Taking Politics Out of Plan B

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Taking Politics Out of Plan B

Kathleen Reeves

I have long mourned the death of science in the emergency contraception debate.

Obama’s repeal last week of restrictions on stem cell research excited Americans not just for what it allowed stem cell research, but for what it said about science and government. At the same time that he repealed the restrictions, Obama announced that he was issuing a memorandum on the role of science in policy-making.

In a letter to the editor in the Times, Nancy Northup, President of the Center for Reproductive Rights, points us to two areas in which policy desperately needs to be unshackled from ideology: emergency contraception and abstinence-only education.

Studies have found that abstinence-only education is ineffective. Proponents of this kind of “education” claim that these studies are biased, etc, etc. And thus proceeds the culture war, somehow circumventing science altogether. I think we can analyze the issue in a more basic, straightforward way.

Opponents of comprehensive sex education argue that teaching about sex somehow condones it, or encourages teenagers who otherwise wouldn’t have had sex to have sex. This argument is curious because it seems to imply that young people are innocent of knowledge until they learn about sex in school. But I think we can all agree that young people growing up in America, regardless of the household they’ve been raised in, know that sex exists. They are not going to learn about the existence of sex in health class.

Sex. Abortion. Parenthood. Power.

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Young people receive confusing messages about sex from the media, and it’s up to them, maybe with the help of family, to sort out their own feelings on the subject. It’s up to schools to provide scientific facts.

If families who believe in abstinence until marriage are so strong in their beliefs, then what their teenagers learn in school should not derail these beliefs. Sexuality education, in other words, doesn’t harm a young person who doesn’t plan to have sex anytime soon. Abstinence-only education reiterates the beliefs of a small minority, helping no one.

Furthermore, I have long mourned the death of science in the emergency contraception debate. In 2004, when the FDA refused to grant Plan B over-the-counter status for women under 18, its acting director, Steven Galson, first cited medical concerns and then, in a surprising show of frankness, cited his own concerns:

Galson said he worries that if young women had easier access to emergency contraception, some might be more likely to have sex without condoms, exposing themselves to an increased risk of sexually transmitted infections.

 

This exceptional moment, the FDA’s foray into politics, has haunted me for years. I was enraged by its bias against young women. Did anyone raise the issue of sexually transmitted infections when Viagra was approved? (Many older men and women, widowed or divorced, are, in fact, at risk for STIs.) I was enraged by its faulty logic—that young women would use Plan B as their primary form of contraception. The drug makes many women nauseous, and it costs about $40 a pop. Are they serious? I was enraged, most of all, by its disregard for science. The FDA overruled its own scientific advisory board in this decision, and it’s the first time that it’s put the same formulation of the same drug in two different categories. And emergency contraception is not new. In 1996—yes, thirteen years ago—the FDA unanimously approved the use of birth control pills in high doses as emergency contraception.

The most troubling element of the decision, in effect to this day, is that the women who may have the most difficulty obtaining a prescription are those under 18. These are the very women who may not want their parents to know they’re having sex, or who may be most uncomfortable discussing it with their doctors. When you’re seeking emergency contraception, you’re not sure if you’ll become pregnant—maybe you’re not even sure to what degree your contraception malfunctioned, if it did. If the hassle is too great, if a family confrontation is in store, it can be easy to make excuses not to get EC—“I probably won’t get pregnant anyway.” This is how unintended pregnancy happens, and this is what the unscientific, groundless Plan B prescription policy leads to. Let’s hope the new FDA doesn’t waste any time fixing it.