The “Hocus Pocus” of Pregnancy and STI Prevention

Amie Newman

A new report reveals that young adults are relying on magical thinking and misperceptions about contraception to the detriment of their well-being.

So, young people – especially young men – know too little about contraception and the ways in which it works. So little, in fact, that it borders on “magical thinking” says a report [PDF] from the National Campaign to Prevent Teen and Unplanned Pregnancy.

It may not be shocking but it is one more hidden mine in a field chocked full as we send young people out into the world without the information they need to remain healthy, infection-free, and knowledgeable about how to prevent pregnancy.

Amanda Hess, writing in the blog, The Sexist, for Washington City Paper, focuses in particular on the lack of knowledge about birth control from the men in our lives in “Rubber Barons: Why Doesn’t Your Boyfriend Know Jack About Contraception?”:

Allison, 26, and her boyfriend were having sex—an activity they had engaged in many times over the six months they had been dating—when her contraceptive vaginal ring fell right out of her vagina. Her boyfriend paused. He developed a sudden concern over the efficacy of the couple’s method of birth control. “He was like, ‘Oh, no. How is it going to catch my semen?’” Allison recalls.

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For about a year now, Allison has used the NuvaRing to prevent pregnancy. Three weeks out of the month, the clear, flexible plastic ring sits in Allison’s vagina and releases hormones into her bloodstream that prevent her from ovulating. It does not “catch” anybody’s semen.

“He played it off as a joke,” says Allison of her boyfriend’s bizarre interpretation of her birth control. “But in the tone of his voice, that honest worry was there. Part of him was thinking, ‘What does this ring actually do?’”

The study does find that men have a startingly poor knowledge of how to prevent pregnancy and how contraception works for both men and women. As Hess notes,

“Twenty-eight percent of young men think that wearing two condoms at a time is more effective than just one. Twenty-five percent think that women can prevent pregnancy by douching after sex. Eighteen percent believe that they can reduce the chance of pregnancy by doing it standing up.”

Unfortunately, the study also reveals that the knowledge black hole does not only pertain to men. There is a serious lack of knowledge when it comes to birth control methods, the ways in which a woman’s fertility works, and how to protect oneself from pregnancy. According to the report, 63% of young adults (ages 18-29) know “little or nothing” about birth control pills. 30% say they know little or nothing about condoms. Among those who report using the rhythm method or NFP (natural family planning), 40% have no idea when a woman’s most fertile time of the month is (says the report, “midway between periods”). Finally, 59% of women and 47% of men think it is slightly likely that they are infertile (?) despite the statistics showing that approximately 19% of women and 14% of men actually are.

The report also shows just how suspicious men and women are about birth control pills and their safety or lack thereof – fearing health risks that span the spectrum from severe mood disorders to cancer to being used as “guineau pigs” by public health institutions and providers.

Despite all of these fears, misperceptions and “magical thinking” young adults still believe, says the report, they’ve got it covered.  A whopping 90% believe they have all of the information they need to avoid unplanned pregnancy.

And still – half of all pregnancies in this country are unintended; STI rates among young people are rising.

Is this really about the absurdity of men (and women) not knowing anything about contraception? Or is it about our failure, as a nation, to adequately address a public health issue of tremendous proportions?

Do young people talk to their physicians about pregnancy and infection prevention? Do young people even have access to the health care they need in order to attain that information? We rely on our schools’ sex-ed programs that may offer incomplete information – or no information at all. Our federal government continues to feed harmful abstinence-only programs with millions of dollars in taxpayer funds. And to what end?

This report is a potent reminder that we are raising children without the information and tools they need to prevent infections and to prevent pregnancy until they are ready. This idea that advocates of abstinence-only programs push –  that somehow we need to block young people’s access to information on contraception because it will help them to decide not to have sex – is absurd. In fact, it has created an environment ripe for unplanned pregnancy and STIs. Half of all pregnancies are unplanned. This isn’t because young men and women don’t care. It’s because we haven’t given them the information and access to care they need to protect themselves.

We now have a nation of twenty-one, twenty-two, twenty-three year old young adults involved in sexual relationships where they know “little to nothing” about how to prevent unplanned pregnancy or protect against STIs. Where do we think young people will learn about pregnancy and infection prevention if not from the adults around them – our medical community, school and parents? Do we think that if a school sex-ed program conveniently “leaves out” information on contraception and birth control, how to communicate ones’ needs in a sexual relationship, how to talk about sex, that somehow this means we’ve erased it from the rest of society’s public discussion as well? That all of a sudden films, television programs, magazines, music, and videos featuring sex become invisible to young people?Of course not. But what we’ve done is create an environment where we saturate society with sex and sexuality and then tell young people  – here, enjoy, but don’t ask us to tell you anything real or meaningful about your sexual selves.

Whether we live in the Bible Belt or the heart of New York City, I guarantee that our children will grow up to be a young adult who has sex. I guarantee it. So, just when are we planning on talking to young people about sex, sexual relationships, sexuality, and sexual health? Because, clearly, according to this report we’re running behind schedule on the birds-and-the-bees discussion. When 23 year old men don’t know how basic methods of birth control work and young women are having sex and have no idea when their most fertile time of the month is, we haven’t done nearly enough.

Sure, individuals, especially adults must claim personal responsibility. Young adults need to seek out the information that will help protect themselves against STIs and unplanned pregnancy. But we’re teaching them that they shouldn’t seek this information out because it’s shameful, embarrassing, not for public discourse. So, why are we surprised when they don’t?

News Law and Policy

Pastors Fight Illinois’ Ban on ‘Gay Conversion Therapy’

Imani Gandy

Illinois is one of a handful of states that ban so-called gay conversion therapy. Lawmakers in four states—California, Oregon, Vermont, and New Jersey—along with Washington, D.C. have passed such bans.

A group of pastors filed a lawsuit last week arguing an Illinois law that bans mental health providers from engaging in so-called gay conversion therapy unconstitutionally infringes on rights to free speech and freedom of religion.

The Illinois legislature passed the Youth Mental Health Protection Act, which went into effect on January 1. The measure bans mental health providers from engaging in sexual orientation change efforts or so-called conversion therapy with a minor.

The pastors in their lawsuit argue the enactment of the law means they are “deprived of the right to further minister to those who seek their help.”

While the pastors do not qualify as mental health providers since they are neither licensed counselors nor social workers, the pastors allege that they may be liable for consumer fraud under Section 25 of the law, which states that “no person or entity” may advertise or otherwise offer “conversion therapy” services “in a manner that represents homosexuality as a mental disease, disorder, or illness.”

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The pastors’ lawsuit seeks an order from a federal court in Illinois exempting pastoral counseling from the law. The pastors believe that “the law should not apply to pastoral counseling which informs counselees that homosexuality conduct is a sin and disorder from God’s plan for humanity,” according to a press release issued by the pastors’ attorneys.

Illinois is one of a handful of states that ban gay “conversion therapy.” Lawmakers in four states—California, Oregon, Vermont, and New Jersey—along with Washington, D.C. have passed such bans. None have been struck down as unconstitutional. The Supreme Court this year declined to take up a case challenging New Jersey’s “gay conversion therapy” ban on First Amendment grounds.

The pastors say the Illinois law is different. The complaint alleges that the Illinois statute is broader than those like it in other states because the prohibitions in the law is not limited to licensed counselors, but also apply to “any person or entity in the conduct of any trade or commerce,” which they claim affects clergy.

The pastors allege that the law is not limited to counseling minors but “prohibits offering such counseling services to any person, regardless of age.”

Aside from demanding protection for their own rights, the group of pastors asked the court for an order “protecting the rights of counselees in their congregations and others to receive pastoral counseling and teaching on the matters of homosexuality.”

“We are most concerned about young people who are seeking the right to choose their own identity,” the pastors’ attorney, John W. Mauck, said in a statement.

“This is an essential human right. However, this law undermines the dignity and integrity of those who choose a different path for their lives than politicians and activists prefer,” he continued.

“Gay conversion therapy” bans have gained traction after Leelah Alcorn, a transgender teenager, committed suicide following her experience with so-called conversion therapy.

Before taking her own life, Alcorn posted on Reddit that her parents had refused her request to transition to a woman.

“The[y] would only let me see biased Christian therapists, who instead of listening to my feelings would try to change me into a straight male who loved God, and I would cry after every session because I felt like it was hopeless and there was no way I would ever become a girl,” she wrote of her experience with conversion therapy.

The American Psychological Association, along with a coalition of health advocacy groups including the American Academy of Pediatrics, the American Counseling Association, and the National Association of Social Workers, have condemned “gay conversion therapy” as potentially harmful to young people “because they present the view that the sexual orientation of lesbian, gay and bisexual youth is a mental illness or disorder, and they often frame the inability to change one’s sexual orientation as a personal and moral failure.”

The White House in 2015 took a stance against so-called conversion therapy for LGBTQ youth.

Attorneys for the State of Illinois have not yet responded to the pastors’ lawsuit.

News Health Systems

The Crackdown on L.A.’s Fake Clinics Is Working

Nicole Knight

"Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options," Feuer said. "And therefore every day is a day that a woman's health could be jeopardized."

Three Los Angeles area fake clinics, which were warned last month they were breaking a new state reproductive transparency law, are now in compliance, the city attorney announced Thursday.

Los Angeles City Attorney Mike Feuer said in a press briefing that two of the fake clinics, also known as crisis pregnancy centers, began complying with the law after his office issued notices of violation last month. But it wasn’t until this week, when Feuer’s office threatened court action against the third facility, that it agreed to display the reproductive health information that the law requires.

“Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options,” Feuer said. “And therefore every day is a day that a woman’s health could be jeopardized.”

The facilities, two unlicensed and one licensed fake clinic, are Harbor Pregnancy Help CenterLos Angeles Pregnancy Services, and Pregnancy Counseling Center.

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Feuer said the lawsuit could have carried fines of up to $2,500 each day the facility continued to break the law.

The Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act requires the state’s licensed pregnancy-related centers to display a brief statement with a number to call for access to free and low-cost birth control and abortion care. Unlicensed centers must disclose that they are not medical facilities.

Feuer’s office in May launched a campaign to crack down on violators of the law. His action marked a sharp contrast to some jurisdictions, which are reportedly taking a wait-and-see approach as fake clinics’ challenges to the law wind through the courts.

Federal and state courts have denied requests to temporarily block the law, although appeals are pending before the U.S. Court of Appeals for the Ninth Circuit.

Some 25 fake clinics operate in Los Angeles County, according to a representative of NARAL Pro-Choice California, though firm numbers are hard to come by. Feuer initially issued notices to six Los Angeles area fake clinics in May. Following an investigation, his office warned three clinics last month that they’re breaking the law.

Those three clinics are now complying, Feuer told reporters Thursday. Feuer said his office is still determining whether another fake clinic, Avenues Pregnancy Clinic, is complying with the law.

Fake clinic owners and staffers have slammed the FACT Act, saying they’d rather shut down than refer clients to services they find “morally and ethically objectionable.”

“If you’re a pro-life organization, you’re offering free healthcare to women so the women have a choice other than abortion,” said Matt Bowman, senior counsel with Alliance Defending Freedom, which represents several Los Angeles fake clinics fighting the law in court.

Asked why the clinics have agreed to comply, Bowman reiterated an earlier statement, saying the FACT Act violates his clients’ free speech rights. Forcing faith-based clinics to “communicate messages or promote ideas they disagree with, especially on life-and-death issues like abortion,” violates their “core beliefs,” Bowman said.

Reports of deceit by 91 percent of fake clinics surveyed by NARAL Pro-Choice California helped spur the passage of the FACT Act last October. Until recently, Googling “abortion clinic” might turn up results for a fake clinic that discourages abortion care.

“Put yourself in the position of a young woman who is going to one of these centers … and she comes into this center and she is less than fully informed … of what her choices are,” Feuer said Thursday. “In that state of mind, is she going to make the kind of choice that you’d want your loved one to make?

Rewire last month visited Lost Angeles area fake clinics that are abiding by the FACT Act. Claris Health in West Los Angeles includes the reproductive notice with patient intake forms, while Open Arms Pregnancy Center in the San Fernando Valley has posted the notice in the waiting room.

“To us, it’s a non-issue,” Debi Harvey, the center’s executive director, told Rewire. “We don’t provide abortion, we’re an abortion-alternative organization, we’re very clear on that. But we educate on all options.”

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