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Is Biology Destiny? Being Female and Hormonal Birth Control

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What does it feel like to be female?

Why is discussion of female biology so controversial?

How does “biology is not destiny” thinking and anti-essentialism impact how we think about being female?

In a blog post I wrote some years back titled ‘Beyond Female’  I asked those  questions. It would later became the catalyst for my forthcoming book ‘Sweetening the Pill or How We Got Hooked on Hormonal Birth Control.’ Over the years, I had come to realize discussing biology, and specifically female biology, was a very contentious issue mired in the politics of the “biology is not destiny” mantra of mainstream feminism. The notion that biology is not destiny impacts how we view birth control and as such it precludes the very mention of any potential dangers associated with hormonal contraception. What follows here is an excerpt from my book with some additional text specifically for Hormones MatterTM, where I explore what it means to be female and the role the pill plays in that discussion.

Female Biology is Important

In order for us to be able to honestly and openly discuss that the pill negatively impacts women it must be acknowledged that female biology is important. Such a discussion cannot avoid the claim that female bodies are different from male bodies.

By arguing that a drug changes female biology and negatively impacts mood specifically, it must be admitted that our experience of life is connected to our biology. It is necessarily claimed that who we are is linked to our biology. To say that the ovulatory cycle, a specifically female bodily system, can not be shut down and ignored without serious repercussion, because it is vitally important to women’s health, is to run the risk of inciting the furor of those who feel they have fought long and hard to wrestle down and defeat the connection between women and their bodies. Such statements are controversial. Even using the word ‘female’ can be contentious today.

In regards to the pill, we need to talk about “women” and “femaleness” because this is integral to how and why the pill came to exist and why it is still taken by so many women. To say that the pill can change the way a woman feels by meddling with her biology reads as anti-feminist. It is also anti-feminist to not take women at their word and validate their personal experience by acknowledging it to be right and true.

Marketing the Pill – Beyond Femaleness

Taking the pill might be seen as an act of trying to get beyond femaleness. As femaleness in our culture is understood in the negative, escaping its confines is good and progressive. Any dislike we develop of being female and of having a female body is rooted in the history of female bodies being seen as problematic and in need of male control.

This drug is not just birth control; it is, as a Yaz tagline once explained “beyond birth control.”

Taking these drugs is about being ‘beyond female.’ Female is not good, female is not something you want, female needs to be controlled, influenced, changed and organized into something neater, easier and less frightening to you and those around you. When we take the pill we shut down the interior indicators of our femaleness. The exterior remains and it is this that makes it acceptable. In actuality, the pill makes women more physically attractive within the boundaries of our Western patriarchal capitalist culture. We are free of messy periods, we may have clearer skin, be slimmer, we may have bigger breasts, and we are supposedly rid of troublesome PMS.

The former YazXpress area of Bayer’s promotional Yaz website asked women to ‘Get with the program!’ Women taking or interested in taking Yaz were able to sign up for an “insider’s guide to Yaz, fashion, music and style.” The articles in this guide were co-created by the magazine editors at Elle and Cosmopolitan, the pages of which frequently feature print adverts for birth control brands. Yaz was associated with an affluent, glamorous way of life.

Taking Yaz would lead to the life of an attractive, confident ‘Sex And The City’ type of woman. Coolness, sexiness, modernity and glamor were linked to taking this brand.

In 2009 Bayer took on Lo Bosworth, star of The Hills, a popular Los Angeles-based reality show about a group of twenty-something women aspiring to make it in Hollywood, as a spokeswoman for Yaz in Canada. Of her support for the drug, Bosworth remarked, “As a ‘Gen Yer’ working in the entertainment industry, I need to be disciplined. I need to make sure I’m taking care of myself so nothing interrupts my day.”

Plastic Surgery versus the Pill

Although certain procedures have entered the mainstream in the US, women who have plastic surgery can come up against much criticism. Discussion circles around ideas of women taking plastic surgery choices too far, getting obsessed with making changes, making choices based on their insecurities or in response to difficult experiences such as the failing career and the bad break up. A woman who chooses to undergo plastic surgery is choosing to change her body. She is exerting control over her body. She is choosing to be ‘beyond’ human through changing her very physicality. She is choosing to not age or not submit to what her genes, her biology, have given her.

How does plastic surgery factor under the women’s liberation message of “my body, my choice” and why is so much said about the psychological and social impacts of this choice?

Why are people who have lots of plastic surgery a concern, but not people who take a drug to shut down their ovulatory cycle, stop their periods and ‘perfect’ their bodies from the inside out?

Environmental Estrogens

We are used to seeing labels for “BPA-free” plastics as we have become more aware of the synthetic estrogens in many everyday plastic products. One study shows seventy percent of items made of plastic leach chemicals that act like estrogen.

The perfected body, as our ideology teaches, is not female but male. If we shut down the essential biological center of femaleness, the primary sexual characteristics, then can we say that women on the pill are still “female”? The mythology of the pill reveals how femininity is valued within our society. Women on the pill still have their secondary sexual characteristics. We understand judgment and valuation of our femininity is directly correlated with our appearance, significantly our attractiveness. Women who are not attractive by the Western cultural standards have their femaleness questioned, as do women who have less defined visual secondary sexual characteristics, such as smaller breasts or a wider waistline or shorter legs. The ideal body in this age of plastic surgery has exaggerated exterior signs of femininity.

Legitimate Concerns For Oral Contraceptives

In a piece for the Vice magazine website, porn actress Stoya writes on her experience choosing a birth control method. She admits she feels hormonal contraceptives are the best choice for an actress having sex with men but states, “the pill and I don’t seem to get along well.” After suffering with side effects in her teens Stoya had not considered using the pill again until she began performing in scenes with men. She started taking the latest brand, “Four months into taking Yaz, I was miserable. I bled profusely the whole time. Instead of migraines once or twice a month, I had them multiple times a week. I had intense mood swings and was constantly dizzy. I had planned on giving it another one or two months, hoping that my body would adjust, and then I fainted while waiting in line at the bank.”

She came off Yaz and four years later decided to try Ortho Tricyclen Lo, but only lasted three months. She now takes Loestrin 24 Fe and still experiences continuous bleeding and mood swings but describes how pleased she is with one particular side effect – an increase in the size of her breasts, “Dragging myself out of bed became a herculean effort, and the idea of showering or brushing my teeth was beyond my abilities. Everything felt tragic and hopeless. My only redeeming qualities were my tits. They were by no means giant hooters, but they were noticeably fuller, which was pretty cool. I started to think hormonal birth control was a patriarchal plot to keep women down by rendering us completely loony. The question, “How can we ever break the glass ceiling, if we can’t stop crying?” actually came out of my mouth. I still feel nuts, but hey… at least this B-cup kind of fits.”

Stoya has self-awareness and insight into her situation but she sacrifices her health and well-being partly, it seems, because she’s not aware of the alternatives or feels they are off-limits to her. She wryly jokes about her predicament.

Female Sexuality

A woman on the pill is likely to experience low libido and will certainly feel some detachment from her sexuality. The feeling of sexuality is different from female sexuality, but is vitally important, as it is personal to women and separate from their relationships to men. Not feeling sexual could lead to a desire to look exaggeratedly sexual and to appear and behave very sexually in an act of over-compensation. Such a desire can be fulfilled in part through plastic surgery.

The Blame Game – On Being Hormonal

We support modifying and suppressing our bodily functions with science to perfect our faulty bodies even when we are generally healthy and well, and even when the notion of what it means to be faulty is so spurious. When experiencing the side effects from hormonal contraceptives women have a tendency to blame what they view as their own overly hormonal, unpredictable, difficult bodies that in reacting negatively to these drugs are behaving badly. It is their bodies that are not good enough for the drugs.

Medical Marketing and Birth Control

Even if we are not ill, science is making us better. We are becoming better humans, better women. The pill is no longer about birth control; it is about being a better, improved woman. It is about moving beyond our femaleness, about asserting loudly that biology is not destiny; but should it be?

Pharmaceutical companies move the target constantly from birth control to menstruation suppression, from acne control to mood control and in so doing they are betraying their motivations. By medicalizing the normal physiology of the female body, and saying overtly that it needs to be controlled and improved upon they are betraying the foundations of pill promotion. If we believe we should get beyond our femaleness we are accepting that women’s bodies are bad and need to be made good. The consumer economy is crafty; it will always find an avenue for assimilation. The pharmaceutical companies are listening at the door to our presumed post-feminist talk. What do you think?

About the Author: Holly Grigg-Spall is a writer and activist. Her work has featured in the Washington Post and the UK Times and Independent newspapers. She has contributed to re:Cycling, the F-Bomb, Bedside Manners, Ms. magazine’s blog, and Bitch, amongst others. You can find out more about her forthcoming book ‘Sweetening the Pill’ and documentary project at Sweetening the Pill, on Holly’s Facebook page or by following Holly on twitter: @hollygriggspall.

 

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Hormones MatterTM is conducting research on the use patterns and side effects associated with oral contraceptives – the birth control pill. If you have used and/or are currently using oral contraceptives as a birth control option, please take this important, anonymous survey. The Oral Contraceptives Survey.

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Male Birth Control – Myth or Available Science?

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I’ve never been able to take hormonal birth control. I have tried and the side effects were so extreme that I almost ended up in the ER more than once. After telling each new doctor my past horror stories, they would each reassure me that I simply had the wrong doses and had to try a different brand. I tried three times in my adult life and every single time was a disaster that seemed to progress from the last. So, I gave up on hormonal birth control.

Most women I know have been on birth control most of their adult life, some even since they were teenagers. While I always tell myself that there might be long-term side effects outside of the ‘clinical trial’ time frames (not that I wish bad health on anyone, but would be my top concern if I was on any medication long term), most women are happy poppin the pill (or now the other various forms of hormonal birth control like IUD, rings, patches, etc). Furthermore, most men are happy letting their lady take on that responsibility.

For the most part, I’m okay not being on a hormonal birth control. It is awkward when dating someone and getting to that point where things might lead to more than just dinner a movie and I have to bring up that little, unpleasant fact, but otherwise I’m happy with my natural mood swings and erratic hormones.

I’ve been with my boyfriend for over 3 years now, so I haven’t had to have “the talk” recently. However, back in my dating days, I was always shocked at how shocked men were that I wasn’t on the pill. It was like the idea of a woman not being on some form of birth control was absurd to them. What I love about Brent (well, I love a lot of things about him) is that after witnessing the extreme effects of hormonal birth control in my body first hand, he has accepted that we have to take other measures to prevent pregnancy. He’s also assured me that if a male birth control comes available he would be willing to try, but only after many clinical trials and a year or two of being on the market (I can’t blame him with the controversial drugs the FDA has approved in the past).

Male Birth Control

Turns out there are forms of male birth control. Quite a few actually and very few of them are hormonal, which would have the most risk and side effects. Some sound weird, and lots are still in clinical trials (And there is no way in hell we would even consider a clinical trial – can you imagine being in the placebo group?!). Let’s look at some of the new forms of birth control that share the reproductive responsibility.

It is important to remember that, like female contraceptives, these treatments do NOT protect against sexually transmitted diseases.

RISUG

In India, they have developed a long-term, reversible solution that is 100% effective in clinical trials. The Reversible Inhibition of Sperm Under Guidance or RISUG might be a good option if your man doesn’t mind needles. According to Techcitement the simple procedure is as follows: “A doctor applies some local anesthetic, makes a small pinhole in the base of the scrotum, reaches in with a pair of very thin forceps, and pulls out the small white vas deferens tube. Then, the doctor injects the polymer gel (called Vasalgel here in the US), pushes the vas deferens back inside, repeats the process for the other vas deferens, puts a Band-Aid over the small hole, and the man is on his way. If this all sounds incredibly simple and inexpensive, that’s because it is.” How does it work? “The two common chemicals – styrene maleic anhydride and dimethyl sulfoxide – form a polymer that thickens over the next 72 hours, much like a pliable epoxy, but the purpose of these chemicals isn’t to harden and block the vas deferens. Instead, the polymer lines the wall of the vas deferens and allows sperm to flow freely down the middle (this prevents any pressure buildup), and because of the polymer’s pattern of negative/positive polarization, the sperm are torn apart through the polyelectrolytic effect.” Another benefit, RISUG does not cause the common side effects of a vasectomy: granulomas and an autoimmune response.

Will it be approved? It has yet to get approval in India, and, according to Science Based Medicine, trials on rabbits are just starting in the US (published May 2012). Perhaps this birth control is just too good to be true and pharmaceutical companies stand to loose too much if men have to get a shot once every ten years and without side effects, are 100% reversibly infertile.

What’s more – this treatment might actually prevent HIV transmission from male to female during intercourse.

Male Hormonal Birth Control

In Denmark, studies are being conducted in hormonal birth controls that rather than taking a pill daily (because men can’t bother with that?), tiny rods are inserted under the skin of the arm that deliver the hormones. These rods deliver etongestral, a progesterone often used in female birth control pills. The etongestral blocks sperm production and is considered reversible. The downside: to block sperm production, it blocks testosterone production as well. Participants of the study have to get testosterone replacement therapy injections every 4-6 weeks to maintain their sex drive, as well as their male characteristics. If approved, patients would only have to change the rods every three years.

There are other hormonal birth controls on trial. Some involve topically applied gels, others pills, or shots every few months; but they all work the same and have the same side effect of blocking testosterone production in the testes.

Other Odd ‘n’ Ends

There are surprisingly lots of clinical trials and products out there for male birth control. And maybe not-so-surprisingly, those that were not hormonal had very few side effects. I suppose it makes sense that it would be easier to control men’s sperm that are located externally, opposed to internally manipulating our eggs.

Suspensories, a pair of brief-like garments holds the testes closer to the body, raising the temperature of the testes and suppressing sperm count and making the remaining sperm poor swimmers. Here are other heat treatments.

Intra Vas Device (IVD), is a set of implants that block the flow of sperm. According to malecontraceptives.org, “These tiny, pre-formed, flexible silicone plugs are inserted into the vasa deferentia, the tubes carrying sperm from the testes. The device is sized to the width of each recipient’s vas deferens, filling the lumen (the opening in the vas tube) but not stretching the tube. Two plugs are inserted in the same vas with a small space between them. If sperm pass around the first plug and enter the space between the two plugs, the second plug blocks them. In order to prevent the plugs from moving within the vas deferens, they are anchored with small sutures to the wall of the vas deferens itself. Once implanted, they can not be felt. The IVD is similar in function to a vasectomy, but it leaves the vasa deferentia intact.”

Hopefully these new forms of birth control will soon be on the market and women like me, who can’t or choose not to, take hormonal birth control will be able to share the responsibilities of reproduction. All I can say is it’s about damn time!

For more information on clinical trials and other treatments check out MaleContraceptives.Org, it had the most inclusive, detailed and reliable information I could find on the subject.

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