White Pills and White Lies: How the History of the Birth Control Pill Highlights Gendered Politics
Updated: Oct 22
As I left the pharmacy, my first instinct was to open the small box I was carefully carrying. I slowly withdrew the medication guide from the package, ready to recycle it. I revised my decision when, in between my index and thumb, I felt the thickness of the meticulously folded pamphlet. Fold after fold, in what felt like an endless sea of paper, I discovered a list of side effects and risks the size of a blanket.
At fourteen years old, although only prescribed to me for painful menstruations, this marked my first experience with birth control. What ensued would be four years of irregular, equally excruciating periods, uncontrollable mood swings, and constant nausea. Too naive to understand that those symptoms were not, as I had been convinced, “merely due to puberty,” I complied every day, swallowing the tiny white pill. At eighteen, when I finally raised my concerns to my doctor, I fell into the trap again when she sold me a dream that would never materialize itself. A month later, I was scheduled for the insertion of my etonogestrel implant, which I was promised would only lead to “minor side effects.” A year later, I find myself two weeks away from the removal of my implant, after months of extreme fatigue, headaches, decreasing eyesight, low morale, and anxiety.
As my experience stands as one in a sea of many, the problem does not lie in birth control itself, but in the culture and attitudes surrounding it, which simultaneously places the responsibility of contraception solely on women, while leaving out the potential impacts on our health that could enable us to make different choices.
In 1960, the American Food and Drug Administration (FDA) approved “Enavid,” the first oral contraceptive, which consisted of a mix of progesterone and estrogen. However, the research that led to the commercialization of the pill is rather questionable. Prior to 1960, some states prohibited the distribution of contraception, making it difficult for researchers to conduct experiments. In elegant patriarchal fashion, biologists John Rock and Gregory Pincus moved the project to Puerto Rico, where they manipulated vulnerable female college students, under the threat of bad grades, into partaking in the trials of their largely untested medication. Despite those tactics, Rock and Pincus only succeeded in recruiting 130 women, a quota they knew would fail to satisfy the FDA. To remedy the issue, instead of referring to the number of women that participated in the experiment, they began writing in terms of menstrual cycles, which amounted to 1,279 cycles, making the study seem larger than it actually was. The fact that the birth control pill, after being trialed on less than 200 women, was launched into the world as a safe and government-approved medication to be taken daily is an example testifying to the history of Western medicine neglecting women’s health.
Although dubiously brought into society, the birth control pill contributed to liberating women from certain aspects of our androcentric society. With newfound ability to plan their future, women started setting longer-term career goals, increasing the proportion of female applicants to law and medical schools from 10 to 50 percent between 1970 and 1990, according to the American Economic Association. Consequently, the pill allowed women to become financially independent from men and to have agency over their bodies. But at what cost?
With the introduction of the pill into mainstream society, women became the sole accountable party of contraception, pregnancy, and family planning. Even today, popular discourse suggests that only women should be held responsible for contraception as they would suffer greater consequences in the case of contraceptive failure, even if that means enduring the myriad of side effects that hormonal birth control can cause. That, and the fact that having a partner on birth control spares men from the “extremely tragic and unfortunate” condition of wearing a condom.
Furthermore, when contraception is considered a “women’s issue,” the financial burden tends to fall onto women. With over a dozen of birth control options for women (most of which are hormonal), ranging from IUDs to hormonal vaginal rings, contraception in Canada can vary from 20 to 400$ monthly per unit (without insurance), comparatively to 2$ for condoms, according to HelloSafe.
Apart from the financial and social loads being placed on women, the birth control pill has considerable effects on women’s neurological system. Setting aside the common side effects - which include nausea, headaches, spotting or breakthrough bleeding, amenorrhea, weight gain, and contact lens use - the birth control pill modifies the body’s sex hormones, which are responsible for informing several parts of the endocrine system. The pill has been shown to severely affect cortisol levels in the brain - cortisol being the hormone that helps the body cope with stress. According to research psychologist Dr. Sarah Hill, women on the birth control pill exhibit low or null levels of cortisol, fitting a similar profile to people with PTSD or severe trauma and incidentally impeding their ability to learn and memorize, as well as to properly regulate stress and emotions.
But if the pill can be so detrimental to women’s health, why is its use still so prevalent? In 2022, Growth Plus Reports evaluated the worth of the global market for oral contraceptives pills at 17.9 billion in U.S. dollars. However, with increasing interest from men in the advancement of male birth control, non-hormonal and reversible options have been in the process of development. Namely, sAC inhibitors, which temporarily affect sperm maturation and mobility, and ADAM, a hydrogel that prevents the sperm from traveling through the vas deferens, a duct connecting the testicles to the urethra, are just two illustrations of said alternatives.
All things considered, the birth control pill should not be seen as purely evil. The pill can represent an effective and comfortable form of birth control for women who react well to the medication. However, as that is not the case for all, changes within the medical field’s approach to contraceptive duty must be made. Hormonal male contraceptives have been outlawed in the past for having similar effects to the ones women on the birth control pill endure daily, narrowing the options for men down to two: the condom, which is not a viable long-term option, or a vasectomy, which often represents too big a commitment. Men should not be held responsible for the lack of male birth control options on the current market, but women should not feel forced into taking medication either. As contraception has always been about choice, both women and men should be able to make informed decisions about their health. But in these times of misinformation where almost every form of female birth control represents an interference with health, do women really have true agency?