Commentary Contraception

Putting the Sex Back in Birth Control: Why the Dominant Narrative on Contraception Undermines Young People

Andrew Jenkins

The progressive community is deathly afraid of talking about sex and young people. We have to stop running away from sex like it’s our movement’s dirty little secret, because despite the supposed mainstream appeal and political expedience that comes with a watered down sexless narrative about birth control, it also comes with a swift price. 

While I applaud Elizabeth Banks for her new ad supporting Planned Parenthood, birth control, and President Barack Obama–and wholeheartedly empathize with her personal story–I’m reminded of a sobering fact: the progressive community is deathly afraid of talking about sex and young people.

That’s right. I said it.

Between Banks new web promo aimed at female voters, Sandra Fluke’s testimony before Congress last February, and the reactive messaging around Rush Limbaugh’s vile comments, one thing has remained clear: our movement is far more comfortable elevating stories about birth control when they don’t involve sex. Pure unadulterated sex. Sex without the fear of an unintended pregnancy. You know… the primary reason young Americans use birth control.

And for arguments sake, maybe there’s a good reason for this. Maybe–just maaaayyyybe–we’re trying to appeal to conservatives. Perhaps we’re making our funders happy. Or maybe we’re just trying to sell a message that is palatable; easy to consume.

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Nope. Bullshit. Not buying it.

As sweet and good intentioned as these justifications sound, what we’re ultimately doing is playing the game that our opponents want us to play and operating under a set of rules that threaten the long-term success of our movement. By running away from a serious discussion about sex in the birth control debate, we’re appealing to a deep-rooted paranoia and fear in this country. Fear of young people having sex. Fear of young people exercising agency over their own bodies. Instead of using this political moment to challenge that stigma and re-frame the debate with a sex-positive message, I’m afraid we’ve taken the easy way out. We’ve chosen to prioritize a sensationalized and fear-based discourse that completely undermines our ability to alleviate the root causes of sexual and reproductive oppression.

We’ve chosen a strategy that undermines young people.

Let’s make something very clear. Birth control isn’t under attack because the powers that be are frightened by the prospect of Elizabeth Banks using birth control for her migraines and heavy flow. Contraception isn’t under attack because of the heartfelt story Sandra Fluke shared about her friend six months ago. In fact, Rush Limbaugh didn’t have anything to say about that story. He did, on the other hand, have plenty to say about Sandra Fluke’s sexuality.

Don’t get me wrong. Elizabeth Banks story has value. Sandra Fluke’s story about her friend is important. Both of these experiences highlight a grave and horrific consequence of limiting access to affordable reproductive health care. But as important and valuable as these stories are, they fall short in exposing our opposition’s true intentions. They fail to radically transform the embedded cultural ideologies that are responsible for these wide spread and relentless attacks on birth control to begin with.

Make no mistake about it: birth control is under attack because it empowers young people with the agency to make healthy choices about sex and sexuality. It gives us social, political, and economic power. And to the structural systems of oppression that rely on our indefinite alienation and disenfranchisement, birth control is a threat of epic proportion. As evidenced so eloquently by Representative Mike Kelly (R-Pa), access to affordable birth control is comparable to Pearl Harbor and 9/11.

“I know in your mind, you can think of the times America was attacked. One is Dec. 7, that’s Pearl Harbor Day. The other is Sept. 11, and that’s the day the terrorists attacked. I want you to remember Aug. 1, 2012, the attack on our religious freedom. That is a day that will live in infamy, along with those other dates.”

Let me translate. According to Representative Mike Kelly, providing young people with the resources to embrace sex–free of consequence–jeopardizes the very fabric of our country. You see, the truth is that birth control enables us to be agents of our own lives, a concept so terrifying–so threatening to entrenched systems of inequality–that those in power have a vested interest in dislocating us from the resources we need to shape our own futures.  

I’ve worked with a lot of diverse young activists over the past six months and I can say with relative certainty that the vast majority of them want a national conversation about birth control that embraces sex and sexuality. Young people know what’s really at stake in this debate because we understand the consequences of a sex-negative culture. We’re experiencing it first-hand. Abstinence-only programs. Parental notification and consent laws. Age restrictions on emergency contraception. Conscience clauses.

That’s why we have to stop running away from sex like it’s our movement’s dirty little secret. Because despite the supposed mainstream appeal and political expedience that comes with a watered down sexless narrative about birth control, it also comes with a swift price. 

We’ve already seen the consequences of this rhetoric. In fact, just a few short weeks after Sandra Fluke’s testimony, and the subsequent Rush Limbaugh debacle, Arizona legislators began to push a bill that went far beyond simply rolling back the birth control mandate. Instead of wholesale denying coverage, the bill attempted to authorize employers with the right to determine whether a person’s justification for using birth control was viable or not. In other words, birth control coverage is a legitimate form of health care, unless used for the purpose of preventing an unintended pregnancy. 

It’s an old story, but I don’t want us to lose the irony here. The very logic behind this nauseating bill in Arizona was born from a sex-phobic, paternalistic narrative that our movement unintentionally helped market to the American people. We avoided a necessary conversation about sex in favor of a story about the “ideal victim,” and consequently, laid the foundation for innovative attacks on birth control access. Attacks focused on the very thing we were running away from to begin with.

If we keep running away from this simple truth–the truth that young people (married people, unmarried people, lots of people) have sex and should have the right to do so–we’re going to miss out on a powerful opportunity to engage and mobilize the Millennial generation. We’re going to lose out on this unique chance to hijack the narrative on sex and sexuality, and truly uproot the systems that benefit from this pervasive moral panic.

The good news is that young people are fighting back. We’re telling our own stories about sex, relationships, and birth control. We’re calling out the media for slut-shaming and victim-blaming. We’re fighting for body-positive images and representations. We’re asking our legislators to support comprehensive sex education, and then creating our own peer-education programs when they leave us out to dry. We’re relentless change-makers and we’re unwavering in our commitment to building a better future. But no matter how much we do – how hard we fight – our impact will always be limited if the movement we’re trying to fight for refuses to advance a narrative that accurately depicts our interests and values.  

If we don’t get our act together and start prioritizing a political conversation about birth control–centered on sex and young people–I’m afraid this ship is going to sink.

News Media

Study: Politicians Dominate Nightly News Reports on Birth Control

Nicole Knight Shine

Study co-author Michelle H. Moniz, assistant professor of obstetrics and gynecology at the University of Michigan, noted that news segments largely framed contraception as a political issue, rather than a matter of public health.

When it comes to asking experts to weigh in on birth control, the nation’s three major TV networks favor political figures over doctors, according to a forthcoming paper in the journal Contraception.

Analyzing nightly news segments on contraception on ABC, CBS, and NBC between 2010 to 2014, the authors found that few broadcasts included medical professionals (11 percent) or health researchers (4 percent). Politicians, however, dominated coverage, appearing as sources 40 percent of the time, followed by advocates (25 percent), the general public (25 percent), and Catholic Church leaders (16 percent).

Sixty-nine percent of news segments on birth control included no medical information, the authors found.

Study co-author Michelle H. Moniz, assistant professor of obstetrics and gynecology at the University of Michigan, noted that news segments largely framed contraception as a political issue, rather than a matter of public health.

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“Health professionals are an untapped resource for ensuring that the most up-to-date, scientific information is available to the public watching the news,” Moniz said in an email to Rewire.

An estimated 24 million Americans watch nightly news, making it an “influential information source,” the authors note.

And although nearly half of pregnancies in the United States each year are unplanned, news segments did not emphasize highly effective contraception like IUDs, the researchers found. Instead, emergency contraception, commonly known as the morning-after pill, warranted the most coverage, at 18 percent, followed by the daily oral contraceptive pill, at 16 percent.

The researchers’ analysis of 116 nightly news segments coincided with the rollout of the Affordable Care Act by President Obama and continued through the June 2014 U.S. Supreme Court decision in Burwell v. Hobby Lobby, which carved out the right for private corporations to deny birth control coverage to employees on religious grounds.

“We found that when the network television media covers contraception,” the authors observed, “they do so within a largely political frame and emphasize the controversial aspects of contraception, while paying less attention to health aspects and content experts.”

The paper was authored by five researchers from the University of Michigan, Ann Arbor; the Veterans Affairs Center for Clinical Management and Research in Michigan; and the Pennsylvania Department of Health.

The study builds on earlier work exposing media bias and gender disparities in reproductive health coverage.

In June, an analysis of prime-time news programs on cable networks CNN, Fox News, and MSNBC by media watchdog group Media Matters for America found that 40 percent of guests on all three networks made anti-choice statements or identified as anti-choice, compared with 17 percent of guests who made pro-choice statements or identified as reproductive rights advocates. On Fox, guests made a total of 705 inaccurate statements about abortion care over a 14-month period.

The nightly news study follows a report earlier this year on gender disparities by the Women’s Media Center, a nonprofit advocacy group, indicating that male journalists dominate reproductive health coverage, with bylines on 67 percent of all presidential election stories related to abortion and contraception. Female journalists, in comparison, wrote 37 percent of articles about reproductive issues.

Commentary Sexual Health

Fewer Teens Are Having Sex, But Don’t Pop the Champagne Yet

Martha Kempner

The number of teens having sex may be less important than the number having protected sex. And according to recent data from the Centers for Disease Control and Prevention, condom use is dropping among young people.

Every two years, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH) surveys high school students to gauge how often they engage in perceived risky behaviors. The national Youth Risk Behavior Surveillance (YRBS) is wide ranging: It asks about violence, guns, alcohol, drugs, seat belts, bicycle safety, and nutrition. It also asks questions about “sexual intercourse” (which it doesn’t define as a specific act) and sexual behaviors.

Started in 1991, this long-running study can provide both a picture of what high school students are doing right now and a historical perspective of how things have changed. But for more than a decade, the story it has told about sexual risk has been the virtually the same. Risk behaviors continually declined between 1991 and 2001, with fewer high school students having sex and more of them using condoms and contraception. But after the first 10 years, there has been little change in youth sexual risk behaviors. And, with each new release of almost unchanging data, I’ve reminded us that no news isn’t necessarily good news.

This year, there is news and it looks good—at least on the surface. The survey showed some significant changes between 2013 and 2015; fewer kids have ever had sex, are currently sexually active, or became sexually active at a young age. More teens are relying on IUDs and implants, which are virtually error-proof in preventing pregnancy.

In 2015, 41 percent of high school students reported ever having had sexual intercourse compared to 47 percent in 2013. The researchers say this is a statistically significant decrease, which adds to the decreases seen since 1991, when 54 percent of teens reported ever having had sexual intercourse.

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Another change is in the percentage of students who had sex for the first time before age 13. In 2015, 4 percent of high school students reported this compared to almost 6 percent in 2013. This is down from a full 10 percent in 1991. As for number of overall partners, that is down as well, with only 12 percent of students reporting four or more partners during their lifetime compared to 15 percent in 2013 and 19 percent in 1991. Finally, the percentage of students who are currently sexually active also decreased significantly between 2013 (34 percent) and 2015 (30 percent).

These are all positive developments. Delaying sex can often help prevent (at least temporarily) the risk of pregnancy or STIs. Having fewer partners, especially fewer concurrent partners, is frequently important for reducing STI risk. And those teens who are not currently having sex are not currently at risk for those things.

While I want to congratulate all teens who took fewer risks this year, I’m not ready to celebrate those statistics alone—because the number of teens having sex is less important to me than the percentage of teens having sex that is protected from both pregnancy and sexually transmitted infections. And that number is lower than it once was.

Among sexually active teens, there were no significant positive changes in measures of safer sex other than an increase in the number of sexually active high school students using the IUD or implant (up to 4 percent from 2 percent in 2013).

Moreover, some results indicate that today’s teens are using less protection than those who were teens a decade ago. The most telling finding might be the percentage of teens who used no method of contraception the last time they had sex. This decreased between 1991 and 2007 (from 17 percent to 12 percent), inched up to 14 percent in 2013, and stayed the same in 2015 (14 percent). There was also little to no change in the percentage of high school students who say that either they or their partner used birth control pills between 2013 (19 percent) and 2015 (18 percent) or those who say they used the contraceptive shot, patch, or ring (5 percent in 2013 and 2015).

For me, however, the most distressing finding is the backward progress we continue to see in condom use. The prevalence of high school students who used a condom at last sex went up from 45 percent in 1991 to 63 percent in 2003. But then it started to drop. In 2015, only 57 percent of sexually active high school students used condoms the last time they had sex, less than in 2013, when 59 percent said they used condoms.

It’s not surprising that teens use condoms less frequently than they did a decade ago. In the 1990s, the HIV epidemic was still front and center, and condoms were heavily promoted as a way to avoid infection. As this threat waned—thanks to treatment advances that now also serve as prevention—discussions of the importance of condoms diminished as well. The rise of abstinence-only-until-marriage programs may have also affected condom use, because these programs often include misinformation suggesting condoms are unreliable at best.

Unfortunately, some of the negative messages about condoms inadvertently came from public health experts themselves, whether they were promoting emergency contraception with ads that said “oops, the condom broke”; encouraging the development of new condoms with articles suggesting that current condoms are no fun; or focusing on teen pregnancy and the use of highly effective contraceptive methods such as long-acting reversible contraceptives (LARC). The end result is that condoms have been undersold to today’s teenagers.

We have to turn these condom trends around, because despite the decreases in sexual activity, young people continue to contract STIs at an alarming rate. In 2014, for example, there were nearly 950,000 reported cases of chlamydia among young people ages 15 to 24. In fact, young people in this age group represented 66 percent of all reported chlamydia cases. Similarly, in 2014, young women ages 15 to 19 had the second-highest rate of gonorrhea infection of any age group (400 cases per 100,000 women in the age group), exceeded only by those 20 to 24 (489 cases per 100,000 women).

While we can be pleased that fewer young people are having sex right now, we can’t fool ourselves into believing that this is enough or that our prevention messages are truly working. We should certainly praise teens for taking fewer risks and use this survey as a reminder that teens can and do make good decisions. But while we’re shaking a young person’s hand, we should be slipping a condom into it. Because someday soon (before high school ends, for more than half of them), that teenager will have sex—and when they do, they need to protect themselves from both pregnancy and STIs.