, and assuming nothing goes wrong, the device can be used for 3-12 years. Although the side effects of IUDs are less impactful, certain brands still might cause ovarian cysts which are painful and can result in infertility if left untreated. Additionally, when pregnancies do occur while someone has an IUD, they much more likely to be ectopic pregnancies – a type of pregnancy in the fallopian tubes, which poses a very high risk to the person. These methods of birth control require work to maintain their effectiveness. That work is placed exclusively and unequally on people with uteruses. Additionally, the financial burden that these methods impose is substantial, and often ignored. In the same way that the often prohibitive cost of menstrual hygiene products is ignored, birth control is often looked at as a non-necessity. Why is it that bodies with uteruses are forced to pay for the sexual freedom that sperm-producing bodies are afforded for free?

Why is it that bodies with uteruses are forced to pay for the sexual freedom that sperm-producing bodies are afforded for free?

The larger cost of hormonal birth control methods is their overall emotional toll. The most influential side effect of hormonal birth control is the hormones themselves. Emotional impacts of hormonal birth control have been tested and retested time and time again. In a 2004 study available on the website of the U.S. National Center for Biotechnology Information, the abstract blatantly states that “Current contraceptive use was associated with an increase rate in depression, divorce, tranquilizer use, sexual dysfunction, and suicide and other violent and accidental deaths. Despite the advent of more ‘user friendly’ contraceptives, the discontinuation rate secondary to side effects has changed little through the years.”

One type of body has been tasked with an amount of labour that is deeply disproportionate to their role in something that involves two people.

The threat of pregnancy has dictated cisgender female experiences of sex and sexuality for centuries. Partners not looking to conceive a child are both aware of possible outcomes, yet one disproportionately faces the emotional labour of an unwanted pregnancy, not to mention the physical toll. In addition to the pressure that pregnancy places on people with uteruses, using birth control methods effectively and safely requires labour. People with uteruses have been burdened with taking their birth control pills on time, checking their IUD strings regularly, changing their patches every week, and other measures that essentially translate to constant awareness of their own fertility. One type of body has been tasked with an amount of labour that is deeply disproportionate to their role in something that involves two people.

 

Hysterectomies vs. Vasectomies

Hysterectomies are a more permanent solution for those who want it or have health concerns which necessitate it. A hysterectomy is the surgical removal of the uterus, preventing eggs from dropping into the uterus, and therefore putting a complete stop to menses. It is “the most common non-pregnancy-related major surgery performed on women in the United States, with one in three women having a hysterectomy by age 60.” Hysterectomies are still a major surgery, and recovery and side effects are still dangerous.

If we want to share the labour of contraception between more than one type of body, we need to change the conversations we have about safe(r) sex.

A study by the journal Menopause over 22 years found that “overall, a hysterectomy was associated with a 26 per cent increased relative risk for depression and a 22 per cent increased risk for anxiety. Women under 35 who had a hysterectomy were at a 47 per cent increased risk for depression and a 45 per cent increased risk for anxiety.” More specifically, the removal of the ovaries that sometimes accompanies a hysterectomy also means a removal of the place where estrogen is produced. This removal, and the subsequent sharp change in hormones, can be harmful to the body and the mind. A change in estrogen levels is associated with  weakened bones, vaginal dryness, and pain during sex, which can be alleviated using estrogen therapy.

Hysterectomies are gender- affirming services for many people, and their role in allowing people to feel comfortable in their bodies is important to recognize. The societal emphasis on having biological children sometimes leads to people being cautioned by their doctors that they may regret their inability to give birth later. The aim of broadening conversations about contraception and sexuality is to ensure that everyone feels like they have a choice.

The risks associated with hysterectomies are often treated lightly in order for the procedure to be presented as the only option for permanent birth control. It is not; sperm can be controlled as a means of birth control through vasectomies. Vasectomies are a simple procedure to block the vas deferens so that sperm can’t travel out of the body. The procedure is meant to be permanent. The procedure can be either invasive or non-invasive, and patients are discharged the same day.

The stark contrast between hysterectomies and vasectomies is most visible in the side effects and dangers of the procedure. Between vasectomies and hysterectomies, the procedure associated with more danger, recovery time, and side effects is the latter. The dangers of hysterectomies cannot be overlooked in favour of perpetuating the assumption that uteruses must be controlled and not placing that responsibility at the source of fertilization: sperm. When looking for permanent forms of birth control, vasectomies should be considered as an option, as long as the sperm-carrying body can safely undergo the procedure.

Logically, the safest place to stop pregnancy is not in the uterus, but with the sperm; ensuring that sperm cannot reach the egg instead of focusing on inhibiting the egg- producing system. However, while vasectomies present a permanent solution for sperm control, they are not a realistic option for people looking to stay fertile.

 

Sperm Control Options

So, what do we turn to? The currently available options for sharing the responsibility of contraception with bodies with penises are minimal, including condoms and a sperm-control pill.

Condoms are 85 per cent effective in preventing pregnancy, according to Planned Parenthood. This means that 15 out of every 100 couples who use condoms as their only method of birth control will get pregnant each year. These odds are often countered by the use of “the pill,” whose use is accompanied by negative side effects in many women.

Side effects associated with current birth control methods are tolerated because they mirror possible effects and complications of pregnancy, but are typically less severe. For example, birth control pills raise the risk of users developing blood clots, but pregnancy increases that risk ten times more – and so these pills are widely available despite the potential consequences. The tolerance for side effects in bodies without uteruses is much lower because the threat of pregnancy is not present. There are no differences between people with and without uteruses and their ability to tolerate pain or discomfort, but convenience for sperm-producing people has been prioritized above all else.

Results from clinical trials testing the efficacy of a male birth control shot performed published in 2016 show that the shot was an effective method of suppressing sperm release. The most common negative side effects described by the subjects were acne, injection site pain, increased libido, and mood disorders. Interestingly enough, many of these side effects are reported from people taking the birth control pill, and risks associated with IUDs can be even graver. Somehow, these possible consequences were not enough to stall the development and distribution of female contraceptive methods, while sperm control has been all but abandoned by the scientific community.

Since the US Food and Drug Administration (FDA) has no guidelines about what levels of safety and effectiveness a male sperm control pill would need to be approved, drug companies are unmotivated to back research in this area. If we want to share the labour of contraception between more than one type of body, we need to change the conversations we have about safe(r) sex. Sperm control is not an impossible goal for contraception – we just need to commit to making it happen.

 

Redistribution

The condom is the only form of birth control that doesn’t place the responsibility on people with uteruses. Unlike all other forms of birth control, the condom also helps prevent sexually transmitted infections (STIs). Unfortunately, condoms are frequently foregone to increase pleasure for one or both partners. The term “raw dogging” is used colloquially when referring to penetration during condom-less sex. Urban Dictionary’s uses of the phrase overwhelmingly connote condom- less sex as a triumph – a positive reinforcement of once again placing the responsibility of birth control only on the body with a uterus.

Sperm control is not an impossible goal for contraception – we just need to commit to making it happen.

Common contraceptive methods, apart from condoms, affect the hormones of the body that they’re used in to prevent the uterus from being hospitable to a pregnancy. These uterine birth control methods are uncomfortable and often painful devices that have a lower guarantee of effectiveness than forms of contraception that target sperm count. Sperm control would be a more effective and less invasive way of preventing pregnancy, but the idea that men should shoulder the responsibility of keeping their sperm out of their partner’s body is one that somehow never comes up in conversations about safe(r) sex. Bodies with uteruses are the only ones being tasked with preventing pregnancy, perpetuating a misrepresentation of how pregnancy occurs. Social emphasis on gynecological systems, and stopping fertilization within the uterus, results in forms of contraception that are biased towards one type of body. It’s time to redistribute this labour.

For more information on birth control check out our infographic on options for bodies with uteruses.

This article is a part of our joint issue with Le Délit on Labour, Body, & Care. To read their pieces, visit delitfrancais.com

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November 12 marks 100 days since the Indian government overturned Articles 370 and 35A of the constitution, dissolving the special status of Jammu and Kashmir, and breaking the region into two Union Territories. The special status of Kashmir was included in the constitution by India’s early leadership as a way of offering “a certain degree of autonomy to its only Muslim-majority state” — one it had incorporated without the consent of its people, who would have preferred independence or accession to Pakistan.” Two thirds of this state have been occupied by India for decades, against the wishes of its inhabitants. Kashmiri separatists have been demanding “azadi” (freedom) for decades. With the abrogation of these articles, it is unlikely that the separatist movement will be able to solidify enough support to achieve their goals of self-determination. Reports on the living conditions inside the areas in the past 100 days have all returned the same verdict: the siege has resulted in massive human rights violations.

These violations are the result of military occupation, and heightened police repression. Majid Maqbool, who is a journalist in the now Union Territories of Jammu and Kashmir, describes the way in which the occupation is visible:

“[C]ensored press, more bunkers, longer military convoys, soldiers atop military vehicles, standing guard on either side of the road with batons and guns in their hands, bringing civilian traffic to an abrupt halt; coils of concertina wires and road blockades occupying virtually all main roads and crossings.”

The intent behind this annexation is apparent: Narendra Modi’s government is aiming to further his party’s Hindu nationalist ideology. Clearly, the current administration could not allow a Muslim majority state to exist with any degree of autonomy, and because the dissolution of article 35A specifically allows non-Kashmiris to buy land, it is feared that the 100-day old occupation is only the beginning of an attempt at launching a settler-colonial project. 

Reports from the area describe cases of torture, arrests and, preventative detentions. It is important to speak about these occurrences, not to sensationalize what is taking place, but rather to understand the reality of a situation that the Indian government is doing its best to sweep under the rug. Modi and his colleagues are being abetted in positively portraying their crimes by news outlets within the country, as well as by organizations such as the Bill and Melinda Gates Foundation, which awarded Modi with the Global Goalkeepers award in September of this year, one month into the occupation. He received this award because of the supposed success of the ‘Swachh Bharat” or “Clean India” campaign, an effort to make India open-defecation free. His government claimed to have built 100 million new toilets in India over the past five years, but these numbers are not backed by independent research groups says Sabah Hamid, who resigned from the Bill and Melinda Gates Foundation over Modi’s award. She is among others who are questioning the thinking behind this award, given the severity of the human rights violations perpetrated in the past 100 days in Kashmir, and across the country in the years that Modi has been in power. 

The campaign addresses only the symptoms of the problem, instead of the root cause: “institutional discrimination against the scheduled castes” writes Vidya Subrahmanium from Indian news outlet The Wire. One day after Modi received the award in New York, two young Dalit men were killed for defecating in the open in Madhya Pradesh.

Modi has transformed Gandhi’s iconic wire framed glasses into the symbol of the Swacch Bharat, and said “Getting the award in the year of Mahatma Gandhi’s 150th birth anniversary is personally significant for me. When 130 crore people take a pledge, any challenge can be overcome.” in his speech in New York. While Modi’s claims that Gandhi advocated for the cleaning up of India are not unfounded,  his legacy is perhaps better represented in the non-violent resistance to colonial rule that is being demonstrated by the Kashmiri people. 

A fact-finding mission conducted in early October by sociologist Nandini Sundar and lawyer Nitya Ramakrishnan reported that while schools are technically open, parents are afraid to send their children because of the presence of armed forces. They also found that children as young as 6 years old “are being picked up and kept for a day to several days, or asked to report morning to evening for several days. Most often there is no record of their detention.” 

This degree of repression has led people to ask if this is really Gandhi’s India. From Sundar and Ramakrishnan’s report: 

“As one man whose brother had been arrested merely for speaking to the media told us, ‘Go back to India and cover every statue of Gandhi so that he doesn’t have to face this shame.’ For Gandhi, the only relevant factor for constituting nationhood was the will of the people.”

Another group, consisting of “concerned citizens from different professional backgrounds” travelled to Kashmir between September 25-30 and Jammu between October 6 and 7. They noted that while the Indian government is trying to present the idea that “their clampdown on civil liberties in Kashmir with an increased military presence, summary arrests of all mainstream and separatist leaders and the communication blockade” have allowed the annexation to occur peacefully, the reality is that the inhabitants of this occupied state are protesting through largely non-violent means. The strength and will required to resist a body as powerful as the Indian government is what we should be celebrating globally. 

We must not allow our attention to be placed on the supposed successes of the Modi government. We must stand in solidarity with Kashmir, and recognize Modi as the leader of an authoritarian state governed by hateful ideas and violence, not a Global Goalkeeper. 

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The event opened each day with a short presentation from an undergraduate research ambassador, who shared their experiences and advice to students wanting to get involved in research. One of the ambassadors, Daniel Krauss, an undergraduate biochemistry student working in the lab of Dr. Hanadi Sleiman, retold how he first came to be involved in the lab, encouraging students in the audience to reach out to professors regardless of department. He also spoke about the research being done in Dr. Sleiman’s lab, which revolves around DNA nanotechnology: using DNA strands as potential ‘building blocks’ in the creation of “unique 3D structures for uses in applications such as drug delivery and organization of other materials.”

In a similar vein, Dr. Paul Wiseman, from the Department of Chemistry and Physics, described his research as being at the intersection of physical science and biomolecular imaging. He explained his lab’s interest in the use of chemistry and physics as a way of looking at the “molecular mechanisms involved in cellular adhesion,” or the way cells stick together.

Another professor presented her work in computational medicine. Dr. Nicole Li-Jessen’s lab is focused on understanding vocal fold biology and wound healing, with an emphasis on how the larynx is “critical to our daily breathing, communication, and swallowing functions.” She explained that the goal of her lab’s work is to “advance personalized medicine in voice and upper airway dysfunctions,” by creating “patient-specific computational models” that would allow physicians to anticipate vocal fatigue and prevent vocal tissue injury.

For patients currently suffering from vocal cord damage, there are few diagnosis or treatment options that aren’t invasive and risky procedures. Dr. Li-Jessen’s lab is working on designing personalized injectable biomaterials that could replace the current solution of invasive throat surgery, which is accompanied by high risks and a long recovery time. Instead, this biogel could be easily injected into the patient’s vocal tissue, its regenerative properties working to repair the tissue. Dr. Li-Jessen’s lab is also developing methods of non-invasive diagnostics, as laryngeal disease is currently diagnosed through invasive procedures that “can cause irreversible vocal fold scarring.” These three projects would significantly improve patient care, and allow for physicians to treat vocal injury much more effectively.

An important area of interest for researchers at McGill is the understanding of biological molecules. Dr. Natasha Chang, an Assistant Professor in the Department of Biochemistry, presented her research, which focuses on understanding the molecular mechanisms that regulate adult stem cell function during tissue homeostasis and regeneration. Muscle stem cells are highly regenerative, which makes them useful as models for studying the deregulation of the cell cycle, which results in degenerative disease and cancer. Dr. Chang’s lab uses experimental visualization to examine Duchenne muscular dystrophy and rhabdomyosarcoma (a form of cancer) as models for understanding exactly why muscle stem cells become deregulated.

Dr. Gary Brouhard, a faculty member in the Department of Biology, studies another crucial part of molecular biology: microtubules, which are important structural components in a cell’s cytoskeleton. Microtubules are rigid but non-static polymers which can ‘shapeshift’ by constructing and deconstructing themselves depending on the cell’s structural needs. Experiments in his lab seek to understand the molecular behavior of these microtubules and what influences their polymer formation. Dr. Brouhard’s lab also examines how microtubules influence disease, with specific attention on a protein called doublecortin (DCX), whose mutations cause a heritable form of epilepsy (double cortex syndrome). As DCX influences the shape and function of microtubules, Dr. Brouhard’s experiments aim to better understand the role of microtubules in this disease in the quest to develop pharmacological therapy.

Dr. Jonathan Sievers, an Associate Professor in the Department of Physics, presented his research, which searches for the signature of dark energy in an attempt to better understand the birth of the first stars in the universe. He described the Hydrogen Intensity and Real-time Analysis eXperiment (HIRAX), a radio telescope array that can map nearly all of the southern sky, with the intent of measuring leftover ripples in the distribution of galaxies that are imprinted by the primordial sound waves that existed in the early universe. This can be used as a ‘ruler’ for charting the expansion history of the universe and for shedding light on the nature of dark energy.

For students interested in the environment, Soup and Science invited several researchers to discuss their more field-oriented research. From the Department of Biology, Dr. Laura Pollock presented her research’s take on ecology: working with quantitative “big data” to better model ecological systems and biodiversity. She cleverly pointed out that we tend to harbour our own biases toward animals we find “cute” or appealing, and that we invest our biodiversity conservation efforts into their survival, meaning many species in need of protection fall under the radar. With better modeling of our knowledge on biodiversity across different landscapes, Dr. Pollock hopes to answer the fundamental questions: “Which species are being overlooked, and how can we better address their conservation?”

From the Department of Earth & Planetary Sciences, Dr. James Kirkpatrick’s research also focuses on better understanding an aspect of the environment: earthquakes. With the interactive use of rock samples, Dr. Kirkpatrick explained that while earthquakes can be measured, they cannot be predicted, as the origins of earthquakes and other tectonic movements originate from over 10,000 kilometres below the surface of the Earth. His lab’s activities range from field observations in mountaintops to performing experiments in the F.D. Adams basement, all with the intent of developing knowledge on the mechanical response of rocks and how they react under various applied stresses.

Running for five days at the beginning of each semester, Soup and Science provides an invaluable overview of the various research activities going on across campus, and the opportunity to discuss and mingle with experts. For those who couldn’t make it, don’t worry: the next edition of Soup and Science will be held in January 2020.

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