What’s Wrong with the FDA’s Plan B Compromise? Almost Everything.

Shaming - starting at pregnancy testOnce again women’s health and autonomy is being compromised for politics. The Obama administration had the mandate and information they needed to make a science-based decision that put women’s health as top priority, and once again they failed to do so.

In 2011 the FDA said that emergency contraception like Plan B and Next Choice should be available over the counter to all who seek it. But in an unprecedented move, then Health and Human Services secretary, Kathleen Sebelius, countermanded their recommendation, requiring that females under age 17 obtain a prescription. This meant that women of all ages had to ask for the medication from a pharmacist, who might lecture or even refuse outright as some disapproving conservative pharmacists have done.

On April 5, Federal Judge Edward R. Korman called the restrictions “arbitrary, capricious and unreasonable” and said that “the secretary’s action was politically motivated, scientifically unjustified, and contrary to agency precedent.” He ordered the drug to be made available over the counter with no age restrictions by May 5. His ruling had support from the American Medical Association, the American Congress of Obstetricians and Gynecologists, and the American Academy of Pediatrics. It also fit the FDA’s scientific risk analysis.

But on Tuesday, April 30, in a decision that was politically vetted, the FDA instead recommended that the age be dropped to 15, that the drug be available with regular reproductive health products, and that cashiers rather than pharmacists verify the purchaser’s age. The Justice Department has said it will appeal Korman’s decision, which would require the restrictions to erased altogether.

On the surface this may seem like a reasonable compromise. Pregnancies to teens under age 15 do happen, but they are so rare that the CDC and most states record teen pregnancy statistics just for girls age 15 and up, the age at which the public health problem becomes significant. Cashiers are in the habit already of verifying age on cigarette and alcohol purchases. And the pressure is on: Religious conservatives have been painting fantastical scenarios in which 11-year-olds walk into drugstores (apparently these are sexually active 11-year-olds with $50 in their pockets) and purchase the medication without being fully aware of the side effects (which in this scenario is somehow worse than an 11-year-old being pregnant or having a baby). So maybe, just maybe, the authors of these dire fables will be mollified and the women and teens who really need the medication will get it.

What’s wrong with a little compromise?

Two things.

First, the job of the FDA is to make rules based on uncorrupted science. Not politics. Not convenience or comfort. Science. Period. Drug companies may advocate on behalf of their profit margins. Politicians may advocate on behalf of political ideology or campaign donors or favorite lobbyists. But the job of the FDA is to do data-driven risk benefit analysis and make clean recommendations based on how foods and drugs actually affect people. In this case those people are women and teens, and the science is clear. Having the drug freely available results in better public health outcomes than does restricting it. Political compromise casts doubt on the whole regulatory enterprise, and the agency, and it should.

Second, the real effect of the compromise isn’t on 11-year-olds, who don’t actually have sex and then show up at drug stores with 50 dollars worth of allowance in their pockets asking for Plan B. The real effect is on females of all ages who are forced to produce ID to get emergency contraception. When a women or teen needs emergency contraception she typically is in a situation she would rather not publicize. A condom has broken. Or she screwed up her birth control. Or she had impulsive sex. Or she got raped.

For a teen, any of the above can be vastly more awkward or traumatic than for a more experienced woman. But either a teen or older woman who needs emergency contraception may not want to show her name to a cashier who has no professional code of confidentiality. Having to show ID to a cashier in order to get Plan B is not as humiliating as being subjected to an unwanted and politically motivated vaginal probe (aka probe rape) prior to an abortion, but it still is an indignity.

And that is exactly what religious conservatives are after. To make contraception more difficult in any way they can. To make sex scary. To make sex humiliating. To punish women and teens for failing to keep the aspirin bottles between our knees. Or daring to pursue dreams that aren’t about motherhood, or even daring to dream of motherhood that is planful and prepared. Mitt Romney, in a commencement speech at Southern Virginia University last Saturday advised graduating students to marry young and—in biblical language—to have a “quiver full of kids.” That’s what this is about, the fact that conservatives think they know when and how and why we should have sex. And that’s what’s wrong with the compromise.

Read more:
The Big Lie about Plan B–What You Really Should Be Telling Your Friends.
Plan B Ruling: Fox and Family Research Council Seize Chance to Spread Misinformation
15 Things Old Boys like Rick Santorum Don’t Want You to Know About Your Body and Your Contraception
A Brief History of Your Period and Why You Don’t Have to Have It

Valerie Tarico is a psychologist and writer in Seattle, Washington. She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings, and the founder of www.WisdomCommons.org. Her articles can be found at Awaypoint.Wordpress.com.

About Valerie Tarico

Seattle psychologist and writer. Author - Trusting Doubt; Deas and Other Imaginings.
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2 Responses to What’s Wrong with the FDA’s Plan B Compromise? Almost Everything.

  1. veraersilia says:

    Right on point. But who listens?


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