Birth control is relevant to us all.
Imagine a girl who, of course, bears no resemblance to the author other than their shared gender identity. I use the word “girl” here very deliberately, because although she is in college, her movements through conversations, rooms, and even friendships are all very jagged: she screeches to sudden stops and jolts backwards before zooming forward again. She calls her mother whenever she doesn’t know what to do (which is often), whenever her bank account balance is “mysteriously” low, whenever her car’s “check engine” light flashes on, and whenever she pulls a muscle.
Girl falls in love. Or doesn’t — it doesn’t really matter. Either way she ends up sleeping with that guy who lives three doors down. Hopefully she plays it smart, but considering how many schools have less-than-stellar sex-ed programs, she wouldn’t be the first to neglect safe sex practices even though condoms are handed out like candy on campus. She is safe until, for whatever reason, she and her partner not to use condoms anymore. We’d like to think she wasn’t pressured to stop, although it’s entirely possible. Indeed, there are several other reasons that she could have wanted an alternative birth control method, such as additional protection against pregnancy, a clearer complexion, or simply a more manageable period.
It doesn’t really matter why she switched. Either way, she ends up on Google. She types “birth control” into the search box, and reads about all the different methods she could theoretically use. But how much will each method really cost? She’s not sure about what her insurance covers. She’s also not sure about what side effects each method might cause. Which one should she get?
If she’s lucky and her insurance covers it, she might visit a gynecologist. She could also turn to her campus health center since she’s enrolled in college, or Planned Parenthood, as millions of women across the country do every year. Even before she makes a decision, she has to consider the initial cost and accessibility of the appointment itself.
But it doesn’t really matter where exactly she turns for help. No matter where she goes, she will sit on a thin piece of exam table paper. It will crinkle every time she adjusts herself, which she will, because she’s nervous — not only is she talking about sex with a complete stranger, but also because she’s faced with making a really important decision about her health. She only grows more nervous and uncomfortable as she sits in the waiting room for what feels like forever, with myriad unhelpful and irrelevant magazines splayed before her on a too-little coffee table. Her mind starts to spin: Will her parents find out? Will this new protection be good enough? Can she afford it?
Eventually, the doctor calls her in. Hopefully, he or she will make the girl as comfortable as possible and engage in evidence-based care. If they do, she’ll have to make some decisions. First, hormonal or non-hormonal? Hormonal contraceptives can cause a lot of problems for some women, from relatively minor issues like irregular periods or weight gain to more serious problems like depression, DVTs, or even pelvic inflammatory disease. On the other hand, the list of nonhormonal contraceptives can be unappealing. Diaphragms or cervical caps can be expensive and a hassle, spermicide and sponges are messy and less effective, and copper IUDs can induce heavier flows and cramps, which is a big no-no if her periods are already intolerable.
If she knows that she doesn’t want children, sterilization could be another option, but only if she can find a doctor who will do it. Then there are all the risks that come with surgery. Even the less invasive Essure — a procedure in which a coil is inserted into the fallopian tubes and causes a blockage— has had severe legal and health complications. She hasn’t even begun to consider that most of these methods do nothing to prevent STIs. She’ll need to find an additional barrier method to protect against those.
But ultimately, the specific method she picks doesn’t matter. She’ll pick one of them and be inconvenienced by her choice in one way or another. The inconvenience might be minor. It might be serious. But chances are it’ll definitely be worse than her boyfriend’s complaint of the inconvenience caused by the decreased sensation he experiences with condoms. But he’ll never really get it anyway, never question his assumption that birth control is ultimately more her responsibility than it is his.
And this is just one of the narratives with which women are familiar — and a particularly privileged one at that. Narratives about what lesbians, transwomen and men, intersex folks, or anyone else that doesn’t fit the heteronormative standard do to protect themselves sexually are almost never told. And yet even schools that have comprehensive sex education rarely address the needs of non-heteronormative and/or non-cisgender individuals. Yet, in actuality, LGBT youth suffer from STIs and pregnancy disproportionately and trans individuals particularly face unique barriers to obtaining quality reproductive healthcare.
To be fair, there are certain responsibilities that inherently come with adulthood. But it’s unnecessary for something as basic as birth control to add to the many inconveniences and responsibilities that are unavoidable by being inaccessible and unaffordable. These unnecessary barriers are just part of the reason that we need to stand up and plant our feet in the coming fight for reproductive rights. Because it does matter.
So where do we go from here? How exactly can we make this whole process easier? Well, there’s been some discussion of at least making the pill available over the counter. More male birth control options are quickly becoming a reality, and they have the potential to cause a culture shift in which both partners in any sexual relationship can and should be responsible for birth control. These are potential solutions for some women, but not all.
Of course, however, these potential solutions all depend on our lawmakers’ approval, and it’s no secret that we’re currently living in a tumultuous political climate for women’s rights. Many women recently scrambled to secure long-lasting birth control before Trump took office out of the fear that their rights would be restricted in coming years. And especially given Vice President Pence’s view on LGBT rights, the ways in which individuals of all identities struggle to obtain birth control are unlikely to be any more visible than they are now.
We may not be able to change our current political climate overnight, but we can work to educate our own peers and communities about birth control, and do so with empathy so that everyone can relate not only to the girl mentioned above, but also to LGBT youth, to low-income individuals who can’t afford birth control, and to men who want to take their reproductive health into their own hands, too.
Birth control is not a niche issue; it affects everyone. Let’s start acting like it.