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  • Writer's pictureCERT

Enough is Enough: Why Contraception Needs Reform

Updated: May 27, 2020

In our recent survey, 95.9% of our 295 respondents told us that they believed contraception is in need of reform. CERT (Contraception Education and Reform Team) say enough is enough and that this needs to change. 

We are a policy research team affiliated with the Buchanan Institute - Scotland’s only student led think tank. In 2019, we recorded the responses of over 300 participants in a scope survey about their contraceptive experiences, and published a report detailing our findings: overall, contraceptive users feel ill-equipped to make decisions regarding their choices, and they do not feel listened to. Reasons for this included a high prevalence of reported side effects, as well as dissatisfaction with the healthcare and education systems. We therefore made several recommendations, including more medical research and improvements to the way in which contraception is taught.

We decided to focus on contraception because of how neglected the issue is in the public sphere. Conversations about side effects and choice were happening all the time amongst our friends, but these weren’t being translated into public discourse or meaningful change. Contraception affects so many aspects of our lives, yet it can seem like little progress is being made to improve it. We firmly believe in the importance of modern contraception in laying the foundations for female empowerment in the late 20thCentury. Yet it’s far from perfect. We think users of contraception are currently being denied justice because they do not feel empowered enough to make informed decisions or have their voices heard.

So, why is this the case? Contraception is an inherently gendered issue. Even its biological framing into ‘male’ and ‘female’ contraception reflects this. There are currently no long-term, reversible ‘male’ contraceptives available – only ‘female’ ones. Thus, users of ‘female’ contraception often have to bear far greater responsibility as well as risk more direct consequences for not using it – i.e. pregnancy. The combination of these two mean that people are a lot more likely to put up with some often life-altering side effects because they feel it pales in comparison to the alternative. 

Choosing contraception can thus feel like choosing the “least bad” option. That is, individuals feeling like they can make an informed decision in the first place. Our perceptions of our choices surrounding contraception are shaped by those around us, which can often lead to misinformed decisions. Many people’s first chance to engage in contraceptive matters happens at school, in sex education lessons. Nevertheless, more than 4 out of 5 people we surveyed said they thought a greater breadth of contraceptives needed to be discussed at school. Even when speaking to medical professionals like GPs, our research found a tendency for patients to be given what they asked for rather than engaging them in an informed conversation about a wide range of options. 

This is arguably due to the patriarchal biases in wider society permeating into medicine and education. Female sexuality is often viewed negatively, whilst male sexuality is viewed as natural. Sex-positive conversations around contraception are lacking, thus creating a great deal of stigma around the issue. However, if people feel uncomfortable talking about it (especially to those with the power to do something about it), then change becomes even harder, because it’s difficult to acknowledge its necessity in the first place. 

But, gender is a social construct, and contraception is only framed this way due to patriarchal and cis-normative narratives. Despite being framed in terms of the gender binary, not all users of ‘female’ contraceptives are cis-women – they can also be used by transmen and non-binary individuals. There is considerable overlap between the experiences of cis-women and other users of supposedly ‘female’ contraception. When cis-women speak to, say, their GP or sex education teacher about contraception, the information they receive is influenced by often sexist notions of sexuality and responsibility. Transmen and non-binary individuals experience this to an even greater extent, as the information they receive is likely further biased by the additional factors of transphobia and cisnormativity – the assumption that everyone is cisgendered which erases genderqueer individuals. We have noticed these tendencies in both academic literature and wider conversations around contraception.

This means our fight for contraceptive justice needs to be inclusive; and not just in terms of gender identity. As well as cisnormativity, heteronormativity also shapes our understanding of contraception. Not all users of contraception are heterosexual. Thinking about contraception in ‘male’ and ‘female’ terms is heteronormative. It erases queer contraceptive users, as well as creating discussions centered solely around birth control, neglecting issues like STD transmission. Like other health-based inequalities, class and race are important intersectional factors in someone’s interactions with contraception. In order to deliver contraceptive empowerment for everyone, we need to think intersectionally. 

So, what do CERT want to do about it? Last year, we wrote our report, and have since launched our campaign. We want to do more research – especially around literacy and stigma. We want to use this research to lobby those with the power to change things. But we also want to be able to make change directly, breaking down stigma ourselves with events and public campaigns. So, we are recruiting now to help us achieve our goals. Applications close on June 1st! Use this link to apply, and find further details across our social media channels. If you are passionate about correcting contraceptive injustices, then we are looking for you!

Cover image source: Reproductive Health Supplies Coalition

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