“Birth Control Is Freedom”: Celebrating Birth Control and Tackling Barriers to Access

This Wednesday, reproductive rights advocates across the nation are celebrating #ThxBirthControl day by drawing attention to everything birth control makes possible—as well as what it will take to protect and expand access.

A recent poll by Power to Decide—the reproductive rights organization behind Thanks, Birth Control Day—sheds light on the variety of reasons people opt to use birth control. A wide majority of respondents age 18 to 34 (94 percent) said they were thankful that birth control allowed them or their partner to decide if, when and under what circumstances to get pregnant and have a child.

More, 84 percent of all respondents appreciated birth control for giving them the ability to work toward educational or professional goals, and 74 percent were thankful that birth control allowed them to manage health conditions. 

The data also showed widespread concern about the state of reproductive rights, given the recent appointment of Amy Coney Barrett to the Supreme Court—51 percent of respondents (including 59 percent of birth control users age 18-34) reported being “concerned about the ability of the public to afford or access their preferred method of contraception considering the most recent change in the Supreme Court.”

On Monday, in the lead-up to #ThxBirthControl Day, Power to Decide hosted their first installment in their new Power Talk series, which are discussions featuring leaders in the sexual and reproductive health field.

The talk—between Dr. Gillian Sealy, CEO of Power to Decide; Dr. Megan Stubbs, sexologist and relationship expert; and Dr. Staci Tanouye, board-certified gynecologist physician and a women’s health blogger; and moderated by Ms. editor Roxy Szal—celebrated all that birth control does for people everywhere, as well as shed light on what’s left to do to make birth control less controversial and more accessible.

Watch the 30-minute conversation here:

A transcript of the event is below. It has been slightly edited for clarity.


Roxy Szal: Can you all speak about some of the benefits of birth control, especially what you’re seeing on the grounds in your respective lanes? What does birth control do for people or allow people to do?

Dr. Staci Tanouye: I mean, birth control is freedom. It really allows anyone with a uterus to live their lives like they want to, with the sexual freedom that they want to—they get to live pain-free, they get to live free of periods or with less periods, and with all of the benefits that birth control has really it just allows them to be who they want to be without any limitations.

Dr. Gillian Sealy: Yeah. I firmly agree, birth control helps people decide when and under what circumstances to become pregnant and to have a child, and that’s just freeing, right? To be able to make the choice around your own reproductive and sexual health. So whether that’s birth control allowing you to complete your education, to improve your financial situation, employment prospects for yourself, it really allows people the autonomy to make those decisions for themselves and their families. 

Dr. Megan Stubbs: I’d like to cosign both of those amazing sentiments. It is freedom; it’s choosing to say my body, my rules, and something we haven’t touched on yet is that it can be gender-affirming—so if something like having a period is going to cause you distress, we have options to prevent that from happening, and that’s really great because we are all about freedom and choosing what you want to have happen with your body.

"Birth Control Is Freedom": Celebrating Birth Control and Tackling Barriers to Access
A rally outside the U.S. Supreme Court while waiting for the court’s decision in the Burwell v. Hobby Lobby case in June 2014. (ALL / Flickr)

Szal: Given all these positive things y’all just mentioned, I want to talk about messaging and perspective. Why, in 2020, is birth control still seen as controversial and what do you wish people knew about birth control?

Stubbs: I think all of the stigma always goes back to the fact that this is related to something sexual, and people have so many hang-ups when it comes to sexuality. Birth control might be a misnomer—because you can be on birth control and not be sexually active. It’s nowhere near the only reason to be on birth control, so it’s really limiting if we’re only looking at the scope of birth control in the form of like oh, you just want to have lots of sex? Well, maybe, but other reasons for being on birth control are totally valid, too.

Tanouye: Like you said, it’s about sexuality, and it’s particularly about female sexuality and trans male sexuality which are things that have been pushed behind closed doors forever, and controlled. So to take back that control is just a wild concept that people seem to sometimes not be ready for. It’s a powerful thing that people aren’t ready to give up from the other side.

Sealy: And as you mentioned, it’s mystifying that in 2021 it’s still this controversial. I can speak from personal experience having grown up on an island that is quite conservative, where contraception was not readily talked about and when it was talked about it was talked about in hushed tones. So I think it also has to do with the way your parents or grandparents talked about sex, talked about contraceptives.

And truth be told, when it comes to birth control, it really is not controversial, right? For one, 86 percent of adults support access to all methods of birth control regardless of race, region, political affiliation, and almost 99 percent of women who have ever had sex with men have used contraception at some point in their lives. 

So I hope that we get to a point where that it’s not seen as taboo and this really is just a part of a person’s health and the choices that they make for themselves. 

Eighty-six percent of adults support access to all methods of birth control.”


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Szal: Obviously, we’re in the middle of a pandemic. COVID-19 has affected people’s sexual and reproductive health choicesas social distancing and the disruption caused by the pandemic have created physical and economic barriers to contraception and other sexual and reproductive health services.

In fact, one in three women reported that because of the pandemic they had to delay or cancel visiting a health care provider for sexual and reproductive health care, or had trouble getting their birth control, and as is often the case, barriers to timely care were more common among Black, Hispanic, queer and low-income patients. 

What do you want people to know about birth control during the pandemic?

Sealy: You laid out the effect that the pandemic has had. There are clearly some impacts that we have all felt ourselves in getting access to reproductive and sexual health as well, and contraception is one of those things. People have really started to think about the formation of their families because of the pandemic, especially as we’re social distancing and sheltering in place.

As we talk about contraception and the pandemic, it’s important that we continue to try to help people who can’t access their contraception. So what we have seen during this pandemic is an increase in telehealth services which has really filled a critical health care gap, including for birth control. And telehealth options have allowed people, for instance, to get birth control delivered to their door. That’s an option for people who are not able to see their physicians face-to-face, and in fact many of these telehealth companies are providing low-cost options, free shipping, and some of them accept insurance which could mean no-cost birth control.

This is really important when we talk about the impact of the pandemic from an economic standpoint. We know that quite a few people have lost their jobs, they are now under-insured or uninsured, so we’re thinking about some of the solutions to these problems as people look to continue their contraception.

Tanouye: I think if any great thing from health care comes from the pandemic, it’s going to be telehealth and the ability to expand our reach to our patients in that way and to allow them better access to us. I’ve been able to see my patients in settings which they would have never been able come to see me in, so if anything comes of this in health care, I hope telehealth stays.

I also want people to know that as physicians and as providers, we are still here. Just because the pandemic is going on and some normal elective services may be shut down, we can’t abandon our patients. I mean, it’s actually against the law for us to abandon our patientsso if you are lucky enough to have a doctor, a primary care doctor, a gynecologist, a pediatrician, anyone that you’re established with, their office is still open. They still have to answer their phones, they still have to return phone calls, and we are still sending out birth control. As a physician I never, ever, ever want to leave my patients without whatever birth control they need, so please call your doctor’s office if you have one. 

Like Gillian said, all of the online telehealth birth control pharmacies are there, and a lot of the big box pharmacies have even transitioned to mail prescriptions. Many insurance companies have mail order options, and if you don’t have insurance, in terms of simple things there are things like 4-dollar prescription drug lists at certain stores and pharmacies trying to make this more accessible.

So I hate the idea that people are going without their birth control — please, know that we are here and we don’t want you to be without your birth control. 

Stubbs: It’s so heartening to hear Dr. Staci as a provider advocate so strongly for her patients’ well-being and care. I think the pandemic has shown us a lot of things, but when it comes to birth control, we don’t need to compromise. We have telehealth options, we have options to still be seen in an office setting and we can get birth control at the drug store, mailed to us. There are ways to make it happen—so don’t feel like you have to get off birth control and compromise your health or your future plans.

Tanouye: I know a lot of people are used to an old-school practice of physicians and health care providers requiring patients to come into the office for their preventative health visits to get their birth control prescription, and I really feel like that’s a completely outdated practice, pandemic aside.

Again, I never, ever, ever want patients to go out without their birth control, so if patients call me and say, ‘Hey, I am not going to be able to have an appointment or a preventative health appointment or anything for this amount of time that’s fine. On the phone, we will confirm that you are safe and healthy and we will send out refills until we can get to a point where we can get a visit for you. Never, ever, ever do we want you to be without that … we won’t hold your birth control hostage just because of the pandemic, we want you to be safe.

Sealy: Following up on that, in a recent poll for Power to Decide, 80 percent of birth control users 18 to 34 said that birth control allowed them to worry about one less thing during the pandemic. We don’t want people to go without their birth control and to know that there are options. Whether that’s calling your doctor or your insurance company to see if it’s covered, or calling to get it delivered to your door, we want to make sure that people know the access points that they can get birth control by. 

If you are lucky enough to have a doctor, a primary care doctor, a gynecologist, a pediatrician, anyone that you’re established withtheir office is still open. We’re still here.

Szal: I love what you said, Dr. Staci—”we’re not holding your birth control hostage”—because sometimes I think between doctors and insurance companies, it can get pretty confusing. So to hear a provider say we do not want you to go without care I think is very powerful.

Here’s something else I’ve been wondering: Contraception affects all of us who want to prevent unplanned motherhood as well as unplanned fatherhood—so why do you think then that contraception is often portrayed as “a women’s issue,” when in reality it’s more of a partner decision?

Tanouye: I think it goes back to the conundrum of people in control wanting it both ways, right? They want to control and legislate people’s uteruses, but they also don’t want to take responsibility for it—they want responsibility to lie on the individual. They want control but they don’t want the responsibility, and so that’s why it always gets pushed onto the uterus owners to take control of all of that.

"Birth Control Is Freedom": Celebrating Birth Control and Tackling Barriers to Access
A rally in St. Paul, Minn., on April 28, 2012. (Fibonacci Blue / Flickr)

Stubbs: I would agree with that, and I think it’s also because there are fewer options for penis-owners to have birth control. There’s barrier methods, they can carry those around, but there’s no pill as of yet.

But if you’re going to be engaging in sexual act with a penis-owner, responsibility should be 50/50—it should be a conversation you’re having with your sexual partner. Unfortunately it’s like Dr. Staci said, more often than not the responsibility falls on the uterus-owners.

Sealy: I think that also happens because people see the female anatomy carrying the fetus and then think that if there’s a pregnancy, the responsibility should fall to the woman. I think it really should be a shared conversation; that’s what needs to happen between two people when it comes to birth control. 

I will say, though, that as we advocate and we push for access to the full spectrum of contraceptive methods for all, we definitely want those allies, right? Those fathers, those male partners, men, we want to hear the voices of men as well who are advocating to make sure that people have the access that they need, especially as we know access issues continue to remain for women of color, women living in poverty, women living in rural areas.

Tanouye: Right, and it takes both parties to make this a more comfortable conversation, both from a control standpoint to an actual contraceptive standpoint to a responsibility standpoint. Both parties have to be comfortable in that space and in that conversation to really make any headway on responsibility of motherhood versus fatherhood or both. Those conversations just need to happen on both sides.

Sealy: And it impacts family formation, right? We definitely know that access to contraception is not and should not only be a woman’s issue. It impacts society, and it impacts families in significant ways.

“It really should be a shared conversation between two people when it comes to birth control.”

Szal: And maybe this might help some of our listeners who have those reluctant allies in their lives, for them to know that birth control is not always related to sex—though of course that reason is valid, and sex is great. So other than sexual intercourse, can y’all speak to some of the other uses for birth control?

Tanouye: Up to 50 percent of people who are using birth control or hormonal birth control of some sort are using it not for birth control and contraception. They’re using it for these other health benefits that we see with all the various hormonal methods—acne control, period control, pain control, so many different other health benefits that we use these hormonal methods for. It’s for people just to be able to literally live their lives, to go to work on a daily basis and not be in pain, to go to school and not worry about you know, bleeding through a pad and onto their clothes.

Stubbs: Sometimes I wonder if we had labeled birth control as something else, and it was like a way to control acne, with the side effect that you also won’t get pregnant, if the branding would somehow make it be less controversial. But because of how it’s billed, people get uptight about it.

So I think if we just say, ‘This is for me, it’s for my body, this is what I’m choosing,’ that should be the end-all argument. When people try to regulate other people’s bodies, that’s when we’re going to have problems. 

Sealy: Megan, you heard it here first, we’re going to call it something other than birth control. You started a movement.

Stubbs: New brand, new brand.

Tanouye: And Megan, you mentioned earlier, too, it can be gender affirming, too, right? Taking periods away for people who periods are traumatizing for, it can be very gender-affirming, so that’s another benefit.

Stubbs: Yeah, for sure. I mean, if you already have gender dysphoria and then suddenly you’re having a period, too, that could just be another layer of confusion. So if we can take away that variable that’s causing you distress, that’s amazing.

I wonder if we had labeled birth control as something else—like a way to control acne, with the side effect that you also won’t get pregnant—if the branding would somehow make it be less controversial.”

Szal: Cannot agree more. Well, as we all know, these questions and topics are so important that we could literally discuss them for days, but I’m going to wrap it up with this final question: Why are y’all thankful for birth control today?

Sealy: I’m so thankful for birth control. Here at Power to Decide we have Thanks, Birth Control Day so we can give thanks for the many opportunities that birth control continues to make possible for women, families, and societies since it was legalized by the Supreme Court for women in 1972. And while it might not be quantifiable it really is evident that opportunities that birth control present helps people to live their best lives. 

And I will just give a personal thanks for birth control because it allowed me to go to school to pursue a Bachelors, a Master’s, my PhD. It helps me to make decisions on the number of children that I wanted for myself. It empowered me to make decisions that were right for me to stay on a path to fulfill my dreams. Birth control was affirming, it was freeing, and I think that all of us here want to give thanks for birth control but also again, to provide that same measure of freedom, access of others as well to make sure that everyone has the opportunity to live their best lives.

Stubbs: Absolutely. To echo what Gillian said, it’s not quantifiable. Being able to say, ‘I’m not going to get pregnant, I don’t want to get pregnant right now’—that’s great, it gives you the latitude to do and pursue other things.

For me, I don’t want kids at all—so I’m on a non-hormonal IUD, and I have sex, and I’m grateful all the time to have double birth control options with using an external condom and an IUD to not have a baby. That peace of mind isn’t quantifiable, but I know it’s there because that’s one thing I don’t have to worry about because of birth control. I’m so grateful for that, having those options is so crucial. Giving people control of what their bodies do is so important.

Tanouye: Yeah, I agree. You know, just like we’ve said, personally it’s allowed me to achieve what I’ve been able to achieve in education, and being the first person in my family to go to medical school and be a physician, to be the physician that I wanted to be, and plan my family when I wanted to. I was able to take control of that and plan when I wanted to have kids, when it was right for me, and I was lucky enough and fortunate enough to be able to do that. 

And I see that for my patients, too, that I’m just so thankful that there are so many different options. We talk about birth control and I think so many people just automatically think oh, the pill, right? Pills are great, and they’re easy, and they’re convenient, but there’s so many other optionsbirth control includes IUDs, it includes surgeries and sterilizations, it includes barrier methods, and it includes fertility awareness methods. I mean, all of these things are birth control. And they all give me and my patients the choice, the options, that freedom to do everything that we want to do to live our lives freely, to have sex freely, to be able to go to school and to work without having to call out sick or to come home for the day. I’m thankful to be able to give that choice and that freedom to my patients every day.

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About

Oliver Haug is an editorial intern with Ms. Magazine and a recent graduate of Smith college. Their writing has previously appeared in Autostraddle and the New York Times' newsletter "The Edit." You can read more of their work at oliverhaug.contently.com, and follow them on twitter here.