Thursday, April 22, 2010

Beyond female

During my time blogging for Bitch magazine I had the opportunity to untangle some of the issues surrounding any discussion of women and their bodies, and women's bodies. I suppose I considered these issues a little when I was at Mt Holyoke, meeting women who dressed like teenage boys and picked a different, man's name, to go by. What most fascinated me then was how they could know what being a man, as opposed to a woman, 'felt' like - and why it was necessary for them to go from 'woman' to 'man' and change their appearance - matching their outside to their inside. I guess even at that time, now I think about that as more than an interesting anecdote of my year at a private all-female college, I was thinking there wasn't really, truly anything in being male or female, and that for the most part this stuff was all constructed socially.

I wasn't sure I felt like a 'woman' - I just felt like me - and could relate to some women, and some men, and not others. I obviously didn't want to deal with the negative connotations of being a woman - and I figured that out through wondering why all the writers, filmmakers etc that I was interested in were men, and thinking about how my vicarious experience of life was through the eyes of men - how men were exciting not just because they were physically attractive, but because their position, their way of life, appeared more exciting to me.

I went to an all-girls school from the age of 11 to 17 too. At the time it certainly doesn't make you like being female. Men become fantasy figures - unreal - and, in a way, better for not being real. I was pretty scornful of the women at Mt Holyoke - there was a lot of underlying talk about how even the most rebellious, inventive students would end up married and working as accountants. When I'd left I got as frustrated with the idea of what it is to be a woman as any of us do.

I started this blog to raise awareness of what the Pill can do to women, how it can make them feel depressed, anxious and make them feel generally low and ill all the time. I wanted to write about this because it had taken me a long time and a lot of time to find out the Pill could do this and I didn't think it was fair that I hadn't known. That's still the reason I write this blog. However, in trying to work out why this stuff isn't talked about more widely I came to all kinds of conclusions and these conclusions have ended up expanding my understanding not just of the basics of female biology, or how completely not basic that biology is, but also this thing of being a woman and what that means.

So, yes, in talking about how the Pill effects women's bodies I have realised I am saying that biology is important, that female biology is important. I'm also highlighting that female bodies are different from male bodies. By suggesting a drug that changes female biology can negatively effect a woman's mood, I am arguing our experience of life is linked to our biology, even perhaps that who we are is linked to our biology. I am pointing out that the ovulatory cycle, a specifically female bodily system, isn't something that can be shut down and ignored without repercussion, because it is in itself vitally important to healthiness.

Now, little did I know when I began writing this blog that these statements would be so controversial - that even using the word 'female' would be so contentious. I'd been feeling like talking about women's bodies was considered risky, and that talking too loudly and illiciting too much attention could provide justification for arguments that women are weaker than men, less capable, more emotional and so on - and that would lead to no good. Women have long been trying to prove that their biology does not matter - because their biology is only seen socially, and historically, in the negative.

The Pill came out of socially acceptable ideas of the female body and perpetuates the negativity towards the female body - the suspicion, the fearfulness, the disgust. If we were as positive about the female body as we are about the male, we would not have the Pill - and we don't have a male Pill because it doesn't 'fit' into the line of history, and the progress of society, the way the female Pill does.

I recently read Chris Bobel's latest book, out in a couple of months, called New Blood: Third Wave Feminism and The Politics of Menstruation. Chris discusses 'smashing the binary' - that is getting rid of the concepts of man and woman - in relation to menstruation activism. Radical activists use the term 'menstruators' in place of 'women' - Chris looks at how such a move impacts on feminism. How useful is breaking down these boundaries she asks, when there is so much discrimination faced by women for being what is still understood as female? She considers whether it helps to say that male and female are social constructs, and work from there, or whether as we don't live in a post-gender world we would be making too much of a leap, and leaving a lot of people behind in doing this.

There's been quite a bit in the news lately about statins - these drugs that lower cholestrol - and they are being marketed as a drug everyone should take as a preventive action against heart problems. This is raising debate about whether healthy people should be on drugs long-term. To me, I need to talk about 'women' and 'femaleness' in talking about the Pill because it is integral to how the Pill came about, and why it came about, and why it's still taken by so many. But talking about the effect of the Pill is talking about human beings, people, quality of life and healthiness. I am not sure women should be pushed as they are into taking the Pill, but then I'm not an advocate for the creation of a male Pill either.

In Chris' book she points out that blaming biology for behaviour is 'classic' anti-feminist. So, in a way, that I write about how the Pill can change the way a woman feels, making her depressed by meddling with her biology 'reads' as anti-feminist. If I say the Pill made me feel terrible, I am saying my biology (my ovulatory cycle here) effects my behaviour, in that how I feel effects how I act. But Chris states that it is also anti-feminist to not take women at their word, and validate their experience. The blog Feministe criticised a Bitch post of mine with a piece that essentially said I should not be critical of the Pill because the religious Right is also critical of the Pill and I am only providing fodder for them. My experience was not valid because it does not fit with the 'feminist' agenda as Feministe sees it. I was seen as being 'anti-science' and science is understood to have liberated women. You can see more here:

Feministe response

I have to say when I was told I was ignorant for saying the Pill didn't 'regulate' periods I decided to stop arguing and let them just read this blog instead - as I have said before, for any new readers, the Pill does not regulate periods, it shuts down the ovulatory cycle, so you don't ovulate and you don't have periods. The bleeding that occurs is called a 'withdrawal bleed' and is not a period. Not every woman taking the Pill will have my experience, but they might have some part of it at some time in their lives - and every woman will not ovulate and this does, always, impact on the body. And the way things are arranged, most women don't get to know this.

I came across on the Bitch comments boards much that suggested the idea of 'overcoming' femaleness, the body. In taking the Pill some women argued they are taking control of their body, and that this action is empowering. They see their bodies, particularly their periods, as troublesome and irritating and are happy to have the ability to turn this part of their biology off. For some their periods are apparently very difficult, making them very uncomfortable every month. For others, periods were considered just a nuisance, an inconvenience. I was surprised to see many women repeat the statement otherwise used by dubious medical and pharmaceutical representatives, that it is not 'natural' for women to have as many periods as modern women do, because previously we would have been pregnant most of the time and not lived very long. It seems to me so clearly misogynistic, I couldn't quite believe Bitch readers could buy it. You can see all this here:

Reproductive Writes: Do We Need To Bleed?

I has never considered before that taking the Pill could be seen as getting 'beyond' femaleness - and as femaleness is understood mainly in the negative, escaping its confines could only be good and progressive. I am interested to see how many self-described feminists really seem to dislike being 'female' and having 'female' bodies - even without allowing that this is rooted in the fact that socially, and historically, female bodies have been seen as problematic and in need of male control, at best. I have spoken before of my own feelings about why I kept taking the Pill, even when I was aware it was making me feel unwell, and how I see that as bound up with my desire to control my body, which I found kind of scary - but only because I was on the Pill from 17 and never heard, saw, or experienced anything to do with my body that wasn't flooded with bad connotations.

After reading these comments at Bitch I talked with Elizabeth Kissling about the Seasonique adverts on television in which a group of women asks 'Who says you have to have twelve periods a year?' and the defiant statement 'Who says?' is repeated over and over. The authority that is being questioned is unclear - it could be other women, men, the pharmaceutical industry, feminists, or as Elizabeth said 'your mother' - the point is that the advert suggests these women are rebelling, by taking Seasonique, against authority. They are overcoming their biology, their femaleness - it is not just birth control, it is, as the Yaz tagline goes 'beyond birth control' - it is about being 'beyond female.' Female, in the way the advert suggests, which is rooted in the culture that suggests, female is not good, female is not something you want, female needs to be controlled, needs influencing and changing and directing and organizing into something neater, easier, less frightening.

The Pill when released was linked up with the idea of rebellion within the sexual revolution, the women's revolution. The Seasonique advert decades later splits this rebellion from any idea of the collective, into something individualistic - something that fits in with how the sexual revolution panned out, because never having periods is about, although this is not said, being 'available' for sex at all times.

When I finally saw this ad on television it made think of plastic surgery and how much criticism women who have plastic surgery come up against from other women, how negatively plastic surgery is considered. And plastic surgery is changing your body right? Controlling your body, being 'beyond' human in a sense, through changing your physicality, by not aging, not giving in to what your genes, your biology gave you. Does plastic surgery come under the banner of 'my body, my choice' - and if it does why is there so much talk about the psychological impact, the social impact 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?

Science is equalised with progress and we are all for modifying and suppressing our bodily functions with 'science' as such to perfect our faulty bodies even when generally healthy and well and the notion of 'faulty' is spurious. Even if we are not ill, science - drugs - are making us better. Better humans. Better women. Statins might make us less faulty - less likely to have high cholestrol - but in what other ways will they make us ill and in what other ways can we deal with this faultiness that is not long-term drug use that impacts the whole body. The Pill is no longer about birth control, it is about being better, improved.

The commercial tagline for the brand Yasmin is 'Beyond birth control.' By moving the issue from birth control to menstruation suppression, or acne control, or mood control - pharmaceutical companies are betraying themselves. In medicalizing the healthy female body, and saying overtly it needs controlling, improving - they are betraying the very old-fashioned foundations of Pill promotion. Just as with the arguments on the Bitch comments board, the root of this talk is rotted. It's accepting that women's bodies are bad, and need to be made good. Capitalism is crafty, it will always find an avenue for assimilation. It's almost like the pharmaceutical companies have been listening at the door of late.

Tuesday, April 13, 2010

Development is the best contraceptive

I've spoken of my suspicions of the population control arguments put forward in support of increasing use of hormonal birth control methods before. In response to the question of the Pill's potential side effects, it is often said that preventing women in developing countries having too many children overrides such concerns. This motivation translates into the myopic view of contraception in the Western world that is backed by a dogged desire to prevent unwanted pregnancy above all else.

As Laura Wershler said in a recent interview I conducted with her, and posted on the Bitch magazine site - unwanted pregnancy is the only acknowledged sign of health in young women.

Not Just Another Choice: Interview with Laura Wershler

As long as a young woman avoids unintended pregnancy, all is well. Although I'd suspected, and read a little, about how poverty has very little to do with population and a whole lot more to do with distribution of resources - I'd not quite got my head around the topic. So when I came across Betsy Hartmann's book Reproductive Rights and Wrongs: The Global Politics Of Population Control I was happy to see my unformed thoughts given some real substance.

She argues that it is not overpopulation that causes poverty, but a coupling of the subordination of women and the monopolization of too many resources by very few people. The belief that overpopulation is the source of the problem has what is described in this book as a 'boomerang' effect on developed countries attitude toward contraceptive research and distribution. The drive of reducing birth rates quickly and effectively dominates programs in developing countries, the US and across Europe. Health and safety concerns are swept aside in favour of high rates of success in preventing unwanted pregnancy. Hence the pushing of the Pill and now long-acting hormonal methods.

In developing countries women are oppressed - Hartmann thinks that if you reduce the system of patriachical power in a country, then you reduce the birth rate consequentially. If women are provided with support, opportunities to earn, independence and decision-making power then population can be stabilized. I've thought before how strange it was for feminists to bring out the population control argument in response to criticism of the Pill and whole-heartedly advocate the importance of preventing women in the Third World having children as it seemed to me to legitimise, or at least show an uncaring attitude toward, the unequal relationship between men and women in those countries. It seemed a bit to me like saying all American teenage girls should be put on the Pill because they might get raped by teenage boys, and preventing them having the resulting pregnancy is more important than dealing with the fact they're getting raped to such a degree that we need a blanket application of hormonal contraceptives.

If there is a high infant mortality rate then women will have more children with the knowledge that many of them may well die before they become adults. Women in poverty also need children to help them survive - to work, to take care of them as they grow older or if they become ill. I have never heard anyone suggest that these women may need, want or just plain have to have children and not want to use hormonal contraception to prevent this happening. Blaming their poverty and hunger on overpopulation allows for social injustice, allows for the oppression of women. So rattling out this argument, as many feminists did when I discussed this in terms of Depo Provera on my Bitch blog, is actually allowing for the oppression of women, and assuming their oppression in an inevitability.

The Rebranding of Birth Control

Hartmann calls population control a 'substitute' for social justice that holds back the emancipation of women. This is interesting to me, as I have said before the Pill could be seen as a substitute for real change in the Western world - changing women as it did, rather than changing society. The Pill only helped women to be assimilated into the male-created, masculinized social structure and allowed for the continued development of the consumer economy. It usefully blotted out long-held, and still held, concerns about women's bodies and reproductive abilities. It didn't address real issues between men and women, but compounded in a way their alienation from each other in order to progress a capitalistic society. I've wound around this all previously. It's like how sexual freedom is now used to show how free and independent women are, and is focussed on above all other areas of women's lives - as Ariel Levy talks about in Female Chauvanist Pigs or Natasha Walter in her new book Living Dolls - except without the Pill part of the discussion.

The Malthusian outlook that backs the population control argument denies that the rich play any part at all in keeping the poor, poor. Basically, it is just thought that the poor should stop being born. But there is no evidence to show population density causes a lack of resources and poverty. Hartmann points out that corporations that own much land in developing countries do push populations into unsuitable areas for farming and living in order to take advantage of better areas and make a profit. Plus governments in developing countries have different priorities to what they should, preventing change.

The emphasis on the most effective methods of contraception and not the safest or best for individual women that is produced by population control programs ensures that many women, once put on hormonal contraception, will experience side effects and soon stop taking the Pill or returning for their injection. If one woman has an adverse experience she will tell many more. Women in developing countries do not get told what to expect - then again, neither do most women in developed countries - and so when they experience problems they will just stop using that method. The inserts in Pill packets contain far less, and often no, information.

The linking argument here that is frequently used both for population control purposes and here in the US and Europe is that hormonal birth control is much less risky to a woman's health than pregnancy - an argument that has a lot of holes - but Hartmann suggests that the Pill and long-acting methods could cause far more health problems for women in the Third World. If a woman has low body weight, poor nutrition, poor sanitation and is not given any health screening prior to being put on the Pill she is far more likely to suffer side effects. In fact, considering how the Pill impacts on the metabolic system, preventing proper absorption of vitamins and promoting vitamin deficiency - this drug could actually be directly weakining women further and preventing them more so from having healthy children. Depo Provera, Hartmann notes, can cause continuous bleeding for some women - and women living in poverty cannot afford to loose the blood or the iron it contains.

In conclusion she argues that, as I have, the dominance of hormonal methods of contraception prevents the development of other methods and research into improvements or even new possibilities. Barrier methods are rarely improved upon and barely advertised in the US and Europe. I had much discussion at Bitch regarding negative attitudes towards condoms. Attitudes that could be turned around if the material used to make condoms was developed to produce a better feel and experience. I notice at my current cashiering day job people mostly buy novelty-type condoms with design additions supposed to improve the experience, so the market is there for a wholesale upgrade. Barrier methods are not considered for third world countries as a viable, effective option because it is understood that women would need the cooperation of men and with developing countries male/female relations as they are this would be difficult. Rather than addressing the root - that the oppression of women prevents the use of barrier methods - and therefore, importantly, increases the spread of HIV - it is thought better to push the Pill and injection on them.

Hartmann believes real reproductive choice relies on women having control over their lives and equal power to men.

I have just found out she is a professor at Hampshire College in Massachusetts, a school right near Mt Holyoke, where I studied for a year. Mt Holyoke is an all-girls place, and very political. At the time I took a lot of fun in sending up and skewering the feminist-like activism that went on and wrote essays about the plight of the American male as seen in Michael Douglas movies and Jackass. I guess all that influence filtered through over time, or fermented, or something, and here I am now writing this.

Other voices

Enough of me - Julia De Laurentiis Johnson hails from Canada and is in her twenties. Here's her story of how she came to come off the Pill for good:

"After being on the Pill for a total of seven years, I was desperate to get off it. It made me feel bloated, stagnate and crazy. I now use a non-hormonal copper IUD and I will never use anything else if I can help it. I love it – it's zero-maintenance and hormone free – but the road to my contraceptive bliss was once helluva trial-by-fire.

In the roughly ten years I've been sexually active, I've used a number of different birth control methods. Being a 90's teenager, I was very well versed in sex education and responsibly used condoms and spermicide sponges when I first started having sex. When I got into my first serious relationship, I went on the Pill – in Canada they would start girls on Ortho Tri-Cyclen, an Estrogen and Progestin pill that was triphasic - three different 'phases' of pills in each pack - and each week the level of the Progestin hormone increased from 25 micrograms in the first week to 35 mcg by the third. I hated it and used it for just two months. After getting over the initial rush of feeling very grown up for being on the Pill, the side effects were too uncomfortable to ignore. I switched to Alesse, a monophastic single phase Pill with a lower hormone level and used it, without obvious incident, for five years.

A year after my steady boyfriend and I broke up, it dawned on me that I was a bit of a hypocrite. Generally, I tried to do good things for my body, like try to avoid processed foods, to use organic hygiene and cleaning products and to eliminate as many unnecessary chemicals from my life as possible - yet here I was systematically swallowing a drug every day, three weeks out of the month, all year long.

At the end of my five-year 'drug habit', I decided I really needed to get off the Pill and give my body a break. Soon after, I started dating someone new and sexual regularity was back in my life - I needed to seriously reconsider my contraception methods. I really didn't want to go back on the Pill and I really didn't want to go back to condoms. We weren't a terribly stable couple to begin with – and definitely not at the commitment level where an IUD or a quarterly Depo Provera hormonal shot would have been appropriate. If condoms are the undergrads of Contraception U and choosing to have an IUD sit in your cervix for years qualifies as a PhD, I felt I was at the stage in my sexual life where I was prepared to take on my Master's: a diaphragm.

I got fitted for my pastel pink latex diaphragm, which came in a pastel pink plastic carrying case, and seeing it peak out of my purse where I had shoved it under my sunglasses case to keep it discreet, I felt as if I had inadvertently become part of a terribly acted sex education video. That device did do the trick, though - i.e. kept me un-pregnant - but it was complicated: It removed a sense of spontaneity from sex, as I had to be excused in The Moment to fit myself with this domed sperm-net. It need to be filled with spermicide, took some manoeuvring to fit it up against my cervix and there it had to stay for an additional 6-10 hours after the act, just to be sure it'd done its job. My partner and I could both feel it, also a bit off-putting and it was still only 94% effective, 2% less then the Pill. But I appreciated that it was non-hormonal and figured that the inconvenience was worth it. When that relationship fizzled, so too did my diaphragm use.

By the time I entered into my current relationship, I'd let my ethics about non-hormonal contraception fall by the way side – I wanted an easy, reliable and totally convenient method of birth control. I was living in London at the time and studying for my Masters degree – I recognized that I didn't have the time or care to be fumbling around in the bathroom for the sake of contraception. So I put myself on a low-dose monophastic Pill called Loesterin and naively thought that it would negatively affect nothing, just as my first monophastic Pill hadn't, acting only as armour for my eggs.

Over the course of 18 months the negative effects of the Pill became obvious. Apart from constant bloat, I had developed bad psychological habits, including second-guessing myself, something that until then had not really been part of my personality. I would easily slide into emotional slumps, had a continuously running undercurrent of the 'blahs' and felt that I could never really focus, like there was a veil of mist across my brain. I'm not sure I had any suspicion that the Pill may be to blame, thinking instead that it was probably all my fault, really, and that I just wasn't trying hard enough to think clearly or positively – don't all women feel like this?

The real turning point came when my partner and I were to be apart for a few months and I decided to go off the Pill to give my body a break. Off the Pill I just felt so…alert. The bloat, discouraging thoughts and cloudy mind ebbed away; I felt like Dorothy discovering a colourful Oz. It made me certain that I was never going back to the Pill.

I read up on my contraceptive options and realized that a copper IUD was the obvious choice. This is why:

It's non-hormonal, which was my number one priority for my new birth control. The copper in the non-hormonal IUD interferes with how sperm is transported, diverting it from the egg. Science is cool.

Once inserted it can be practically forgotten. There's nothing to remember to take! Except for a yearly pap test to make sure everything's ticking along, there is no maintenance involved – sex can remain as spontaneous as it was while on the Pill. Ok I lied –this was my number one priority.

It's inexpensive, a one-time cost of $100-$200, often covered by health benefits and lasts for up to five years.

It's entirely reversible. If/when you want to get pregnant, just get it removed.

It's the greenest method of birth control. It doesn't just reduce physical waste (no pill packs or condoms to throw away) but hormonal waste as well. Not only has it been proven that Estrogen from Birth Control Pills flood the water system through sewage, disrupting fish sex organs but also that the hormone cannot be fully distilled out of our own drinking water and may adversely effect human male fertility. If I could do my part by not adding to the Estrogen-laden pee filling my community water filtration system, this counted as a plus.

Ok, here are the cons:

It takes a while to get set up. First, you need to book an information session with your gynaecologist. They run you through every possible pro and con to help make you certain it’s the right method for you. Then you get a pap test to determine everything in there is running fine, because it's about to get a long-term foreign roommate. Then you gotta wait a few weeks for the results.

It needs to be inserted by a medical practitioner. This means another appointment. They also give you pills to insert vaginally to numb the surrounding area a few hours before the procedure. These pills can make you cramp like a bitch.

Periods tend to be a bit heavier. If you already have heavy periods, this may not be for you.

The insertion: It's quick but it hurts like absolute hell. It isn't the actual insertion of the device that hurts, it's when they measure the depth of your cervix. It does only last a couple of minutes, and I did take extra strength pain pills beforehand, but it hurt, like the worst imaginable cramps and my body shook a bit from the shock. But then, as quickly as the pain comes, it dissipates. Soon afterward, you just feel a bit tender. Get yourself an ice cream.

If the idea of pain scares you, don't let it. Though, quite bizarrely, an estimated 2% of American women use the IUD it is intensely more popular around the world. If millions of women can do it, so can you.

I wish I could go back in time and tell that teenage contraceptive novice how much headache she could have saved herself."