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Birth Control Isn’t Really About “Women’s Health.” It’s About…

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This is a polemic:  Access to birth control isn’t really about my “health.” It’s not principally about the management of ovarian cysts or the regulation of periods.


Birth control isn’t about my health unless by health you mean, my capacity to get it on, to have a happy, joyous sex life that involves an actual male partner. The point of birth control is to have sex that’s recreational and non-procreative. It’s to permit women to exercise their desires without the sword of Damocles of unwanted pregnancy hanging gloomily over their heads.

This proposition is radical only by default, because mainstream liberal voices in Congress, especially, have euphemized women’s desires out of the current birth control and abortion disputes.

I understand why they’ve done this, in terms of narrow political expediency. We’ve been on the defensive about reproductive rights and women’s sexual liberty for decades. We’ve used a euphemism of “choice” for years.

The problem with choice is that it pairs the philosophically monumental with the rhetorically puny. On the one hand, “choice” describes the abortion cause that we’ve taken thousands of political casualties to defend; on the other hand, it describes 20 brands of toothpaste.

Rhetorically, liberals have also argued from the exceptional cases to defend reproductive rights, sensing a more sympathetic ear when they do. For example, assaults on abortion rights are often combatted with the anecdote of the tragic but less common abortion-seeker: victims of incest, rape, or life-threatening medical danger. 

These three subjects form a hallowed trinity of morally unimpeachable abortion users, because they became pregnant or need an abortion through “no fault of their own:” In other words, through no exercise of their libido, or their desire.

It should go without saying that these women matter in the abortion debate. But the more we argue by way of non-consensual examples, the more we communicate that we’re embarrassed by the larger population of unexceptional, consensual examples of women who get pregnant or use birth control because they want to have sex.

The phrase “women’s health” in the birth control dispute is the latest nimble euphemism.  

There are many examples. Barbara Boxer frames the birth control issue a la mode as about “defending women’s health. We will fight for women and their families and their economic well-being and their good health,” her website declares on the matter.  EMILY’s List refers to the “war on women’s health.”

The New York Times (a reliable source for yuppie prudery and subtle anti-feminism alike—remember their atrocious coverage of the gang rape of an 11-year old in Brownsville, Texas?), used the outlier example of a lesbian college student who only took the pill because she had an ovarian cyst—not to have sex, you can be reassured!—and she couldn’t afford it without health insurance, so she ended up with a ruptured cyst, and a costly hospital stay.

We tiptoe around the heterosexual woman’s unsightly libido, and end up with a strangely euphemistic rhetoric, a defense of birth control that seems to involve no sex, desire, sperm, or men. It’s all about access, “women’s health,” and the non-libidinal reasons to use birth control.

This might secure sympathy in the short run, but when we euphemize, we convey a squeamish, ambivalent view of our own values. When we rely on exceptional cases, we embolden no-exceptions extremism. We give up on defending the promiscuous abortion seeker, but cling to the trinity of Non-Consenting Cases. Then, bit by bit, social conservatives, sensing opportunity, start chipping away at the exceptions, too.

Now, if the Oklahoma “personhood” bill becomes law—and 12 other states are considering similar legislation—abortion will be absolutely outlawed, along with many forms of birth control.

It’s counterintuitive, but when deeply-settled rights are most in danger, it’s not the time to euphemize, or retreat from assertions of sexual liberty and self-governance. It’s time to gun it instead.

So here’s the subject I advocate for, because no one dares to speak her name: It’s the 20-something unmarried heterosexual woman who wants to have sex, has sex, enjoys a good sex life with her boyfriend, and, in that sex life, uses birth control. Or, she accidentally gets pregnant.

She doesn’t get pregnant because she’s a victim of non-consensual sex. She gets pregnant while enjoying sex. She doesn’t use birth control to regulate her menstrual cycle. She uses birth control because she has sex

I advocate for the slut who sleeps with lots of men, as well as the woman who sleeps with only one, ever. Promiscuously heterosexual, and happy about it? I’ve got your back. 

A second polemic:  If birth control isn’t actually about women’s “health,” it’s also not strictly speaking just about women, or a women’s issue. Again, this is a basic but mysteriously obscure truth of the issue. The rhetoric emphasizes “women’s health,” rather than the desire-driven world where it takes two to tango, one from each biological sex, and to get pregnant or need to plan to avoid pregnancy. So we end up focusing on women’s equality in health insurance coverage. That’s a critical issue, certainly.  

But when we start talking about birth control as being, well, about sex, it becomes clear that it’s an issue for men and women.

Don’t men have some right to have sex without the fear that every relationship will come with the game-changing threat of unwanted pregnancy?

Are men destined to go back to the contraceptive roulette days of condoms, rhythm method, luck, or nothing? And, how many men would want that life back? How isn’t this a men’s issue and a women’s issue—or a men and women, together, issue? Without access to affordable, reliable, convenient birth control, heterosexual men’s and women’s sex lives are effectively rolled back to the pre-Griswald 1930s.

Birth control doesn’t come across as a men’s and women’s issue because acknowledging that would be to declare the idea that we want people to have recreational, non-procreative sex lives as part of their humanity, their intimate life, and their human experience.

The days of second-wave feminism when Erika Jong gleefully celebrated women’s sex lives feel like another world. I’m looking at my collection of second-wave feminist paperbacks on my shelf. I could throw a pen and any book I’d hit would have some affirmation of a pro-sex agenda for women—an article about the myth of vaginal orgasms, for example, or the importance of the vibrator as a tool of liberation. Second-wave feminism wasn’t just fighting against sexual violence. It was fighting for the emancipation of the female libido.

Where would you find that attitude today in the cultural mainstream?

In glossy women’s magazines, it’s true, you’ll find “ways to please your man” features, and at least these magazines are writing about sex, but I don’t really see theirs as a feminist treatment of sexuality. They might want to run more features on “ways to please yourself” to boost their feminist bona fides.

In the world of public health, you’ll see erudite discussion of sex as a social “morbidity” and “risk factor”—to wit, “girls who have sex are much less likely to get admitted to a top tier school”—but that’s not exactly a triumphant narrative of women’s libido, either.

You can go to slasher flicks and get the Hollywood “Have Sex and Die” narrative, or, in more self-declared “feminist” flicks such as Thelma and Louise or the The Piano, the slight variation of “rebel, have sex, and be forced to kill yourself, or lose a finger for your trouble.”

It makes me wonder, who stole my libido?

Even though personal liberty in private relations is a foundational concept of modern liberalism and its understanding of the right to privacy, sexual liberty isn’t exactly the rallying cry.

And that’s unfortunate, and consequential. Because it seems to me that the bottom line of 21st-century politics is that you can’t be embarrassed or equivocal about the things you believe. It always shows. 

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