Why None Of The Anti-Plan B Arguments Are Remotely Convincing

And also, pictures of puppies!

Dec 15, 2011 at 6:00pm | Leave a comment

As you probably know (if, for instance, you read s.e. smith’s excellent post), last week Kathleen Sebelius overturned the FDA’s recommendation to make emergency contraception pill Plan B available on drugstore shelves to people of all ages. Currently, Plan B can be acquired over the counter, but not as we currently use “over-the-counter” -- you have to actually go up to the counter and get the stink-eye from the pharmacist. And you have to be 17 or older.

As with anything involving reproductive choices, especially for teens, this has caused medium dudgeon on both sides. Technically my day job does not involve reading feminist Twitter streams, so I haven’t been as steeped in the debate as I would be if I were independently wealthy, but I’ve still managed to see a lot of back-and-forth. And while there may somewhere be legitimate reasons for keeping Plan B off the shelf, I haven’t heard any yet.
 
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The usual anti-choice crowd is kind of down for the count on this one -- if anyone tries to tell you Plan B is an abortion pill, tell them to Google up the difference between their ass and a hole in the ground. Plan B prevents eggs from being released, just like birth control pills but retroactively.
 
Depending on when in your cycle you take it, there’s a chance it’ll prevent a released egg from being fertilized, or thin the lining of your uterus so a fertilized egg can’t implant -- which happens naturally something like 30-50 percent of the time, maybe more.
 
But its primary mechanism is just keeping you from ovulating in the first place. And if it’s a crime to prevent an egg from being fertilized, then abstinence is a crime as well.

But a lot of liberals and progressives, including President Obama, have their own objections. Some of these objections, like some of the arguments about the HPV vaccine, try to pretend the whole debate has nothing to do with whether teenagers should or shouldn’t be having sex -- it’s just about their health. This is a load of hoopla, but whatever: the health arguments aren’t convincing, and neither are the sex arguments. Here are some of the ones I’ve heard.
 
(Incidentally, maybe I should have replaced "your kid" with "someone's kid" because I'm not a parent and don't want to be displaying a tin ear for how to talk about other people's children. But I do want to say that I'm not trying to be judgmental or tell people how to raise their kids -- my point is that what your kids need and what other people's kids need might not be the same.)

“This drug could be dangerous if you use it wrong, and kids shouldn’t be able to get it easily.”

This is the claim I’m seeing most often, and it has some merit. It makes sense that people want to protect their kids. We expect, for instance, that defective products that could harm children will be regulated. We expect our food and drugs to go through some kind of approval procedure -- though usually from the FDA, which is fine with putting Plan B out on the shelf.

But you can already get drugs at drugstores. Any kid who goes into a CVS can get access to painkillers, cough medicine, laxatives or diet pills. All of those are dangerous if used wrong, potentially way more dangerous than Plan B.

“But I’ve taken Plan B, and it made me feel sick.”

Yeah, Plan B can make you feel sick. Big whoop. So can the aforementioned painkillers, cough medicine, laxatives and diet pills. And, more to the point, so can pregnancy.

In fact, pregnancy and Plan B make you feel sick in exactly the same way. Plan B is just a high dose of progesterone, a hormone produced by your own body, and produced in greater quantity when you’re pregnant. That’s right: The active ingredient in Plan B is also something that would be in your system if you needed Plan B but didn’t get it.

If your daughter has had unprotected sex, or had an unexpected contraception failure, or has been raped, there’s only one way to keep high doses of progesterone out of her system: Pure luck. Otherwise, if she doesn’t get it from Plan B, she’s going to get it the usual way. And she’ll be puking for three months instead of one day.

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“OK, fine. I don’t want my kid being able to get Plan B because I don’t want to encourage her to have sex. Happy now?”

Hey, at least you’re being honest, imaginary interlocutor who is a parent! Until we acknowledge that these debates are always, at their heart, about legislating women’s sexual behavior, we’re not going to get anywhere. (Even if they're not about that for you, they are on the whole.)
 
And it’s understandable that a parent would feel this way -- although it’s not really a good basis for policy. I mean, my sister’s 27 and I still haven’t totally gotten over the idea that she’s not a virgin.

Here’s the good news: The majority of teenagers 16 and under haven’t had sex -- 17 is the average age for teens to lose their virginity, at which point they can get OTC Plan B anyway. Most teenagers who are sexually active use contraception, and that’s becoming more common all the time. We get steeped in the narrative of the irresponsible teenager who can’t even take pills properly, but according to the Guttmacher Institute, between 80 and 90 percent of teens who are having sex are taking precautions. And most of them, at that age, aren’t doing it in the first place.

That said, shit happens. Smart kids can do dumb things. Good kids can make mistakes. Any kid can be assaulted -- 7 percent of women who had sex before 20 report that it was non-consensual, according to Guttmacher. And kids whose parents don’t want them having sex can decide, consciously and deliberately, that their parents are wrong. Denying easy access to Plan B doesn’t prevent these things from happening -- it just makes it harder for them to turn out OK.

The best laid plans of mice and men and parents go oft awry. Instilling your values in your children, forbidding them to do things you disapprove of, talking frankly with them about how to protect themselves -- none of this means there won’t be unexpected situations that need to be dealt with before they have serious consequences. Emergencies, if you will. And emergency contraception is for emergencies.

I wouldn’t let my child climb down off the roof on a ladder -- unless there was a fire. I wouldn’t let my child break the car window -- unless the car was underwater. I wouldn’t let my child take ipecac -- unless she’d accidentally swallowed poison. And in any of those emergency situations, my hypothetical child has my full permission to do what needs doing without asking me first. This is no different, except they’ve got three days to do it and at the end of it all your car is still OK.

Plan B is like 70 times more expensive than a condom, if you buy your condoms in bulk -- it’s unlikely to become any teenager’s primary form of birth control, unless that teenager is independently wealthy. It’s for emergencies. And an emergency is something that needs to be dealt with pronto before it gets worse, regardless of how you feel about the fact that it happened in the first place. You don’t refuse to dispatch ambulances to people who were driving too fast or standing on precarious chairs, and you don’t cut off emergency contraception recourse because you don’t want kids having sex.

Also, leaving all this aside -- if having contraceptives on the shelf encourages kids to have sex, maybe we should get rid of the condoms and spermicides too. (N.B. It doesn’t! We should not.)
 
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“I’m fine with my kid having sex and even getting Plan B, I just want her to tell me first.”
 
That’s awesome. And if you truly have good and appropriate communication about sex and protection, she probably will. But that’s your family. In other families, sometimes the sex and the parental permission come from the same place.

Most people don’t have consensual sex at 12 or 13 years old -- in fact, legally, they can’t. I found one paper, from the Illinois Coalition Against Sexual Abuse, that said 60 percent of girls under 14 who are "sexually active" have no sexual experience other than rape. If you’re 13 and you need a morning-after pill, maybe it’s because you’re a little precocious or whatever and you chose to have sex with your boyfriend. But it's probably not.
 
Instead, it may be because you’ve been raped or abused by the very same people who would need to give you permission to get emergency contraception. A survey by the Women's Safety Project estimated that one in six girls is sexually abused by a family member before the age of 16. (This survey, it is a little out of date, no? Sorry about that. I wish I were a sociologist so I could be more up on the literature.)

This is an awful reality and I don’t blame decent parents for being unwilling to acknowledge it. But the truth is that requiring parental permission for Plan B further victimizes girls who are being abused by family members, by effectively cutting off their access to the only form of contraception they may be able to use. And if you think 12-year-olds should be forced to ask their rapist dads for permission to prevent their incest babies because Plan B might give them a tummy ache, then I think we’re done here.

This applies to a mercifully small percentage of young teens in this country. But I’m willing to bet it’s a bigger percentage than the percentage of teens who will eat $50 pills willy-nilly and make themselves sick just because they don’t need a prescription.

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I understand feeling squirrelly about young teens and emergency contraception because you don’t want them to have emergencies or need contraception. I know it's easy for a non-parent to opine on issues about teens and sex, and much more emotional for parents. And trust me, I’d like to see those boxes gather dust on the shelves.
 
I’d also like it if nobody’s kids ever had to shop in the bandage aisle at CVS, or the painkiller aisle, or the aisle with the yeast infection creams. It would be great if we were all fine all the time.

But the choice isn’t between kids having access to Plan B and kids never ever getting into the kind of situation Plan B is designed for. It’s between them getting into those situations and having recourse, or getting into those situations and potentially being stuck. If I were a teenager, I’d rather have a stomachache and peace of mind.