Are We 'Hooked' on the Pill?

The author of a controversial new book about the alleged risks and dangers of hormonal birth control shares her thoughts on the matter.
Publish date:
September 21, 2013
feminism, reproductive health, the pill, contraception, women, controversy

Holly Grigg-Spall, author of the new book Sweetening the Pill (Oct. 7; Zero Books), didn't set out to ruffle feathers. Still, she's the first to admit that publishing a resoundingly negative "feminist critique" about the alleged dangers of the pill -- a health milestone critically significant (and critically beloved) to the reproductive freedom of millions of women -- might be controversial. And oh, is it ever. Grigg-Spall's book isn't even out yet, but it's sparked virulent backlash from feminist critics, prompting some women to form a petition asking the publisher to pull the book from shelves -- before it's even on them.

Lindsay Beyerstein at Slate wrote that Grigg-Spall's book is part of a "disturbing effort to reduce women to their biological functions in the name of feminism." Others share that view, arguing that Grigg-Spall's book is "half-baked, anti-science, reactionary politics-disguised-as-feminism" -- and poorly researched to boot (Grigg-Spall relies heavily on anecdotal evidence to support her claims that the pill can provoke "depression, anxiety, paranoia, rage, panic attacks" and other unfortunate side effects).

Like Grigg-Spall, who stopped taking Yasmin because of the side effects she experienced, I'm not a fan of the way the pill affects my body chemistry. I've tried multiple brands, but I didn't love how any of them made me feel (bloated, sore, and like even more of a moody bitch-on-wheels than I usually am). I also don't love the idea of popping hormones every day. But that's just me; I know plenty of women who swear by the pill and deal with no ill effects whatsoever -- I'd never dream of trying to impose my beliefs on them.

Birth control is an intimate, loaded subject that's as political as it is personal. When the first oral contraceptive was released in 1960, it introduced the explosive idea that women could have the power to choose when or if they'd get pregnant; apparently that idea is still explosive. I asked Grigg-Spall a few questions about her book via email.

xoJ: Why do you think Sweetening the Pill is so controversial among feminist critics? How do you feel about the book's reception so far?

HGS: I think it's only fair that I wait until the book is available to everyone before I consider responding to any individual critical reviews, of which there have only been a few. The majority of those that have read the book at this time, prior to its official release, have had a very positive response. They have described the book as "a wake-up call" and "potentially life changing." I've received many emails and messages from women wanting to thank me for providing validation for their personal experience and who feel they have otherwise previously found little support for their decision to not use hormonal birth control for the good of their health.

I wrote a book that asks the question: Why can't we criticize the pill? I, of course, expected a critical response, particularly from feminist pundits perhaps. Nothing that has been said in opposition to the book's arguments has surprised me. I have only been somewhat surprised, I might say, by the outright refusal of some to read the book before forming and publicly declaring their own opinion. Assumptions have been made that I am anti-abortion, anti-choice, a religious conservative, possibly Catholic, peddling a Christian right-wing agenda, and advocating banning the birth control pill -- all of these assumptions are wrong and discovering this would take a minimal amount of research.

But, as I say, if you write a book criticizing the status quo then you'd be a fool to not expect a certain amount of fury. I'm a first-time author published by a relatively small U.K. company; if this book were not important it would not be causing such a stir. When reviewers tell you not to read a book, when a petition is started asking for an end to its publication, then you know there's a work that demands some attention from you personally, rather than dismissal based on reviews.

xoJ: What originally sparked the idea for this book -- was it largely based on your own personal experience?

HGS: Yes, but really it was the experiences of other women. In sharing my own personal experience through my blog I was contacted by so many women who had been through the same problems. There were too many women who wanted to come off hormonal birth control, had been made sick and miserable by these drugs, but found the lack of support -- the doctors saying it's "all in your head," the articles stating that this is a necessary compromise because it's better than pregnancy, the systematic silencing that sees individual women and their bodies blamed instead of the drug -- meant they did not have the strength to make the transition seemingly alone. Sharing my own experience gave them that needed validation to say, finally, "I know this is not me. I know it's the pill causing me to feel this way."

I don't want women to go through what I did -- suffering for months, years, because I didn't realize the pill was causing my physical and mental health issues. Instead of never considering that it could possibly be the pill that's the cause, I wanted to make sure women were aware that it could very well be the source of the problem.

xoJ: What birth control methods do you suggest for women who can't or don't want to deal with the pill and its potential side effects?

HGS: I'm not prescriptive in my work. There's a good reason that the end of my book is written in the first person. It's not solely my responsibility here to provide the solution to the problem that I have outlined. Our healthcare providers need to step up. Our schools and colleges need to step up. Our prominent feminist movement leaders need to step up. There are women who do not want to use hormonal birth control and providing alternative methods, support, and information is a feminist issue, a social issue. The dominance of hormonal birth control in our culture has eroded the pillars of choice, knowledge, and freedom.

In the book, I discuss my transition off the pill and what helped me to find a suitable non-hormonal alternative for contraception. I believe body literacy can be very important in building the confidence to stop using hormonal birth control for your health. I think all women should have knowledge of their fertility cycles and understand how their body changes during the fertile and non-fertile phases. They should have body literacy. I don't see how we can have truly informed consent without this education, or without honest discussion of the side effects of drugs, or without open conversation about alternatives to hormonal birth control for pregnancy prevention and alternatives for the treatment of cycle health issues like PCOS, cramps, heavy bleeding etc.

I would like to see increased awareness of and access to barrier methods like the diaphragm and the cervical cap. I'd like to see the development of commercially available naturally-derived spermicides that cause less health problems for women. I want to see condoms developed to be more user-friendly and pleasurable. I would like for education in the Fertility Awareness Method of tracking the two or three signs of the fertility cycle to be democratized, provided via trained practitioners at healthcare clinics, schools, colleges.

The documentary I am currently working on is sort of the second part of the Sweetening the Pill project -- we will follow a group of women as they explore the alternatives available to them and illuminate that learning curve. We will, we hope, see what works for each woman, how and why, and what does not.

xoJ: Why do you think the pill has sustained such widespread popularity over the past 50+ years?

HGS: That's a huge question and one best answered by the 60,000 words of my book! The popularity of the pill is ideologically based. It is the culture that presents the pill as the answer to all female-associated ills and not the pill itself that I am taking issue with in this book. It is the method and motivation of how this drug has become popularized that I criticize. The feminist women's health activist and writer Barbara Seaman once said that the medicalization of women's bodies in their healthy state revealed the underlying cultural message that what needed to be treated and controlled was clearly "the disease of being female." The pill is now seen as the magic bullet, the cure-all, for any ailment affecting women. Unfortunately although it may alleviate the symptoms of certain ailments, it does not "treat" anything. To paraphrase the founder of Justisse Healthworks for Women, Geraldine Matus, prescribing the pill in this blanket way is like "using a sledgehammer to fix a Swiss watch."

xoJ: Do you really think it's possible for women to get "hooked" on the pill? What does that look like?

HGS: The subtitle of my book refers more so to our social and cultural dependence on the pill to provide apparently easy, non-intrusive contraception and to, as I've said above, "fix" women. We may find it very hard to contemplate modern society without the pill.

However, I do describe my own experience of trying to come off the pill after ten years of use. I found it very difficult. I was not aware, at first, of effective alternatives. I was fearful of my body. I was scared that the heavy periods of my teens would return and I did not know how else to deal with this if they did. I was worried it would negatively impact my sex life and my relationship. Even after my terrible experience with Yasmin I decided just to try another brand. I came off for two weeks, felt immensely better physically and emotionally, but still decide to go back on. When I did, finally, come off the pill entirely, I went through withdrawal -- insomnia, anxiety, mood swings, fatigue, headaches, and nausea. Psychological and physical addiction are linked. The word "addiction" is provocative and perhaps somewhat over-used in the media, however this was my experience and the experience of women who contacted me.

We live in a culture that has accepted the idea that there is no alternative -- not for contraception, not for treatment of cycle health issues -- but also no alternative to the way we live now, to how we structure society, and to how we can progress as a society. That is, I would suggest, indicative of a kind of addiction situation.

xoJ: What are you most hoping readers take away from Sweetening the Pill?

HGS: As I said above, I primarily hope that women who have suffered on hormonal birth control will receive validation and that the pill will no longer be dismissed as a possible cause of negative changes to physical and emotional health. I hope it will make people reconsider listening to women's experiences as foundational to not only positive and productive women's health advocacy, but also to the feminist movement. I hope it will inspire women to demand better than the false dichotomy that claims their choice amounts to hormonal birth control or pregnancy. I hope it will give women the strength to talk back when they're told their side effects are just down to the power of suggestion, to throw off the hand that pats them on the head and tells them to try another brand of pill, to tell the doctor who says the pill will just "regulate" their periods that they won't be fobbed off with misinformation, and to ask that we take the pill off its pedestal and consider it for what it really is -- a powerful drug that despite its important impact for women and society over 50 years ago, should not be unquestioningly accepted as women's savior and instead eyed critically. I hope it will inspire them to ask, always, who controls the control, why and how.

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