The FDA, Plan B, and How America is Missing the Point (Again)

When I heard that the FDA was prepared to lower the age restriction on Plan B from 17 to 15, I got excited-~-until I remembered that the FDA has tried this before, and failed.  In November/December 2011, the FDA announced a plan to remove the age restriction, and women’s health advocates were hugely optimistic.  But the Department of Health and Human Services blocked the change, keeping the age restriction in place.  This past week, however, the FDA announced that they were ready to lower the age limit, and the Obama administration announced that they were “comfortable” with said change.  Here’s hoping the change really sticks this time.

The change in policy is based on scientific evidence that shows that the morning after pill, or Plan B, is safe for women younger that 17.  Girls under 17 can actually already access Plan B, but only if they have a prescription; as previously discussed on this blog, young women are unlikely to feel comfortable going to their parents and announcing that they need to see a doctor about Plan B, as it is essentially an admission that the girl has had unprotected sex, news most parents are unlikely to take well.  Since it’s not medically necessary to have the decision reviewed by doctors, it makes sense to make Plan B made available over the counter.

15 is still an arbitrary age restriction.  Girls who are 14, or 13, or 12, who are sexually active may still need access to this medication, who are likely to feel uncomfortable having this conversation with their parents.  15 is a victory, but it’s not a complete victory.  There’s more to do in terms of making it so young women are able to access reproductive healthcare.

A big part of the controversy over Plan B is the lack of understanding of what this medication does.  To be very clear: Plan B is emergency contraception.  It must be taken within a couple of days of unprotected sex in order to be effective.  Plan B does not terminate pregnancies and is not an abortifacent; its only purpose is to prevent a pregnancy from occurring.  Because people sometimes refer to it as the “abortion pill”-~-even though it’s not-~-it often gets more backlash than is truly warranted.

That aside, politics is of course rearing its ugly head in the conversation over lowering the age restriction.  Conservatives seem concerned that this will lead to 15 and 16-year-olds having rampant unprotected sex.  This is an unwarranted claim: people are going to have sex regardless of whether or not they have access to Plan B.  This isn’t going to lead to more sexually active teenagers; it is just going to lead to fewer pregnant teenagers, which can only be a good thing.  For whatever reason, though, the age-old “if you don’t talk about teens having sex, they won’t have sex” rhetoric still seems to hold, despite mounting evidence that this approach is not working, and this debate has been thrust back into the spotlight by the proposed changes to the Plan B regulations.

This was a debate that was highlighted last year when New York City’s health clinics started issuing Plan B to minors, causing outrage.  Despite the criticisms, however, the program appears to be successful: falling rates of teen pregnancy across the city and increased access to comprehensive healthcare for students are major victories for this initiative.  But what the New York City program included was something that America badly needs: conversations on how to come up with an acceptable Plan A so you don’t need to keep falling back on Plan B, and an acceptance of the fact that teens are having sex, and this is a reality that we need to engage with.

This is a broader debate about teens, sexuality, and sexual health, and America needs to start having real conversations about how to address the real problems they are facing.  If abstinence-only isn’t working, then it is time to look at what options we can offer teens to help them have safe sex and make positive decisions about their sexual and reproductive health.  The time for these conversations is now-~-we can’t keep putting it off so we can debate about the morality of letting a 16-year-old prevent pregnancy.

I understand the concerns about teens having sex.  Teen pregnancy is a legitimate problem, and the 15-24 age bracket accounts for 50% of new STI infections every year.  If I were a parent, this would be terrifying to me.  But pretending that teens aren’t having sex, or trying to simply stop them from doing so, is not halting the spread of these problems.

Making Plan B available for younger girls is an important step in helping them prevent pregnancy, but we need a much broader debate on why young women should have access to other forms of contraception, so that they can have a legitimate Plan A.  We need a much bigger dialogue about consent and female sexual empowerment, so that girls are able to say no when they mean no, and can make good decisions when they choose to say yes.  We need to teach people how to correctly use condoms so that they can be effective, and make sure teens feel that they can get tested if they may be at risk.  Most of all, we need to lift that taboos on discussing sex and sexual health that make it impossible to really deal with the issues.

The personal may be political, but it is also very personal.  It’s time for people to be able to make the right decisions for themselves, and I for one am glad to see our government moving towards allowing young women to do just that.  My point is simply this: it’s not enough.  It’s not enough to let girls clean up the mess after they’ve gotten into it.  It’s not enough to tell them not to have sex.  It’s not enough to say “use a condom” if people still feel they can’t just buy them, or they’re worried their parents will find said condoms and there will be repercussions.  We don’t just need to change our policies, we need to change our rhetoric, and we need to change it now.

~ by Randi Saunders on May 5, 2013.

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