Why Don’t “Gender Critical” Activists Care About Teens on Hormonal Birth Control?
If you’re worried about teens being coerced into taking hormones with permanent effects, birth control is a far larger issue than…
If you’re worried about teens being coerced into taking hormones with permanent effects, birth control is a far larger issue than transgender HRT.
The ability of transgender people (particularly transgender kids) to access affirming healthcare is under attack. In the UK, a high court recently ruled that transgender teens cannot meaningfully consent to puberty blockers, and thus may not be granted access to such treatment until after turning eighteen. In Arkansas, a bill recently passed restricting minors’ access to gender-affirming healthcare, and similar bills have been floated in Missouri, Florida, Ohio, Illinois, Oklahoma, Colorado, South Carolina, Kentucky, and South Dakota.
The argument underlying this latest push to curtail trans people’s rights is that the effects of taking puberty blockers are not sufficiently studied and that the medication can have permanent effects on a transgender teen’s health that might persist even if they desist and go on to identify with their assigned-at-birth gender. This point is often raised in the same context as fear-mongering over “rapid-onset gender dysphoria,” a supposed psychological condition concocted by the non-accepting parents of transgender teens, who claim their children somehow caught the transgender bug simply by meeting other trans people or talking to them online.
In the gender-critical movement, there is much consternation and gnashing of teeth over minors, particularly “girls,” being manipulated and pressured into taking hormonal medications they don’t understand and aren’t actually meaningfully consenting to, and which might wreak long-lasting havoc on their bodies.
Curiously, the activists raising this point seem to forget that there is an entirely different class of hormonal medications frequently foisted upon teenagers, which are far more widely prescribed and come with more than their fair share of adverse health effects: hormonal birth control. It’s interesting that in the discussion about puberty blockers and a minor’s ability to consent to them that such a widely-used and potentially life-changing hormonal medication doesn’t ever seem to come up.
I’m a transgender person who has been on both hormonal birth control — which I used to call “reverse HRT” because it triggered my gender dysphoria so badly — and on testosterone gel. For my part, if I were going to talk about the experience of being pressured into taking a hormonal medication that changed my body forever in ways I didn’t anticipate, with a variety of negative side effects, and which I’d go on to regret for years, I wouldn’t be talking about the testosterone gel I signed up for at an informed consent clinic. I’d be talking about the birth control pills I started when I was eighteen.
Growing up as a teenager in the early aughts, I had several friends who were pushed to go onto hormonal birth control by their parents and doctors. One friend had no choice but to go on the pill because she was taking Accutane, which could have caused severe birth defects had she gotten pregnant while taking it. Other women I knew were pushed onto the medication because their parents didn’t trust them to use condoms reliably, or because they had painful and irregular periods and birth control was presented as the easiest solution.
At that point in time, there was very little talk about the side effects of hormonal birth control. My friend who was on Accutane (and was also a smoker) was aware of the warnings that birth control could cause blood clots in people otherwise at risk. She and I took a lot of long walks as teenagers, partially in hopes of staving off the blood clots. When I later started taking the pill myself, I continued to be an avid, almost compulsive walker. I was terrified the medication I was on might kill me. Beyond that, and some general talk about the pill causing weight gain, I wasn’t well versed in what side effects it might have, or even how the pill worked.
Since first writing about this topic, I’ve heard from dozens upon dozens of people who were pressured to go onto the pill when they were minors. Doctors told them it was their only option for managing post-menstrual dysphoric disorder or polycystic ovarian syndrome, parents assumed they were sexually active and sought to control their reproductive abilities; sometimes people were even forced to take the pill just because they had body hair or a few zits. Gender critical activists love to wring their hands about the “trans cult” pressuring teenagers to get on puberty blockers, but when it comes to this much larger population of teens forced onto birth control, there are crickets.
I started taking hormonal contraception as an adult, but I can’t say the choice was driven entirely by my own agency. I was a college freshman, and my boyfriend at the time really wanted us to use something other than a condom. He was anxious about the risk of getting me pregnant, dissatisfied with how sex felt with a condom and thought it would be simpler if I just used a drug to control my fertility.
The proposition creeped me out. I didn’t like the idea of medicine altering my body, of my reproductive system being something other people got to have a say about. Yet my boyfriend kept whining and wheedling and wearing me down, and I did keep worrying I might get pregnant, so I agreed to go on the pill. The doctor I visited at Ohio State’s student wellness center wrote me a prescription with no question asked, and without providing me with any information about the drug beyond a quick warning about blood clots. I didn’t even get a say in which kind of birth control pill I was put on.
My body was still developing when I started hormonal bc, and the drug rapidly hyper-feminized my body in ways I hated. My breasts ballooned and my body became softer. My face got rounder, and my body hair became more light. My energy levels tanked and I stopped exercising. I had never been strong, but my muscle tone got even weaker, which was depressing after a summer spent biking, swimming, kickboxing, and finally beginning to feel at home in my body.
Even worse, after starting the pill I began experiencing mood changes. I’d go absolutely insane with sadness and despair a week before my period, every single month. During each cycle’s “hell week”, as I called it, I sobbed relentlessly and felt hopeless and lonesome and dreamed of death. This pattern went on for years, but I had no idea the pills were to blame. Doctors were still claiming there was no link between hormonal birth control and depressive or anxious symptoms, despite patients having complained about those side effects for decades. To this day, many medical professionals deny the link between contraceptives and depression and suicide, despite all evidence to the contrary, particularly among young people.
I am far from the only person to experience adverse health effects of the pill. Hormonal contraceptives can change a person’s body shape, metabolism, libido, eyesight, blood pressure, seizure risk, fertility, bone density, and much more. These changes don’t always go away after a person stops taking the pill. Yet most people who begin taking hormonal BC have little idea about most of these effects, even to this day. Even when minors are prescribed this medication, there is very little concern expressed about whether they understand the long-term health risks, or if they can consent to endure them — in sharp contrast to much of the rhetoric about trans teens taking hormone blockers.
If I had known the pill was going to make me almost psychotically depressed and increase my chest size in a way that would dramatically worsen my gender dysphoria, I would have never gone on it. Hell, I barely wanted to go on it knowing about the risk of blood clots. Yet I had almost no other options at my disposal, and at that point in time, going on the pill as a sexually active young person was considered almost compulsory. Note here that the issue was the lack of information and lack of options; restricting my choices or taking my rights away would not have helped.
The pressure to allow my body to be hormonally altered was immense. It’s nothing like the small modicum of encouragement to seek out gender-affirming healthcare some trans teens experience if they’re lucky enough to have supportive family and friends. What I faced was omnipresent and unquestioned. Yet all the trans-exclusionary feminists who claim to care about the body autonomy of teen “girls” have nothing to say about the experiences of people like me.
Conversely, when I began looking into transgender hormone replacement therapy in my late 20s, I was provided with a ton of agency, information, and treated with compassion and care. My healthcare provider at the Howard Brown Health Center in Chicago, Jon Stryker, was open and warm, and patient with me in a way very few medical professionals have ever been. He explained the effects and risks of starting testosterone in an accessible and utterly uncondescending way and answered my questions in depth. He listened to me and wrote me a prescription for low-dose Androgel based on my specific desires and needs. Because taking T comes with some health risks that I was actually informed of, I was required to undergo regular blood tests, which I still undergo today. I have actual knowledge about how my medication is affecting me — what my T levels are, my cholesterol, and more.
When it comes to HRT, I’ve been supported in making informed decisions about I treat my body. The exact opposite was always true with hormonal birth control. In that realm, I was gatekept, denied information about side effects, had my prescription switched without being told it had happened or why it happened, and universally had my complaints about low energy and mood completely ignored.
I hope this is already clear, but I would never use my negative experiences with birth control as a reason to legally curtail minors’ access to what is often life-saving medication. Hormonal birth control kept me from getting pregnant and being tied forever to a boyfriend who was coercive and manipulative toward me. Throughout the world, the pill has liberated people and granted them a level of control over their own bodies they never would have experienced otherwise.
Many minors and adults need and want affordable, easy access to hormonal birth control. For many, the benefits of the drug are well worth the risks. Granting those people agency is not a threat to me. In fact, if birth control had been less gatekept by the medical establishment, I would have been able to experiment with different types of birth control more easily and would have had an easier time stopping and starting the pill as needed. Taking away people’s agency by restricting access to these drugs, or fear-mongering about them, would only make the rampant medical abuse of power more common. It would only leave more people desperate and unempowered.
The exact same thing is true of hormone replacement therapy for transgender people. Many minors want and need puberty blockers. Many adults need and want HRT. These medical treatments do come with risks, and studying those risks and informing people about them is an essential part of empowering them to make healthy choices about their own bodies. After all, not having the medication that you need is highly risky itself.
If I’d gone on blockers as a teen instead of on birth control, my body would look wildly different, and my early adulthood would have been marked by significantly less gender dysphoria and emotional turbulence. But I wasn’t trusted to make an educated decision about my own destiny back then — I was scarcely given any information about trans healthcare or contraception at all. I was just funneled onto the pill, told very little about it, and then ignored.
What I needed, as an eighteen-year-old, was to be respected, informed about my options, and treated as though my unique desires and needs were valid. I needed the freedom to break free of a medical paradigm that assumed it knew what was best for me and that I was not competent to make my own decisions. I’d never argued that other people should have a harder time getting birth control because I now regret having gone on birth control. The existence of the pills was never the problem. It was my lack of knowledge and power that was the issue.
If gender-critical activists really cared about the health and wellbeing of young people the way they claimed to, they would be up in arms about the droves of people who were forced onto birth control without ever knowing about its long-term effects. They wouldn’t only want to see more research into the long-term effects of blockers and HRT; they’d want there to be a push to educate the public about the numerous risks of birth control, as well. If they really cared about the ability of minors to understand the effects of hormonal medication, they’d notice that the informed consent model that works so well for trans people could actually serve as a blueprint for how to respectfully engage with teens looking into contraceptives.
Of course, you’ll never see a trans-exclusionary person note these parallels because doing so would reveal their hypocrisy. They don’t actually care about minors’ health. They want to reduce the number of people who identify as trans and go on hormones. And they don’t care about body autonomy or consent either, not really. They’re more than happy to see a huge population of teenagers and young adults forced onto a hormone they don’t understand the long-term effects of — provided that hormone matches the gender that was also forced upon them at birth.
Interested in stopping hormonal birth control? A few years ago I wrote a seven-part series about my switch from the pill to the copper IUD. You can read it all in order here:
The IUD Chronicles, Part 1: Why I’m Going Off Hormonal Birth Control
I’ve been on the pill for over a decade. It’s time to get reacquainted with a hormone-free me.devonprice.medium.com
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