What Your Doctor Won’t Tell You About Birth Control

By Kimya Afshar

Doctors are nothing more than the fancy white jackets they sport and stethoscopes they hang around their necks; these social niceties are symbolic of their function as tools of tradition, carrying along a historical legacy of know-all and apolitical, altruistic practice.

This social construction is the intention, at least.

Even with all of the painstaking years of education and training undergone, they still cannot escape the sociocultural influences which dominate the social bloodstream, and the politics surrounding the medicine they practice. This isn’t a condemnation of the necessary work of doctors–this is only an attempt to illuminate the necessary trepidation we’ve since become numb to when confronted with the mysticism of a pill which cures all. 

The birth control pill is an over-prescribed lifestyle drug whose consequences are seldom discussed in progressive spaces; the implicit expectation for women to take this drug has significant consequences, both socially and physically.

It’s common for doctors to prescribe the pill to girls as young as thirteen years old as a form of hormonal correctional therapy–which conveniently doubles as an early inauguration into pregnancy prevention. Within the heteronormative conversation surrounding sexual health, there is an underlying expectation for women to take on the burden of preventing pregnancy anyways. Might as well start ‘em young, right? 

Okay. Now you’re thirteen, equipped with a small rectangular apparatus housing thirty pale pills, handed to you in a brown paper lunch sack–as if your friendly pharmacist were a gentle parent sending you off to school with some lunch. Birth control peregrination is instead the commencement of a curious social normality–the modification of female hormones and thus, the entire feeling and functioning of a body, all in one casual prescription.

Women are prescribed birth control with alarming ease. Hormonal acne? The pill should fix that. Painful cramps? Take that little blue tablet. Want to control when you bleed? Go on, disrupt your body’s natural chemical homeostasis. For the vast majority of women, the ubiquitous normalization of birth control means a brief revision of the potential side effects as your doctor nonchalantly hands you a prescription. In the new age of zoom-dominated human interaction, many times doctors prescribe the pill over the brief interaction through a screen. 

In the 60’s, the Food and Drug Administration in the US approved the first form of the oral contraceptive: a pill which had dangerous quantities of estrogen, reported to have caused blood clots, heart attacks, strokes, and cancer. Finally, after the proliferation of this form of contraception throughout the 60’s, feminists in the 70’s began to question the safety of the pill and the validity of its relatively widespread use. After nearly 10 years of FDA approval and distribution, the pill was eventually modified to contain safe amounts of hormones for regular ingestion.

The historically reckless handling of the pill should be cause for concern: proof that a governmental entity, in its advertising and distribution, is vastly profiting through the over-prescription and under-education surrounding birth control; even now, the notion of birth control has shifted from a tool of family planning and personal health to a lifestyle drug, a careful marketing strategy which has normalized the thing, and even mitigated the severity of committing to this drug. 

The discourse surrounding the birth control pill is therefore heavily politically charged, and thus productive conversation surrounding widespread use of the pill is a strenuous landscape to navigate. Much of the anti-pill discourse is an extension of the anti-abortion movement, and people which perpetuate this rhetoric frequently cite religious conflictions. Most poignantly, the Catholic Church has been a staunch advocate against the pill, citing its promotion of adultery and promiscuity. Additionally, female reproductive rights in the United States are under siege, and contraception is greatly symbolic of female individuality and autonomy from social or religious impositions. And now, given women’s rights to abortion and reproductive rights are a beleaguered topic, it is increasingly difficult to facilitate a productive conversation surrounding birth control and its widespread usage.

Much of the prominent discourse surrounding the pill takes root in “wellness” trutherism, a dialogue which veers dangerously into the realm of paranoia and pseudoscience. Still, there is a worthwhile conversation outside of rouge Facebook groups and Reddit rabbit holes: the pill is still uncharted territory for many women, and the ease with which women are prescribed this commodity responsible for hormonal manipulation is dangerous. 

Further, there is an unspoken expectation for women to be on birth control. This assumption is simply an extension of an implicit form of female objectification; by cultivating a social and cultural norm for women to be on birth control, the burden of pregnancy prevention falls upon women. This notion is inherently tied into the sexualization of women and girls. Being on birth control–no matter the initial intention of beginning the treatment–implies the worry-free, neat, sexual environment which it imbues within a woman. The same standards are far off from the social and cultural conditioning traditionally imposed upon men: the expectation to sacrifice comfort in order to prevent the consequence of pregnancy, which has a much lesser impact upon men personally, is a more alien concept in public discourse. The discreteness of the pill, the harmless impression its small package implies, is symbolic of the secrecy with which birth control is treated in polite society.

Just as the pill is treated–a quick, obvious addition to a woman’s body with little to be discussed or cautioned–so is the expectation of secrecy surrounding experiences with it. Women experience hormonal chaos throughout their relationship with the pill. The first three months often include drastically significant changes in mood, weight, libido, disposition, acne, and the list extends as far as the effects of hormones upon a human body. Finally, when the adjustment period has waded, the new homeostasis founded by the body is different from the natural state of the body. But the worst part is, there’s no predicting how things will change. 

Like many people with a period, a doctor wrote me a prescription for birth control. While my own history may be more drastic it still acts as a cautionary tale, illustrating the potential harms of popping hormonal pills as a teenager. After getting prescribed the pill at the age of 16 for my hormonal acne, I developed a (benign) tumor in my left leg directly atop my nerve. Aside from the medical nightmare of my affliction, I experienced drastic weight gain, depression, and a complete shift in my temperament when I began birth control. After waiting for the adjustment period to wane, my body settled into its new hormonal reality, but still never felt quite the same. My doctor barely covered these side effects. After only a month or two of having my license, I drove myself to the nearest CVS to pick up my prescription. 

The pill has a cultural and social legacy steeped in misogyny and marketing. While there are myriad benefits to birth control, and a multitude of positive experiences, a main one being the contribution of the efforts of female sexual liberation–still we must approach this normalized lifestyle drug with trepidation. The lack of progressive discourse around birth control demonstrates the danger of allowing the performative feminist narrative to smother critical discussion of female sexualization. The increasingly casual modification of female hormones should be a cause for conversation. By receiving the pill without judgment, we assume our fate as compliant and dutiful perpetuators of the outdated tradition of submission.

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