"When Trump got elected, I got an IUD. Turns out this was a common thing. Many women all across the country had the same thought. It was such a time of uncertainty. What would this presidency look like? What would happen to our reproductive rights? Would birth control continue to be covered by insurance? Would abortion remain legal? So many questions came up for me and it gave me the very real fear that my choice would be taken away. I have an autoimmune condition and have lived most of my life knowing all too well what it feels like to lack complete control of my body. The back pain, the fatigue, and the other symptoms this condition leaves me with are not something I can wave away with an easy fix. It's not a good feeling. Birth control for me has always been about taking my agency back. Unlike the autoimmune condition, I can find a solution and take matters into my own hands. I got an IUD in the wake of the Trump election because having one meant that whatever happens in the next four years, I have control. I can keep it in, I can take it out, and its presence is not something that is subject to the whim of political changes. Reproductive choice was not something I was willing to lose.
So, I went to my gynecologist. I had insurance and it felt like a relatively simple process. I went in and asked for information about the different kinds of IUDs. I was given a pamphlet with three options and sent home to do my own research. It was hard to figure out what the best choice for me was without professional guidance. There is so much on the internet and it's hard to parcel out what is true and what would be best for my body. If I hadn't been very motivated to get an IUD, the way that I was counseled would not have inspired me to get one. I would have felt much more comfortable with what I was getting myself into had I had more professional support.
A year later I started working at Planned Parenthood. This opened a world of new perspective for me. First, I was trained into a model where counseling is at the core of practice. When people came in wanting an IUD, we spent time going over many options, answering questions, and problem solving for each patient. The model was all about evidence-based medicine and shared decision-making. As part of the training process, I followed staff members and was exposed to different styles of care. The staff was diverse, and everyone had their own unique way of connecting with patients. People used humor, presence, openness, compassion or whatever the individual situation called for. Reproductive health is filled with intimate conversations, and I learned that quality care is about matching the style of the patients and figuring out how best to connect and gain trust. It's about how to make patients feel safe and heard in their healthcare process. I like the counseling style of Planned Parenthood because it allows space for staff to remain true to who they are. You cannot provide quality care with being truly authentic.
Given the intimacy of the conversations, reproductive health is about so much more than just the care itself. It's about education, sensitive and trusting conversations, and assessment of emotional and physical health and safety. When people don't have access to this kind of care, so much more than just the physical part of healthcare is lost. This makes me think of a 14-year-old patient that I had the privilege of working with. Her pregnancy was a surprise to her because her previous sexual education was so lacking that she didn't realize that the sexual practices she was engaging in could get her pregnant. She truly didn't know enough about the process to even know she was having sex. When a clinic closes or laws restrict access, you take away needed procedures, but you also take away all the sexual education gaps that reproductive healthcare is filling.
Planned Parenthood and her abortion experience was this young patient's sexual education. It's not fair that she didn't even know to be on birth control because she didn't realize she was having sex. It's not fair that she had two STD's because she didn't know how to protect herself or even that protection was necessary. It's not fair that she had to learn about sex, pregnancy, and STDs during an appointment for abortion counseling at 14 years old. But this is the position that her life circumstances and the current system left her in. This is an example of one of the many gaps in the system that Planned Parenthood fills. Reproductive freedom and access to quality healthcare is not just about abortion. It's about all the counseling, the guidance, the education, and the emotional support that comes along with the intimate conversations and relationships of trust that are built throughout the process.
Reproductive freedom makes me think of another patient that I worked with. This woman had just moved to the US from China and came to Planned Parenthood for an ultrasound. She had had a child many years before and due to the one child policy in China, her provider had placed a metal, circular IUD in her uterus that could not be removed. We had never seen a device like this before. She came to us with questions: Could we remove it? Could she have another child now that she is in the US? I think about this case often because it exists on the opposite end of the spectrum of choice. Here was a woman who wanted more children, but a political decision and sub-standard health care had taken that choice away from her. Women's reproductive autonomy has been threatened from all angles. In our own country, we have both a history of forced sterilization as well as forced continuation of pregnancy. Fundamentally, this is the same issue. It's about taking away women's reproductive autonomy and it has devastating consequences. Every individual is different and health care must be tailored to meet their given needs. And needs change. This is why access to choice is the most important piece of this puzzle. When I was working at Planned Parenthood, I would often ask myself, "If I found out that I was pregnant today, what would I do?" And the truth is, the answer changed every day. I would argue we can never know what our answer to that question would be until we are faced with actually having to make that decision. And so the laws must reflect the variability of our answers to these tough questions. We must have a system that provides the care that an individual may need in any given moment in time.
I loved being a part of the abortion care provided by Planned Parenthood because it allowed me a window into human complexity. Nobody ever wakes up thinking, "Hmm, today I would love to have an abortion." And yet when faced with the decision, there are so many different reasons that lead women to make that hard choice. I saw patients who were having an abortion so they could take care of the kids they already have. Other patients were in abusive relationships. Some simply weren't ready to become a parent. Others were in school. Some were having an abortion because birth control had failed them despite doing everything "right." Just like everything else in life, the experience and the circumstances that lead to it, are so varied. Why is this one part of health care so stigmatized when its complex circumstances are experiences that so many share?
I am now in medical school at UVM and when I think of my future as a physician, I hope to be an abortion provider. However, I recognize that unfortunately, this is not a simple decision. I want to have kids someday, and I feel hesitant about what that would mean for my family. I have heard stories of doctors being the target of anti-abortion threats or attacks and this makes me wary. I was lucky to work in a state where threats at Planned Parenthood were minimal, but lots of doctors travel to other less supportive parts of the country to provide abortions where access is scarce. These are the places that really need medical support and attention, but providing that care can be a scary endeavor. It's an interesting consideration when going into the medical field. In most other areas of medicine, we aren't faced with decisions about our personal or family's safety. Abortion care is such a socially and politically charged field that it gives me pause. I feel passionate that this care be provided and therefore recognize that we must make this a more feasible field to go into. Change is slow, but I do believe it is happening. More conversations are being had, more stories are being shared, and there is a heightened awareness as our political climate faces these important issues. It's a balance to figure out just how vocal to be or how best to enact change.
One in three women have an abortion. This statistic is so important to share because it speaks to just how common, yet silenced this experience is. In my time at Planned Parenthood, I learned first-hand that abortion happens all the time, it will continue to happen, and that nobody is immune to this predicament, no matter what we may tell ourselves. We need to talk about it more; we need to break down the stigma. Story sharing is so powerful because it allows us to see the human side of the decision. People's minds and perspectives change when it becomes personal; when someone they know or love is faced with making a reproductive choice. But this altered perspective will never be gained if we all remain silent. It takes a lot of bravery and strength, but we must engage in open conversation and political action in order to ensure that reproductive freedom is a right to which we all have access."
*Name has been changed for privacy.
"Thinking back to the night I lost my virginity….it’s pretty cringe-worthy. I was probably about 15 and visiting my older brother at college. There was a lot of peer pressure that night; lots of dudes chest thumping, pre-gaming in a dorm room. The plan was to head out to a party, and everyone seemed to think that it was very important that I hook up with someone that night. I ended up pairing up with a nice girl. I think we were both pretty terrified, but were in a similar boat – it felt like role-playing. She was also college-visiting and was still in high school, too. Looking back, I believe that it was consensual – but it mostly felt awkward and uncomfortable. We did use a condom, I remember that much. I think back to that night and it’s so far from the way I wish it had been. My main impression of that night is that she and I were both playing out our roles. We thought, “this is what we were supposed to being doing,” and so we did it. But there are always two very different perspectives with any story. It's challenging to think back on that night because…I think it was consensual. Notions of consent had been hammered into my head enough that I think I at least verbally asked for consent (probably in the least smooth way possible), but it's a great example of an interaction with super shady grey areas. I would not be completely surprised if she felt like it wasn't consensual, and just that possibility makes me cringe. Sex through most of high school continued to be dominated by peer pressure for me, and it wasn't a comfortable or beautiful experience until I really fell in love with someone a year or two later. Then it was beautiful. But that was far from how it was presented to me as a teen.
I share my virginity story because I recently watched the film Break the Silence and was struck by the virginity stories that women shared. It's such a vulnerable time and my real take away is that toxic masculinity truly hurts us all. It’s been making me think lately about why male sexuality is so troubled. I think when we hear the words "toxic masculinity" we think about aggressive men perpetrating violence in one form or another against women. And this is certainly a very large piece of the problem. But another part, which is ultimately very intertwined, is that toxic masculinity also silences any man – especially a young man – who might want to do things differently. I think back to high school and remember all the times of pretending. Everybody is playing out this role of the “tough dude.” I wasn’t necessarily aware of it, but I was terrified of not being the tough dude. Masculinity told me I should be something that I was not, and I felt pressured to live up to it.
These insidious roles hurt everybody, but they work because of fear and insecurity, and because of that, I just don't think we can leave it up to young men to get this right on their own without a lot of help. We need to make sure men and boys are talking about these things very early on. We need to break this male silence; to delve into conversations about experiences of sexuality, discuss the complexity, the importance of consent, and talk about what it actually means to be a man. What does that look like to you? I think back and remember some really well-intentioned teachers trying to facilitate these conversations in high-school, and I remember them being horrifyingly awkward and uncomfortable. But the conversations need to be had. We need more settings, more mentors, more role models, more safe places for men to start practicing communicating about this early on. Because the alternative is dangerous for all parties involved. It's how the seeds are planted for perpetrating violent, non-consensual and potentially traumatic experiences, even in cases when the young man is horrified by that possibility and doesn't mean to hurt anyone. Toxic masculinity forces boys to become men they don't even want to be. We need to talk about that.
I’ve been thinking of men’s relationship to the movement for reproductive rights a lot recently. Just recently, a guy very close to me told me a story that really made me think. A few years ago, this guy was traveling across the country for work. He had just recently gotten out of a relationship and had a one-night stand with a woman. They had connected, it was consensual, she was on some sort of birth control, but they didn't stay in much contact after that. Over the years she was intermittently in touch with him. He told me that it had always seemed strange to him - he interpreted her communication as her wanting to pursue a romantic relationship, but for his part he felt like they had talked about that beforehand and that wasn’t really a possibility. About a month or two ago, she came out to where he lived and they met up and had dinner. She ended up telling him that she had gotten pregnant the night of their one night stand and had an abortion. She had wanted to tell him all these years, but hadn’t felt comfortable doing so. I can only imagine – I’m sure it's not an easy thing. And culturally she came from a place where this decision was really difficult for her. It's hard to know how to talk about these things. Finding out years later really rocked my friend. He was struck by it, the fact that for a little while there, he was, or could have been, a father. It made us both think about the male perspective on all of this in a new way. I think it’s so frequently the case that men have no idea when partners have an abortion. And that’s so difficult, because I hate to say that it’s women’s responsibility to tell them. But I was thinking about the statistic - if 1 in 4 women have had an abortion, that means roughly 1 in 4 men have also, right? That statistical flip is really eye-opening. We never talk about it that way, but it's got to be true. But I think the truth is that men generally just don’t end up knowing, and that unfortunately makes it so much easier for us men to get off the hook, to just be passive supporters of reproductive rights, without really knowing that part we play in this. It makes me think back on my own experience….I don't think any of the women I have slept with have conceived….but I don’t know, right?
This silence makes it too easy for us to be passive supporters. I include myself in this - men who are well meaning, who would call themselves pro-choice, but who are sitting back and watching women wage this fight. I am in awe of the strength of the women standing up for their rights and braving this broken system. And as men, sometimes it's hard to know how to get involved. We don’t want to take the stage from women – I think it’s important that women lead here. And, this links back to all of toxic masculinity - we are uncomfortable talking about this stuff. Most men were never taught how, and never had a chance to practice. Men generally have a pretty low level of knowledge in this subject matter, and even well-intentioned men may be scared of being ridiculed or betraying ignorance. Because that still happens all the time. It's been interesting watching this play out in medical school – everyone still laughs when a male student answers a question about menstruation – it’s how we all learned to react from such an early age! Men are clearly scared to enter the conversation. This has been largely a women's movement and thank god for all the hard work women have done. But I keep coming back to that statistic - 1 in 4 women, and therefore, roughly 1 in 4 men. This is clearly a men's issue too, but we’re not seeing that way. I don't want to put any more responsibility on women. I hate to say that women should always have to tell their partners or it's the woman's job to wake us up to our role in this. But, to women, I would say, if at all possible, tell your partner. Invite us, demand us to be a part of the conversation. Women should not be alone in this fight. The act of getting pregnant takes both of us and we need men to start showing up for this movement.
I feel like I was a prime example of a passive supporter. I am a heterosexual male who needed to be pulled into the movement. I'm a super busy medical student. The night that Break the Silence was screened at UVM, I went because I had been pulled in to help at the event. I probably wouldn't have gone otherwise. It would have been easy to say that I was too busy. But I was one of only a few men who were at the screening, and it got me thinking. How do we pull men in? How do we get them in the door? I think this film would have deeply touched so many men in the UVM community had they been there. But how do we get them to show up if they don't recognize that this is their issue too?
I bet that a lot of men are on the cusp of taking that next step. We need to enter the very uncomfortable space that so many of us are avoiding. Because the truth is, we aren't currently winning this fight. States all across the nation are passing legislation that limits access to the care that women need. Men are half the population. I believe that if we could pull more men into this conversation, if we stopped being passive and recognized that reproductive freedom affects us all, we could see more legislation pass like Proposition 5. At no point in my life so far have I felt ready to be a father, so reproductive freedom is deeply important to me, too. "