Saturday, May 1, 2010

Disability and birth control: part one

Picture: Several cartons of Plan B contraceptive stacked one of top of the other against a beige background.

This post is part one in a series. Please check out parts two and three.

This year, Blogging Against Disablism Day falls in the context of a great deal of celebration around the 50th anniversary of FDA approval of the hormonal birth control pill. Since most of my disability experiences have come with the birth control pill, I thought I’d take the BADD opportunity to talk about the intersection and write out my birth control narrative – what works for me, what doesn’t, and what ableism has to do with it.

Birth control is and was often (though by no means always) constructed as an unambiguous win for women. It’s strongly, strongly associated with the birth of the second wave of the feminist movement (though I’ve noted that the second wave is often omitted, effectively erasing the work of the first wave). And hormonal birth control has been wonderful and liberating for women in the final balance. The fiftieth anniversary of hormonal birth control should be celebrated. Hormonal birth control is wonderful.

But it is not unambiguously positive for women. It is not all of our liberation.

Birth control as a topic is simply not centrally relevant or empowering to every woman. Not all women are at risk of pregnancy. Widespread (rather than individual) centralization of birth control in feminism alienates and marginalizes their already problematized bodies: trans women, intersex women, older women, lesbian women, women with disabilities that affect their reproductive system, asexual women, women who want to get pregnant. Not to mention the loaded history of otherwise non-privileged bodies with birth control in light of the eugenics movement.

In the course of discussion of birth control, though, options which are not hormonal birth control or condoms are often erased or devalued. IUDs are unobtainable. Withdrawal is silly and irresponsible. Diaphragms are old-fashioned, ineffective, and irrelevant.

But these are the options those who need non-hormonal birth control. The voices of folks who need and use alternative methods of birth control are ignored or erased in favor of more popular methods. The downsides of these methods are not discussed or dismissed as minimal, marginal.

Women with disabilities are often (though not always) sexual, and some of us are at risk of pregnancy. When we go to the doctor, our questions may be brushed away because of disbelief in our sexuality. Our concerns about certain methods may be ignored because we are women, and not competent to make decisions about our own bodies. Our desires may be blocked due to our finances. Our fertility and desire for children may be discouraged or ignored based on the assumption that we don’t want to pass on to children the qualities and conditions that make society uncomfortable with us.

I’m writing about my experience with birth control for a few reasons.

The first reason: to provide a narrative of my disability and how I’ve experienced it: its causes, its fluctuations, its triggers. Folks with disabilities are socialized to be ashamed of our bodies and our disabilities. It’s important for those of us who can and want to contribute our voices to the conversation surrounding disability in an effort to counter harmful stereotypes and tropes.

Another reason: to provide a practical example of how ableism and reproductive rights intersect, and how feminist and mainstream constructions harm marginalized folks by normalizing some experiencing and othering others.

The last reason: to provide an alternative birth control narrative – a different story of how I’ve prevented getting pregnant thus far. I’m not the only one who’s had hormonal birth control pushed upon me, but I have found a system that’s wonderful for me. I want to share my methods and my journey towards them in the hope that someone whose birth control needs are challenged will find some useful tool in my story.

Check back tomorrow for said narrative. Also check out:

Pregnancy, my greatest fear

OCD, language, and my place on the disability spectrum: parts one and two

See more of BADD 2010.

ETA 5/5/10: I forgot to mention somewhere that trans men are often excluded from discussions of birth control, though many trans men use it. In a post that critiques the discussion of birth control in feminist communities, this erases the experiences of some folks, which is not cool. Apologies.


  1. Very interesting post. I would also add "lesbian women" to your list of people who are excluded by the focus on birth control.

    I have also thought about this issue in relation to abortion rights. Mainstream feminism is understandably very concerned about abortion rights since they are constantly under attack. I think choice is very important and I have attended protests in support of abortion rights. But, the issue of abortion is more relevant to straight, sexually active women than it is to women who are either unable to get pregnant or extremely unlikely to have an unwanted pregnancy.

    That doesn't mean we should back off on abortion. Everyone should care about this issue, including men. But feminists should make sure other issues are getting attention too -- otherwise people may feel like the movement only cares about issues surrounding reproductive choice.

  2. Thanks for noting my omission, DiDi! It has been changed, and you are absolutely right about abortion.

  3. Another non-hormonal form of birth control is sterilization.

    I realize that this is not a temporary form of birth control like the others that are listed. However, there are women out there, like myself, who never want to have children. I knew this at a fairly young age. And yet, I was talked into using other forms of birth control in spite of some serious health risks.

    My doctor kept warning me of stroke after I reported the symptoms that I was having from birth control pills. My first thought was that a stroke was better than getting pregnant! That doesn't sound like someone who wants to be a mother, huh? And yet friends, family, and all of society presented insidious messages like "You'll change your mind one day" and "Every woman wants to be a mother."

    I used birth control for about 5 years longer than I should have because of the idea that I was too young to know for sure. I should have gone with my gut feelings and gotten my tubal ligation at 24, not 29.

  4. Oops, having some trouble with blogger and blogspot and cookies ..... finally got it working but I checked the wrong button. The last comment was supposed to be from ahimsa.

  5. ahimsa,

    Not only is it totally offensive that people tried to make that decision for you, but should you have someday changed your mind, there's always the possibility of fostering or adopting a child in need -- I guess people don't think that's "really" being a mom?

    Anyway, I'm glad you eventually got the surgery you wanted.

  6. I was just thinking about this. First, the fact that there are undoubtedly more people like you, RMJ, who have had symptoms of anxiety, OCD, depression etc worsened by being put on hormonal birth control and don't realize it because BC is so common a prescription (...incidentally, I know more than one person personally who has been put on birth control to CONTROL ill-defined depression, usually because a doctor suspected PMDS, but not always).

    However, there are also a TON of other conditions that are affected by hormones. Speaking just from my own experience, I have a lot of comorbid conditions that are clearly and undoubtedly affected by hormone fluctuations: catamenial epilepsy, migraines, and anxiety/depression. Because I've only ever been (and only ever anticipate being) with a woman, I don't take birth control.

    I have taken various hormone based medication (birth control for a month - I hated it - and progesterone for a couple months) at times, so I don't know that I personally would suffer, but then again my seizures are much worse than they were at the time. More to the point, many people have hormone-affected conditions that might be thrown haywire by BC.

    Different kinds of BC might also differ in their effects, but I think in being cognizant of the differences in people - rather than just suggesting someone try a different medication, as if the use of medication is the most important part - we, as feminists need to be aware that there is more to think about than reproductive health, and more to reproductive health/education than hormonal birth control.

  7. Just a short note to say "thanks" to faye! I also wanted to add that it has been 20 years since my tubal ligation and I've not had a single regret over my decision.

  8. I'm really glad you're writing about this--I know so many women who have had their negative experiences with birth control dismissed by their doctors. I'm all about hormonal birth control and all it has done for women, but I hope we keep seeing innovation, and keep trying to find something better, and don't erase the experiences of women for whom hormonal birth control is irrelevant or problematic.
    I also think it's completely absurd that doctors don't talk about withdrawal as a method--it's failure rate is on par with other methods that are talked about openly. I think this speaks to our society's paternalistic view of women's medical care.
    There was an interesting interview over at Bitch with Laura Eldridge, who has written a book about hormonal birth control. I discuss the interview and the reliability of contraceptive methods here (since you said you didn't mind blog whoring! :P )

  9. Definitely, a great post.but interesting is that first i know about tubal reversal by and then from this site i found to much knowledge about tubal ligation as well as other birth control procedures.

  10. I have also thought about this issue in the abortion rights. The mainstream feminist understood very concerned about abortion rights, because they are constantly under attack. I think the choice is very important, I also participated in the protest, support for abortion rights. However, the issue of abortion is straight, sexually active women, than it can not be pregnant or highly unlikely that women have unwanted pregnancies.

    This does not mean that we should abortion backup. Everyone should be concerned about this issue, including the men. But feminists should ensure that the other issues are also increasingly concerned about - otherwise, people will feel like sports is only concerned about the issue of reproductive choices around.
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