What sucks about condom snorting

Sure it’s a little gross to watch someone snort a piece of latex up their nose and pull it out through their mouth. We can all agree that it’s one of those stupid things young people do, just like sticking cinnamint gum wrappers to your forehead until it burns, piercing your own ears with safety pins, or standing against a wall while a friend runs into your chest to make you pass out. In my opinion, these types of shenanigans are developmentally appropriate; for the most part, everyone survives and grows out of it and it’s no big deal. The problem with condom snorting is not that teenagers are snorting condoms, but that journalists are having a field day with this because they’re snorting condoms. Like, condoms for sex.

For example, Kat Stoeffel writes in New York Magazine’s The Cut (emphasis added):

Teenagers are snorting condoms up their noses and pulling them out of their mouths, on camera and on the Internet, according to a Huffington Post report that raises more questions than it answers. A YouTube search for “condom challenge” yields more than 200,000 results, most of them NSFW due to gross noises. Is this the “gateway sexual activity”? Or is this what happens when there’s no sex ed? Is it an elaborate ruse to buy and possess condoms? And is this better or worse than the condom’s intended purpose?

Seriously? Let me clear this up.

“Is this a gateway sexual activity?” No.

“Is this what happens when there’s no sex ed?” No. What happens is one out of two young people will get an STI by the age of 25 and most wont know they are infected.

“Is it an elaborate ruse to buy and possess condoms?” No. Teenagers have every right, if not every imperative, to buy and posses condoms. Just like teenagers should own helmets, wear sunscreen, and use seatbelts, they should possess and use condoms. If they want to snort a few up their nose, so be it.

“Is this better or worse than the condoms intended purpose?” ARE YOU KIDDING ME?  Teenagers have sex. Condoms should be used for sex. Teenagers should use condoms when they have sex. Snorting condoms is not going to keep teenagers from having sex. There’s nothing wrong with teenagers having protected sex. Condoms are used to have protected sex. It’s really awesome when teenagers use condoms to have protected sex. Do we need to go around one more time?

I’m not sure what the health risks are of condom snorting, but I imagine choking is a legitimate concern. Still, it’s a fairly innocuous pastime compared to the expansive list of dangerously stupid things teenagers have devised to occupy their time, like skateboarding off rooftops, playing with fireworks, giving themselves homemade tattoos, etc.

The media hand-wringing over condom snorting is reminiscent of that of the cinnamon challenge, but this time it will have the added bonus of panic since this time they’re snorting lubed latex that’s made for (hushed whisper) s-e-x. 

This is a case where kids will be kids, and adults need to grow up.

Quick reactions to the New York Time’s take on MTV’s Teen Mom

Last week the New York Times published an article about the effect of MTV’s reality shows 16 and Pregnant, Teen Mom and Teen Mom 2 on combating teen pregnancy. While the article acknowledged that some have challenged the franchise for glamorizing teen pregnancy by turning these girls into celebrities, it overwhelmingly asserts that the shows have had a positive effect by drawing attention to the issue and providing a vehicle for discussion. Still, I’m not sure I’m ready to jump on the “Yay, Teen Mom is the best for sex ed!” bandwagon.

Here are some off-the-top-of-my-head reactions to the piece. I should also preface these by admitting that I am an avid viewer of these shows.

  1. It’s great that the shows are providing entry points for conversation for both parents and educators, but are the majority of viewers actually having those conversations?
  2. A friend of mine who is the mother of teenage girls noted a lack of empathy that some teens have for the girls on 16 and Pregnant and Teen Mom. While some people (myself included) do react emotionally to the girls’ hard-luck stories, others have little pity or sympathy, often assuming that the girls were “stupid” or “careless” or “sluts” and look what happened.
  3. The show doesn’t actually provide sex ed information, just says “Teen pregnancy is 100% preventable, go to our website.” If the programs were truly meant to prevent pregnancy, wouldn’t they want to include real sex ed info as much as possible?
  4. The show does not do enough to address abuse, physical or emotional. While MTV did react to the physical abuse depicted in the first season of Teen Mom, they have not addressed different forms of emotional abuse that aren’t hard to pick out, including emotional abuse from boyfriends (like Adam in Teen Mom 2) and extremely unhealthy parent-child relationships.
  5. Dr. Drew is a manipulative creep and should not be involved. The New York Times calls him a “hand-holder,” but after watching one too many finale specials, his involvement makes me cringe. He consistently encourages the girls to try to make it work with the baby-daddies, even if they don’t want a romantic relationship with them, and even when the baby-daddies are deadbeats or abusive.  This is not the message that teen viewers should walk away with at the end of the season.
  6. While educators use 16 and Pregnant, Teen Mom and Teen Mom 2 in classrooms with little or no opposition, the one-time special No Easy Decision, in which a girl chooses abortion, is not used in this manner. One teacher cites not wanting to “test the limits.”  While the No Easy Decision special was super well done – seriously, I loved it – it was only aired once at an odd time and clearly no one is using it to spark discussion. There is no question that as a franchise, these shows ignore abortion as much as possible in order to remain “neutral,” which really isn’t very neutral at all.

Genital Herpes (part 6): Conclusions

This is the final post in my series on genital herpes.  We we have discussed the fact that genital herpes is the most stigmatized STIeven more so than HIV. We know that herpes jokes are overwhelmingly common and popular, and that anyone offended or hurt by those jokes is silenced by the risk of exposure.  We know that people with genital herpes are thought to be sluts, cheaters, and liars.  We know that people with herpes are described as lepers, monsters, or “dirty.” We also know from listening to people’s stories that it is a traumatizing and unbearable experience to find out you have herpes, but that after a few years, you go on with your life and it’s not so bad.  All of this leads me to the conclusion that dealing with herpes stigma is the worst part about having genital herpes.  In other words, the emotional effects of herpes stigma are much worse than the physical effects of the STI. I have even heard that some doctors advise against getting tested for herpes because if you aren’t having symptoms, the the risk of emotional devastation from a false positive is worse than the risk of delaying the diagnosis.

We may not be able to cure herpes, but we can certainly work to reduce stigma associated with it and make the experience of a herpes diagnosis less emotionally devastating.  So why aren’t more people trying to do this?

If that’s true, then why don’t messages about genital herpes from sexual health professionals fail to address the pervasive stigmas associated with the disease?  Instead of talking about the genital herpes we know from jokes, monster metaphors, Google image searches, and celebrity divorce scandals, health organizations give us dry fact sheets and statistics.  The genital herpes described in those fact sheets doesn’t feel like the same genital herpes we laugh at, recoil from, or vilify in pop culture. One explanation is that health communicators avoid acknowledging stigmas and negative metaphors associated with genital herpes in their messaging in order to remain neutral or non-judgmental.  It is also possible, however, that health communicators do not wish to reduce stigma because framing genital herpes as “ no big deal,” or “ nothing to fear,” could have negative consequences for prevention efforts because people will care less about being cautious. There may even be perceived incentive to cultivate and encourage stigma in order to “scare” people into practicing safer sex.

Some health resources do address stigma, however. Perhaps the best example of a health resource that acknowledges and addresses the stigma of genital herpes well is the American Social Health Association. The ASHA Herpes Resource Center features personal narratives, hotlines, and support groups, with the same prominence as factual information about the STI.  They understand that the emotional devastation of genital herpes is as much a part of the experience of the STI as the physical symptoms, and just as important to treat. The ASHA’ s approach could serve as a helpful model for health providers, educators and communicators.  The health education community needs to take an approach that not only encourages prevention, but also discourages further stigmatization of the disease.  The medical community needs to take an approach that treats not only the physical symptoms of genital herpes, but the social and emotional effects of the disease as well. And as for individuals, we all need to step up and do our part to get educated and put a stop to this pointless discrimination.

I have spent a lot of time really thinking about genital herpes this month because I’ve been writing a paper on it for school.  Most of us, though, don’t spend a lot of time thinking about genital herpes, or how many of our friends might be dealing with the shameful secret and how our careless jokes might make them feel.  And since sex is like Russian Roulette and any one of us might wind up with genital herpes, helping to fight the stigma, shame, and fear of the disease will help make the diagnosis less emotionally devastating when/if it happens to us, or our friends or partner.

So here are some things you can do:

  • Add “people with STIs, including herpes” to your mental list of groups that face discrimination (like GLBT folks, people with disabilities, women, Muslim Americans, African Americans, Latino Americans, etc). Recognize their struggle and support them when you see discrimination happening.
  • Take a stand against herpes jokes that would make someone who has it feel ashamed or uncomfortable.  Step in and say, “Dude, that’s not funny.  How would you feel?”
  • Pay attention to language.  Pay attention to metaphors like “monster,” “leper,” and “dirty” or “clean.” Try to stop using them yourself, and try to get your friends to stop as well.
  • Pay attention to stereotypes.  Correct people when they try to say that being a slut means you probably have herpes, or that people with herpes are liars and cheaters.
  • Tell your story.  If you have herpes, it may be too scary or too risky to “come out” about having herpes in public or to your friends and family.  But you can share your story anonymously either online or using a pen name.  Share your experience to help dispel the myths about herpes, and to let others know that they are not alone and that herpes is not the end of the world.
  • If you’re in college, investigate your health center and on campus sex ed resources.  Pay attention to how they talk about herpes and whether or not their approach is reinforcing or rejecting stigma.  If you don’t like what you see, try to change it.

If you have other ideas, please share them in the comments.

When I started this series, I talked about how I was uncomfortable with the idea of blogging about this and forever associating myself with genital herpes. I knew that everyone would be wondering if I had it, because why else would I write about it? Well, I’m not going to tell you if I have it.  But it’s interesting to think about – if I did, would that change how you felt about what you read?  If I didn’t, would it change it in a different way? I don’t know.  What I do know is that most people aren’t comfortable enough to speak out about herpes awareness, but I am and I did it.  And my world did not come crashing down.

I hope that this, in some way, gives others the courage to speak out and make a difference. Because when almost 25% of the population is demonized for having a virus, well, it’s just unnecessary. People with herpes are not sluts. They are not monsters. They are not predators. They are not dirty.  They are just people, and like anyone else with a disease, they deserve respect and compassion. After all, any one of us could end up with herpes. And when that happens, my friend, the joke’s on you.

Genital Herpes (part 5): Talking bout the herp

We hear illness narratives all the time.  We invite cancer survivors onto talk shows to tell their stories.  We read memoirs written by people struggling with mental illness or disability.  These narratives are told for a number of reasons: to help one make sense of his/her/hir illness; to assert control over one’s illness; to transform one’s identity; to justify one’s medical and life decisions; and perhaps most importantly, to build community. Telling our stories of illness helps us relate to one another – to know that we aren’t going through this alone.  Because they provide such an important function in our society (support, hope, community, love, strength, etc) these types of illness narratives are an increasingly popular vehicle for discourse about health and illness in popular culture.  But what about people with herpes?  We don’t hear their stories in the mainstream media.

If you want to hear stories about what it’s like to have genital herpes, you need to go online.  Due to the extreme stigma associated with the STI, the “community” of people living with genital herpes exists only on the internet, where they can connect anonymously through blogs and online forums. There are even dating sites where people with herpes and other STIs can find matches who understand.  It is not hard to imagine that before the internet, genital herpes was a much more isolating experience.

When you have genital herpes, you have the same reasons for sharing your story as anyone else.  Telling your story helps you make sense of what happened (“why me?”); deal with the loss of control over your body; your transforming identity (becoming a stigmatized/tainted member of society); the decisions you now have to make, like telling a sexual partner; and most importantly, it helps create a community where you can find support and connect with others going through the same thing.

There are two distinctive types of stories people tell about having herpes – those that internalize the horrible stigma surrounding the disease, and those that reject it.  The first type that internalize stigma (I am dirty, I am a whore, I am a monster) are pretty upsetting.  When people believe all that negative stigma about people with herpes to be true about themselves, their experience sounds unbearable.  These stories use the same metaphors we talked about earlier. An online forum user wrote: “ I woke up today feeling so empty, alone, rejected & depressed!! … I’m not angry at the person who gave it to me, yet. It’s[sic] my fault.” Another wrote: “ This thing has taken me away from myself… all I’ve been thinking about is being gone. Dead … I just don’t see how I’ll ever be happy again.”  These stories are heartbreaking and make it sound like getting genital herpes is the end of the world.  And isn’t that what we are all so afraid of?

The good news is that the majority of stories like this come from people who have been recently diagnosed with genital herpes. Narratives from people who have had the virus for a number of years, however, are much more positive.  Instead of internalizing all the stigmas and metaphors about herpes, they reject them.  They tell their stories with the goal of helping others feel okay about having herpes.  These stories are there – just like stories about surviving cancer – to help folks realize that herpes doesn’t have to be the end of your life.  In fact, it’s really not that big a deal at all!

These stories often begin by remembering what it was like when they first found out they had genital herpes.  A forum user wrote: “ I remember the devastation. I thought it was the end of the world; I quit eating and lost about 5 pounds in two days. I thought I was the most disgusting, gross, infected, worthless piece of trash in the world.”  But then he goes on to explain how, with time, he came to regard herpes as something totally manageable: “ I came to realize that, as far as living with it, it’s just like dandruff, psoriasis or some other skin disease for the most part; it breaks out, I get uncomfortable, and it heals in time …. It’s really not a big deal once you learn how to handle it.” Actually, a lot of people living with genital herpes think of it like a skin condition. Another forum user wrote: “This skin condition (personally I really see it as that) is only as big and frightening as you allow it to be.”

In these narratives, people with herpes reject the idea that they are sluts or “dirty.” A forum user made this pretty clear when she wrote “People who take a shower are clean. Those who have herpes are NOT DIRTY.”  In this interview on the Tyra Banks Show (a rare case where someone with herpes shared her story on TV!), Michelle Landry made it clear that she wasn’t any of those negative stereotypes.

Many people share their stories as a conscious effort to encourage those who do not yet
have an STI to protect themselves and to provide support for those who do.  On Sex Etc., Holly Becker wrote: “So, think about my story when you’re having sex. Ask your future partners the hard questions, too … And think about my story when you hear that someone has an STD. Most likely, if they have one, they are scared and lonely, and could use a friend.” An anonymous message post reads: “I hope my words and experience with this can help others learn to be OK with themselves after being diagnosed with this. Life does go on and you can be happy!!!”  More great stories like this can be found at the ASHA Herpes Resource Center.

Some people find the experience of opening up and talking about having herpes as liberating. In an interview about his book Monsters, Ken Dahl said, “ I’ ve got nothing to lose now, and it’ s really liberating. Now I kind of want to do it for everything else in life, because no one can make fun of me. What can they say that I haven’ t already said?”  Christopher Scipio, author of Making Peace With Herpes (2006), has become an advocate for this:

Instead of being imprisoned by this disease, I decided to free myself. I am nolonger afraid of saying the word and letting people know that I am one of “ them.”I have herpes, but herpes doesn’ t have me … I am at peace with my place in this world, and I have discovered the joy of encouraging others to liberate themselves from the stigma.

If you try, you can find plenty of stories about having herpes that really convince you that hey, this isn’t the end of the world.  Thanks to condoms and suppressive therapy (drugs like Valtrex), you can still have a healthy sex life with herpes.  The drugs also help suppress breakouts and make them less severe when they do happen.  Herpes will not kill you, and doesn’t really have any serious complications or health risks (except you might need to get a C-section to avoid passing it to your baby).  All in all, it’s a relatively mild condition that is totally manageable.

Sounds to me like dealing with the stigma and shame of herpes is a lot worse than dealing with the disease itself.  Is it really worth the agony?  We’re going to hash it out in Part 6, the conclusion of this series on genital herpes.  Stay tuned!

For more in the series:

Part 1: This is a post about genital herpes

Part 2: Actually, genital herpes IS a joke

Part 3: More than 51 million Americans are cheaters and whores, apparently

Part 4: Herpes makes you dirty and also a monster

True Blood Danger: The Health Risks of Vampire Sex

It was only a matter of time.

For the past couple years (thanks to Twilight and it’s R-rated cousin True Blood) the world has been seduced by the notion of vampire sex. After finishing season 3 of True Blood, I remember remarking to a friend, “I wonder if people are actually trying this?” Turns out, they are.

This MSNBC report identifies biting and licking each other’s blood as a new “teen fad.”

Teenagers obsessed with the “Twilight” vampire saga, or those simply fascinated with fangs, reportedly have been biting each other — hard – and then licking or sucking the blood.

It reports some important health risks of this behavior as well:

Such talk alarms medical experts, who warn about the dangers of blood-borne diseases such as hepatitis and HIV, as well as the risk of nasty infections. Typically, 10 to 15 percent of human bites wounds become infected.

“If you break the skin, your mouth is pretty dirty,” said Dr. Thomas Abshire, a pediatric blood and cancer specialist and spokesman for the American Academy of Pediatrics. “The human mouth flora is dirtier than a dog or cat’s.”

It doesn’t surprise me that people are doing this. In True Blood, we see blood sucking as a sexual act – one that heightens intimacy and pleasure. After watching 2 seasons of True Blood back to back, I cannot say it hadn’t occurred to me that this was something people might want to try.  Plenty of people are kinky, and considering the popularity of Twilight and True Blood, biting and blood has become sexualized – even fetishized. I agree that those who have been tempted to experiment with this should be aware of the health risks listed above. It looks like there may need to be a call for education about STI transmission through blood and biting, as well as information on keeping human bite wounds clean.

But much of the MSNBC story annoys me. I highly doubt that teenagers are the only people who have tried, or are doing this. I also doubt that “These are kids who think they are real vampires,” as Dr. Orly Avitzur, the medical advisor to Consumers Union, the agency that publishes Consumer Reports magazine, stated. I agree with a student quoted in the piece who argued that biting is a common practice that has “gotten a bad rap because of this whole vampire thing. In reality… a lot of teens bite – and leave marks – for the thrill of it.” According to his statement, it sounds like biting is common, but licking or drinking blood is not. The MSNBC article suffers from the obvious sensationalism of the story, but does make a necessary point about health risks of biting and licking blood.

So how do we educate adventurous and curious folk about the health risks of playing vampire? Can we find a way to provide non-judgmental education without encouraging the behavior? And who’s responsibility is it to provide this education?

At the base level, we need to remind people that blood is dangerous; even if vampires cannot be infected with HIV or other STIs, (although in an early episode of True Blood, they reveal that vamps are susceptible to Hep D), humans can. Any time another person’s blood gets in your body, you are at risk for STIs like HIV – which, unlike vampires, is a very real threat.

Now, here’s a sex study that makes sense

After a dubious study from The Heritage Foundation nearly drove a friend of mine to insanity, it’s nice to see some conclusions based on actual research that account for and acknowledge socio-economic forces at work. In this study, researchers from the London School of Hygiene and Tropical Medicine (UK) analyzed data from 59 countries. They conclude that sexual health strategies must go beyond individual risk reduction and address social and economic determinants of behavior. (They also use funny spellings like “analyse” and “behaviour.”) (I’m allowed to make jokes because I lived there, ok? Sheesh.)

Here is the first part:

The analysis revealed the huge regional variation in sexual behaviour but also showed that there has been less change in behaviour over the past two decades than was thought:

  • There is no universal trend towards sex at a younger age. However, a shift towards later marriage in most countries has led to an increase in premarital sex, more so in developed countries and for men. Sexual activity in single people tends to be sporadic.
  • Most people are married (or live together in partnerships) and most sex happens in stable partnerships. Marriage does however not always safeguard sexual health.
  • Monogamy is the dominant pattern everywhere, but having had two or more sexual partners in the last year is more common for men and in industrialised countries.
  • Condom use has increased almost everywhere, but rates remain low in many developing countries.
  • School-based sex education improves awareness of risk and ways to reduce it. It increases the intention to practise safer sex and delays rather than hastens the onset of sexual activity.

So, contrary to certain bio-determinist beliefs, it seems as though we aren’t experiencing an “unprecedented rise in casual sex.” No universal trend towards sex at a younger age, either! Instead of looking at rates of “sex outside of wedlock” as evidence of moral decay, this study uses social logic to explain how premarital sex has increased while people aren’t having sex any younger: delay of marriage. And hey, they found that sex education actually “increases the intention to practise safer sex and delays rather than hastens the onset of sexual activity.” (We knew that, but it bears repeating!)

Regional variations in sexual behaviour do not correlate with sexual health status. Higher rates of partner change in industrialised countries are offset by higher levels of condom use and better access to treatment results in better health. The authors explored the main reasons for the variations:

  • Some of the variations can be explained by demographic and structural changes. The age structure and ratio of men to women in a population can limit or extend opportunities to form new partnerships.
  • There is a striking gender difference in sexual behaviour. Multiple partnerships are more common for men than for women. This is in line with a double standard in most societies that makes non-exclusive relationships more acceptable for men than for women.
  • Poverty, deprivation and unemployment work with gender inequity to promote partner change, multiple partners and unprotected sex.

Let’s talk about that “striking gender difference.” At first glance you might see this as support for the bio-determinist argument that men are just less monogamous and/or can’t keep it in their pants. But not so!  The authors make sure to first of all use the word “gender” and not “sex” to imply that this is not a XY/XX distinction, but a man/woman, “gender-as-a-social-construct” distinction. They point out, rightly so, that the data correlates with the double standard in most societies that makes non-exclusive relationships more acceptable for men than women (aka the “player” v. “slut” double standard). They also point to the influences of poverty, deprivation and unemployment on promoting partner change, multiple partners, and unprotected sex.

The authors highlight the need to base interventions on evidence rather than myths or moral stances. Approaches focusing exclusively on expectation of individual behaviour change are unlikely to produce substantial improvements in sexual health. Comprehensive multi-level behavioural interventions are needed that reflect the social context. These should attempt to modify social norms and tackle the structural factors that contribute to risky behaviour. Examples include mainstreaming HIV and sexual health in development projects; empowering sex workers through business and IT training; and integrating sexual health education into microfinance schemes. However, the success of these strategies requires decision-makers to accept the reality of sexual practices.

Wow.  I have shivers. Can we just read that again?

The authors highlight the need to base interventions on evidence rather than myths or moral stances. Damn straight!

Approaches focusing exclusively on expectation of individual behaviour change are unlikely to produce substantial improvements in sexual health. Comprehensive multi-level behavioural interventions are needed that reflect the social context. Amen!

These should attempt to modify social norms and tackle the structural factors that contribute to risky behaviour. Examples include mainstreaming HIV and sexual health in development projects; empowering sex workers through business and IT training; and integrating sexual health education into microfinance schemes. HELL YES!

However, the success of these strategies requires decision-makers to accept the reality of sexual practices. BAM.

And then, just when you thought this couldn’t get any better? They list and link to their sources and give an explanation of who funded the research. And guess what? It’s academic! Not a lobby group!

It’s work like this that gets me excited to begin my MA in Health Communications at Emerson next week. There is such a need for information about sexual health that serves not to moralize or control, but to actually reduce the spread of STDs based on the reality of sexual behavior and the social forces that influence it.

Love21: Trendy maternity fashion for pregnant teens

The ever-trendy, ever-crappy Forever 21 is launching a new line of maternity clothing called Love21, which like the rest of their clothes, is aimed at teenage girls. The Gloss reports that the line will only be available in 5 states – 3 of which (Arizona, California, and Texas) happen to be on the list of states with the highest rates of teen pregnancy. Coincidence? Of course not.

The Gloss suggests that this is “brilliant marketing” to an existing customer base that addresses the need for maternity wear for teens. This raised a lot of red flags for me, as I remembered the fuss over MTV’s Teen Mom and the cries that today teen pregnancy and teen motherhood is being glorified by the media. Now will it be glorified by the fashion industry?

There is a bit of the “chicken or the egg” dilemma at work here. Does providing teen maternity wear help glorify – and therefore increase – teen pregnancy? Or does providing teen maternity wear fill a pre-existing need, and perhaps validate the choices of young women, or at least help them avoid some of the stigma of being a pregnant teen by still looking hip and trendy? Could one even argue that denying a pregnant teen the right to wear fashionable and age-appropriate* clothing is a form of punishment through shaming? (“Well, it’s your fault for getting knocked up, so you’ll wear what you can find and be grateful.”)

*Er, maybe “appropriate” isn’t the right word to describe Forever 21’s clothes, but…

As much as I wish that there were less of a demand for teen maternity wear, condemning of Love21 doesn’t sit well with me. This comparison is not exactly one I enjoy making, but I support plus size clothing lines even though I wish less Americans were obese. Is this not similar? I’m not sure if the distinction matters, but it makes me even more uncomfortable to condemn the line when I remember that pregnant teens will not all become teen moms. Pregnant teens also include those who are planning to give the baby up for adoption. (Or does that distinction reflect a bias on my part?)

Clearly I’m divided on the issue, and somewhat unsettled. Still, Forever 21’s choice to name the line “Love21” is telling. I think that teen pregnancy is hard enough without having to wear “old lady” maternity clothes. Let’s not punish pregnant teens by withholding fashion, but redouble our efforts to provide education and access to reliable, relatable, scientific, comprehensive sex education – not to mention access to Plan B and safe and legal abortion services.

“EC is not the abortion pill”: a Rhetoric Fail for ellaOne

As a sex educator and counselor, I have given the emergency contraception (EC) spiel many times. There are two important points that must be made. The first is to explain that “the morning after pill,” is a misnomer because EC it works for up to 72 hours after unprotected sex. The second is to make absolutely sure that everyone understands that EC is NOT! THE! ABORTION! PILL!

Differentiating between Plan B (EC) and RU-486 (the abortion pill) was a key component of the strategy to make Plan B available without a prescription, to convince pro-life pharmacists to dispense it, and to reassure women that taking Plan B will prevent pregnancy without terminating or harming an embryo if pregnancy has already occurred. This strategy was effective, and necessary, and is often used to promote EC as the solution to “the abortion problem.”  If everyone had access to EC, women wouldn’t need to have so many abortions, and we can all agree that abortions are the least desirable outcome. Unifying as this strategy can often be, it is problematic.

A form of EC already used in 21 European countries called “ellaOne” is headed to the FDA for U.S. approval and is generating a great deal of controversy. EllaOne works differently than Plan B, and can prevent pregnancy for up to five days. FIVE DAYS.  Like Plan B, ellaOne is more effective the earlier it’s taken, but studies seem to be showing it is still more effective than Plan B.  This is a big deal.

Folks don’t realize that time can be a major barrier to obtaining Plan B, especially for those who live in rural areas, or anywhere that doesn’t have 24 hour pharmacies or Choice-friendly clinics or pharmacists.  Sometimes it can take a day or two to figure out where to get Plan B and negotiate how to get there and how to get the time off from work. The cost of Plan B (around $50) is also a barrier, and it may take a few days to scrape together the money to pay for the pill.  An extra 2 days of effective prevention could make ellaOne a real game-changer.

The problem is that ellaOne may have some chemical similarities to RU-486, the abortion pill.  According to the Washington Post, it is possible that ellaOne could induce an abortion by making the womb inhospitable to an embryo. (Much like what happens during a miscarriage.) But ellaOne (ulipristal acetate) is NOT the same as RU-486 (mifepristone). The differences are explained in this fact sheet.

Regardless, the Pro-Life lobby is well on its way to preventing ellaOne from being approved by the FDA. As Ms. Magazine reminds us, the Pro-Life lobby prevented the FDA from approving Plan B until 1998, when it had already been used in Europe since the 1970s. It took another 8 years of fighting to make Plan B available over the counter for women 18 and up. Plan B was only made available over the counter to 17 year olds in 2009. Getting ellaOne approved by the FDA will be a political battle rather than a medical one. And unfortunately, we have already sabotaged our case with our own anti-abortion rhetoric surrounding EC.

By driving home the distinction between EC and the abortion pill and stressing that EC is acceptable because of this distinction, we have set up ellaOne to fail. If ellaOne does cause “abortions” (or miscarriages, or “spontaneous abortions” just like ones that occur naturally), well, we’re screwed. We played the game of rhetoric, and now we might have to put our foot in our mouths.

I keep putting “abortions” in quotations because it’s important to acknowledge that no one is really sure if ellaOne causes abortion. The reason is not because we don’t understand what the drug does – we do – it’s that there is no consensus on when life begins, so it’s pretty hard to define what is and what isn’t an abortion when we’re talking about fertilized eggs and uterine implantation.  Does life begin with a fertilized egg? Does it begin when that egg implants on the uterine wall?  Does an egg that naturally fails to implant an abortion? A miscarriage? Or just another period? It’s confusing, but the Pro-Life lobby is happy to spin it. By claiming that ellaOne has similarities to the abortion pill, it will be viewed as an abortion pill. And by demonizing the abortion pill as the pro-EC rhetorical strategy has done, we have hurt the case for ellaOne.

In most cases, the people promoting EC are Pro-Choice and actually support RU-486.  From a Pro-Choice, pro-healthcare-access point of view, RU-486 is a good thing. It is a great option and has the potential to make abortion safer and more accessible for many women. It has even been administered via webcam to women in remote locations!

And ellaOne, even if it does sort of cause “abortions,” would be a great product to fill that in-between space – the space between Plan B and abortion. For those truly concerned with reducing the demand for abortion – real, unambiguous abortion – ellaOne is actually a good thing. A really good thing.

Let’s hope that it doesn’t take another 30 years to give American women better control over their own health, bodies, and lives.