Healthy Options

On January 20th, American news media started reporting that the Obama administration has decided to expand preventative care for (cis) women around the country. By 2013, health insurance plans must cover all FDA-approved forms of birth control, from the Pill to the intrauterine device to Plan B without copays. Also included without copays, according to this HuffPo article,

are breast pumps for nursing mothers, an annual "well-woman" physical, screening for the virus that causes cervical cancer and for diabetes during pregnancy, counseling on domestic violence, and other services.

My mind is blown.

I still remember when I went on the Pill as a hormone-riddled high school student, and how much my mother emphasized to me that, her disagreement with my choices aside, it was important to her that I have access to safe and affordable contraceptives. Up until I stopped using hormonal contraception a few years later, she made sure that I had access to an annual OB/GYN visit and covered my copays. It was "only" $10 each for the visit and the prescription, but as a student, $10 was quite a bit of money. My mom saved me approximately $130 each year for the check-up and the knowledge that I was preventing a pregnancy I was entirely unequipped to handle at that time. Wow.

This expansion of the law- if it's implemented as written- seems like it could be an enormous step forward for encouraging cis women to take charge of their health. Increased access to preventative care as listed in the article not only assists someone with estrogen and a uterus in choosing if, when, and how to reproduce, but permits that person additional leeway by opening up available options (IUDs, for example, can be rather pricey). If "other services" can include hormone replacement therapy (HRT) for menopausal women, too, then that's a step forward in increasing access to hormones for someone who may be transitioning their body (i.e. male to female). For students and young people who don't have the means to support those copays, or who don't have supportive parents the way I did, this expansion could make a huge difference in terms of their access to information and care. It's like Planned Parenthood gone wild.

Worth pointing out as well is the fact that this shifts the burden that cis women have historically had in health care costs. Condoms, vasectomies, and spermicides aside, the responsibility for preventing pregnancy has been unfairly placed on cis women's shoulders since the Pill became accessible fifty or so years ago. All of the major innovations in contraceptives- particularly hormonal- have focused on altering cis women's body chemistries and functioning. I'm not saying this is entirely bad, particularly in light of the fact that prior to the Pill cis women often had very little say in what their partners did or didn't do to keep pregnancy at bay, but it has resulted in cis women having higher ongoing costs when they want to prevent pregnancies or ensure that their reproductive systems are functioning well. While only certain things will be covered- for example, I doubt the expanded coverage will include alternative contraceptive planning methods like the fertility awareness method- it's certainly better than nothing.

To me, though, all this will be worth very little if people aren't given accurate and thorough information about their bodies, reproduction, and health as they grow up. The focus on abstinence-only sex education in the U.S. hasn't done a whole lot to impact teen choices, other than to limit access to contraceptive information and generate an increase in sex behaviours that come with other risks (i.e. sexually transmitted infections). It also puts a focus on penetrative, penile-vaginal sex that forgets the multitude of sexual expressions and the way our reproductive systems impact our bodies. Estrogen- one tiny hormone- is responsible for so many things, from weight fluctuations to breast development to serotonin production. That's right! A sex hormone is related to a happy hormone! Who knew?

So while I applaud the steps the current administration is taking to ensure that cis women (and, hopefully, all women) have equal access to preventative care, I would also ask that we push harder to ensure that people have equal access to information so we know what to ask for. The Pill is great, unless it causes you to develop blood clots or breast cancer or suicidal ideations, so it's worth knowing that these are potential risks. It's worth being told what HPV is and why it's a concern for whom so you can accept or decline the vaccination and screenings. We need to be taught from an early age how bodies work and how to take care of them properly so that we can choose to do so. But thank you, in the meantime, for this wonderful step forward.

Note: this article was also posted on Go Girl Magazine.