Today, SCOTUS is hearing arguments about whether businesses should have to cover birth control for their employees in their health insurance plans and I just. It’s hard to read.
I was going to make up this big informational persuasive post about the situation. But I’m just. I’m just so sad and angry and tired. So I figured I’d make an emotional one instead.
Let me tell you about my hormonal birth control journey.
(Rest under a cut for length and content. cw: mental illness, graphic discussion of medical issues, injuries, & menstruation, discussions of suicide & self-harm, discussion of opioids, alcohol, & recreational drug use.)
I started taking hormonal birth control late in high school to help regulate “painful periods”. It wasn’t for actual birth control at that point and I hadn’t been diagnosed with any disease, not even POTS yet. I just had “painful periods”.
Things were okay for a little while, but when I got to college, things started to fall apart. The double whammy of undiagnosed mental illness and a barely-diagnosed chronic illness (POTS was relatively unknown at the time and my doctors gave me information which I now know is incorrect) really caused me to spiral during my first year of college. I didn’t know it yet, but I react very poorly to some forms of hormonal birth control. Put succinctly, they drive me batshit insane. On one pill, I literally did not leave my apartment for over a month. I became very literally agoraphobic. Bouncing off the walls, irritable, angry, high suicidal ideation. As bad as side effects can be.
But I didn’t know that yet. I just stopped taking BC as part of the whirlwind of medicines and doctors that my life became for about two years while I was on my (first) medical leave from college.
My ribs were coming out back then. I didn’t know that yet, either. I knew that when I was around 16, I started getting severe back pains. The first time it happened, I had to go to the ER because I couldn’t breathe and my teachers thought I was having a heart attack. I got a narcotic shot in my butt. It did nothing to dull the pain. That’s how much it hurt. But it went away on its own eventually and I over the years I started medicating reoccurrences with a lot of different things. Physical therapy. Muscle relaxers. (Medically prescribed) opiates that made me puke. Prescription strength Advil. Wine.
I didn’t see that it was all connected yet. Not yet. I didn’t realize, with my periods as irregular as they were, that the back pains were coming around the same time in my cycle each time.
My “painful periods” got worse. I talked to an OBGYN, with my mother in the room. I told her that I was scared of something like childbirth. I knew that my blood flow was dangerously bad. What if the fetus didn’t get enough blood? Oh, my doctor laughed, that wasn’t a problem. The fetus would always get enough blood. The risk was that I wouldn’t. That it, like the tiny vampire it was, would take it all until I simply died. If I got pregnant, I would likely die. I asked about permanent sterilization. My mother cried. My doctor said no. I didn’t ask again.
I went back on birth control.
It was odd. I didn’t want children before that visit, not really. I was so tired all the time. I knew I’d never be able to manage to raise a child — and honestly, I didn’t care to try. I was so depressed. I was so sick. It sounded like so much work. I still don’t want to have kids. But it still feels… weird, knowing that I can’t. And knowing that I could die if I get knocked up.
I’m bisexual, but I have zero sexual contact with men (because I don’t love them, despite being somewhat sexually attracted to them) and zero sexual contact with people with penises (because they could literally kill me and it would be no one’s fault). But I’ve been followed home by men before. I’ve had cabbies lock me in and ask me for a date. I’ve had men who won’t take no for an answer. And my god, it terrifies me that I might have to deal with both sexual assault and a slowly creeping murder all at once.
(It’s laughable to think he’d be tried for both.)
I ended up getting sick off birth control a few times. I went on and off it periodically during my college career. I now in retrospect see that a lot of my “meltdowns” were a combination of discrimination-based stress, physical breakdowns, and hormonal whirlwinds. At my worst times, I was on birth control. The wrong ones.
My periods, over time, got worse. My back would hurt. The cramps were unbelievable. I couldn’t feel my legs. I could feel them too much. I couldn’t keep food down. I’d be so angry, so sad, so everything.
I went to the doctor again. I was diagnosed with both endometriosis and PMDD. PMDD, or premenstrual dysphoria disorder, is like PMS on steroids. I remember telling my doctor, in halting tones, that I wasn’t well before my periods. That I always had depression, always had anxiety, but I wasn’t well before periods. At her prodding, I confessed that sometimes I would just lie there for hours, for days, in the fetal position. That I’d clutch at my own arms, mooring myself, because I knew that those white knuckles were the only thing between me and killing myself. That my brain, always somewhat malevolent, became an inescapable mantra of death. That I’d just lie there and sob because it took everything I had not to hurt myself. That I’d find claw marks, bruises, on my arms later, and all I could do was get some ice.
It was better than the alternative.
I told my doctor about how painful my periods had always been. How I’d heard a story once about, y’know, that Spartan boy? The one who hid a fox kit under his shirt during an examination and stayed perfectly silent even as it clawed at him so he wouldn’t be caught with it? How it tore at his stomach until he fell down dead, still silent? I told her how I felt like I was holding a fox kit every damn month and sometimes I couldn’t stand the pain of it. Sometimes I considered ending that pain, one way or another.
She put me back on birth control.
A little less than a year later, or in layman’s terms, about a year ago, my mental health was so bad again that I was almost committed. Literally committed. I had to go stay with my parents for a few months while I transitioned to new medications because it wasn’t safe for me to be alone. I learned that the birth control I was on could create those symptoms — but they didn’t start until months after you’d started taking it. So you didn’t realize it was the medicine. You just assumed you were crazy and unlikable and so, so angry. At the world, at your loved ones, but mostly at yourself.
I learned, around that time, that I also had Ehlers-Danlos syndrome. That the pain I felt every month right before my period wasn’t just cramps. It was my bones coming undone from their sockets. It was my hips dislocating. It was my ribs popping out of my spine. I realized that that lump my parents could feel in my back wasn’t a hard knot of tense muscles. It was my fucking rib poking out of my back. I learned that there is a period right before menstruation that mimics a period during pregnancy where your joints loosen — your body thinks it is preparing you for birth, for loosening your pelvic cavity so an entire head can pass through. For someone with Ehlers-Danlos syndrome, that period of joint looseness was enough to wreak absolute havoc on a system of already-weakened joints.
I learned how to put my own ribs back in with a foam roller. I started drinking marijuana tea for the pain. I went on a different birth control. I stopped taking the placebo pills. I had to fully eradicate that entire portion of my cycle. Goodbye PMDD and ribs constantly popping out. I don’t miss you!
I am still on that pill, y’know. Every day I take it and wonder if I’m one step closer to the day when it inevitably destroys me. The last one took about a year. Tick tock.
Or maybe I finally found the one that works… I really just don’t know.
The fact of the matter is that I have a full handful of maladies that require birth control so I can function. PMDD, endometriosis, dangerous pregnancy, EDS. I need hormonal birth control. I would probably be dead by now without it. The PMDD especially was that bad. My internal organs are likely a scarred-up mess. But the birth control itself almost killed me, too. God, it was close.
Simply put, birth control is heaven and hell all wrapped up in a pill. It treats illnesses and it prevents pregnancy. In other words, it provides you with both freedom and peace of mind. It is absolutely essential. But it’s also monstrous. The sheer number of sometimes-deadly side effects that come with hormonal treatments is staggering. Which is why you need to be under a doctor’s careful eye when you’re on it. You need to be free to choose whichever brand you need. You need to be free to switch kinds at a moment’s notice. None of these things are possible in a system where these pills are not fully covered by insurance.
(And yes, I know, this is a stupidly American problem in so many ways. Obviously the ideal thing here would be single-payer for all medical procedures. But that’s not up for debate here and insurance for BC is. Because for some reason we let some people’s religious convictions determine others’ health care. But I digress.)
Please don’t worry too much for me. I have a good employer who has told me in no uncertain terms that I don’t need to worry about my healthcare coverage. But there are so many people just like me. Who may not have diagnoses yet. Who may have “problem bodies”. Who only know that they need to do something and that they might have to go through several pills to find it. Whose employers either have the strong religious belief that hormonal birth control is a sin or the strong religious belief that they want to pay as little as possible for their workers’ health care. (Call me cynical.)
Those are the people I worry about. Those are the people I feel absolutely sick over as I watch the SCOTUS argue whether we should be allowed to have life-saving medicine. The people who I know will fall through the cracks the second that the cracks are widened enough for them to do so. The people who will die.
It’s a tense time right now. It’s a tense time for very obvious reasons. But this morning I find myself to be even tenser, and my stomach hurts thinking about it. It feels like all I can do is stare at a pill packet and remember every horrible reason I need it and every horrible thing it’s done to me and I just.
It’s a lot.
