Posts in College Voices
Seeking (Birth) Control

I have taken approximately 2,604 birth control pills in my life. Every night for almost seven years, the incessant alarm on my phone sounds at 10pm reminding me to grab my water bottle and swallow my pill. They are a consistent aspect of my life, which being on a first-name-basis friendship with the pharmacist at my local Walgreens epitomizes. They feel like a core part of me, determining when, where, and how I start to bleed.

I began taking them in the seventh grade to regulate my hormones in order to control acne. Contrary to popular belief, I am not alone in this, as many women use birth control to regulate their periods, lessen their cramps, and curtail the debilitating symptoms of PMS.

My experience with these pills has been tumultuous, to say the least. At first, I could not say enough about their strength and success. My skin was clear, I knew exactly when my periods were starting, and I felt so grown-up taking a pill from an aluminum case every day. But that honeymoon period (pun intended) did not last long. About six months after taking my first pill, I returned to the doctor that had initially prescribed them. The pills were changing who I was as a person. My entire family had noticed that the week before my period, I became withdrawn and extremely moody, crying multiple times a day. At first, this was attributed to a combination of cliché teenage mood swings and PMS. However, it wasn’t long until the characteristics that had defined my personality– a quick sense of humor, a happy-go-lucky attitude, and a passion for pulling pranks– had all but disappeared. To my shock, my doctor explained that this was not unusual or uncommon for women taking oral contraceptives. She told me we could experiment with different formulas of pills, but some bodies simply could not handle the pills. I was devastated.

 

I have tried eight different kinds of birth control pills with varying levels of success. Although an inconvenience in my life, I came to terms over the years with the pill being a core aspect of my womanhood. But after spending a semester enrolled in Women, Gender and Sexuality Studies exploring why women deserve more than what society often expects them to accept, I have come to believe that we deserve more from our birth control products.

 My experience is not unique. Women have learned to expect serious side-effects with any form of birth control. These side-effects include, but are not limited to: nausea, weight fluctuations, headaches, anxiety, depression, and suicidal thoughts.

Strangely, there is no outrage about this extreme failure in medication efficacy. In the US, 62% of women are currently on some form of birth control, yet any action being taken to improve it is underfunded and under-appreciated. Women accept less effective medications with more side effects because we, as a society, have learned to be comfortable with a lower standard of care for women.

Widespread apathy towards women’s health is extremely evident when one looks at a recent study experimenting with men’s birth control. In this study, 320 men were given birth control shots every night for eight weeks, in an effort to share out the responsibility of avoiding unwanted pregnancies. The sample considered men of varying backgrounds and levels of sexual activity. Despite potentially optimistic results, we will never see this study brought to fruition. It was halted due to the men experiencing “severe” side effects, such as mood swings and acne. Prior to the termination of the study, many women were hopeful that men’s birth control was finally a solution to their own undesirable experiences. However, the scientists would not allow men to endure these negative side effects for even eight weeks, when millions of women experience them for the entirety of their reproductive years.

This begs the question of why society is untroubled by the less than ideal standard of care given to women yet does not believe it is acceptable for men to tolerate comparable experiences. The lack of women in STEM careers, a reluctance to believe women’s symptom descriptions, and a greed-driven pharmaceutical industry are all connected to this double standard. The compounding of these three elements creates structural inequalities in healthcare that put women in physical danger and must be addressed sooner rather than later.

Women are underrepresented and undervalued in STEM careers. I am a two-year member of WashU’s Women in STEM Club, which aims to increase support and mentoring for women in STEM fields so that they can be better prepared to endure the journey ahead of them. As a college student aspiring to have a future career in the field of medicine, this cause directly affects the trajectory of my life. A 2013 study called “What's So Special about STEM? A Comparison of Women's Retention in STEM and Professional Occupations” explored the environment faced by women in different careers. The results found that women in STEM have a statistically significant increased tendency to remove themselves from their fields. Due to careful consideration of any confounding variables, the study uncovered that the main cause for the mass exodus from upper STEM fields by women is not due to children, as many people tend to believe, but rather because of a “hostile work environment.”

This unsustainable work environment is evident at a well-known and iconic leader in the technology field, Google headquarters. In August of 2017, an executive engineer penned an internal memo to the entirety of Google named, “Google’s Ideological Echo Chamber.” In this memo, the employee explains that women are biologically more predisposed to neuroticism, have less drive for higher status, and are more agreeable than assertive. He claims, “This may contribute to the higher levels of anxiety women report on Googlegeist and to the lower number of women in high stress jobs.” He later explains that accommodations should never be made for any employees on the basis of gender or race, as the only reason women and minority groups are underrepresented in tech is because of “biological disadvantages.” This memo went unaddressed by Google leadership for many days. Eventually, an apologetic email that contained plans for improvement was sent out to the company staff, but the damage was already done.

Women’s perspectives are integral to the creation of a successful product for women, yet the vast majority of scientists creating, testing, and marketing birth control products are men. I believe men cannot possibly comprehend the debilitating side effects of birth control pills, and therefore will not fight as hard as women would to find a solution. Because of this, it is essential that we encourage and support young women considering careers in science–which must occur early in a girl’s life. A 2004 research study done by Patricia VanLeuvan uncovered that there is a massive dip in interest in science careers of young girls between the seventh grade and the first year of high school. Careers that have better representation of women, such as medicine and biological sciences, experienced a lesser decrease in interest than less represented fields, such as engineering. This research shows that when one generation of women are inspired to pursue fields in STEM, a domino effect will result in the coming generations.

A recent episode of Grey’s Anatomy, one of my personal favorite shows, explored society’s shortcomings at recognizing and treating women’s self-reported symptoms . Dr. Miranda Bailey, a world-renowned and extremely respected Chief of Surgery, goes to a rival hospital’s ER and calmly explains that she believes she is having a heart attack. The ER doctors and cardiologists, all her friends and all white males, immediately begin questioning her history of OCD and anxiety, blaming these disorders as the reason for her symptoms. Chief Bailey responds with authority and confidence, relaying that heart attacks often manifest themselves differently in women, with symptoms such as shortness of breath without pain, anxiety attacks, and jaw and neck pain. Even with her expertise and obvious medical savviness, the other doctors refuse to believe her until her heart literally stops beating for two minutes. It is no wonder that doctors regularly disregard women’s self-reported symptoms, when Dr. Miranda Bailey, one of the most beloved doctors in the TV world, was not believed when she described her condition.

A study aptly named, “The Girl Who Cried Pain,” exposed the unfortunate truth that female patients are “more likely to be treated less aggressively in their initial encounters with the health-care system until they ‘prove that they are as sick as male patients.” This statement translates more tangibly to a nationwide average 49-minute wait time for men compared to a 65-minute wait time for women after reporting the same acute abdominal pain in an ER.

The lower standard of care given to women who choose to take birth control is ignored by those who have the power to improve it, specifically a greed-driven pharmaceutical industry. “Big pharma” makes billions of dollars every year off of birth control products, including pills, IUDs, vaginal rings, patches, and shots. These profit margins are only increased by women trying multiple versions of each product, as they are forced to do when side effects are too debilitating for them to function. These profits serve as positive reinforcement for big pharma to continue making imperfect products.

For many years, big pharma companies have gotten away with imperfect pills, knowing that they are the preferred choice of birth control for sexually active women. A recent study in the UK shows that these tides are turning. Bayer Healthcare, a leader in the market of contraception products, conducted a research study investigating women’s attitude towards varying forms of birth control. This research was confirmed by the Office of National Statistics, and found that 31% of women chose, at some point in their lives, to switch from the pill to Long Acting Reversible Contraception, or LARC’s. These women were totally unsatisfied with the side effects and overall effectiveness of the pill and decided that their bodies and minds deserved better.

Society has taught women to expect a lower standard of care from all healthcare providers, ranging from doctors to CEO’s of pharmaceutical companies. This custom is dangerous for the physical and mental well-being of women, which further effects all aspects of society. Therefore, it is time that we, as women, demand more for ourselves. We deserve birth control that does its job with no side effects. We deserve to be heard when we go to the Emergency Room asking for help. We deserve to be represented in fields that make decisions about our health. We deserve (birth) control.

Works Cited:

“(Don’t Fear) The Reaper.” Grey’s Anatomy, season 14, episode 11, ABC, 1 Feb. 2018. https://www.hulu.com/watch/1215330.

Fassler, Joe. “How Doctors Take Women's Pain Less Seriously.” The Atlantic, Atlantic Media Company, 15 Oct. 2015, www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/.

Glass, Jennifer L., et al. “What's So Special about STEM? A Comparison of Women's  Retention in STEM and Professional Occupations.” Social Forces, vol. 92, no. 2,  2013,  pp. 723–756. JSTOR, JSTOR, www.jstor.org/stable/43287810.

Haelle, Tara. “Does Some Birth Control Raise Depression Risk? That's Complicated.” NPR, NPR, 9 Oct. 2016, www.npr.org/sections/health-shots/2016/10/09/497087838/does-some-birth-control-raise-depression-risk-thats-complicated.

JV. “Side Effects Are OK for Women's Birth Control - but Not for Men's?” USA Today, Gannett Satellite Information Network, 1 Nov. 2016, college.usatoday.com/2016/11/01/male-birth-control-side-effects-come-on/.

Planned Parenthood. “Birth Control Methods & Options | Types of Birth Control.” Planned Parenthood, National - PPFA, www.plannedparenthood.org/learn/birth-control.

VanLeuvan, Patricia. “Young Women's Science/Mathematics Career Goals from Seventh Grade  to High School Graduation.” The Journal of Educational Research, vol. 97, no. 5, 2004,  pp. 248–267. JSTOR, JSTOR, www.jstor.org/stable/27548037.

Sarah is currently a junior at Washington University in St. Louis, studying Psychological and Brain Sciences. She strives to one day incorporate her passion for women's health into a career in the medical field.

 

Dear Andy: A Letter to a Lost Friend

Dear Andy,

Wow, it’s been a while since we last spoke. I’m about to start my junior year—can you believe that? It still seems like yesterday that you and I met through South Boston Afterschool. On the T-ride to South Boston, we talked in Chinese (I had just started; you helped me with my tones). We talked about girls (we talked a lot about girls). And sometimes we talked about more serious things. About how we were so afraid to fail, about how we constantly felt pulled in all directions. About how hopeless we felt.

When you quit South Boston Afterschool, I just figured it was a sophomore slump. Maybe your economics tutorial was taking up too much of your time, or maybe you were working on a new start-up, trying to be the next Mark Zuckerberg. You were stressed out the last time I saw you. I wasn’t too worried, though. I thought what everyone else here thinks: Junior year will be better than sophomore year. Senior year might be a bit tougher because of job searching, but you’ll be set after that. You’ll be a Harvard grad the rest of your life.

But then you jumped off a tower in downtown Boston. I thought wrong.

Andy, I spent a long time trying to figure out how to write this letter. It’s been on my mind every single day now for months. I almost gave up, because the words just wouldn’t come to me. It was too painful to express.

Then, in May, my best friend since we were babies ended his own life. He had just gotten into Georgia Tech. He had so much talent. He had such an incredible life ahead of him. His mom found his body. They couldn’t show it at the service.

His death inspired me to write this to you. Because it’s not just him, and it’s not just you. Writing this next part terrifies me, Andy. I’m scared because we live in a world where I can’t even write this letter without knowing in my heart that no matter what people will say, they will look at me differently. I want to make a big impact after I graduate, but I know that publicly discussing my complicated history with mental health—a conversation that should not be any more damning than talking about asthma or a heart condition—might prevent me from doing this. But that is exactly why I have to write this letter. It is time for us to reconcile with the reality of the world that we live in. It is time for me to say now what I should have told you before: You are not alone.

I should have told you about fifth grade, when I would stay up every single night thinking terrible thoughts. I had to make sure once, twice, three, four, five times that our doors and windows were locked, because I had to be sure. I had to know that no one would come in and slit my parents’ throats, and then beat my head in with a baseball bat.

I should have told you about sixth grade, when I touched flowers, and leaves, and people’s hair. My classmates did not understand, so they signed a petition asking me to stop. They gave it to the teacher, who presented it to me. Even today I remember the hurt and shame I felt when I saw the names of so many friends written on that piece of paper. They didn’t know that I could not help it; they did not know that it was outside of my control.

I should have told you about seventh grade, when germs consumed me. Bacteria crawled all over my body and inside my mouth. I would go to the bathroom repeatedly in the middle of class to frantically rinse my mouth and scrub my hands. When my best friend sneezed on me to see my reaction, and another spat in my juice and forced me to drink it, and another threw meat at me because she knew I was a vegetarian. I wondered if I had any friends at all. Maybe they were just pretending to like me because I was so funny to watch. I felt worthless; I felt hopeless; I felt powerless. I felt like I didn’t deserve to live.

But more important than any of that, Andy, I should have told you about how finally enough was enough. My mom got me help. She got me help, even when my teacher asked, “Why does he need therapy? He makes all A’s—he’ll be fine.” My mom replied, “I will be sure to write on his tombstone that he had all A’s after he kills himself because he hates his brain.” She knew what too few understand, that objective achievement means very little when life is nothing but shame and darkness.

Because of her intervention, I acquired tools to deal with my compulsions, to say “It Don’t Matter” until it really did not matter. Overcoming my compulsions was the hardest thing I’ve ever done, but it was worth it. I’m here today Andy, writing this letter to you, because my mom got me help.

Andy, I am sorry that I never told you about my middle school self. And I am sorry that I never told you how therapy empowered me to reclaim the beauty in life.

But I hope this letter to you will help change things for others. I hope it will convince someone who is like me all those years ago to find the support that they need. I hope it will encourage someone like me now—too busy with their midterms, their finals, and their papers—to check in on a friend. I hope it will encourage us as a community to fight against the stigma surrounding mental health issues both in our college and in our nation. And most of all, I am sorry that we live in a society where we could not talk openly to each other.

I miss you more than you can know, Andy. By relating this story—of what I did wrong with you, and what my mom did right with me—I want us to make a difference in the world. Then I will know that I am doing your memory proud.

Will

Originally published in the Harvard Crimson, September 2, 2015

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In Reflection: Will’s thoughts on the process of writing and publishing this letter

At first, writing Dear Andy was pure catharsis. It was also extremely difficult. For years I had not been able to even talk about my history with mental health and the tragedies of my friends' suicides. To put my feelings into words for thousands of people to see would have been unthinkable to me. But after receiving support from my friends and my fraternity brothers, I found the voice to write my article. As a result of the attention that my article received, I am now working with a number of organizations on and off campus as well as Harvard administrators to improve mental health services. The feedback I have received since writing Dear Andy has inspired me to fight for mental health reform, both on campus and beyond. This has become my passion, and I am not going to give up until I have done everything in my power to change things.

William F. Morris IV is a member of the Harvard College Class of 2017 and is a joint concentrator in history and East Asian Studies.

A Reckoning with Social Anxiety

My social anxiety plays me like a deceitful little game, except I spent the last 15 years pretending like I wasn’t on the court. The painful shyness I faced as a child, my inability to smile at any adults except my parents until the age of eight, the meeting with my fourth-grade teacher that my concerned mother sat through, afraid her daughter wasn’t voicing her needs: it’s always been you, dear social anxiety. My conviction in middle school that my friends didn’t care about having me around: that was you, too, wasn’t it? You pushed and pushed with such excruciating force until that stupid conviction became my reality. As did tears, insecurity, and a lack of reassurance I desperately needed. In high school you hid behind black skinny jeans, punk rock band t-shirts, and an eating disorder that wasn’t glamorous like in the movies. You danced around obsession, meticulous numbers, and crippling self-judgment. This is my reality, and the reality of millions of other people. And we are being ignored.

What if our society ignored the number of people who suffered from cancer each year? What if we claimed that cancer wasn’t real and its effect on lives was simply a conjugation of one’s imagination? If we stigmatized this illness, how would it impact those 15 million Americans who live with it? How would it make them feel? We don’t ignore those battling a physical illness because it’s usually easy to see how they manifest, yet mental health disorders can be harder to see and are thus treated differently.

The number of people who live with cancer every year is equivalent to the number of North Americans who live with social anxiety. That’s roughly 7 percent of our continent’s population. The disorder is more prevalent among teenagers and college students: an estimated 10 percent of college students suffer from significant social anxiety disorder, and general anxiety disorder affects an astounding 25 percent of teenagers. So why is the second most commonly diagnosed form of anxiety disorder is also so commonly overlooked? It’s challenging enough to live with a mental illness: its stigmatized reputation is an additional obstacle to overcome.

The stigma American society has so carelessly placed upon those struggling with social anxiety is rooted in insensitivity and judgment. The ignorance that drives this stigma not only discourages people from seeking help but attempts to convince them they have no problem to begin with. The pressure to break out of the shyness and nervousness becomes debilitating. When someone is repeatedly told their struggles don’t exist or their social awkwardness is just something they need to suck up and get over, we begin to believe it. I know I did.

My social anxiety made me question all the wrong things. I questioned the value of my curvy physique. I questioned my ability to be alone for hours at a time and not crave any verbal exchange. I questioned why people assumed I was so shy when I didn’t raise my hand in class, even though I always knew I had something to offer. At the time, I didn’t know what kept restricting me. I had questioned why everyone I knew was making friends at college, while my “friends” kicked me out of their roommate pool instead.

My first semester in college drained me. The pressure of constant socialization and having to present my best, bubbly, and agreeable self to everyone I confronted took a toll on my mental health. If I was anything but outgoing and always eager to go out on a weeknight, I was afraid my worst internal fear would come true—people would only pretend to be my friend because they felt a sense of pity towards me. I spend an exorbitant amount of energy and time rehearsing what tone I would use to respond to my name during attendance call in class, or considering which shoes would make the least noise when I walked into a 300-student lecture. One night my roommate asked me to make a phone call to the resident hall janitor because our window was jammed. I knew exactly the look I shot her, one brimming with such nerves and astonishment that makes someone wonder if they’ve suddenly sprouted a second head. She stared back at me quizzically and within seconds quickly muttered, “Never mind, I’ll do it.” The conversation ended abruptly. Why couldn’t I do it? Social anxiety.

But now I know it’s you, anxiety. Things make sense now: why I over-think the most basic social interactions, why I can’t present an accurate first impression no matter how hard I try, and why making friends is a hurdle I never fail to trip over. I need constant reassurance from the people in my life that I matter to them; that they want me to be there, and I haven’t just shoved my way in. I understand now that you are the driving force behind that heavy weight of insecurity that has traveled with me throughout my first year of college. But I want you to know that I am not afraid of you. Coming to college has given me the courage to speak openly about the daily challenges you provide. Because of you, I have discovered my passion of advocating for mental health awareness. I have overcome my eating disorder. I have made a friend or two, and I’m working on making some more. Thank you for being a constant in my life, dear social anxiety. Yes, you are a piece of me. But if you think you are going to define me, you are so painfully mistaken.

Mikayla is a sophomore at Boston College studying Communication with a minor in Management and Leadership. She is an active writer for Spoon University, an online food publication, and also enjoys playing guitar and spending time in New York City.