Last week, there was a strange kerfuffle over access to contraception in the small town of Bartlesville, Oklahoma. Reports emerged suggesting that the local hospital, a Catholic facility, had forbidden any gynecologists associated with it—which meant all but one gynecologist in the town—from prescribing contraception to patients. Since then, the hospital has issued a confusing denial of sorts, which is generally being interpreted to mean that the doctors will be able to continue prescribing contraception as long as they do it in their private practices.
Whether that means the original story was just a rumor or this denial constitutes a quick backtracking from the Catholic hospital is a story for another time. But one thing that jumped out at me is that even in this retraction, the hospital administration insisted on using language that implies that contraception is not a normal part of health care. “Consistent with Catholic health care organizations, St. John Health System operates in accordance with the Ethical and Religious Directives for Catholic Health Care Services, and therefore does not approve or support contraceptive practices,” the hospital said in its statement, talking about birth control like it’s a rare and disreputable behavior, instead of a normal part of women’s health care.
It’s tempting to write off phrases like “contraceptive practices” as just another example of Catholic officials demonstrating how out of touch they are with the way that most people live their lives. (A recent example: A Catholic nun made headlines after stating that masturbation makes you gay, a statement which, read literally, would mean everyone is gay.)
The problem is that this kind of rhetoric, geared toward marginalizing contraception and trying to redefine it not as health care but as a sexual kink, is becoming a mainstream conservative preoccupation, especially in light of the Affordable Care Act listing contraception as a preventive care service that must be covered without a copay, creating a massive right-wing backlash.
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There are plenty of examples in my podcasts from the past few months of the intense right-wing campaign to deny that contraception is health care, and make it seem like something only dirty girls use and that proper people can only acknowledge with shame or scorn. The purpose of all this is obvious enough: If contraception can be marginalized rhetorically, then it will be that much easier to make the case for restricting access. Certainly, if the right wing can frame contraception as a “lifestyle” choice, like watching porn or using sex toys, then it becomes much easier to strip away insurance coverage or federal subsidies to make contraception more affordable, all while playing dumb and pretending they’re not trying to take people’s contraception away.
Can this framing take hold? It’s an open question. On the one hand, more than 99 percent of sexually active women have used contraception at some point in their life, and 62 percent of women of reproductive age are currently using a contraceptive method. That level of ubiquity, plus the undeniable fact that pregnancy is a major medical event, makes it hard to imagine that the right could get very far with the attempt to kill our current understanding of contraception as a health-care decision and instead get people to think of it as a “lifestyle” choice.
Of course, abortion is also really common. It’s rare compared to contraception, which many women take on a continuous basis, but about one-third of women will have an abortion in her lifetime. Yet abortion is treated as far rarer and more marginalized than it is, with quite a few people not even realizing how many women they know who have had one. Women who have abortions usually don’t talk about it with most people in their lives; conservatives were able to shame and demonize women who have abortions to the point where such discussions are incredibly hard to have. Most of the discourse about abortion deals with the politics of it, rather than the experience of it. Because of all this, abortion has been successfully marginalized in health care, not covered by government insurance, and understood by most people to be a medical experience separate from your everyday health care.
It’s clear this is what the right is trying to do with contraception, and they have a potent weapon to do it: sexual shame. That’s why Mike Huckabee connected using contraception with being unable to control “libidos.” That’s why Sean Hannity is so insistent on talking about “free” condoms as an alternative to getting birth control from your doctor. He knows that few, if any, women are going to divulge the personal details of their sex lives that make relying on condoms (or only condoms) less than ideal for them. He also emphasizes getting condoms in bars—again, to separate contraception from mainstream health care and relocate it to a place where people go to drink alcohol. The implication is that non-procreative sex is like drinking, a fun but unhealthy behavior that shouldn’t be covered by health insurance. But sex really should be understood as something closer to eating, a natural part of everyday life that can be healthy or unhealthy, depending on how you do it. And in order to make it healthy, it needs to be considered an important part of health care.
All this can be derailed by having an honest, straightforward conversation about sex. These pundits get away with their sneering and implications of sleaze only as long as no one replies bluntly, “Yes, I have sex. Most people do, and usually quite frequently. Do you not know this?” That helps shift the shame burden back onto conservatives. They’re trying to hijack social shame about having a sexuality to punish and control.
Well, that goes both ways. There’s also a substantial social shame to being considered an uptight prude, or somehow sexually incompetent, especially as an adult. By forcing the issue and talking about sex as a normal, healthy part of most people’s lives, we can put conservatives on the defensive, and force them to explain why they don’t think that should be so. Believe me, they do not want to have this conversation. So we should make them have it.