You may have heard that the FDA may finally remove age restrictions for the morning-after emergency contraception pill in the United States. If you've heard that, you may have started to hear some panic or fear-factoring, not just gratitude and relief.
Currently, in the United States, someone must be over the age of 17 in order to get Plan B at a pharmacy without a prescription. Until two years ago, the age limit was 18. It's still kept behind the pharmacy counter for people of all ages, but those over 17 do not need a prescription from a doctor or a clinic to purchase it.
For a long time now, organizations like ours and many, many other reproductive choice, justice and health organizations, have been lobbying to remove that age restriction, something other nations -- like Canada, Australia, Denmark, Norway, Sweden, Israel and others -- do not apply; a restriction which has never been supported by sound health data. The restriction per age has long been about politics, not health.
In fact, a medical council formed expressly to inform the FDA about Plan B in 2003 recommended it be provided without prescription regardless of age then, a recommendation the FDA did not follow. More than one staff member at the FDA during the years this has been an issue, including the highly dedicated Susan Wood, resigned in protest of decisions about Plan B access and the political motives for those decisions, which stood counter to sound medical information, what the basis of FDA decisions are supposed to be about.
We feel, like so many other sexual health and adolescent health organizations feel, like you might yourself, that young people should have the same rights with their reproductive choices that those over the age of majority do, including the ability to access safe contraceptive methods the same way as those over the age of majority do. We feel that decisions for all citizens like this need to be centered on credible health information, not political or personal agendas or religious beliefs.
Given this possible sea change, you may find yourself, not unlike some former members of the FDA, having discussions or heated arguments about this with people who really do not get it for a while, and in those, you're probably going to face a serious lack of facts. In case you need them, here's a quick and dirty roundup of some typically uninformed statements with some factual information and context to counter them with.
But Plan B is so unsafe! It's like a GIANT dose of birth control pills!
A lot of over the counter medications, also without age restrictions are not only dangerous, but far more associated with serious health risks.
For instance, you can get all of the following over the counter here in the U.S., none of which have any age restrictions (links are to informational listings about them, including health risks): ibuprofen, acetaminophen, cough syrups or cold medications which contain dextromethorphan or pseudoephedrine, sleeping pills or energy drinks. Heck, you can get candy bars within reach even if you are still only crawling around in footie pajamas, but we don't hear people talking about putting them behind the counter for the safety of diabetic kids.
Plan B is a medication just as safe or safer than some of those things, especially when those things aren't used as directed, which happens a lot, no matter how young or old people are. No deaths have been linked to Plan B, and we can't say that about any of the other things I put on that list above.
It's also not quite right to say that it's a "giant dose of birth control pills."
Most people who use the pill use combined oral contraceptives: a combination of a synthetic estrogen and a synthetic progestin. And while both of those things carry potential health risks, especially for people who have health or lifestyle issues that heighten those risks, the larger risks tend to lie with the estrogens or the combination of estrogen and progestin. Plan B does not contain any estrogen, only levonorgestrel, a progestin. That matters and makes it tough to compare to the most common daily-use oral contraceptives. That's also some of why reputable medical organizations assert that emergency contraceptive pills are usually safe even for people for whom regular contraceptive pills are unsafe. The World Health Organization lists no medical condition for which the risks of emergency contraceptive pills outweigh the benefits.
Too, people who use either combined birth control pills or minipills tend to use them for longer than one or two days like with emergency contraceptive pills, but instead will take a pill every day for weeks, months, years or decades, depending on how long they use them for. Very few people will start using birth control pills and only take two out of a pack.
Most oral contraceptives have 100 to 150 micrograms of levonorgestrel per pill; emergency contraceptive pills contain either two two 750 microgram levonorgestrel pills to be taken 12 hours apart (or together: taking them apart is mostly about reducing the chance of feeling nauseated) or one 1500 microgram pill, to be taken 12 hours apart. Almost everyone who uses a birth control pill for more than a week or two is taking in as much of the hormone in Plan B or, and most typically, far more. And these medications aren't like a sleeping pill or even an advil when it comes to overdose, if that concerns someone about the amount of hormone in Plan B. Not only do we know this is a safe amount to be used as directed, "overdosing" with oral contraceptives does not present the kinds of dangers we see with other kinds of medications. It might also help to take a look at the facts about frequent use of emergency contraception: in a word, we have no evidence so far, after more than decade of research, that has found any more or different risks than ongoing, proper use of other hormonal contraceptives.
Let's not forget that pregnancy can be one of the riskiest things there is when it comes to people's health. Preventing pregnancy with a safe medication like Plan B poses far less risk to someone's health, especially a young teen's health, than a pregnancy does.
But, but... it is SO DANGEROUS for TEENS!
But, but... it isn't. Not that anyone has discovered so far with many years of scientific study, anyhow. There has NEVER been broad medical or scientific support for the decision to require a prescription for minors, but not older people. It's been the other way around: most healthcare professionals and medical organizations, like the World Health Organization, the American Academy of Pediatrics, the American Medical Association and the American College of Obstetricians & Gynecologists, as well as, again, many doctors at the FDA, have objected to these age restrictions. The people who tend to oppose it most are people like this. (Note: that link is to an anti-choice site, the American Life League, which is hopefully obvious from the first sentence, but may become more so by the total lack of contextualization with the information given there, such as a lack of mention that all the risks they list for the MAP exist with a pregnancy. And maybe when reading their website.)
So much of what people know and have heard about emergency contraception has been informed and greatly influenced by people and organizations who are anti-choice, and who oppose Plan B and often other kinds of contraception, not because of concerns for anyone's health, but because of their political agendas to limit the control people -- most commonly women -- have over their bodies and reproduction.
Again, know what's dangerous, sometimes truly, earnestly dangerous? Pregnancy. Now, that doesn't mean people need to be afraid of pregnancy or that we're saying people who want to become pregnant shouldn't make that choice if it's a wanted choice. But there's a reason why maternal mortality rates are so high in places where pregnant people can't get sound, consistent care during pregnancy, labor and deliver from healthcare providers, including educated midwives. That's because pregnancy is dangerous. Preventing pregnancy with safe, studied contraceptives is always statistically safer than becoming pregnant. So, if someone wants to flip their lid about how dangerous contraceptives like Plan B are, they better at least be pulling out all the same stops and more about how potentially dangerous being pregnant and giving birth can be, too.
And even though legal abortion is also very safe, and in the first trimester, safer than a full-term pregnancy, emergency contraception is safer than abortion, too.
Some people have concerns that teens will not be able to understand how to use EC properly without getting a prescription from a doctor. While it doesn't make much sense to have that concern about EC and not all the other medications a young person can currently get over the counter, some studies have found that concern also is not sound. "Two studies were published in 2009 regarding emergency contraceptive label comprehension for teens. Raymond et al. found that 79% or more of adolescents aged 12-17 correctly understood six key concepts found in labeling: 1) EC prevents pregnancy after unprotected sex 2) it should be taken as soon as possible 3) it should be taken within 72 hours 4) it should not replace regular contraception 5) it does not protect against sexually transmitted infections (STIs) 6) it should not be used by women who are already pregnant." (The Reproductive Health Technologies Project, Tough Questions and Answers about Adolescents and Over-the-Counter Emergency Contraception, 2009) By all means, patient and consumer literacy is always something to be concerned with, but we have no reason to believe this is a greater concern with teens regarding Plan B than it is with people of all ages.
It might also help to know that there are already some contraceptive methods as available to teens as to those over the age of majority which we know or suspect may pose different or greater risks for them, like Depo-Provera, which may present risks around bone density for younger teens. And young people should be informed by their doctors or pharmacists of any risks these or other medications or devices present to them based on age, when there are any, just like people should be informed when older age increases a risk, or when a given health condition or lifestyle issue may increase risks.
And if there were different or greater risks with Plan B for young people than those one, three or ten years older, those same standards should be applied and, you can be certain, would be applies. Thing is, based on all the study of these medications so far, we don't have any data to suggest the risks are different or greater for those under 17.
I am not okay with teenagers being able to give themselves an abortion by just walking all willy-nilly into a pharmacy.
Even as a strongly pro-choice person, I don't know if I'd feel comfortable with that, either. I am, however, a fan of walking willy-nilly. It's much more fun than just plain old walking, that's for sure.
But that's moot, since no one of any age can give themselves an abortion by just walking into a pharmacy and getting Plan B, including in places where people of every age can access emergency contraception without a prescription. That's because you can't use emergency contraception to terminate pregnancy.
A lot of people -- some out of ignorance, some who know better but know how easy it is to obscure the facts by just muttering the A-word -- have the odd idea that emergency contraceptive pills and a medical abortion, or "the abortion pill" are the same thing. They're not. Plan B and other emergency contraception not only is a very different medication, it does very different things. Even if someone wanted to terminate a pregnancy with Plan B, this medication can't do that: it lacks that capacity.
You can get information on the "abortion pill" -- a bit of a misnomer by itself, since medical abortion involves two medications, not just one -- here.
But more people will have sex without using birth control if they can just get EC easily.
Emergency contraception has the word contraception in it because that is what it is: it, like other methods, is contraception. Is it as effective as several other methods? Nope. It's also more expensive, too, especially if people are using it often.
I'm not sure why anyone is this concerned about people choosing this method of contraception rather than others by this token, but for those who are, so far, we also don't have any data that shows that when EC is made more available, including giving minors the same access those older have, that there's any basis for that concern. As reported by the Alan Guttmacher Institute years ago, providing adolescents with advance doses of emergency contraception neither increases their likelihood of having unprotected sex nor negatively affects their use of condoms or hormonal contraceptives.
Perhaps more to the point, if one is worried about people not using contraception, then it's tough to figure how it makes sense to limit their access to contraception.
Want more information about emergency contraception, including teen health concerns? Check out these links:
If and when you get tired or arguing with someone about this who just will not let go of the non-facts, do yourself a favor and just print them out, pass them on, and give yourself a breather. Bashing one's head into walls is something we know isn't healthy. :) If, on the other hand, like some of us (coughcough) you seem to have dedicated much of your life to arguments like this and you find what we gave you here isn't enough? Leave a comment with an aspect or issue you want more information about or help voicing. We're glad to help you out.
(...or a counselor, LGBTQ center, doula, shelter, rape crisis center or other in-person sexual/reproductive health, sexuality and/or crisis care serving teens and young adults!)
As a youth-serving organization which provides most of our services online, we're all too aware the internet has limits. You can't get tested for chlamydia or pregnancy online. You can't get ongoing, one-on-one counseling or therapy where your counselor can hand you a tissue when you need one. The internet can't provide anyone a warm bed or a meal, an IUD, pre-natal care or an abortion. Google can't provide us HIV healthcare or emergency contraception.
As part of what we do, we refer users to offline services, but many of our users are often reluctant to seek out in-person services we or others can't directly vouch for. Years ago, we began to notice that when one of our users told another near them about a service they used and liked, or when one of our staff could vouch for having gone to a service ourselves, that often made all the difference in the world. Those users tended to feel immediately more comfortable using those services and were more likely to go and use them. Of course!
We all know one of the best ways to find quality sexual healthcare and other in-person care services is by asking people we know and trust for a recommendation. But that can be difficult, especially for young people: so many are either ashamed about sexual healthcare and other related services, or are afraid that disclosing they've had care will result in a breach of their privacy. Many young people don't even get care they need in the first place, so don't know anyone to refer someone else to, especially in areas where services are limited or where seeking out services presents a profound personal risk.
We know you can't always get a good recommendation in-person, so we're aiming to build the next best thing.
Readers can use our new online tool to find out who Scarleteen users around the world have gotten great care from that they'd personally recommend, and see listings of care services our staff, volunteers and allies know to be bonafide. Or, you can enter your own review to help others find services they need from providers you know are great, or add your review of a provider or service to an existing listing. If you're a service provider, you can enter information about your clinic, center or practice and it will be published for review. Any of the above can be done anonymously, so no one has to worry about privacy.
Services listed will be specifically youth-serving or open to youth: they may not be not adult-only. Because teens and young adults themselves will post reviews, young people will be able to have a real voice when it comes to how they're being served, and their peers can get recommendations from peers, not just from older adults. Before going live, listings for services/providers we are not very familiar with will be verified by a phone or email contact made by one of our staff or volunteers.
As an organization which advocates for youth and supports youth rights, we know too well how hard it can be to find services that truly serve youth well, especially around sexuality. We've heard from users who just didn't even know where to start in seeking out that care or were terrified to even try, fearing judgment or disrespect. We've heard from users who used the phone book or Google and wound up at places which couldn't serve them or wouldn't serve them; from users who thought they'd gone to a family planning clinic when they'd actually gone to an anti-contraception organization, thought they had been going to an abortion clinic or to all-choice options counseling when they'd gone instead to a crisis pregnancy center, or who were not served by providers because of their age, gender identity or economic status. We hope this tool can help to prevent those situations.
We also know there are fantastic providers out there who serve young people wonderfully: we want to make sure the millions of young people who come to Scarleteen each year can find out who those excellent providers are, so they (you!) can get the in-person services they (you!) need and feel more confident and capable in seeking them out.
Obviously, this is a big project, and one that, by design, we can't do without the help of our users, allies and colleagues. We know and have personal experiences or relationships with many clinics and other services, but as we aim to create an international database, and there are only so many pap smears or STI tests any of us can get at different clinics around the world. There's no way we can possibly do this on our own. We also know it couldn't be as good or as useful if we did: we want this tool to be very grassroots and very youth-driven.
Are you a young person who has gotten excellent care from a clinic, private or individual provider, center or shelter, or did a service still in operation serve you well when you were younger who you want to recognize and share with young people now? Are you or do you work for a provider of sexuality, sexual health, and/or crisis care services that serves young people and is dedicated to doing so well? If so, we're asking for your help by adding a listing or review.
Of course, if you're a young person (or any person!) looking for excellent services in these areas, we are thrilled to invite you to start using this new tool to seek out the services you want or need. Obviously, as we're just beginning to build the database, there won't be many listings to look through just yet, but keep your eyes peeled. We're confident that in no time at all, given how great our users and allies can be at helping us out, we'll have a plethora of listings for great help and care internationally. This has been a long project in the making, and we can't express how excited we are to finally roll it out!
Many props and thanks to our developer, Clara Raubertas, for all of her work with us on this. It was a big concept in which the executive director had a lot of big ideas she wasn't always so crystal-clear about (ahem), and Clara worked with patience and dedication to help make this happen. An additional and important thanks to all the individuals who have given us their financial support, at any amount: this is part of what your donations have funded, and we couldn't have done it without you.
(Because this is a new service, please let us know if you have any problems using it, or if you think we accidentally left something vital out. We expect there may be some things we need to refine as we build it further, and as always, your input is invaluable. Thanks!)
Update 1.13.11: Currently, we have a couple snags. Users may only pick one service at a time to choose from, and areas without postal codes are not working in the search. We're working out both of these issues, however, and expect to have them remedied soon!
Update 1.29.11: Snags fixed! Yay!
Also, a question came up as to why we have LGBQ services and trans and gender-variant services as separate tickboxes/options. Options like those, just like the options for teen-specific care, and survivor-specific care, are for folks looking for specialized care and specifically-inclusive services. Users may pick up to five different tickboxes for searches, not just one.
We separated LGBQ services from trans and gender-variant services because trans and gender-variant people have a range of orientations like everyone else, including heterosexuality, but primarily because a service which can or does serve gay, lesbian, bisexual or queer people well will not automatically serve trans or gender-variant people well, or offer the services trans or gender-variant people want or need. A reader suggested this was perhaps because we didn't understand trans people needed reproductive healthcare: quite the opposite! A trans person seeking reproductive healthcare could tick the box for that healthcare AND for trans-specific services to best assure they get that kind of healthcare from providers who also are educated about and able to serve trans people well with that healthcare or other kinds of services. In the same way, someone who wanted reproductive healthcare and was also an assault victim could pick two boxes to intersect that, or someone who was LGB could pick the two boxes to address that intersection. For anyone who wanted reproductive healthcare without narrowing that care in any way, they could just tick the box ONLY for that healthcare.
We're happy to discuss this more here, and just like any other part of the project: adjustments can always be made!
I am a 15 (almost 16) year old virgin. My boyfriend and I are thinking about having sex. We love each other, we are both mature and know everything, and we both ARE ready. He isn't a virgin, he had sex once before. While having a discussion on the phone he mentioned to me about this round-a-bout and that he doesn't like using condoms. I am completely 100% for condoms and would never risk myself getting pregnant or getting something (even though I know he doesn't have anything). But he insists that he barely pre-cums and when he does "finish" he knows beforehand. I know guys just say that. I've thought about it and maybe after were used to intercourse I'll think about the pull out method. But ONLY if we use another type of protection.
What do you think about the pull out method? For the other question I have, what is safer to use, in a girl's point of view? Morning after pill? The Ring? Birth control? How can I get my hands on a Morning after pill? Thanks ever so much.
P.S. your site rocks =]
I was at a party and got really drunk that I can't even remember what I was doing that night and all I wanted to to do was fall asleep. But this one guy I knew got in bed with me too and I remember we did some stuff and he tried having sex with me. I can't exactly remember if he did get it in. But I remember that in the process of him trying it was hurting really bad. Is there a way that I can find out if we had intercourse or he did get it in me?
I am in my early 20s and recently had to stop taking the contraceptive pill because of a medical reason. Now that I am medically ok again, I planned to re-start the pill at some point this week. However, me and my BF of 2 yrs got drunk last night at a party and stupidly had unprotected sex. I am too embarrassed to go to a doctor and ask for a Plan B pill I have heard that if I take two contraceptive pills now (or asap) then it acts in the same way a morning after pill does...is this true?
My boyfriend and I had intercourse on Valentine's Day. Well, as he started to ejaculate he told me to get off and I felt him ejaculate on me a little so I told him the condom broke. He told me he went in me a little, but I told him not to worry because it was the day after my period. Well I WAS supposed to get my period on the 7th and now I'm 5 days late! Lately I've been feeling tired, sick (like I'm gonna puke it happens through out the day at least once or more), dizzy, moody, my nipples are bigger (unless they were already that big and I'm now just noticing them), and I've been getting stomach aches. But now I'm starting to get little cramps like I'm going to start my period! Am I going to start soon or do you think I'm pregnant? HELP!
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