Re: Bitter Pill

1

I hate to say this

Don't feel bad, Becks. Growing more conservative as you reach middle age is a pretty common occurrence.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 8:46 AM
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You need to compare the incidence and severity of the side effects with the incidence and severity of what's being prevented. I don't know which way it tips, but you can't point at any medication and say that the side effects make it unacceptable without weighing the benefits.


Posted by: SP | Link to this comment | 10-23-07 8:49 AM
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1: between this post and the "this kind of thing gives liberals a bad name" post, she'll be writing for Slate soon enough.

I kid! I kid! Mostly!


Posted by: Sifu Tweety | Link to this comment | 10-23-07 8:51 AM
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Besides, everyone knows the best way to avoid pregnancy is to just take it in the ass like the born again Christians.


Posted by: gswift | Link to this comment | 10-23-07 9:01 AM
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My kneejerk reaction is to support the program, and disagree with Becks.

The pill is being given out through a clinic with full medical consultation. Many girls will probably have side effects, but this is something they can monitor with the clinic doctor and staff, who can help them weigh costs and benefits in their individual case. If anything, the girls would benefit from the opportunity to learn about the way their own personal body functions, what it reacts well to, and what it reacts badly to.


Posted by: rob helpy-chalk | Link to this comment | 10-23-07 9:05 AM
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4 is probably NSFW.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 9:05 AM
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I noticed that the girls will either consult with a dr. or a nurse practitioner. This may be one of those cases were a consult with a nurse practitioner is more likely to be productive than a consult with a doctor. The issue here is less about identifying unique constellations of symptoms and more about human decision making. The girls are thus more likely to get good advice from someone coming from the culture of nursing than the arrogant, ambitious culture of doctors.


Posted by: rob helpy-chalk | Link to this comment | 10-23-07 9:10 AM
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4 is probably NSFW.

Probably? Possible I guess, but it has a big graphic obscuring the naughty bits.


Posted by: gswift | Link to this comment | 10-23-07 9:11 AM
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It's NSFW.


Posted by: DS | Link to this comment | 10-23-07 9:12 AM
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Given my own experiences with doctors playing down the side effects of the pill ('What? You think the pill is causing this thing you're here to see me about? Impossible, you hysterical girl!"), I'm inclined to agree with Becks.

Yeah, side effects vs. pregnancy, I know. But condoms do seem like the better route for teenagers.


Posted by: Blume | Link to this comment | 10-23-07 9:13 AM
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OT: Mleblanc is blooging at BPhd!

the girls would benefit from the opportunity to learn about the way their own personal body functions

Out of curiousity, does no one use a diaphrhagm anymore? I know, no STD protection, but none with the pill either, and that seems to be what the kids are using. I would never have been together enough in high school to take a pill every day without forgetting. Of course the diaphragm means you have to be able to locate your own cervix, but that's a feature, IMO. Maybe it's just un-sellable.


Posted by: Penny | Link to this comment | 10-23-07 9:13 AM
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uh - dia - fill in the spelling.


Posted by: Penny | Link to this comment | 10-23-07 9:13 AM
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8: Not everyone lives in the latter-day Gomorrah that is SLC.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 9:14 AM
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User error seems likely to be a lot higher with a diaphragm than with condoms, I'd think. (More complicated timing, necessity of spermicide.)


Posted by: Blume | Link to this comment | 10-23-07 9:15 AM
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If anything, the girls would benefit from the opportunity to learn about the way their own personal body functions, what it reacts well to, and what it reacts badly to.

It's the educational aspect that makes me fully support contraceptive pills for 11- to 13-year old girls. The sooner the girls learn to submit to the pornocratic regime, the better.


Posted by: Invisible Adjunct | Link to this comment | 10-23-07 9:16 AM
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11- Does the clinic offer injections or patches, or just pills?


Posted by: SP | Link to this comment | 10-23-07 9:16 AM
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I dunno. The effectiveness rates are going to be way higher for the Pill than condoms, particularly for kids who are just learning how to use condoms, and I'm not sure what I think about the side effects. Yes, plenty of people have them, but not enough to put off most women from the Pill as a means of birth control. So, set up the program with real attention to education about side effects and so forth, but I think the benefits of the more effective birth control are likely greater that the harm done by side effects.

But I'm really not sure here.


Posted by: LizardBreath | Link to this comment | 10-23-07 9:17 AM
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The diaphragm seems like a giant pain all around -- requires elaborate prep before sex, many of us are allergic to spermicide, and it seems like it would interfere with stimulating the G-spot (which is real, folks). I'm speaking as a man here, of course.


Posted by: marcus | Link to this comment | 10-23-07 9:17 AM
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I'm ok with it - anyone of any age can get the pill from Family Planning clinics over here, and you have a pretty long talk about it first and they're good at checking up on people. So as long as this is well supported, then I don't see that there should be major problems.

The pill's no protection against those social diseases though. I think it's a reasonable method to use if you're in a relationship, but I wouldn't want my girls going on the pill and then thinking they're ok to shag whomever they fancy. (And obviously I'll be preaching to them about the advantages of anal.)


Posted by: asilon | Link to this comment | 10-23-07 9:18 AM
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18 to 11


Posted by: marcus | Link to this comment | 10-23-07 9:18 AM
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Yeah, you want to promote a culture of doubling up with condoms.


Posted by: LizardBreath | Link to this comment | 10-23-07 9:19 AM
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Man, do I hate the pill, for me. When I was taking it in college, under the usual medical supervision, it made me (a) insane, and (b) plagued with migraines. Why it took me three and a half years to think of going off it is beyond me. I know there are better formulations now, but I am totally uninterested in exploring them.


Posted by: redfoxtailshrub | Link to this comment | 10-23-07 9:20 AM
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It's too bad that girls that age would probably expel an IUD.


Posted by: Amber | Link to this comment | 10-23-07 9:21 AM
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It's the educational aspect that makes me fully support contraceptive pills for 11- to 13-year old girls. The sooner the girls learn to submit to the pornocratic regime, the better.

I seem to remember that easy access to contraception has no effect on age of first intercourse, if that would be reassuring. Let me look around for support on that.


Posted by: LizardBreath | Link to this comment | 10-23-07 9:22 AM
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21 - I think so.

I haven't been on the pill since I was about 24 though, and wouldn't go back on it, so I'm not sure how keen I'd be to recommend it to my daughters.


Posted by: asilon | Link to this comment | 10-23-07 9:23 AM
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It's too bad that girls that age would probably expel an IUD.

Really? I didn't know that. Do teens flex their uterus a lot or something?


Posted by: gswift | Link to this comment | 10-23-07 9:24 AM
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Why it took me three and a half ten years to think of going off it is beyond me.


Posted by: Blume | Link to this comment | 10-23-07 9:25 AM
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Nulliparous women in general have higher expulsion rates.


Posted by: Amber | Link to this comment | 10-23-07 9:25 AM
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The sooner the girls learn to submit to the pornocratic regime, the better.

Preach it, sister!


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 9:26 AM
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23 - seriously? Having recently got a Mirena fitted, there's no way I'd suggest that to a teenage daughter, unless I hated her. And it might not work with Becks's idea of giving them time to get used to their bodies either - which I *do* agree with. (Hell, my girls are so homeschooled that they don't even know about disposable sanpro!)


Posted by: asilon | Link to this comment | 10-23-07 9:26 AM
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24: Maybe not. This is the strongest statement I found in a couple of minutes looking, and presumably it would have been stronger if there were better data:

There is no evidence that availability of contraceptives will lead to earlier sexual intercourse, or lack of availability of contraceptives will result in postponement of sexual intercourse. Also, there is no evidence that giving adolescents information about contraception will lead to earlier age of first intercourse, increased sexual activity or greater numbers of lifetime sexual partners.

Posted by: LizardBreath | Link to this comment | 10-23-07 9:28 AM
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requires elaborate prep before sex
no more than a condom, really
many of us are allergic to spermicide
hadn't though of that
and it seems like it would interfere with stimulating the G-spot
I think it usually sits quite a bit higher than that.


Posted by: Penny | Link to this comment | 10-23-07 9:28 AM
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It's not as bad as getting pregnant at thirteen. The copper version allows for natural (if heavy) menstruation. There was a British model specifically targeted toward young women that had a lower copper load and was affixed directly to the uterus instead of being held in by a "T" shape, but the jury is still out on whether it actually has lower side effects and expulsion rates.


Posted by: Amber | Link to this comment | 10-23-07 9:29 AM
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It occurs to me that I've never been, or maybe once or twice, intimate with someone on the pill. Barriers were thought safer and less likely to have harmful side-effects by nearly everyone I've ever been with.


Posted by: I don't pay | Link to this comment | 10-23-07 9:30 AM
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30:Having recently got a Mirena fitted, there's no way I'd suggest that to a teenage daughter, unless I hated her.

That bad for you? I've got a copper-T, and it's been no problem. The fitting was unpleasant, but an unpleasant five seconds or so. What was the negative?

28: Nulliparous women in general have higher expulsion rates.

Could be higher, but are they actually high? But I do think that doctors are very reluctant to prescribe IUDs for younger women not in monogamous relationships expected to last for the life of the IUD, because STI's can cause unpleasant complications if you have an IUD.


Posted by: LizardBreath | Link to this comment | 10-23-07 9:31 AM
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24: Even if true, that would not do much to remove my objections. I don't think the schools should be legitimizing/normalizing sexual activity for 11- to 13-year old girls.

I also don't like the implicit message that birth control is the woman's (er, sorry, girl's) concern.


Posted by: Invisible Adjunct | Link to this comment | 10-23-07 9:31 AM
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"Expulsion" to me makes it sound like it's going to come flying out while you're doing a problem at the board.


Posted by: gswift | Link to this comment | 10-23-07 9:31 AM
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38

Where's Fontana Labs?


Posted by: Penny | Link to this comment | 10-23-07 9:32 AM
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I think this issue is like parental consent for abortion. Ideally, I would love to live in a world in which every young woman could trust and confide in her parents about such a significant life event (unplanned pregnancy, regardless of the solution). But we don't, and the negative consequences of trying to legislate what should be healthy human relationships are too high.

I would also love to live in a world in which people weren't often pushed to medical solutions and one in which teenagers in particular were able to get used to their bodies' natural rhythms without external hormonal interference. But we don't, and the positive consequences of having reasonably reliable birth control available to teenagers are significant.

Another piece of the puzzle is that Pill is invisible and private. In other words, teenage girls can just use it -- they don't have to negotiate birth control with a partner (whether same-age or older). That's not a small issue.


Posted by: Witt | Link to this comment | 10-23-07 9:34 AM
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In other words, teenage girls can just use it -- they don't have to negotiate birth control with a partner (whether same-age or older).

Are you positing this as a positive or a negative aspect?


Posted by: Blume | Link to this comment | 10-23-07 9:37 AM
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I don't think the schools should be legitimizing/normalizing sexual activity for 11- to 13-year old girls.

To be fair, the pornocracy doesn't extend that far down the age scale. Wasn't Tracy Lord at least fifteen or sixteen when she first (in)famously made porn?


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 9:38 AM
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Are you positing this as a positive or a negative aspect?

I was gonna say; maybe that's a feature.


Posted by: I don't pay | Link to this comment | 10-23-07 9:39 AM
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33 - fitting 13 year olds with IUDs really does sound like a pornocratic regime though.

35 - it's been ok since it was fitted, but I just hated the fitting. Incredibly painful, and then the damn thing didn't detach from the applicator, so then she had to remove it and go off to another room to get another one, and then the incredible pain again. I'm way down the stoic end of the spectrum (childbirth and smear tests - no problem), but it really upset me. Have told C he has 5 years in which to get a vasectomy as there's no fucking way I'm doing that again.

I also don't like the implicit message that birth control is the woman's (er, sorry, girl's) concern.

Yeah, hope they're giving out condoms to all the boys too.


Posted by: asilon | Link to this comment | 10-23-07 9:39 AM
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Are you positing this as a positive or a negative aspect?

Positive. Again, I'd love to live in a world in which no teenager (girl or boy) was ever in an intimate situation with someone that they didn't trust to negotiate those issues, but given the number of adults I have talked to who are too cowardly* to bring it up, I don't want to delude myself.

*Yes, I am being judgmental.


Posted by: Witt | Link to this comment | 10-23-07 9:40 AM
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Becks' point, and it seems like a good one, isn't primarily about sex, is it? It's that the people who will be taking this drug don't yet know their own bodies and won't have a good idea of what's normal and what needs to be discussed with a doctor. Add the facts that teens are embarrassed to discuss their bodies, and particularly embarrassed to discuss their bodies in relation to sex, and you could have a lot of young women suffering unpleasant side-effects in silence.

More generally, and speaking for myself, it's troubling how willing people are to give kids and youngsters drugs. Nobody really knows what that shit does.


Posted by: ogged | Link to this comment | 10-23-07 9:41 AM
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I don't think the schools should be legitimizing/normalizing sexual activity for 11- to 13-year old girls.

This is a genuine concern, and it's hard to balance it against providing help and support to those girls who are sexually active at that age, and will be whether or not the schools normalize it. I don't think there are good general rules -- whether something's a good idea or not is going to depend very sensitively on exactly how it's carried out.


Posted by: LizardBreath | Link to this comment | 10-23-07 9:43 AM
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I had horrible experiences on the pill. I got little to no warning about side-effects. It changed my personality greatly, for the worse, on top of constant exhaustion and irritability. When my "health care provider" accidentally gave me a scrip for a generic, which I was told was the same as what I was on, I ended up thinking I was losing my mind and went into therapy for two months. It fucked me up horribly. I even started to suspect that birth control pills are responsible for every misogynistic stereotype of women's emotional behavior there is.

I'm with Becks on this one. Non-hormonal birth control until they get the pill right.


Posted by: A White Bear | Link to this comment | 10-23-07 9:44 AM
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, it's troubling how willing people are to give kids and youngsters drugs. Nobody really knows what that shit does.

One way to find out.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 9:44 AM
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Expulsion rates vary from 3-15 percent. According to my doctor, it commonly happens when you're on the toilet and many women (even, in one case, a midwife of her acquaintance) don't notice until they get pregnant. You're supposed to check the string regularly to prevent these surprises, which helps with the "get to know your body" aspect.

STIs are an issue, but total normalization of long-term birth control would disengage it from association with contemporaneous sexual activity.


Posted by: Amber | Link to this comment | 10-23-07 9:45 AM
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46: The issue is really...why is the school the thing in charge of making these decisions? Why not some other, let's say, government-based health entity? After all, the disturbingness of "normalizing this sort of thing among 12-year-olds" is largely because it would be done by the schools, the very things that teach our kids what to do and how to act.

In Britain, don't they have "youth clubs" in each community that fulfill some of the functions that have been delegated to schools here?


Posted by: Cryptic Ned | Link to this comment | 10-23-07 9:46 AM
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Let's give all the teen girls the Depo shot and kill their sex drive. It'll be "birth control in schools meets abstinence."


Posted by: gswift | Link to this comment | 10-23-07 9:46 AM
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The question I have is if the prescription is given confidentially is there anyone that is making sure that the prescription is getting recorded somewhere that outside doctors are going to know about? Someone on a recent thread brought up that the pill reacts with a lot of other medications.


Posted by: CJB | Link to this comment | 10-23-07 9:47 AM
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I should say that I am sufficiently fanatic about avoiding hormones that I do my best to avoid rGBH milk and milk products, buy organic meats, etc. I'm just drawing a distinction between my personal biases and what I think is helpful from a public health standpoint.

My niece can expect a long series of informal chats about health issues long before she's ever going to have to make this choice.


Posted by: Witt | Link to this comment | 10-23-07 9:48 AM
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I don't think there are good general rules -- whether something's a good idea or not is going to depend very sensitively on exactly how it's carried out.

Is that "Centralized govt. programs may not be the best form of repsonse to certain problems"?


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 9:49 AM
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I do my best to avoid rGBH

that's rBGH. Unless you mean GHB, which should also be avoided.


Posted by: Cryptic Ned | Link to this comment | 10-23-07 9:50 AM
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Several of my previous partners have had issues [mood changes, etc.] with one or more types of pill. Some of them, it immediately ceased on changing to a different brand.

Personally, I think the UK system is fine. Teenagers can approach their doctors or a family planning clinic for contraception if they want it, and that choice is confidential.


Posted by: nattarGcM ttaM | Link to this comment | 10-23-07 9:50 AM
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51: I may just be being depressive here, but I have the suspicion that that wouldn't cut into rates of sexual activity much. Just into the number of girls actually enjoying themselves.

Generally, I really don't know what to think about the side effects question. If the emotional side effects are as common as they seem anecdotally to be, Becks and others may be right that it is a terrible idea. I may have come into this dismissively because the Pill doesn't seem to do anything to me but keep me from getting pregnant.


Posted by: LizardBreath | Link to this comment | 10-23-07 9:51 AM
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Grrrr, typos. Imagine I said rBGH. As in bovine growth hormone.


Posted by: Witt | Link to this comment | 10-23-07 9:52 AM
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54: Nope. I didn't say anything about such things being sensitively responsive to local issues. (Which, of course, they might be; it just wasn't what I was actually thinking.)


Posted by: LizardBreath | Link to this comment | 10-23-07 9:53 AM
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Is that "Centralized govt. programs may not be the best form of repsonse to certain problems"?

What is the centralized govt program here? Making something available? I wouldn't support anything more intrusive than making something available.


Posted by: Cryptic Ned | Link to this comment | 10-23-07 9:54 AM
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50, 56: Yeah, the US issue is that the schools are the only social democratic institution we've got. Poor kids don't have doctors, and no kid has a doctor unless they either have the money to pay, or involve their parents. (Gross overgeneralization; there are some free clinics, PP provides care on a sliding scale basis, but there are plenty of kids who aren't going to get any services that don't come through the schools.)


Posted by: LizardBreath | Link to this comment | 10-23-07 9:55 AM
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52- The clinic at the school is a general health clinic, not just a birth control clinic. I don't know if you were implying that, but I hope this doesn't become one of those planned parenthood misconceptions- "If only that horrible school sex clinic offered health services besides the pill, I'd support it!"

55- No, he just avoids recombinant Boston public broadcasting.


Posted by: SP | Link to this comment | 10-23-07 9:56 AM
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Yeah, the US issue is that the schools are the only social democratic institution we've got

True, and very distorting, not least of education.


Posted by: I don't pay | Link to this comment | 10-23-07 9:57 AM
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re: 61

Yeah, there are big social differences. Family planning clinics here give out free condoms too.

Amusingly, the student newspaper at my first college used to give away condoms with the paper. Stapled [I shit you not] to the top corner of the page.


Posted by: nattarGcM ttaM | Link to this comment | 10-23-07 9:59 AM
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Through the edge, not the middle, of the package I hope.


Posted by: LizardBreath | Link to this comment | 10-23-07 9:59 AM
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I don't understand, if the girls are being given consultation with a medical professional before being prescribed, why the consultation is restricted to one method of birth control. Makes no sense. It suggests that the programme hasn't been very well worked out, which, if it's an initiative of a single school, isn't very surprising - it shouldn't be up to the school.

I imagine nobody wants to encourage middle school kids to be sexually active. But if some of them are anyway, there probably isn't a good response, only a less bad one.


Posted by: OneFatEnglishman | Link to this comment | 10-23-07 10:01 AM
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re: 65

Yes, through the edge of the packaging, but I was always amused by it. The probability of error must have been quite high.


Posted by: nattarGcM ttaM | Link to this comment | 10-23-07 10:01 AM
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On my first blog, I wrote a pretty close description of what happened to me on birth control, especially the cheap generic Trinessa, and I got hundreds of emails over the next year from women who had been almost forcibly put on it by parents after they found out the girls were sexually active. Almost all of these young women were poor, about half were American Indians, and they all said the same thing: Trinessa killed my sex drive entirely, made me gain weight, and made me so impossible to be around that I lost my boyfriend and gradually became suicidal.

I guess there's enough of a conspiracy theorist in me to wonder if this isn't basically the forced-Depo lite of eugenics American-style.


Posted by: A White Bear | Link to this comment | 10-23-07 10:01 AM
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why is the school the thing in charge of making these decisions?

There's probably a practical answer that goes something like, For some kids (e.g., the underinsured), the school clinic is the only time they come into contact with nurses and such. But yeah, I'm really bothered by the fact that it's the schools, given their educational function.

I recognize the problem that LB raises in 46. But I can't support the notion that because some (in this school district, apparently a small percentage) middle-schoolers are sexually active, the middle schools should legitimize sexual activity for its students.


Posted by: Invisible Adjunct | Link to this comment | 10-23-07 10:03 AM
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The clinic at the school is a general health clinic, not just a birth control clinic. I don't know if you were implying that, but I hope this doesn't become one of those planned parenthood misconceptions- "If only that horrible school sex clinic offered health services besides the pill, I'd support it!"

That wasn't what I meant to imply. If that is the main treatment point for the children it probably isn't a big deal. I assumed that a good portion would have outside doctors as well. Maybe I am not correct on that though.


Posted by: CJB | Link to this comment | 10-23-07 10:04 AM
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70: in some school districts, the proportion that have outside doctors will be near 0.


Posted by: soup biscuit | Link to this comment | 10-23-07 10:06 AM
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That's silly. The school offers first aid, does that mean they're 'legitimizing' hurting yourself?


Posted by: neil | Link to this comment | 10-23-07 10:06 AM
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70: in some school districts, the proportion that have outside doctors will be near 0.

In Maine?


Posted by: Cryptic Ned | Link to this comment | 10-23-07 10:07 AM
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The unfortunate thing is that it's freaking difficult to get even private medical practitioners to take seriously various side-effects of the pill. I'm on my third formulation in a year right now, and it's been a real pain to get decent information.

For those of you keeping score: the first pill (a generic from PP) doubled the size of my gazongas and made me feel crazy, the second pill (an incredibly expensive tri-phasic brand-name) was fine except for that weird thing of having two periods every month, and the third pill (a cheaper brand-name from PP) so far seems to be okay.

So, I'd be a little worried about putting young women on the pill, even with outstanding medical supervision.


Posted by: Jackmormon | Link to this comment | 10-23-07 10:08 AM
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the middle schools should legitimize sexual activity for its students.

But they're not. Providing birth control isn't an approval of sexual activity. This is just another example of the argument that sex should be made as risky as possible for kids to encourage them to hold off until they're older. It's no different than the objections some people had to the HPV vaccine.


Posted by: Matt F | Link to this comment | 10-23-07 10:08 AM
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One aspect I don't quite understand is who is expected to get this. They're going to just make it known that it's available and let the girls come to them, right? We're discussing above the (population) tradeoff of side effects versus pregnancy, and it seems like the kids that go to get this would be extremely well served by having it there. Giving the same dose of everything to all girls in the school would be bad, clearly, but they aren't doing that.

(as to the Pill versus any other method, the negotiation and privacy aspects seem like they're significant benefits)


Posted by: Nathan Williams | Link to this comment | 10-23-07 10:09 AM
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Jackmormon: yikes!


Posted by: soup biscuit | Link to this comment | 10-23-07 10:09 AM
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I assumed that a good portion would have outside doctors as well.

Even if they do, it's tricky to get an appointment without your parents knowing.


Posted by: Matt F | Link to this comment | 10-23-07 10:10 AM
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45: given the number of women in their 20s and 30s I have known who commented on at least some mood/physical differences when on the pill, I agree with Becks post as well. And these are confident, educated women who take the initiative with their doctors to get the prescription right, not shy teenagers dealing with harried school nurse. Based just on my own observation, it's a minority -- some women hardly seem to be affected -- but a pretty substantial one (20-30% of those who try??).


Posted by: marcus | Link to this comment | 10-23-07 10:11 AM
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Increasing the amount of teenagers using hormone-manipulating substances sounds like a great way to make up for the lack of great art produced by a generation without depression. What was that article about "Prozac curing the next Van Gogh" or something?


Posted by: Cryptic Ned | Link to this comment | 10-23-07 10:12 AM
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The school offers first aid, does that mean they're 'legitimizing' hurting yourself?

Analogies: still banned.


Posted by: ogged | Link to this comment | 10-23-07 10:12 AM
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The structure of one's day around school at that age - schoolbus to and from home, no public transit, probably suburban/rural - you aren't going to any clinic other than the one at school without some serious adult cooperation.


Posted by: Nathan Williams | Link to this comment | 10-23-07 10:12 AM
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This is just another example of the argument that sex should be made as risky as possible for kids to encourage them to hold off until they're older.

Why can't this, or the first clause anyway, be the public Democratic response? "Why, sir, are you voting to make sex as risky and dangerous for people as possible?" I bet sex polls high with voters.


Posted by: Armsmasher | Link to this comment | 10-23-07 10:13 AM
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83: institutional stupidity & cowardice explains a lot about the D's, really.


Posted by: soup biscuit | Link to this comment | 10-23-07 10:15 AM
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JM's experience sounds pretty typical of the women I know.

the middle schools should legitimize sexual activity for its students.

Look, this isn't designed to signal approval of pre-teens having sex. nobody approves of that. But I'd rather they had safe sex than babies. If you know of a better solution, what is it? I assume you're not suggesting giving them the pill, but putting them in detention first.


Posted by: OneFatEnglishman | Link to this comment | 10-23-07 10:15 AM
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I found that it was very hard, as a young woman, to tell anyone in health care that I was sexually active and using condoms without them insisting on writing a scrip for the pill. I just threw them away until I was 24 and decided to try it. But people who provide health care for young women can be very pushy and very scary about insisting that if you don't get on the pill, it's because you hate yourself and want to die in a ditch somewhere, buried in a mountain of unwanted babies. Plus, you could get raped! By someone not wearing a condom!

I'm just saying, I know it doesn't sound like forced birth control, but already, it nearly is.


Posted by: A White Bear | Link to this comment | 10-23-07 10:15 AM
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Even if they do, it's tricky to get an appointment without your parents knowing.

Not to mention kids are almost always on their parents' health insurance. Think of the torrent of medical paperwork that comes with any appointment (much less prescription) in the US, and then imagine trying to hide that from your parents. Who presumably pay the health-insurance bills.

(Assuming you have some form of health insurance, however limited.)


Posted by: Witt | Link to this comment | 10-23-07 10:16 AM
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I don't understand the "it's not legitimating sex" argument. It clearly is, but you might think that's better than the alternatives.


Posted by: ogged | Link to this comment | 10-23-07 10:17 AM
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And to OFE's comment from earlier, my understanding from the article was that the Maine school has already been offering non-prescription birth control. This is the next step.


Posted by: Witt | Link to this comment | 10-23-07 10:17 AM
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86: YMMV? This just wasn't the case for lots of women growing up where I grew up.


Posted by: Armsmasher | Link to this comment | 10-23-07 10:17 AM
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87 is a good point.

I'm pressing the 'your country is crazy' hotkey now.


Posted by: nattarGcM ttaM | Link to this comment | 10-23-07 10:18 AM
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90: I think it's just that health care for young women is too politicized, by both parties, to have anything to do with their health. Either you can't get the pill to save your life, or people force you on it such that you'd imagine they were getting kickbacks from big pharm. What about actually educating young women and men both about birth control and sexuality?


Posted by: A White Bear | Link to this comment | 10-23-07 10:20 AM
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I think what AWB is describing is class-linked, although not in all cases. When I hear stories about that kind of bullying, it's usually poor or working-class girls. (Really, girls. Not women.)


Posted by: Witt | Link to this comment | 10-23-07 10:21 AM
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91: you're only just figuring this out now?


Posted by: soup biscuit | Link to this comment | 10-23-07 10:21 AM
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88: I don't understand the "it's not legitimating sex" argument. It clearly is, but you might think that's better than the alternatives.

Seriously, what does 'legitimating' mean in that sentence? I'm not sure what would make me think it was true or false.


Posted by: LizardBreath | Link to this comment | 10-23-07 10:23 AM
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re: 94

No, that's why I have a hotkey.


Posted by: nattarGcM ttaM | Link to this comment | 10-23-07 10:23 AM
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91: you're only just figuring this out now?

No, that's why he has a hotkey.


Posted by: ogged | Link to this comment | 10-23-07 10:23 AM
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Dammit, McG.


Posted by: ogged | Link to this comment | 10-23-07 10:24 AM
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Heh.


Posted by: nattarGcM ttaM | Link to this comment | 10-23-07 10:24 AM
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96/97 suggests there is a time when depressing it wasn't sensible though --- I can't think of one in recent memory.

Maybe if you just leave a stapler holding it down.


Posted by: soup biscuit | Link to this comment | 10-23-07 10:25 AM
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doubled the size of my gazongas and made me feel crazy

You can't make an omelet without breaking eggs.

Non-hormonal birth control until they get the pill right.

They have the pill right; it's just that you can't make a single pill that always plays nice with 4 billion different people's body chemistries. Some people have bad reactions variously to aspirin, Tylenol, and opiates, too, but we don't say "No pain medications until they get analgesics right."

middle schools should legitimize sexual activity for its students

That's no more legitimization than providing clean needles to junkies (or, as noted, HPV vaccines to 11-year-olds). It isn't about signalling approval or disapproval. It's about acknowledging the realities of human behavior and crafting policies with harm reduction as the first priority.


Posted by: apostropher | Link to this comment | 10-23-07 10:26 AM
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I don't understand the "it's not legitimating sex" argument.

Isn't there a distinction between legitimating sex and frankly acknowledging that it happens?

Thank God this won't be a problem at the convent where my daughters will be confined as soon as they're 12.


Posted by: Jesus McQueen | Link to this comment | 10-23-07 10:26 AM
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Yeah, your country is fucked up. Becks, although there may be qualms about the pill, giving people a choice and an opportunity has to be a good thing. Free birth control for everyone.


Posted by: asilon | Link to this comment | 10-23-07 10:26 AM
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Fine. Pwn me all you want. See if I care.


Posted by: Jesus McQueen | Link to this comment | 10-23-07 10:27 AM
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102: better make that 9. Just saying.


Posted by: soup biscuit | Link to this comment | 10-23-07 10:27 AM
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here are my big problems:
1. it seems pretty likely that young girls who go on the pill will treat it as an alternative to condoms, and while you can, worst case scenario, get an abortion if you get pregnant, if you wind up with herpes or AIDS or even untreated chlamydia at 13, you are looking at a life of humiliation, expensive drugs, and/or infertility for the next 60 years.
2. how well funded is this public school clinic that their staff can watch dozens of crazy-on-a-good-day adolescent girls for psychological reactions to medication?
3. throwing artificial hormones into pubescent bodies seems incredibly risky. does anyone know of studies to make sure this won't increase cancer rates or other problems for this age group specifically?
4. admittedly, i have a personal bias like becks'. the pill done made me Crazy to the point of ruining an otherwise functional relationship. it was bad enough at 25; when it happened at 18, i thought i was just insane; at 14, i can't imagine how awful it would have been.


Posted by: k | Link to this comment | 10-23-07 10:27 AM
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They have the pill right; it's just that you can't make a single pill that always plays nice with 4 billion different people's body chemistries.

Nah. Getting it right would be being able to tell with some accuracy before prescribing it which pill wouldn't make the specific patient crazy. Observing yourself for emotional disturbance is really hard.


Posted by: LizardBreath | Link to this comment | 10-23-07 10:29 AM
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better make that 9. Just saying

Hmm. Now that I think about it, why wait? Pardon me, I've got some arrangements to make, pronto.


Posted by: Jesus McQueen | Link to this comment | 10-23-07 10:30 AM
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I don't understand the "it's not legitimating sex" argument

You also think Journey is great.


Posted by: apostropher | Link to this comment | 10-23-07 10:30 AM
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That's not an analogy, it's a simple assertion that schools provides all kinds of services without legitimating the needs that are served. I will decline to provide examples so that my non-analogical point will stand out in all its shining glory.

Maybe it would be an inappropriate analogy if I said, "refusing to offer birth control so the kids will be abstinent is like refusing to offer algebra class so the kid will all take calculus instead." Ahh, that felt better.


Posted by: neil | Link to this comment | 10-23-07 10:31 AM
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Getting it right would be being able to tell with some accuracy before prescribing it which pill wouldn't make the specific patient crazy

Nobody knows they're allergic to penicillin until they have the reaction.


Posted by: apostropher | Link to this comment | 10-23-07 10:32 AM
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what does 'legitimating' mean in that sentence?

I'm operating on little sleep today, so this probably won't be helpful, but at that age, I remember having very little idea of what was "normal" and looking around for clues as to how to behave. If someone affiliated with the school had given me a lesson about condom use, I would have thought "holy crap, everyone else is having sex." It seems almost tautological that discussing birth control with a kid also communicates that having sex is a normal thing for them to be doing. That's what I mean by "legitimating." Again, you might think that it should still be done, but I don't understand how it's not legitimating.


Posted by: ogged | Link to this comment | 10-23-07 10:32 AM
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...giving people a choice and an opportunity has to be a good thing.

An awful lot of right-wing garbage has been forced down our throats to this tune. Ignoring the specifics of this particular discussion, I'm very skeptical whenever someone breaks this out. No, giving people a "choice" doesn't have to be a good thing. Particularly where those involved may not be fully informed, where the incentives may be skewed, etc. etc. etc ad nauseum.


Posted by: Brock Landers | Link to this comment | 10-23-07 10:33 AM
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discussing birth control with a kid also communicates that having sex is a normal thing for them to be doing

Teaching a kid self-defense also communicates that getting beaten up is a normal thing for them to be doing.


Posted by: apostropher | Link to this comment | 10-23-07 10:35 AM
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I agree that the self-observation process is both extremely difficult and not even encouraged, as it is. I think most of us who have had bad pill experiences know what it's like to tell your doctor, "No, really, I'm gaining weight, I'm sluggish, I nearly tore the jugular vein out of a stranger on the Q train today," and getting back, "Have you tried eating less?" (That's a direct quote in my case.) My doctor convinced me that it couldn't be the pill--I was on a "good" one--and that, instead, I was just gradually becoming psychotically violent, ill-tempered, and fat.


Posted by: A White Bear | Link to this comment | 10-23-07 10:35 AM
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112 gets it right. Let's replace "legitimating" with "mainstreaming" or something.

It reminds me of when I saw a list of "things you can do to not waste water/electricity/whater". A lot of them were "Do not do [thing I had never even considered doing because it was entirely pointless] because it is entirely pointless." For example, "Don't leave the water running when you brush your teeth." After I saw that, I thought "do people really leave the water running when they brush their teeth?" and then I found myself doing it sometimes.

It's the Overton Window, perhaps?


Posted by: Cryptic Ned | Link to this comment | 10-23-07 10:36 AM
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111: And that's a problem too.

112: To do this responsibly, I'd want a middle school clinician to be offering accurate information like 'no, most kids your age aren't having sex yet', and being available for and steering the kids to appropriate counseling to the extent possible without scaring them off. Sure, putting balloons up over the clinic with a sign saying "Happy Fun Fuckfest 2007: Get Protected Now!" would be legitimating sex in that sense, but I don't think the prescription of contraceptives with reasonable and appropriate counseling does.


Posted by: LizardBreath | Link to this comment | 10-23-07 10:37 AM
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Further to 117: That's pretty much what I meant in 46 by:

I don't think there are good general rules -- whether something's a good idea or not is going to depend very sensitively on exactly how it's carried out.


Posted by: LizardBreath | Link to this comment | 10-23-07 10:39 AM
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It's the Overton Window, perhaps?

I hadn't heard that; cool. Also applicable to Pete Stark's comments in the thread from a couple of days ago.


Posted by: ogged | Link to this comment | 10-23-07 10:39 AM
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If well-executed, & done in the context of a real clinic & appropriate follow up, I think this would do more good than harm. That's a big "if," During college, I had the same experience as others about: (1) emotional side effects, (2) doctors not taking them seriously & one of them telling me that it was more likely that I was having the first episode of a mental illness that runs in my family. One of the most miserable months of my life.


Posted by: Katherine | Link to this comment | 10-23-07 10:41 AM
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I think what AWB is describing is class-linked, although not in all cases.

I've had similar experiences to AWB, both at PP and at the frikkin' Harvard Student Health Services. Must! Take! Pill! Here's a scrip! Go fill it NOW! Will solve all problems!
(Also for Trinessa, by the way. Made me so sensitive to sunlight I would cry if I went outside without sunglasses.)


Posted by: Blume | Link to this comment | 10-23-07 10:41 AM
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Sure, LB, if they take heroic measures to counteract the implicit message, maybe it'll be a wash, but I doubt that it will be done that way, and I'm not even sure you really can counteract the implicit message: here's some birth control, now don't have sex.


Posted by: ogged | Link to this comment | 10-23-07 10:42 AM
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Also applicable to Pete Stark's comments

Pete Stark doesn't understand the "never apologize" rule of politics either. [bangs head on desk repeatedly]


Posted by: apostropher | Link to this comment | 10-23-07 10:43 AM
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I wonder if best practices for a BCP scrip should incorporate a baseline mood evaluation, to be compared to one two months in. I don't know what sort of instrument you'd use for it, but it seems as if it should be possible. But that's thinking about BCP generally, not the school context.


Posted by: LizardBreath | Link to this comment | 10-23-07 10:43 AM
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here's some birth control, now don't have sex.

But that's not the message -- that seems very different from "If you come to us asking for birth control because you're already having sex, we'll help."


Posted by: LizardBreath | Link to this comment | 10-23-07 10:44 AM
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125 gets it exactly right.


Posted by: soup biscuit | Link to this comment | 10-23-07 10:45 AM
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Pete Stark doesn't understand the "never apologize" rule of politics either. [bangs head on desk repeatedly]

Arrrrgh! Another Democrats tearfully apologizes for saying something true. God, we're fucked.


Posted by: ogged | Link to this comment | 10-23-07 10:45 AM
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Pete Stark doesn't understand the "never apologize" rule of politics either. [bangs head on desk repeatedly]

Well you've gotta understand, the Club for Growth is sponsoring a primary challenger to the guy. Or, um, there must be some explanation.


Posted by: Cryptic Ned | Link to this comment | 10-23-07 10:45 AM
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Oh man, the student nurse at my highfalutin' Grad School U. was so goddamn mean about my refusal to go on the Pill.


Posted by: Jackmormon | Link to this comment | 10-23-07 10:48 AM
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Hey, Cynthia McKinney's out of office for 'talking crazy'. It's not like primary challengers only happen to Republicans.


Posted by: LizardBreath | Link to this comment | 10-23-07 10:48 AM
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Seriously. And:

Last week, House Speaker Nancy Pelosi, D-Calif., said Stark's remarks on Thursday were "inappropriate and distracted from the seriousness of the subject at hand."

No, in fact, focusing on his words distracts from the seriousness of the subject at hand. Stark was describing the seriousness of the subject at hand.


Posted by: neil | Link to this comment | 10-23-07 10:49 AM
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Wasn't Cynthia McKinney actually crazy though?


Posted by: ogged | Link to this comment | 10-23-07 10:49 AM
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I think I agree that LB is right that this is very context-dependant, and done correctly it could be a net plus and done incorrectly it could be a net harm. But I think that even imagining that a program like this being run by the state schools are going is going to end up being done "right" is laughable. I expect that the bad experiences women here have had trying to get their symptoms addressed, and worse, will be the norm.


Posted by: Brock Landers | Link to this comment | 10-23-07 10:51 AM
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God, we're fucked.

Are we more like the Cubs or the Phillies?


Posted by: apostropher | Link to this comment | 10-23-07 10:52 AM
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"If you come to us asking for birth control because you're already having sex, we'll help."

But that's now how it will work. The way it will work is: Every 7th and 8th grade girl who goes to see the school nurse will now be given a little chat about her birth control options. On the assumption (probably well-founded) that even those who are already sexual active would be too shy/uncomfortable to raise the topic themselves.


Posted by: Invisible Adjunct | Link to this comment | 10-23-07 10:53 AM
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Oops! I meant, But that's not how it will work.


Posted by: Invisible Adjunct | Link to this comment | 10-23-07 10:56 AM
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132: What's so crazy about her? Proposing articles of impeachment against Bush and Cheney?

133: The side-effects stuff is enough to make me think that it might be a bad idea. But if the Pill didn't have side-effects, I think doing this sort of thing sensitively enough to make it a net plus is well within the capabilities of the schools. I hate that 'of course the government is going to screw everything up' thing.


Posted by: LizardBreath | Link to this comment | 10-23-07 10:57 AM
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The way it will work is: Every 7th and 8th grade girl who goes to see the school nurse will now be given a little chat about her birth control options.

I'd doubt this -- I wouldn't support a program that did that sort of thing, but it really doesn't seem likely to me that that's what the Maine schools are doing.


Posted by: LizardBreath | Link to this comment | 10-23-07 10:59 AM
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What's so crazy about her?

I can't remember; I was asking.


Posted by: ogged | Link to this comment | 10-23-07 11:05 AM
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On the assumption (probably well-founded) that even those who are already sexual active would be too shy/uncomfortable to raise the topic themselves.

I bet this is not true of 7th-8th graders, the way it might be true of shy high school girls. I'd guess it's the more extroverted 7th-8th graders who are sexually active, and that group often just blurts crazy shit out pretty easily.


Posted by: heebie-geebie | Link to this comment | 10-23-07 11:09 AM
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Unlike successful Reps. like Pete Stark, she doesn't backtrack comically from anybody bringing up out-of-context quotations. This, and her habit of holding slightly-outside-the-mainstream views on 9/11 and Israel, make it very easy to paint her as a looney. (Punching a cop and surrounding herself with Black Panthers is just the icing on the cake.)


Posted by: neil | Link to this comment | 10-23-07 11:09 AM
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139: Here's Chris Suellentrop's answer.


Posted by: apostropher | Link to this comment | 10-23-07 11:10 AM
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Do teens flex their uterus a lot or something?

Whenever they're standing near me, yes.


Posted by: apostropher | Link to this comment | 10-23-07 11:11 AM
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The article does say that kids need their parents' permission to use the clinic.


Posted by: ogged | Link to this comment | 10-23-07 11:14 AM
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That Suellentrop article is a key example of taking her statements way, way farther than you can reasonably take them. Has McKinney actually said that "around every corner, [she] sees a secret cabal plotting her demise?" No, but she complained when the Supreme Court when they ruled that her district was illegally gerrymandered. Same thing, basically. And he takes three paragraphs to build up the innuendo around what a crazy paranoid bitch she'd have to be to say something nutty like "A complete investigation might reveal...[that] President Bush or members of his administration have personally profited from the attacks of 9-11." It's practically like calling him an Illuminati lizardoid!


Posted by: neil | Link to this comment | 10-23-07 11:16 AM
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At Cala U, the default position of the objines seems to be to throw the pill at you.

My experience on the pill has been mixed. The low-dose triphasic pill was great except for the mild-crazy making until it just inexplicably stopped working properly; the monophasic pill I tried at one point made me seriously crazy (my objine believed me and switched it immediately, but I had to figure it out on my own); and now I'm on the Nuvaring, which I suspect is the reason the big number (systolic?) on my blood pressure has gone up 30 points, but I don't have any proof and you cannot get a doctor to worry about blood pressure that is 120/60.

I've been able to track whether the pill was working for me because I didn't go on it till I was 24 or 25, so I had an idea of how my body worked.

I still think the pill should be available through the clinic, but I would like the school's policy to be to push condoms about 500 times harder than the birth control pill. Aside from the pill being a little tricksy chemically, the last thing we need to do is reinforce to teenagers that the real reason we worry about protection is pregnancy, not disease. They're 11. They count long-term relationships by celebrating six week anniversaries. They need condoms.


Posted by: Cala | Link to this comment | 10-23-07 11:16 AM
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141, 142: Yeah, none of that seems horrendously crazy to me. We talked about the cop 'punching' incident at length here, and it seemed like mostly bullshit.


Posted by: LizardBreath | Link to this comment | 10-23-07 11:18 AM
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By the way, that article is now five years old. Does anybody now think, with Rudy Giuliani cruising towards the Republican presidential nomination, that it's so outrageous to suggest that politicians may have personally benefitted from the aftermath of 9/11? I guess that six months after the day in question, it was, though.

Also infuriating: Incidents like these ground her wilder scenarios in a reality with which many of her constituents are familiar. As McKinney put it in a 1996 interview with the Progressive, "African Americans have always known that a little bit of paranoia was healthy for us." Like most conspiracy-mongers, McKinney taps that paranoia to weave facts into a web of fiction.

I'm guessing Suellentrop has never lived under Jim Crow. Or maybe he just thinks it was a wild paranoid conspiracy theory.

OK, sorry, I'll stop threadjacking.


Posted by: neil | Link to this comment | 10-23-07 11:20 AM
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To be clear, I don't think McKinney is actually crazy; those are just the standard charges thrown at her.


Posted by: apostropher | Link to this comment | 10-23-07 11:21 AM
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Yeah, I have to say that none of the McKinney stuff in that article or on wikipedia seems so crazy. Politically unwise, but not nuts. But (LB will love this) people don't generally get a reputation for being nuts without being kinda nuts, so I'm going to defer to the press corp on this one.


Posted by: ogged | Link to this comment | 10-23-07 11:23 AM
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What I'm saying. Stark shouldn't have backed down, but it's not as if there weren't real risks to him from holding his ground.


Posted by: LizardBreath | Link to this comment | 10-23-07 11:23 AM
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But (LB will love this) people don't generally get a reputation for being nuts without being kinda nuts, so I'm going to defer to the press corp on this one.

I can't really do the appropriate reaction here in a text-based medium, so just picture something with my eyes rolling hard enough to give me muscle-strain.


Posted by: LizardBreath | Link to this comment | 10-23-07 11:24 AM
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people don't generally get a reputation for being nuts without being kinda nuts

Now that's nuts. People can get the reputation other people want for them, very easily, without doing anything much.


Posted by: soup biscuit | Link to this comment | 10-23-07 11:25 AM
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111 is not entirely true- you can test for allergies without directly administering the allergen- but the analogy to birth control pills is apt because there is no such test to tell whether a certain hormone formulation will make your gazongas double.


Posted by: SP | Link to this comment | 10-23-07 11:26 AM
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What's so crazy about her? Proposing articles of impeachment against Bush and Cheney?

Short of video of her eating her own poop, what's going to be sufficient evidence? She doesn't need to be crazy, she just needs to seem crazy to a sufficient number of people without actually adding anything to the Dem coalition. Not understanding that as this point in her career is crazy.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 11:27 AM
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it's not as if there weren't real risks to him from holding his ground

Please. He has as safe a seat as exists in the US Congress. The other side routinely spouts insane shit and pays no price for it. They count on the squeamishness of our side 1) not to ever call them on it and 2) to always back down when challenged.


Posted by: apostropher | Link to this comment | 10-23-07 11:29 AM
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Well, she could have said she saw a UFO, for instance.


Posted by: neil | Link to this comment | 10-23-07 11:29 AM
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I hate that 'of course the government is going to screw everything up' thing.

It's not the government part I was stressing. Most people here are recounting experiences from (private) medical practices and clinics, which seem also to have screwed this up pretty badly in many cases. And those are professionals, dealing with more educated and assertive populations. Take patient sophistication (at least with respect to their own bodies) down a notch, kick up the paternalism levels (from the already too-high "medical practice" level to the astronomical "middle-school administration" level), and it's a recipe for very bad results.


Posted by: Brock Landers | Link to this comment | 10-23-07 11:30 AM
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The other side routinely spouts insane shit and pays no price for it.

The other side's base is crazy. Someone (Schmitt?) keeps saying that it's a mistake for Dems to think that they should play to the characteristics that are the other side's strengths. I think I agree with that.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 11:31 AM
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155: Okay, I knew Ogged was just chainyanking, but you sound serious. Let me lay this out for you as a sequence of events:

McKinney: Bush and Cheney should be impeached.

Media: Look at the crazy crazy woman.

You and your ilk: The media wouldn't be saying she was crazy if there wasn't something in it. Anyway, once people are saying she's crazy, she's a liability, there's nothing to be done but shun her.

Voters: (vote for someone else in the primary).
.
.
.
Stark: The war is Bush's adolescent fantasy.

Republicans: Make the filthy bastard apologize! He's unhinged!

Stark: Sorry.

You and your ilk: Hey, why'd he back down? Democrats have no spines.


Posted by: LizardBreath | Link to this comment | 10-23-07 11:33 AM
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159: The point, though, is who is going to extract a price? Short of being convicted of a crime, Pete Stark isn't going to lose that seat until he decides to retire. I'm not saying spout insane shit; I'm saying stop apologizing. It is completely, totally counterproductive.


Posted by: apostropher | Link to this comment | 10-23-07 11:34 AM
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Maybe it was just an emotional reaction to the whole House just having ganged up on him. I'm sure that all the Republicans made speeches to his face about what a vile traitor he is, while the Democrats made speeches to his face about how they totally disagree with that stupid, awful thing he said.

I noticed that the matter at hand right before the censure motion was a vote to approve National Bullying Prevention Awareness Week. Just sayin'.


Posted by: neil | Link to this comment | 10-23-07 11:37 AM
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160: I think in McKinney's case, you're making a bunch of assumptions, including one about precisely how wedded to the media the community that votes for her is. I think that's particularly a mistake when you're talking about a minority community that isn't wholly trusting of the media to begin with. It's not like Marion Berry never got re-elected even after the media had negative stories about him.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 11:38 AM
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163: My assumptions don't have to be right (and she lost her primary by a hair, so media presentation was probably enough to swing it), they just have to be shared by the Democrats in power. The Democrats in power believe that voters won't support them once the Republicans and the media start slinging mud. Looking at the history, that's not a crazy thing of them to believe.


Posted by: LizardBreath | Link to this comment | 10-23-07 11:41 AM
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Prescriptions should be written by health care practitioners, not school boards. Period.

The schools can and should do massive safe sex ed, distribute glo-in-the-dark condoms with emoticons, change the school mascot to "Mr. Latex-y," etc., etc., but should have absolutely no say in whether and to whom the clinics prescribe the pill or any other treatment.


Posted by: Sir Kraab | Link to this comment | 10-23-07 11:41 AM
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Pete Stark isn't going to lose that seat until he decides to retire

I assume the DNC is in full "win every seat" mode, and that they're worried about presenting a united, "non-crazy" face everywhere. As I think I've said before, I like Pelosi and Reid (particularly Pelosi) a lot, and I'm willing to cut them enormous amounts of slack prior to the '08 elections.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 11:41 AM
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165: but should have absolutely no say in whether and to whom the clinics prescribe the pill or any other treatment.

I'm not sure which side of this you're coming down on -- literally, it sounds like 'let the clinics prescribe the pill to middle schoolers', but that clashes with the rest of the comment a bit.


Posted by: LizardBreath | Link to this comment | 10-23-07 11:42 AM
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Hey administrator types, I sent 4 of you an e-mail (2 seconds ago) asking for a thread to discuss venues for the Boston World Series meetup.


Posted by: Bostoniangirl | Link to this comment | 10-23-07 11:43 AM
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A lot of people have said that this Al Gore guy is totally nuts- must be something to the rumors.


Posted by: SP | Link to this comment | 10-23-07 11:43 AM
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They wouldn't let them print it if it weren't true!


Posted by: Cala | Link to this comment | 10-23-07 11:45 AM
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164: I'm not sure I'm seeing your point. I thought that in #160, you were offering a summary of what happened and what might happen. My problem was with the former as a summary. I think she has lost twice in the primaries ('02 and '06), both times by roughly 58% to 42%.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 11:46 AM
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That screaming Dean guy too- totally unhinged.


Posted by: SP | Link to this comment | 10-23-07 11:46 AM
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the DNC is in full "win every seat" mode

What wins seats in San Francisco ≠ what wins seats in West Virginia; it's a big heterogeneous party and a big heterogeneous country. Acting like a bunch of terrified pussies who jump at their own shadows, however, loses seats everywhere.


Posted by: apostropher | Link to this comment | 10-23-07 11:47 AM
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Why is Becks more qualified to make medical decisions than doctors?


Posted by: Will | Link to this comment | 10-23-07 11:47 AM
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Acting like a bunch of terrified pussies who jump at their own shadows, however, loses seats everywhere.

Don't worry, Pete Stark will be running a commercial in which he wrestles a water buffalo.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 11:49 AM
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IIRC, this is what got McKinney in trouble. I don't find it comparable to what Stark said; the context is also quite different. Stark's apology reminds me a lot more of Durbin's.


Posted by: Katherine | Link to this comment | 10-23-07 11:51 AM
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I think she has lost twice in the primaries ('02 and '06), both times by roughly 58% to 42%.

Well, in '06, that was the runoff. She won the first round of the primaries, but not by enough to avoid a runoff. But if you think media portrayal of her as a crazy woman, and voter reaction to that portrayal, had an insignificant effect on the primary, I don't know how to convince you otherwise.


Posted by: LizardBreath | Link to this comment | 10-23-07 11:52 AM
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condoms do seem like the better route for teenagers.

Um, condoms are much less effective with typical use than the pill. And they require women to negotiate with their partners about use, which can be pretty tough, especially for girls that age. And my son is a condom baby.

I don't think the schools should be legitimizing/normalizing sexual activity for 11- to 13-year old girls. I also don't like the implicit message that birth control is the woman's (er, sorry, girl's) concern.

ARGH. Look, you may not *like* the idea that kids that age have sex but, well, they do. We can take the abstinence only route, sure, and let the girls deal with the fallout of unwanted pregnancy; or we can be, you know, *responsible adults* and realize that kids are going to be doing things we do not want them to do, and ensure that they are *safe*.

And I am sorry, but *reliable* birth control *is* the woman's concern. You have a problem with that, take it up with the pharmaceutical companies, but again, let's not put kids at risk because we don't happen to like reality.

Anyway, I'm pretty sure that even if they came up with a 100% reliable form of birth control for men, bc would still be the woman's concern because guess what? We're the ones that actually get pregnant.

Gah.


Posted by: bitchphd | Link to this comment | 10-23-07 11:54 AM
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McKinney lost the '02 primary, presumably, because it was an open primary, meaning Republicans could vote for her opponent in the primary without even having to switch parties, to punish her for speaking out against Bush. These primaries have since been declared unconstitutional.


Posted by: neil | Link to this comment | 10-23-07 11:58 AM
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I think there was also something where her father said she lost +/or was facing a primary challenge because the "Jews have bought everybody" or words to that effect.


Posted by: Katherine | Link to this comment | 10-23-07 11:58 AM
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167: Oh, sorry. I can see why what I said is confusing. What I mean is the school board was right to allow the pill at the clinics; it should have done so from the beginning, because what prescriptions/treatments are available for any condition should be left up to the clinic. (Though it's fine to decide that the clinic will handle only a certain range of conditions because of lack of expertise or resources.)

Bravo to the board for bucking politics; the last thing it should do now is offer its medical judgements.

Becks has potentially valid concerns about the effects of hormones on girls, but they're not relevant to the particular policy debate in the article.


Posted by: Sir Kraab | Link to this comment | 10-23-07 11:58 AM
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Basically, totally pwned by 174.


Posted by: Sir Kraab | Link to this comment | 10-23-07 11:58 AM
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180: According to Wikipedia, she 'fired' him from her campaign for that. (He hadn't had a formal position, so she didn't have the option of actually firing him.)


Posted by: LizardBreath | Link to this comment | 10-23-07 12:00 PM
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discussing birth control with a kid also communicates that having sex is a normal thing for them to be doing

Teaching a kid self-defense also communicates that getting beaten up is a normal thing for them to be doing.

Genius.


Posted by: Sir Kraab | Link to this comment | 10-23-07 12:03 PM
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I've never had a doctor tell me that I needed to be on the pill. At a time when I wasn't sexually active I had a doctor tell me that I should get an IUD. I'd fallen off my bike and was there because of my arm. She'd seen me when I'd asked for a psych referral and wasn't treating me at that moment, so she wanted to follow up with me to make sure I'd gone to see a doctor. It was really embarrassing, because I was in an open ward situation, and I don't even think that teh curtain had been pulled.


Posted by: Bostoniangirl | Link to this comment | 10-23-07 12:06 PM
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Okay. And on the "side effects" thing, as (I think) LB quietly said at the beginning: the side effects of the pill, people, are jack shit compared with the side effects of being pregnant. Especially if you don't want to be pregnant. Especially if you are a middle-school kid.

Moreover, there are *different kinds of pills*. I get migraines on combination pills. Fine; I take progestin-only pills. I prefer other forms of birth control, yes; but the pill is cheap and more to the point, it is *effective*. It's ridiculous to say that kids should use other forms of birth control--all of which are either more invasive or less reliable. Or that they should "learn about their bodies" first, or that they're "too shy to talk about side effects". This is being done under medical supervision (I heartily approve of the clinic's using nurse practitioners, btw), and if anything is going to teach them to pay attention to their bodies and talk about side effects, it's dealing with a concerned, knowledgeable adult--not just being left to figure shit out on their own.

I'm sorry, this is the school being completely 100% responsible. They are giving these girls the *option* of medication that they may need; they are doing it along with providing counselling and medical supervision; and they are doing it in the face of a lot of people losing their shit over them "encouraging" these girls to have sex and/or to, god forbid, reliably prevent pregnancy.

The concern about this sounds exactly like the concern over PP "encouraging" abortions and "ignoring" "post-abortion trauma" syndrome. Yes, these girls are young. Yes, in a perfect world children would not need birth control, no one would ever need an abortion, and golden ponies would fly through the air. We don't live in that world.


Posted by: bitchphd | Link to this comment | 10-23-07 12:07 PM
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No, banned.


Posted by: neil | Link to this comment | 10-23-07 12:08 PM
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B--I do think that it's important to stress to girls that they should be using condoms in addition to the Pill because of the risk of STDs.


Posted by: Bostoniangirl | Link to this comment | 10-23-07 12:14 PM
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it was very hard, as a young woman, to tell anyone in health care that I was sexually active and using condoms without them insisting on writing a scrip for the pill.

You know, AWB, I think that these clinicians were doing the right thing. Okay, you didn't want the pill; but it's more reliable than condoms, I'm sorry, and they were encouraging you to move to a more reliable form of b.c. and giving you the ability (scrip) to do so if you decided to fill it.

at that age, I remember having very little idea of what was "normal" and looking around for clues as to how to behave. If someone affiliated with the school had given me a lesson about condom use, I would have thought "holy crap, everyone else is having sex."

Right, because if adults don't talk about sex to pubescent kids, they'll never know it exists.

Ogged, come on.

The way it will work is: Every 7th and 8th grade girl who goes to see the school nurse will now be given a little chat about her birth control options. On the assumption (probably well-founded) that even those who are already sexual active would be too shy/uncomfortable to raise the topic themselves.

I fail to understand why educating girls who are hitting puberty and beginning to have sex drives about birth control is a bad thing.

Also, IME, responsible clinicians (and I think we should grant the doctors and nps in this school the benefit of the doubt), will ask about sexual activity and then say, "IF you decide to become sexually active, you should know how to prevent pregnancy and disease." Which is what *all* responsible adults should be saying to kids that age.


Posted by: bitchphd | Link to this comment | 10-23-07 12:20 PM
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It's a first, but I have to disagree with B and side with Becks on this issue. It's not that I don't want kids to have sex, or that I want them getting pregnant, or anything. Sex it up, youngins! Fine by me!

But dear lord in heaven, use a fucking condom. The Pill will not keep them from getting herpes. or HPV. or HIV. I won't even bother to list all the curable diseases it won't stop them from getting. "k" said it in well in #106--they will treat it as an alternative to condoms, not a backup. Hell, even Bitch PhD treats it as such when she says one of the benefits is that the girls won't have to talk to their boyfriends about birth control. So, great, get all the incurable diseases you want, some of them deadly, but at least you'll never have to have an uncomfortable conversation! or an abortion! (probably) (how much you wanna bet that preteens will sometimes forget to take their pill?)

I'm sorry, but as a bearer of two STDs that I can never get rid of, I just can't stomach the implication that the Pill is the cure-all for complications of sex. It's not. It only works as a contraceptive, and not all the time at that. (I personally know two Pill Babies, now teenagers.) Nothing is 100% accurate, but messing with teen hormones is a patently bad idea.


Posted by: mousey | Link to this comment | 10-23-07 12:21 PM
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188: No doubt, but I thought we were talking about birth control.


Posted by: bitchphd | Link to this comment | 10-23-07 12:25 PM
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Mousey, it isn't an either/or situation. Condoms are the best way to prevent disease. BCPs are the best way to prevent pregnancy. Way way way way more reliable than condoms.


Posted by: apostropher | Link to this comment | 10-23-07 12:26 PM
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No doubt it's hard for a thirteen-year-old to talk to her boyfriend about using a condom, and no doubt they'll screw up the condom use, but I'm not going to bet on the average 13-year-old being very good about taking the pill at exactly the same time everyday.

And again, a long-term, committed, monogamous relationship is... what, three months if they're super duper soul-mates? This is a group that should be using condoms anyway.


Posted by: Cala | Link to this comment | 10-23-07 12:32 PM
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Honestly, this conversation--between intelligent, reasonably sex-positive people--is really shocking me.

It's also, I suppose, demonstrating why our national attitudes and policies about adolescent sexuality are so royally fucked up.


Posted by: bitchphd | Link to this comment | 10-23-07 12:33 PM
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192: It shouldn't be, but I think in practice it will be. As a teenager, the worst thing that could happen would be being pregnant. No one ever thought 'oh no, the condom broke, maybe I got her... ill with syphilis!' I think the clinic should offer the pills, but I don't think we're being realistic if we think that access to the pill won't likely decrease condom use among teenagers.


Posted by: Cala | Link to this comment | 10-23-07 12:35 PM
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but I'm not going to bet on the average 13-year-old being very good about taking the pill at exactly the same time everyday.

For most formulations, she doesn't have to. The side effects are an issue, the STD thing is an issue, but on effectiveness as birth control, the Pill really does beat condoms hands down, no questions asked.


Posted by: LizardBreath | Link to this comment | 10-23-07 12:35 PM
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193: Well, for *most* types of pill, you don't actually have to take it at exactly the same time each day. Some of them you do.

And in any case, the rates of efficacy for b.c. are based on *typical* use, which includes making mistakes.


Posted by: bitchphd | Link to this comment | 10-23-07 12:35 PM
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is really shocking me

Me too. people, if B and I are standing shoulder to shoulder on something, you can rest assured it's God's own truth.

Also, I'm surprised at the apparently widely-held belief that teenagers are far less savvy than they actually are.


Posted by: apostropher | Link to this comment | 10-23-07 12:36 PM
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Honestly, this conversation--between intelligent, reasonably sex-positive people--is really shocking me.

People disagree with you. Life is filled with pain.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 12:38 PM
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I don't think we're being realistic if we think that access to the pill won't likely decrease condom use among teenagers.

Probably, given that adults are likely to be less stringent about condoms if the woman is on the pill, sure. But that's still not an argument against making the pill available (which I know you're not saying). And hopefully, if we educate kids right, the idea that they need to protect against *both* pregnancy and disease will become ingrained.


Posted by: bitchphd | Link to this comment | 10-23-07 12:39 PM
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Eleven-year-olds aren't teenagers.

196, 197: I know the stats, honest. I'm wondering what the typical use % is for younger users, given that the typical use %'s I've seen I imagine includes the typical Cala U OCD grad student who takes it on a timed schedule.


Posted by: Cala | Link to this comment | 10-23-07 12:40 PM
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People disagree with you. Life is filled with pain.

Coincidence? I don't think so.


Posted by: M/tch M/lls | Link to this comment | 10-23-07 12:40 PM
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199: I am not shocked when people disagree with me. I am shocked when people let wishful thinking override the facts on the ground.


Posted by: bitchphd | Link to this comment | 10-23-07 12:40 PM
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201: Nonetheless, kids aren't idiots, even at 11. And if they are, all the more reason to help ensure that they don't get knocked up.

I doubt that the number of OCD grad students really affects the statistics much.


Posted by: bitchphd | Link to this comment | 10-23-07 12:42 PM
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201: It's possible the age group makes a difference, but I have a hard time picturing young teens as significantly less competent with taking the Pill, but just as good at condom use. If there's a dropoff in accuracy of typical usage, which there might be, I can't see it reversing the effectiveness of the two methods. Possible, but not immediately plausible.


Posted by: LizardBreath | Link to this comment | 10-23-07 12:43 PM
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I agree with Cala in 195. It will realistically become an either/or. I think they should offer the pill, but push push push condom use. Because:

1) The male half of the species should have to at least think about birth control. It really should not be on the females to fuck up her bodily hormones at their very onset in order to accomodate every condom-averse boy or conversation-averse girl.

and 2) if birth control is the only concern, why not offer freely available Plan B? Same stuff, but they only have to use it if the condom breaks, and it makes them consider sex without condoms as something that requires a clinic visit. I like that idea a lot, because it is true on many levels.


Posted by: Wrenae | Link to this comment | 10-23-07 12:44 PM
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Maybe the only people disagreeing have moved on, but can we get comity on these points: You have to teach kids to use birth control for them to use it, but you don't have to teach them to have sex for them to do it.


Posted by: neil | Link to this comment | 10-23-07 12:45 PM
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push push push condom use

Nobody is arguing against this.


Posted by: apostropher | Link to this comment | 10-23-07 12:46 PM
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I kind of like Wrenae's 206.2. The main objections that I see are that it might take time to get an appointment (and time is of the essence, especially on the weekend) and Plan B qua Plan B is more expensive than a script for BC.


Posted by: Bostoniangirl | Link to this comment | 10-23-07 12:47 PM
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These are children that we are talking about. We know that they are totally controlled by their hormones. We should shoot them full of birth control and wrap their little bodies up in condoms.

We should be passing this stuff out in Pez dispensers. Access to these things shouldnt be an issue.

Likewise, we should be teaching them that all of their little friends are disease carrying varmits, certain to infect them and inpregnate them.


Posted by: will | Link to this comment | 10-23-07 12:47 PM
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why not offer freely available Plan B?

Because Plan B, which is a massive dose of hormones, can have side effects like vomiting. And teaching kids that reliable birth control isn't something they should use *regularly* is wrong, and a bad idea.

it makes them consider sex without condoms as something that requires a clinic visit.

So again we have the "they should be punished for having sex" thing. Do you go see a doctor every time you do something that you know is health risky? If not, what in god's name makes you think a middle school kid would?

And anyway, a condom doesn't have to actually break for you to get knocked up while using it. You can have leakage. You can have pinholes. You can have slippage. None of this, of course, is an argument against using condoms--any more than the fact that yes, people get pregnant sometimes on the pill is an argument against the pill--but it *is* an argument against teaching kids to *rely* on condoms for birth control.


Posted by: bitchphd | Link to this comment | 10-23-07 12:48 PM
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I kind of like Wrenae's 206.2. The main objections that I see are that it might take time to get an appointment (and time is of the essence, especially on the weekend) and Plan B qua Plan B is more expensive than a script for BC.

There's also a huge effectiveness difference, no?


Posted by: LizardBreath | Link to this comment | 10-23-07 12:48 PM
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Ogged, you have a very bizarre impression of how teenagers function. Maybe this is because boys don't talk about Personal Icky Emotional Relationship Stuff, but since this is about teenage girls, I'll tell you what it's like. As a teen, I knew everything about my friends' sexual progress. I knew at all times which of them had given a blowjob, which had had intercourse, which wanted to have intercourse and which were "saving it" for marriage, which had been "fingered" and whether they considered it ok or not by their own moral framework. We talked about sex constantly, and when I decided to have intercourse for the first time I had discussed it with my friends for months.

So you think girls are going to decide what's normal based on what the nurse practitioner tells them? No, they're going to decide based on what their friends are doing, what their parents say, whether they go to church and It Is Forbidden, and whether they give a damn about what Church/Priest/Rabbi says or not.


Posted by: m. leblanc | Link to this comment | 10-23-07 12:49 PM
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204: The worry is that they jettison condom protection on the grounds that they've taken the magic anti-baby pill, but that they're not taking the pill consistently enough to get the contraceptive effects (aside from taking it every day within a three hour window, if you miss one or two pills, you lose protection, and this effect is more pronounced with the lower dosages.) So you end up with a net result of less overall protection, and no disease protection at all.

This doesn't mean they shouldn't prescribe the pill, but my experience with university clinics is that this does come at the cost of educating kids about condoms. Plenty of objine visits; no one's ever mentioned condoms to me, as a back-up for birth control or for disease prevention. Because I was on the pill, you see.


Posted by: Cala | Link to this comment | 10-23-07 12:51 PM
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Didn't someone somewhere suggest that some part of a decrease in the rate of abortion was related to Norplant or one of the five month things? Tag 'em on the first day they get their periods. Make it mandatory, like vaccinations.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 12:51 PM
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There's an effectiveness difference, yes.

Sigh. Plan B, like all hormonal bcp, prevents ovulation. If you are taking *regular* hormonal bcp, you prevent ovulation all the time--yay! If you just use condoms and then go get Plan B, you are *not* preventing ovulation before insemination; you are only preventing ovulation *after* you get your hands on Plan B and take the first pill. In other words, you are gambling that you have not yet ovulated.

Plus, of course, you have to *go to a clinic* to get it (if you are under 18), or to a pharmacy that stocks it if you are over 18. Which takes time. Possibly a whole day, or if you're talking a school clinic, an entire weekend. God forbid the kids have Monday off or that they fuck over a break.

And also if you're so concerned about the hormones on regular bcp, you should know that side effects for Plan B are more common and worse.

Which again, is not a reason not to use it if you need it, god knows.


Posted by: bitchphd | Link to this comment | 10-23-07 12:53 PM
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So you end up with a net result of less overall protection

Only if they're worse at taking the pill than at using condoms. Which still seems unlikely.


Posted by: LizardBreath | Link to this comment | 10-23-07 12:55 PM
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214.1: Again, this is no more likely than kids being sloppy about condom use.

I grant you that it's a legitimate concern, but I don't understand what you're arguing against. Or for--other than yes, kids should be told that condoms are for disease prevention, which I think we all agree.

For what it's worth, *every* doctor I have ever seen has made a point of reminding me that being on hormonal birth control does not prevent disease, and I should be using condoms as well. And yes, many of those have been university clinic docs.


Posted by: bitchphd | Link to this comment | 10-23-07 12:56 PM
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Plenty of objine visits; no one's ever mentioned condoms to me, as a back-up for birth control or for disease prevention. Because I was on the pill, you see.

That's an argument for better objines, not fewer scrips for the pill. I've always gotten the "it doesn't protect against STDs" and "you and your partner have to be tested" lectures along with the pill.


Posted by: Sir Kraab | Link to this comment | 10-23-07 12:58 PM
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B & I know where all the good clinics are.


Posted by: Sir Kraab | Link to this comment | 10-23-07 12:59 PM
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Man, I must have lived in a different world. Every time I've gone in to get a scrip for the pill, there's been a Very Long Discussion about STIs, backup methods, and even a few who didn't want to prescribe it (although I made them, with my sterling argument) because I "hadn't been in a relationship long enough." Paternalistic and horrible, but nonetheless, it's not like they were forcing it on me.

I went on BCP at 17 with no prescription and no doctor visit (the country I lived in, they didn't really enforce prescription requirements). Yes, I'm more educated and self-aware, blah blah blah, but I read the package insert very carefully and was paranoidly watching for side effects. None, until I moved to the US, switched to another pill, and suddenly my tits hurt constantly. Changed after a month.

Obviously, side effects are real and happen to a lot of people, many of them in this thread. I don't think that's reason enough not to prescribe the pill, especially when it's the most effective way to prevent pregnancy and works so well for so many people.

People, have we all forgotten about the study that says teenagers are going to have sex regardless of what you teach them in school (I realize LB already mentioned this), the only difference is how safe the sex will be? Here, that means some 12-year old getting on the pill would probably be having sex anyway. Getting her on the pill if she wants it, and talking Very Very Sternly about using condoms too (and providing those!), sounds like nothing but a good policy.

Also, why do we think teens are totally stupid? I don't see why "this will not protect you from a bunch of diseases that you very well might get that could be a serious problem for you, let me explain some of them and HERE ARE CONDOMS FOR YOU USE THEM EVERY TIME" wouldn't work for a whole lot of kids?


Posted by: m. leblanc | Link to this comment | 10-23-07 1:01 PM
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As a teen, I knew everything about my friends' sexual progress.

This was emphatically not true for me.


Posted by: Jackmormon | Link to this comment | 10-23-07 1:03 PM
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219: It wasn't an argument for fewer scrips, just an argument against the idea that of course condoms will still be pushed just as hard if the girls are on the pill. In my experience, which may not be universal, once an unexpected pregnancy is off the table (or thought to be off the table), talk of condoms goes way, way down. Disease prevention and contraception haven't been very well separated in the sex ed I've had, mostly because they seem to enjoy scaring us with talk of diseases.


Posted by: Cala | Link to this comment | 10-23-07 1:04 PM
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You didn't talk about sex with your friends, though?


Posted by: m. leblanc | Link to this comment | 10-23-07 1:04 PM
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It's interesting how much of this argument seems to be based on people's own personal experiences--the pill worked for me, the pill had terrible side effects for me, I've mostly had good docs, I remember having a really shitty one, etc.

It makes me wonder what the effect of demographics are on those assembled; I assume that none of us were sexually active in middle school, that few of us have had unwanted pregnancies (though I think LB, at least, has talked about having had an abortion), that maybe half of us have had curable STDs (though there are a couple of people who I know have admited to having uncurable ones). I suspect that our assessment of the relative risks of things has a lot more to do with our own personal experiences than we would like to admit.


Posted by: bitchphd | Link to this comment | 10-23-07 1:05 PM
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Not until I was about 21. And then not in much detail.


Posted by: Jackmormon | Link to this comment | 10-23-07 1:05 PM
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Yeah. My assumption (and I'm not sure how well this is borne out by the facts) is that pregnancy is a very likely outcome of unprotected sex, while catching an STD is much less likely. This isn't a reason not to wear condoms, but it does make me think of Pill-without-condoms as, while not ideal, probably better than condoms-without-Pill, at least for someone who isn't fanatically competent with the condoms. But I'm weighting the risks based on bad things that have happened to me, and bad things that haven't, rather than looking up stats.


Posted by: LizardBreath | Link to this comment | 10-23-07 1:09 PM
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That's an argument for better objines, not fewer scrips for the pill. I've always gotten the "it doesn't protect against STDs" and "you and your partner have to be tested" lectures along with the pill.

Absolutely.

Also, some people do not remember what they do not want to hear. So when doctor says, "use condoms," some people tune it out.

The rally cry should be "A pack of condoms in every car and every house!"


Posted by: will | Link to this comment | 10-23-07 1:12 PM
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Based on my experience, I don't think we have to worry about teenagers having much sex.


Posted by: M/tch M/lls | Link to this comment | 10-23-07 1:13 PM
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I suspect that pill-without-condoms is better for people in long-term monogamous relationships than the alternative, whereas the opposite is probably true--or at least perceived to be true--for people who aren't. And I do know that generally condoms are pretty effective at preventing pregnancy. So I don't think it's *bad* to push condoms at kids, though I do think that arguing *against* the option of hormonal bc for kids is unwise.

And it's probably true that, having never had an STD in my life, I personally tend to forget the importance of condoms in these discussions. But yes, I know that they are important and that using them should be stressed; I just don't think that it therefore follows that *also* using the most reliable birth control you can (taking into account your own reactions to hormones, your personal preferences, etc.) shouldn't be.


Posted by: bitchphd | Link to this comment | 10-23-07 1:16 PM
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I assume that none of us were sexually active in middle school.

That's a pretty strong assumption, B!


Posted by: soup biscuit | Link to this comment | 10-23-07 1:17 PM
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So again we have the "they should be punished for having sex" thing.

No, that is not what I said. And it's certainly not what I feel. I am absolutely fine with 13-year-olds having sex (with other 13-year-olds, not adults/perverts, obvs). I don't want to punish them at all. I want them to reach their 18th birthday without having acquired a life-long disease. That is all. If you have sex WITHOUT A CONDOM, you are likely to be "punished" with an incurable STD which requires at least one clinic visit. Sure, it's possible to get the STD even with a condom, but much less likely. That is why I said that sex WITHOUT A CONDOM is something that should be associated with a clinic visit, however inconvenient or embarrassing that may be. Genital warts are inconvenient and embarrassing too. So is cervical cancer. It's not my fault that these are potential side-effects of sex WITHOUT A CONDOM.

I'm only using caps like that so you don't skew my remarks. Sex by itself does not merit the "punishment" of a clinic visit. Sex WITHOUT A CONDOM does. Clear? Good.


Posted by: wrenae | Link to this comment | 10-23-07 1:18 PM
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My bad experiences aside, if my daughter were sexually active in high school I'd want her try condoms AND a low dose pill.

If this is a full fledged health clinic, then I don't really see the objection. Yes, it can be done better & worse, but all medical treatment can be done badly, & sexually active people should have access to contraception, full stop. I'm more worried about sexually active h.s. kids NOT being on the pill than about encouraging sexual activity--I would tell my daughter to use the pill AND condoms in high school, frankly. The thing I worry about is if it's drive-by prescriptions from the school nurse w/o proper follow up.


Posted by: Katherine | Link to this comment | 10-23-07 1:19 PM
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231: I'm making assumptions based on perceived class and educational levels, yes. Were you having sex in middle school? Because I don't mind being wrong; I was just explaining a perception that I suspect I'm not alone in holding.


Posted by: bitchphd | Link to this comment | 10-23-07 1:19 PM
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232: Okay, I see your point; but I still think your original comment was wrong, and that arguing that we should, as a matter of policy, increase kids' chances of getting pregnant in order to teach them a lesson is fucked up.


Posted by: bitchphd | Link to this comment | 10-23-07 1:21 PM
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234: well, yes. On the other hand, I barely made it through middle school before dropping out, so I suspect it's just one of several assumptions that don't quite hold for me (which doesn't make them bad assumptions, as a whole)


Posted by: soup biscuit | Link to this comment | 10-23-07 1:21 PM
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233: Yep.


Posted by: LizardBreath | Link to this comment | 10-23-07 1:21 PM
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233 is right.


Posted by: soup biscuit | Link to this comment | 10-23-07 1:22 PM
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233 is correct, and I'd add that I'd want that if I had a kid--boy or girl--who was sexually active at *any* age.

236: I stand corrected. What, then, as the only person who's identified themselves as being in the target audience for said proposal, do you think of it? I'm inferring from your comments that you basically think it's a good idea, yes?


Posted by: bitchphd | Link to this comment | 10-23-07 1:26 PM
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I lost my virginity in middle school.

Genital warts are inconvenient and embarrassing too. So is cervical cancer. It's not my fault that these are potential side-effects of sex WITHOUT A CONDOM.

Centers for Disease Control: HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered.


Posted by: apostropher | Link to this comment | 10-23-07 1:26 PM
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it does make me think of Pill-without-condoms as, while not ideal, probably better than condoms-without-Pill

Really? To me that's so very backwards it's almost unfathomable. You'd take a 20% less chance at pregnancy (less than that if you're careful, and note that pregnancy is, um, "cureable") over NO std protection whatsoever (which may be permanent and incurable)??


Posted by: Brock Landers | Link to this comment | 10-23-07 1:29 PM
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People worry more about pregnancy than infection.


Posted by: Cala | Link to this comment | 10-23-07 1:32 PM
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A teenager I know well holds the 233 view, and wouldn't go forward a few weeks ago w/o the condom, despite the low-dose bc. Seems to have negotiated the interpersonals well enough, as they expect to get back to it.

But class and educational level contribute mightily, I'm sure.


Posted by: I don't pay | Link to this comment | 10-23-07 1:34 PM
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239: In principle think it's a good idea, with the caveats about medical practice, and the idea that it's not shopped as instead of condoms. Optimally, any school would have easy access to a full service, anonymous clinic with no fuss about it. Amongst the many things this clinic would provide is access to and councling about birth control.

That, and any moron talking about `abstinence only' programs would get thrown down the front steps in full view of the students.

Even with good intentions this way, kids come up with some really stupid stuff when left to their own devices; e.g. `Man, I need to get some bigger condoms, it broke three times' and nobody around knowing to tell this idiot that he's putting them on wrong.


Posted by: soup biscuit | Link to this comment | 10-23-07 1:35 PM
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Look, it's hard enough to get kids to use any birth control at all. Asking girls to use both the pill and a condom strikes me as overly complicating things that need to be simple.

There is no perfect solution here. But given all the plusses an minuses on all the various sides, I come down as favoring condoms over the Pill as the better birth control option for teens.

Please note the word is "better" not "best". There is no one option that's going to fit every need and every case.


Posted by: lux | Link to this comment | 10-23-07 1:36 PM
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I lost my virginity in middle school.

The question is how old you were, not the location.


Posted by: will | Link to this comment | 10-23-07 1:38 PM
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241: And you the pro-lifer. For those STD's that are curable, I'd rather be on antibiotics than have an abortion. (That was meant to be funny, rather than rude. On looking at it, I'm not sure if the tone came off right.)

But it depends on your patterns. Each partner who remains monogamous while with you is one possible exposure to STDs, but as many chances at getting pregnant as you have sex. (Of course, you can't ever know that anyone's being monogamous.) So, if your total number of partners is pretty low, and you believe that those partners also have a fairly low number of partners, the odds swing way over in terms of pregnancy being way likelier than STDs.

I still think everyone should be using condoms whenever not in a monogamous relationship, getting tested all the time, and all those good things. But pregnancy just seems to be (and I haven't looked up the numbers) a vastly likelier risk.


Posted by: LizardBreath | Link to this comment | 10-23-07 1:38 PM
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I bet sex polls high with voters

Their own sex, yes. Other people's sex, not so much.


Posted by: Hogan | Link to this comment | 10-23-07 1:39 PM
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Not quite on topic, but I am very frustrated that after 12 years of using condoms, mostly without hormonal BC involved, within a year of switching to hormonal BC only (in a long-term monogamous relationship) there was a pregnancy-causing failure. Not as a teenager, clearly, and I know it's not statistically representative. But it's very, very frustrating to be the exception like this.


Posted by: John F. Kennedy | Link to this comment | 10-23-07 1:44 PM
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247: Very old stats, and they're obviously not doing the controls we'd need here, but on a quick google:

Approximately 4 in 10 young women in the U.S. become pregnant at least once before turning 20 years old.( Facts in Brief: Teen Sex and Pregnancy, The Alan Guttmacher Institute, New York, 1996).

In the U.S., 1 in 4 sexually active teens become infected with an STD every year.2 Some common STDs are chlamydia, gonorrhea, genital warts (also known as HPV - human papillomavirus), and herpes. (Facts in Brief: Teen Sex and Pregnancy, The Alan Guttmacher Institute, New York, 1996).

Obviously STDs are lower risk than pregnancy if everyone's monogamous or nearly monogamous. Is that a realistic expectation?


Posted by: Brock Landers | Link to this comment | 10-23-07 1:44 PM
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241: I, personally, think that because for me, personally, the pill has been much more important than condoms. That's not backwards; it's how my life and sexual experience have worked out.

It doesn't follow that I'd recommend pill-without-condoms as public policy, however; after all, I've never needed an abortion, and I'm not going to say that abortion availability isn't important, either.


Posted by: bitchphd | Link to this comment | 10-23-07 1:44 PM
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248: I can report that my sex pole is very high...ladeez.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 1:44 PM
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JFK, it probably won't make you feel better if I tell you that I have a friend who got pregnant with twins while on the pill. Twice.


Posted by: bitchphd | Link to this comment | 10-23-07 1:46 PM
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I've mentioned this before. A friend of my sister tearfully asks her: how do you know if he used a condom? Her sex ed teacher needs to be thrown down the stairs.

249: Dude, and you're a male! The pill makes men pregnant!


Posted by: Cala | Link to this comment | 10-23-07 1:48 PM
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250: Note the comparison between all "young women" for pregnancy, and "sexually active teens" for STDs. That's a much bigger denominator for pregnancy, right? And some things defined as STDs are only imperfectly prevented by condoms, or aren't a terribly big deal. (That is, I don't know if I've ever been tested for HPV, offhand. I may be infected with it, which means I may have a higher risk of cervical cancer, but still not terribly high. I've never had symptoms associated with it. Is that sort of infection making it into the stats?)


Posted by: LizardBreath | Link to this comment | 10-23-07 1:48 PM
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Her ovaries were irrepressible.


Posted by: neil | Link to this comment | 10-23-07 1:49 PM
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250: Roughly a quarter of Americans only have one sex partner ever, for what that's worth (NHSLS 1992).


Posted by: Nathan Williams | Link to this comment | 10-23-07 1:49 PM
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257--
which must be exhausting for that one sex partner.


Posted by: kid bitzer | Link to this comment | 10-23-07 1:51 PM
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258: And yet he still has time to post all those God-awful links....


Posted by: Not Prince Hamlet | Link to this comment | 10-23-07 1:54 PM
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Okay, this is more recent (2005):

Since many teen girls have not had sex and therefore are not at
risk for pregnancy, a more accurate measure of teen pregnancy
rates may be the number of pregnancies among sexually active teen
girls aged 15-19. This rate has also declined (from 211.8 per 1,000
in 1995 to 197.1 per 1,000 in 1998).13

Compared to older adults, adolescents (10- to 19-year-olds) are at
higher risk for acquiring STDs for a number of reasons, including
limited access to preventive and regular health care and
physiologically increased susceptibility to infection.15
• Approximately one in four sexually active teens contracts an STD
every year.16


Posted by: Brock Landers | Link to this comment | 10-23-07 1:54 PM
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255: Yeah, there's statistics out there that say that most sexually active adults have probably got HPV even if they don't realize it.

That said, most HPV strains are, I think, fairly benign. There are only a couple/three, I think--maybe six?--that cause cancer, and a few more that cause warts. Generally, you only find out if you have HPV (of any type) if you have an abnormal pap.


Posted by: bitchphd | Link to this comment | 10-23-07 1:56 PM
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I'm with the CONDOMS CONDOMS EVERYWHERE crowd.


Posted by: Jackmormon | Link to this comment | 10-23-07 1:56 PM
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260: Nonetheless, Brock, *most* STDs are fairly easy to treat, whereas no pregnancies are.


Posted by: bitchphd | Link to this comment | 10-23-07 1:57 PM
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So, one in five sexually active girls gets pregnant, one in four sexually active kids gets an STD. My sense of the risks may have been off, but that's complicated by the individual factors I mentioned -- that is, that STD risk scales with the number of partners, while pregnancy risk scales with the number of incidents of intercourse.


Posted by: LizardBreath | Link to this comment | 10-23-07 1:58 PM
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But yeah, CONDOMS CONDOMS EVERYWHERE. I'd just like them doubled up with the Pill for anyone who can tolerate the side effects.


Posted by: LizardBreath | Link to this comment | 10-23-07 2:00 PM
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*most* STDs are fairly easy to treat, whereas no pregnancies are

Define easy. As I recall, the latter has a course of treatment that lasts less than an hour.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 2:02 PM
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Indeed. No one here is arguing *against* CONDOMS CONDOMS EVERYWHERE.


Posted by: bitchphd | Link to this comment | 10-23-07 2:02 PM
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that lasts less than an hour.

Tim? Have you ever had outpatient surgery and walked in and out in an hour? I doubt it.


Posted by: LizardBreath | Link to this comment | 10-23-07 2:04 PM
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LB, I don't think we're diagreeing about anything. I just have a hard time comprehending your judgment that teens generally would be better off with pills and no condoms than with condoms and no pills (even granting they'd best have both). Given that condoms provide pretty good protection against pregnancy, and pills provide no protection against STDs, I'm just baffled. But I think B's probably right that this just comes down to differing personal experiences.


Posted by: Brock Landers | Link to this comment | 10-23-07 2:04 PM
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`Man, I need to get some bigger condoms, it broke three times' and nobody around knowing to tell this idiot that he's putting them on wrong

But think of the psychic benefits of such a belief. Wouldn't that be worth something?


Posted by: I don't pay | Link to this comment | 10-23-07 2:05 PM
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The thing is, the Pill provides darn near perfect protection against pregnancy. (Nothing's perfect, but the Pill's pretty close.) If you're on the Pill, pregnancy isn't a worry at all, the only worry is STDs, and there are other things you can do to cut your risk in that regard.

If you're using condoms only, pregnancy is still a significant worry, and so are STDs -- condoms provide some, but imperfect, protection.

I'm not claiming that this is a mathematically proven to be preferable course of action -- I'd have to do a lot more work to rigorously defend it -- but psychologically, being able to dismiss one major worry completely feels preferable to having to worry about two issues on a lower level.


Posted by: LizardBreath | Link to this comment | 10-23-07 2:08 PM
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*most* STDs are fairly easy to treat, whereas no pregnancies are.

What? I'm pro-abortion.


Posted by: Jackmormon | Link to this comment | 10-23-07 2:09 PM
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Course of antibiotics = easier than outpatient surgery, even if you put the social/emotional issues to one side.


Posted by: LizardBreath | Link to this comment | 10-23-07 2:10 PM
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244: OTOH, I actually did need bigger condoms and spent a long time thinking that the things were that much more unpleasant, since to think anything else would just be self-flattery.


Posted by: William H. Taft | Link to this comment | 10-23-07 2:11 PM
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If you're using condoms only, pregnancy is still a significant worry

Wha? If the condom breaks, you go get Plan B. That's how it works. You go get your Plan B, the people at Planned Parenthood yell at you for not being on the Pill, and you make your decisions and keep using condoms until you're old enough and stable enough to decide that you and your partner are able to be 100% monogamous while getting regularly tested for scary things.


Posted by: Jackmormon | Link to this comment | 10-23-07 2:12 PM
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If you notice the condom breaking, rather than, say, developing a pinhole leak. I'm not trying to sound like the 'condoms suck' brigade, it's just that all the accidental pregnancy stories I know are barrier-method based, and not always with a failure that was apparent at the time.


Posted by: LizardBreath | Link to this comment | 10-23-07 2:15 PM
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272: So am I, but I'd rather take antibiotics than lie on a table with my feet in stirrups while someone vacuums out my uterine lining.

275: Right, and Plan B isn't universally available, and it's less effective than the pill.


Posted by: bitchphd | Link to this comment | 10-23-07 2:18 PM
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I was a condom baby.


Posted by: apostropher | Link to this comment | 10-23-07 2:19 PM
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Course of antibiotics = easier than outpatient surgery, even if you put the social/emotional issues to one side.

I'm not sure that's true. I (dimly) recall arguments advanced by doctors in favor of certain types surgical intervention because when it's done, it's done, with less need to rely on the patient's responsibleness, etc. That may reflect the bias of MDs. And I could be misremembering the argument. But it's not clear to me that it's wrong.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 2:19 PM
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I actually did need bigger condoms

I truly do not get this complaint (which I've heard a lot of men make). A regular condom can *fit over your head*--the material it's made of, you know, stretches. What exactly is the "bigger condoms" issue about, other than bragging rights?


Posted by: bitchphd | Link to this comment | 10-23-07 2:21 PM
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I'm not sure that's true.

Tim, am I just totally misunderstanding you? Taking a run of antibiotics is vastly less painful, traumatic, and expensive than getting a frigging abortion, for Christ's sake.


Posted by: apostropher | Link to this comment | 10-23-07 2:21 PM
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The apostropher was born holding a condom in his hand.


Posted by: neil | Link to this comment | 10-23-07 2:22 PM
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279: Have you ever had your cervix scraped, Tim? Would you rather have a colon exam than take antibiotics?


Posted by: bitchphd | Link to this comment | 10-23-07 2:22 PM
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A regular condom can *fit over your head*

Not comfortably.


Posted by: Brock Landers | Link to this comment | 10-23-07 2:22 PM
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I'd rather get an abortion than feel like I did on the pill, though, I tell you what.


Posted by: redfoxtailshrub | Link to this comment | 10-23-07 2:23 PM
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Have you ever had your cervix scraped, Tim?

Only once, but I enjoyed it.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 2:24 PM
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284: So the men who "need" bigger condoms have dicks the size of their heads?


Posted by: bitchphd | Link to this comment | 10-23-07 2:24 PM
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(This is part of why it's good for me to be reminded that many women have a much easier time with it, by the way.)


Posted by: redfoxtailshrub | Link to this comment | 10-23-07 2:24 PM
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286: Well then fine. You have my blessing to forego the pill and have as many abortions as your little heart desires.


Posted by: bitchphd | Link to this comment | 10-23-07 2:25 PM
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Since the argument has reached a point of comparing inconvenience and discomfort, how worried should we be about resistant strains of the STIs now controlled by antibiotics?

I've seen an ad campaign that seems to suggest it is a factor.


Posted by: I don't pay | Link to this comment | 10-23-07 2:25 PM
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I've always been curious about what pregnancy is like for women who can't tolerate the side effects of the pill.


Posted by: bitchphd | Link to this comment | 10-23-07 2:26 PM
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B, LB, this might be a (slightly) different-generation thing. I grew up convinced that if I had sex without a condom I was immediately going to get AIDS and die. Bacterial STIs, by comparison, sounded funny. (That was before I developed my deep phobia about antibacteria-resistent syphillis, obviously.) I always knew thta if I got pregnant when I didn't want to be pregnant, I would have an abortion.

This was back when I was waiting for marriage, mind you. Now I am going to go look for barbequed something.


Posted by: Jackmormon | Link to this comment | 10-23-07 2:26 PM
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Tim, am I just totally misunderstanding you? Taking a run of antibiotics is vastly less painful, traumatic, and expensive than getting a frigging abortion, for Christ's sake.

I'm not saying that it's not any of the above, but my understanding is that (a) abortion treats pregnancy in a manner that is a dead certain cure, and (b) treatment of STDs by antibiotics and the like is not quite as certain for reasons relating to patient failure, etc.


Posted by: SomeCallMeTim | Link to this comment | 10-23-07 2:26 PM
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the material it's made of, you know, stretches

Yeah, but it squeezes down on whatever it's stretched over, which is not necessarily pleasant.


Posted by: Matt F | Link to this comment | 10-23-07 2:27 PM
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Seriously, were I to need an abortion, I would have to schedule one at a busy, busy clinic (and this in a liberal city), find someone to go with me (who would then have to get time off work), go to the stupid clinic and wend my way past all the creepy pro-lifers, wait in the waiting room for a gazillion hours, and have a procedure which, for two of my friends, hurt like a motherfucker.

Pass the antibiotics, please.

Even if the procedure is short, the run-up is long.


Posted by: Frowner | Link to this comment | 10-23-07 2:27 PM
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290: I'm sure it's a big deal and yes, everyone should use condoms.


Posted by: bitchphd | Link to this comment | 10-23-07 2:27 PM
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B, LB, this might be a (slightly) different-generation thing.

Ouch. JM just called you old.


Posted by: will | Link to this comment | 10-23-07 2:28 PM
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The bigger condom thing is legit, and not just for dudes with 14" cocks. Especially since penises are wider at the base, the regular ones will stay on and *work* sure, but a bigger one will stay all the way down comfortably , instead of rolling up and making you feel like "ahh! This thing is going to pop off!"

So, yeah, a condom can fit over your head. But if it's too small, it will roll up a little and feel tight.

I say all this not having a dick.


Posted by: m. leblanc | Link to this comment | 10-23-07 2:29 PM
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The issue is not just the ability to put it on the presidential willy, but how much pressure it applies. If it's too tight it cuts off circulation to the cockhead, which has the opposite effect of wearing a cockring.

Also, most of the sensation men get while, er, using a condom comes from their friction against the condom; if it's too tight, less friction, less sensation. Pleasure Plus, which isn't marketed as 'XL', has a flared tip which produces the same effect.


Posted by: William H. Taft | Link to this comment | 10-23-07 2:29 PM
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292: It probably is; AIDS hit the consciousness while I was in high school, and while god knows I don't want it, I have always known I don't want to deal with an unwanted pregnancy.

I do seriously think that the "oh well, have an abortion" thing is pretty flip, though. I mean, sure, I've never had one, but it doesn't take a lot of imagination to realize that it would probably really fucking suck.


Posted by: bitchphd | Link to this comment | 10-23-07 2:30 PM
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Besides the actual abortion procedure, it turns out that: (a) if you discover you're pregnant before about 8 weeks, you get to have some nerve-wracking waiting until then, as at least some abortion providers don't want to operate too early and risk *missing*, and (b) you may bleed for a month afterward. It isn't just visit, whirr, done.

(Maybe this is all well-known? It wasn't to me, but I'm male, even if I consider myself pretty well educated on sexual health issues)


Posted by: John F. Kennedy | Link to this comment | 10-23-07 2:30 PM
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289: Woo! Blessings for meeee! Of course, I am lucky enough that condoms have served me fine so far, and at this point I would have a baby, instead. But, as you say...

291: Yeah, there's an unpleasant thought. I'll be sure to let you know if and when I find out.


Posted by: redfoxtailshrub | Link to this comment | 10-23-07 2:30 PM
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298 makes sense. But as a non-cock owner, I have to admit, I want that thing to fit *tight*, dammit. I don't want to even think about the possibility of leakage.


Posted by: bitchphd | Link to this comment | 10-23-07 2:32 PM
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Becks point that the pill often has severe side effects that are difficult to disentangle from teenage emotional upset, is being ignored.


Posted by: ogged | Link to this comment | 10-23-07 2:34 PM
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Surely it's more likely to break if it's under tension even before friction comes into play.


Posted by: neil | Link to this comment | 10-23-07 2:35 PM
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302.1: Oh, I was only being an ass to Tim, who I think deserved it. I figure you've got a little more realistic idea of what an abortion might be like, probably, what with the whole pap smear, menstrual cramps, kind of thing.

302.2: Please do, because I really do wonder about this. For me, the pill's no big deal, but pregnancy, bah.

Of course part of that is probably psychological; I freely admit that my fear of pregnancy is so ingrained that I've never actually "tried" to get pregnant--the closest I can get is no longer trying not to (and with PK, we were still using condoms because I wasn't *sure* I was okay with the idea of pregnancy--the best I could do was knowing that I was okay with the idea of it happening by accident).


Posted by: bitchphd | Link to this comment | 10-23-07 2:36 PM
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304: I don't think it's being ignored so much as put aside, on the grounds that the side effects of pregnancy, y'see, are so much worse.


Posted by: bitchphd | Link to this comment | 10-23-07 2:36 PM
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305: If it's not under tension, it's not going to stay on, right?


Posted by: bitchphd | Link to this comment | 10-23-07 2:37 PM
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The (tighter) ring at the base keeps it on, not its deathgrip on the entire surface of the penis.


Posted by: neil | Link to this comment | 10-23-07 2:38 PM
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Thesis: Condoms suck.


Posted by: Cala | Link to this comment | 10-23-07 2:40 PM
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on the grounds that the side effects of pregnancy, y'see, are so much worse.

Debaters' crap. You use a condom, the chances of pregnancy are low. If there's a problem with the condom, you use Plan B, which sucks for a day or two, but beats the hell out of feeling suicidal for months or years. If Plan B doesn't work, you get an abortion, which also sucks, but is the third line of defense and an unlikely outcome.


Posted by: ogged | Link to this comment | 10-23-07 2:40 PM
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301: JFK, why didn't you go with RU-486? I guess it's properly called Mifepristone.


Posted by: Bostoniangirl | Link to this comment | 10-23-07 2:42 PM
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Maybe it would be good if teenage girls, and maybe even boys, all had access to quality medical care from providers who aren't sexist pricks. Utopian, I know, but still seems like it would be a cool thing.


Posted by: Not Prince Hamlet | Link to this comment | 10-23-07 2:45 PM
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274: This doesn't make them break though, just makes them less- or uncomfortable.


Posted by: soup biscuit | Link to this comment | 10-23-07 2:47 PM
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Thesis: Condoms suck

They gave me a feeling of protection, responsibility and control. I never had any rips, and have no idea about pinholes, etc.


Posted by: I don't pay | Link to this comment | 10-23-07 2:48 PM
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313: back here in the real world, we have schools pushing abstinence vows.


Posted by: soup biscuit | Link to this comment | 10-23-07 2:49 PM
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316: Yeah, every good Utopian idea tends to founder on the shoals of People Suck.


Posted by: Not Prince Hamlet | Link to this comment | 10-23-07 2:50 PM
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311: The point is that most women do *not* have major side effects to birth control pills; therefore letting your concern about the few that do lead you to an argument that bcp shouldn't be available to girls who need them is wrong.

And again: Plan B is not universally available, and it's damn hard to get for the group of people we're talking about, which is 11-13 year old girls. Not to *mention* how fucking hard it would be for them to get an abortion.

You wanna dismiss this as debater's crap? Come the fuck on.


Posted by: bitchphd | Link to this comment | 10-23-07 2:51 PM
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Thesis: Condoms suck.

This rather undermines the CONDOMS CONDOMS EVERYWHERE message, no? (And yes, I agree that condoms suck.)


Posted by: bitchphd | Link to this comment | 10-23-07 2:52 PM
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I'm not entirely sure. I think the waiting time and certainty of the surgical procedure was considered preferable to the scenario where RU-486 was taken but didn't quite work? Sometimes a surgical followup is needed, I think. There was probably also a bias towards letting medical professionals handle everything in a clinic setting.

This is second- or third-hand; my partner discussed this in detail with her doctor and I was just told about the conversation later. Since it was a pretty difficult time, the last thing I wanted to be doing was bringing up all of these things again - the line between trying to understand in detail, and sounding like I was second-guessing her, would be hard to maintain.


Posted by: John F. Kennedy | Link to this comment | 10-23-07 2:52 PM
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319: how about: CONDOMS CONDOMS EVERYWHERE --- BECAUSE THEY SUCK SO MUCH LESS THAN MANY ALTERNATIVES?

kinda loses something, doesn't it.


Posted by: soup biscuit | Link to this comment | 10-23-07 2:55 PM
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321: It does, but come to think of it otoh it might get big points and be more effective because it has that ring of truth to it....


Posted by: bitchphd | Link to this comment | 10-23-07 2:57 PM
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The point is that most women do *not* have major side effects to birth control pills; therefore letting your concern about the few that do lead you to an argument that bcp shouldn't be available to girls who need them is wrong.

What is "most?" If, say, 10% of the kids were having side effects, I'd say that's way too high. Especially considering there's another option that doesn't have side effects.

And again: Plan B is not universally available, and it's damn hard to get for the group of people we're talking about, which is 11-13 year old girls. Not to *mention* how fucking hard it would be for them to get an abortion.

We're not debating generalities, but whether this school should offer birth control pills. Presumably this school could instead offer condoms and Plan B.


Posted by: ogged | Link to this comment | 10-23-07 2:57 PM
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Guess I don't think they do suck very much.


Posted by: I don't pay | Link to this comment | 10-23-07 2:58 PM
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The point is that most women do *not* have major side effects to birth control pills

I do wonder what the actual proportions are, whether they are better or worse depending on how old you are when you take the pills, and how the rate of significant side effects compares to the in-practice failure rate of pills vs. condoms for this demographic. I think it's mean to curtail the birth control options you make available to anyone, but I also have a lot of sympathy for the idea that prescribing the pill for people in early adolescence is a tricky proposition.


Posted by: redfoxtailshrub | Link to this comment | 10-23-07 2:58 PM
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Condoms really are not that bad as a barrier method. My wife and I have used them for years, because BCP's made her libido tank.

Granted, part of why I don't find them unpleasant is because we are using Naturalamb, which are not guaranteed against STD's. But: we have had no pregnancy problems, after hundreds of times. Latex will only be more effective against pregnancy.

I know reported rates for pregnancy as a result of failure are higher with condoms than with BCPs. But I suspect that's a lot of operator error, or just outright lies.

My point is just: condoms do not suck. Maybe cheap ones do. But decent ones are reliable, comfortable, and a good means of avoiding hormonal problems.


Posted by: james buchanan | Link to this comment | 10-23-07 2:59 PM
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I've always been curious about what pregnancy is like for women who can't tolerate the side effects of the pill.

I don't understand this question. Why would it be different?

304: I still think it's a valid point. And I absolutely think that because of the "personal experiences" that B mentions in 225.


Posted by: Blume | Link to this comment | 10-23-07 3:01 PM
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Yes, the school should offer birth control pills. BCP are the most reliable birth control method out there. They are the cheapest method that *girls control themselves*, which is important.

I already talked about why the "condoms and Plan B" alternative is crap upthread. Honestly, proposing Plan B--which is called plan "b" for a reason--as an alternative to regular bcp is simply irresponsible. Proposing condoms *with foam or another spermicide* is responsible only as an alternative to bcp *for girls or women who cannot or will not take bcp* (b/c of side effects, lifestyle issues, whatever), because condoms and Plan B--alone or in combination--are less reliable than bcp and are less within the control of the actual girl who's risking pregnancy.

(Which doesn't even get at the side effect issues with Plan B, or the problem that a lot of people think Plan B is an abortificiant.)


Posted by: bitchphd | Link to this comment | 10-23-07 3:02 PM
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327--
because pregnancy itself induces massive hormone swings.


Posted by: kid bitzer | Link to this comment | 10-23-07 3:02 PM
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oral with a condom/dam: sucks.


Posted by: soup biscuit | Link to this comment | 10-23-07 3:03 PM
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reported rates for pregnancy as a result of failure are higher with condoms than with BCPs. But I suspect that's a lot of operator error, or just outright lies.

ARGH.


Posted by: bitchphd | Link to this comment | 10-23-07 3:04 PM
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330--
oh sure, but oral sex in general sucks, don't you think?
except when it licks, nibbles, kisses, and so on.


Posted by: kid bitzer | Link to this comment | 10-23-07 3:04 PM
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Presumably this school could instead offer condoms and Plan B.

Plan B only works within 72 hours. Condom failure is not always apparent, and pregnancy takes longer than 72 hours to register.


Posted by: apostropher | Link to this comment | 10-23-07 3:04 PM
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...except when it licks, nibbles, kisses, and so on

in theory, sure, but if you're using a barrier, who can tell?


Posted by: soup biscuit | Link to this comment | 10-23-07 3:05 PM
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how worried should we be about resistant strains of the STIs now controlled by antibiotics?

Somewhat OT, but I think we should all be much more seriously concerned about antibiotic-resistant infections.

I know someone who had some sort of skin cancer, and after the dermatologist had removed whatever it was, she got a bad infection.

She's been in the hospital twice for a few days, since she's had this infection. The surgeon has had to reopen the site a couple of times, and for a while, she had some sort of wound-irrigating device. She had to use every antibiotic out there. As a last resort she had to go on Linezolid, an antibiotic which has the side effect of inhibiting monoamine oxidase. There are MAOIs which are used as antidepressants, but they can't be combined with other psychotropic medications, red wine or aged cheeses, because the risk of serotonin syndrome is too high.

It stays in your system for a while. Without her concerta and other psych meds this woman is goign out of her mind. Antibiotics aren't always fun.

Thesis: All medical treatments can be painful and have side effects.


Posted by: Bostoniangirl | Link to this comment | 10-23-07 3:05 PM
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which is called plan "b" for a reason

Condoms are Plan A. And what is this stuff about what the girl controls? She controls whether the dick that goes in her has a condom on it or not.


Posted by: ogged | Link to this comment | 10-23-07 3:05 PM
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And what B said earlier about being shocked by the attitudes in this thread? It's only getting worse, you Puritans.


Posted by: apostropher | Link to this comment | 10-23-07 3:06 PM
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because pregnancy itself induces massive hormone swings

I get that. Would being susceptible to side effects of the pill necessarily make you more susceptible to the worse effects of pregnancy, though? The pill side effects seem so random, in my case even varying wildly among different generics of the same name-brand pill.


Posted by: Blume | Link to this comment | 10-23-07 3:07 PM
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Plan B only works within 72 hours. Condom failure is not always apparent, and pregnancy takes longer than 72 hours to register.

What percentage of cases are we talking about now? Versus what percentage of girls having side effects from the pill? Anyway, foxytail gets it right in 325.


Posted by: ogged | Link to this comment | 10-23-07 3:07 PM
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336: Condoms are less reliable than BCP. Promoting them as Plan A over bcp *for purposes of birth control* is irresponsible.

She controls whether the dick that goes in her has a condom on it or not.

Riiiiiiight.


Posted by: bitchphd | Link to this comment | 10-23-07 3:08 PM
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328: deserves reiteration: by all means encourage condoms for STI reasons, but ferchristsake make it clear to young girls that if they are going to have sex they can and should take control of birth control options. Also teach them to insist on condoms, sure, but discouraging BCP on speculation seems crazy to me.


Posted by: soup biscuit | Link to this comment | 10-23-07 3:08 PM
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318: I think part of the argument here has been that it's not a statistically small percentage of women that have had trouble on the pill, but a significant minority of women, and that in many of those cases, the fact that the pill was the problem was something that a) was hard to convince the doctor and b) hard to self-diagnose if the woman didn't already have a good idea of what her baselines are.

I don't think that these problems are significant enough to ban the pill at the clinics, but if the program is to succeed, they need to ensure that the nurses fall on the very aggressive monitoring side of the spectrum rather than 'prescribe it to anyone who could be pregnant ever' spectrum. Because nothing will shut this program down faster than someone's little darling attempting suicide because she just felt so sad after starting on the pill.

319: Only if we put it on the school pamphlets.


Posted by: Cala | Link to this comment | 10-23-07 3:09 PM
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She controls whether the dick that goes in her has a condom on it or not.

ah, the naivety of youth ogged.


Posted by: soup biscuit | Link to this comment | 10-23-07 3:09 PM
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It's only getting worse, you Puritans.

What does this have to do with Puritanism? (Some of the stuff upthread, yes, unapologetically guilty.) We're just talking about balancing the risk of side-effects and the risk of pregnancy and the risk of disease. These are empirical questions, there's little data on how kids react to the pill, so people are extrapolating from personal experience, which is fine.


Posted by: ogged | Link to this comment | 10-23-07 3:10 PM
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336: Condoms are less reliable than BCP. Promoting them as Plan A over bcp *for purposes of birth control* is irresponsible.

Only if you bracket considerations like the one Becks has brought up about rather severe side effects.

Riiiiiiight

Good one.


Posted by: ogged | Link to this comment | 10-23-07 3:11 PM
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It's only getting worse, you Puritans

We do come from the right part of the continent for it. And we hew our own wood and carry our own water.

It seems for the non-serum STIs, Syphillis, Gonnorhea, possibly Herpes, condoms are the best available protection.


Posted by: I don't pay | Link to this comment | 10-23-07 3:12 PM
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Here's a thought, then, Ogged: how about if, before you argue against the *most effective non-permanent method of birth control out there*, we say that the burden is on you (hypothetical you) to go out and find out what the rates of side effects are, what they are for young women, and what the statistics are on Plan B failure.

What percentage of cases are we talking about now? Versus what percentage of girls having side effects from the pill?

Let's say its 1% vs 10%. 1% of girls on the condoms + Plan B plan get pregnant and have to deal with somehow procuring an abortion at the age of twelve. Whereas 10% of girls on bcp have side effects like weight gain, bigger boobs, larger mood swings. Let's say that a full 2% of those girls have really *bad* side effects--a large amount of weight gain, depression, headaches.

Even so. Pregnancy is worse.


Posted by: bitchphd | Link to this comment | 10-23-07 3:12 PM
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Having not read this thread since comment 100, and now reappeared, I am completely bewildered by the apparent shift from a consensus that BCP frequently causes severe and disturbing side effects even in adults and more so in teens, to a consensus that the side effects are hardly worth thinking about.


Posted by: Cryptic Ned | Link to this comment | 10-23-07 3:12 PM
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348--
not that mysterious, ned.
it's just a mood swing. we're all on the pill.


Posted by: kid bitzer | Link to this comment | 10-23-07 3:15 PM
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I need to leave this thread. We're talking about objecting to a policy based on actual existing evidence because of random speculation and concern-trolling about the poor girls who might have side effects, and I'm really going to lose my temper if I keep this discussion up.


Posted by: bitchphd | Link to this comment | 10-23-07 3:16 PM
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concern-trolling about the poor girls who might have side effects

Some of us believe in parenting, B.


Posted by: ogged | Link to this comment | 10-23-07 3:17 PM
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See, that's just it: "it's just a mood swing." Oh, you've just got bigger boobs. (That's a good thing, right? Wink wink.) Weird bodily changes you don't even realize are due to the pill? No big deal, at least you're not pregnant!


Posted by: Blume | Link to this comment | 10-23-07 3:18 PM
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Right on, B.


Posted by: Sir Kraab | Link to this comment | 10-23-07 3:19 PM
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B, your 'random speculation' is my 'really distressing thing I've personally experienced that I feel like no one is taking into account'.


Posted by: Blume | Link to this comment | 10-23-07 3:19 PM
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351: Fuck you.
352: No, I am not saying "no big deal." I am saying "less of a big deal than getting knocked up in middle school." And I'm talking about the most *common* side effects; yes, very bad side effects exist, and yes that should be taken seriously. But they're less common than getting pregnant without using birth control. Which should also be taken seriously.


Posted by: bitchphd | Link to this comment | 10-23-07 3:19 PM
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ogged, you're trying to parent other people's kids, not to mention their doctors.


Posted by: Sir Kraab | Link to this comment | 10-23-07 3:20 PM
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352--
"Oh, you've just got bigger boobs."

and oddly enough, it's all happened since about comment 100.


Posted by: kid bitzer | Link to this comment | 10-23-07 3:20 PM
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Hey, while we're offering up stupid anecdotes: I mentioned that my monophasic pill experience led to mood swings, but it was really far weirder than that. I could have dealt with crying jags.

You know that little internal monologue everyone has, like the cop in Anansi Boys thinking 'evil doers beware! evil doers everywhere!' or the self-motivational things people are told to say to themselves? When I switched pills, I felt a little blue, and shrugged it off as just a transition effect. And then that little monologue started interrupting my thoughts with nasty endings. Like "I'll just wrap these Christmas presents and take my father's gun and blow my head off" or "I am going to school and would it be quick to step in front of the bus?" "I have a headache and take the whole bottle of aspirin."

I wasn't depressed, but part of my brain decided to develop suicidal ideation on its own. Sort of amusing in retrospect, but terrifying at the time. I called my objine and she pulled the scrip immediately. Part of my worry (though, again, not enough to pull the pill from the school clinic) is that had my nurse practitioner not been on the ball, or I had been too young to know what was normal for me or too shy to make a fuss... then what?

This ain't no slightly larger boobs, is what I'm saying. The clinic better be on the ball.


Posted by: Cala | Link to this comment | 10-23-07 3:21 PM
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247

"... Each partner who remains monogamous while with you is one possible exposure to STDs, but as many chances at getting pregnant as you have sex. ..."

This assumes if your partner has a STD you are certain to get it the first time you have sex which is just wrong.


Posted by: James B. Shearer | Link to this comment | 10-23-07 3:22 PM
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ogged, you're trying to parent other people's kids, not to mention their doctors.

We're having a debate about public policy, which involves considerations that effect other people, and there also seems to be plenty of anecdotal evidence just in this thread that doctors are often not responsible prescribers/monitors of the pill.


Posted by: ogged | Link to this comment | 10-23-07 3:22 PM
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less of a big deal than getting knocked up in middle school

I'll agree with you there. But it's not an either/or.


Posted by: Blume | Link to this comment | 10-23-07 3:23 PM
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Blume, you're making the argument for better doctors, not for letting school boards or Becks or ogged decide whether the pill is a good prescription for any individual girl or woman.

Which is B's (and apo's and my and . . .) point.


Posted by: Sir Kraab | Link to this comment | 10-23-07 3:24 PM
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There's no way most of the drugs that came on the market decades ago would ever make it through FDA approval today. Stories like 358 would set up protest groups, hearings, black box warnings...


Posted by: SP | Link to this comment | 10-23-07 3:25 PM
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Couple of things

This program is not widespread but is only happening at the most urban of middle schools in the entire state, King Middle School. King is a pretty small place (comparatively speaking) - 450-500 students but is actually pretty diverse as the Portland area has a sizable immigrant population (primarily Somali Bantu). The health center is not run by the Middle School, but rather by the Portland Department of Health and requires a parents permission to be seen. And if the school board acts parents will be able to opt their kids out of sexual health counseling (something even more dangerous).

The health center treats primarily the lower-income immigrant populations that attend King and for various cultural reasons it makes it very difficult for many of these adolescents to discuss sexual health issues with their parents or to seek services. According to the 2006 statistics only 5 students of the hundreds treated were counseled about sexual health issues, although school officials implemented this program as the rate of pregnancy increased.

Often with public health and especially sexual health issues in America we get caught up in the moral/social wars between ideologies and lose sight of the public benefits of responsible medicine. I think a lot of posters brought up important points and I think that Becks original post was well informed - I've dated girls on and off the pill and it can really effect them if they don't know their bodies well.

But. . . Portland's program is aimed at a population that would otherwise not seek or afford this type of care and it is done in the only setting (as many commenters posted on) where these students can receive social services. I would expect that its done responsibly and serves a public need - which is way this is important - even if we don't all agree with it.


Posted by: mainer | Link to this comment | 10-23-07 3:26 PM
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354: The random speculation is the argument that such side effects--which are AWFUL AND WOMEN WHO HAVE THEM SHOULD NOT TAKE THE PILL--are so common and of such overriding concern that we shouldn't provide the pill to sexually active girls.

Because, seriously: we give it to women, right? Why argue against giving it to girls, given that we don't have evidence that these effects are any stronger or more common in younger women, except out of condescension? Yes, bad side effects are a big deal and *any* woman who's prescribed bcp should be warned about them. But they are *very uncommon*, and the question is not "should we take them into account" but "should we be so concerned about them that we withhold effective birth control from some people."

Also I am sorry I said "fuck you" to Ogged, but some of us actually take this whole birth control/women's health/avoiding unwanted pregnancy thing pretty seriously, and it's damn irritating to have that blown off as "debate tricks" or with haha funny jokes about who really cares about the kids here.


Posted by: bitchphd | Link to this comment | 10-23-07 3:27 PM
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a. There is plenty of anecdotal evidence to back up alien abduction.

b. I don't see what in that comment has anything to do with parenting.


Posted by: Sir Kraab | Link to this comment | 10-23-07 3:27 PM
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My snide comment to ogged re: anecdotal evidence isn't to diminsh Cala's, Blume's, AWB's, and others' experiences. They're awful. But they have to be considered in light of all the evidence available.


Posted by: Sir Kraab | Link to this comment | 10-23-07 3:29 PM
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B, if you can't see the trollishness of 365, I can't help you.


Posted by: ogged | Link to this comment | 10-23-07 3:29 PM
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Okay, Sir Krabb and Mainer have taken the ball and they're a lot calmer than I am, so now I really will go do something else. Thank god.


Posted by: bitchphd | Link to this comment | 10-23-07 3:29 PM
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368: Thanks, I don't want your help. Can you see the trollishness of some of your comments upthread, or is it just me with my total lack of concern for children and unplanned pregnancy that's crossed the line here?


Posted by: bitchphd | Link to this comment | 10-23-07 3:32 PM
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And, I should point out.. other side effects I've had, on other pills? Pretty close to zilch. Maybe slightly bigger boobs. I have no idea why that one hit me with the crazy bat, but it did.

I think the pill should be available to younger women that need it. But I think if the clinic is smart (and I don't know the district's input on this), it will require follow-up visits for the younger clients. Because not only are we uncertain of the effects of the pill on the 11-14 year old set, they are very likely not telling their parents if they're at the school clinic. And while it's good the clinic is there for them, it also means that their parents aren't going to be noticing the mood swing, or if they are, they won't be attributing it to the pill.


Posted by: Cala | Link to this comment | 10-23-07 3:32 PM
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368 is the epitome of a trolling accusation so false as to be itself trolling.


Posted by: Sir Kraab | Link to this comment | 10-23-07 3:32 PM
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114

"Teaching a kid self-defense also communicates that getting beaten up is a normal thing for them to be doing."

Teaching a kid how to fight communicates that fighting is a normal part of life.


Posted by: James B. Shearer | Link to this comment | 10-23-07 3:33 PM
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83

"... I bet sex polls high with voters."

Sex for 11-13 year old girls? I doubt it.


Posted by: James B. Shearer | Link to this comment | 10-23-07 3:35 PM
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Right. And women's self-defense training teaches them that rape is a normal part of life.


Posted by: Sir Kraab | Link to this comment | 10-23-07 3:35 PM
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Cala's point in 371 is what I find so crazy scary random-- that it seems so random what reaction any one individual might have to any certain one. With antidepressants it seems that there is a much wider consciousness that you might have to try several different ones to get the right fit, but BCPs, not so much.


Posted by: Blume | Link to this comment | 10-23-07 3:36 PM
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Ack, posted too soon... to follow up on 371... my objine is awesome, in that as soon as I noticed a problem, she switched over my scrip, had the pharmacy fill it, and told me not to worry. But she didn't find out the crazy-making properties in the course of a follow-up visit. Not a problem if your patient is an adult. Perhaps a problem if your patient is eleven or twelve.


Posted by: Cala | Link to this comment | 10-23-07 3:36 PM
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To pick up a completely irrelevant thread of the conversation, I'm an anecdotal sorta-counterexample to the proposition that pregnancy would be worse for women sensitive to the pill. I've never had any side effects from the pill, and I've been on at least two, maybe three formulations. (Not deliberate switching -- changed providers, and the new provider preferred another alternative.) But pregnancy gives me wild mood swings.

And on JM's generational point, I'm in her generation from that point of view -- AIDS was fully present in the public consciousness a couple of years before I ever thought of having sex.


Posted by: LizardBreath | Link to this comment | 10-23-07 3:36 PM
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I'm pleased by Mainer's news that it's run by the Public Health Department, although at the school, and hope that continues.

To something else he says, I'm guessing, though, that the side effects can take even those who know their bodies well unawares.


Posted by: I don't pay | Link to this comment | 10-23-07 3:37 PM
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I think that some of the later half posters (past 100) or so lost the point that the school is simply trying to prevent teen pregnancy and provide services that are probably VERY unavailable in the Portland area. It's being done with the best intentions for general public health.

The arguments pro/con the pill and the arguments pro/con the pill versus other options is ignorant (partially) or the larger problem facing this school and their proposed solution. Mainers are intelligent people - generally progressive but also independent and conservative.

They're not trying to make a statement here - but instead trying to serve their kids and neighbors - keep that in mind as you viciously argue meta - arguments about what is one of more socially dividing issues of our times.


Posted by: mainer | Link to this comment | 10-23-07 3:38 PM
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The thing about the side effects is that anecdotally from this thread, they're common and severe enough that the way BCPs get prescribed for adult women is pretty much malpractice. If statistics bear out the anecdotal evidence, I'd totally buy that the standard of care for BCP prescriptions needs to be revamped generally, but I'm not clear, if that's not going to happen, why this is an argument against prescribing them to young girls specifically.


Posted by: LizardBreath | Link to this comment | 10-23-07 3:40 PM
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Mainer, I don't think anyone has been doubting their intentions.


Posted by: Cala | Link to this comment | 10-23-07 3:40 PM
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Some people argue against giving drus like Prozac to kids because they have never been tested for safety or effectiveness on children. Any similar concerns for BCP?


Posted by: James B. Shearer | Link to this comment | 10-23-07 3:41 PM
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Just for you, Kraab, just this once:

Why argue against giving it to girls...except out of condescension?

In the post, Becks said,
before you take any medicine that screws with your body chemistry like that, you need to have a firm understanding of where your "baseline" is so you can evaluate the side effects

You might disagree with that, but it's not just condescension. I call B's move "trolling" because it recasts a good faith argument as a character flaw.

"should we be so concerned about them that we withhold effective birth control from some people."

No one has advocated withholding effective birth control; only whether we're better off advocating a different method of birth control that is less effective, but has fewer side effects and also offers greater protection against disease. Again, B is trolling in that "withhold effective birth control" casts condom advocates as Puritan ogres.

some of us actually take this whole birth control/women's health/avoiding unwanted pregnancy thing pretty seriously

The implication, again, is that those who disagree with B don't take the problem seriously. In the specific instance, I dismissed B's facile remark about the side effects of pregnancy because the implication of her argument was that our choice is between the pill and nothing, which is false.

And now I'll bow out to enjoy some of the other fine threads this blog has to offer.


Posted by: ogged | Link to this comment | 10-23-07 3:42 PM
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384: You know, Ogged, 'hostile' isn't 'trolling', and making an accusation of the latter when you mean the former is unpleasant. If you don't think B's comments were insincerely made purely to elicit a reaction, you don't think she was trolling.


Posted by: LizardBreath | Link to this comment | 10-23-07 3:45 PM
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381: Though I think there's a good argument for requiring follow-up visits or at least phone consults for women and the bcp, the big difference is the age of the patient. Most eleven-year-olds can't get prescriptions on their own; there are good reason why the pill would be an exception to that rule for all sorts of reasons already cited. But that does mean that the clinic is prescribing a drug known to have some bizarre side effects to a minor who (by assumption) pretty much isn't going to have parental guidance or support or oversight.


Posted by: Cala | Link to this comment | 10-23-07 3:45 PM
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Teaching a kid how to fight communicates that fighting is a normal part of life.

But this would often be an inaccurate communication.


Posted by: Cryptic Ned | Link to this comment | 10-23-07 3:48 PM
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Low-dose BCP, such as Katherine favored way up 233 way, is often prescribed for acne by Dermatologists to young teenagers. Some data and studies should be possible about that, since I'd guess it's more of a middle- and upper-middle phenomenon, so records and visits and all are good and reliable.

I heard a doctor on NPR Sunday morning saying that previous practice for cough medicine, testing in adults and subdividing the dose for children, wasn't good enough. Similar concerns would seem to apply.


Posted by: I don't pay | Link to this comment | 10-23-07 3:48 PM
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389

Having no relevant expertise and no idea how to bring comity to the thread, I just made a contribution to Planned Parenthood and will now go off to a meeting hoping that by the time I get back the conversation will have moved on.


Posted by: Not Prince Hamlet | Link to this comment | 10-23-07 3:49 PM
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I heard a doctor on NPR Sunday morning saying that previous practice for cough medicine, testing in adults and subdividing the dose for children, wasn't good enough. Similar concerns would seem to apply.

That was a case in which the cough medicine turned out to be less effective in children than in adults. (in fact, completely ineffective in children) Not a case in which the cough medicine was more dangerous to children than to adults.

If something has not been tested for SAFETY in children, then it shouldn't be used on them. If it's been tested for safety, but not for efficacy...well, it could work, and usually there's reason to believe it will if it works in adults.


Posted by: Cryptic Ned | Link to this comment | 10-23-07 3:51 PM
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389: Probably an excellent plan.

386: This is a good point, and I should have picked it up the first time you made it upthread -- I'd say that it definitely makes sense for the standard of care for a BCP prescription under these circumstances to include attentive followup for moodswings and such.


Posted by: LizardBreath | Link to this comment | 10-23-07 3:53 PM
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We see plenty of lawsuits relating to other drugs that cause suicidal ideation: why not suits about the pill?

If some eleven-year-old gets BCPs from this clinic and then walks in front of a bus, how quickly will her parents shotgun the health department & school district with lawsuits?


Posted by: Amber | Link to this comment | 10-23-07 3:53 PM
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385: Another vote for the pocket LB! Can I take you everywhere with me?

And with that, I, too, walk sensibly out the door.


Posted by: Sir Kraab | Link to this comment | 10-23-07 3:56 PM
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280, 287, 303, 308: B, why do women need different sizes of pantyhose available? They stretch, right? And you want them under tension so they don't slide down?

I can use an ordinary-sized condom. I much prefer a larger one. As noted above, using a condom of appropriate size improves reliability, as you're less likely to tear it or have it, uh, fall off the end, if it's big enough.


Posted by: Hamilton-Lovecraft | Link to this comment | 10-23-07 4:13 PM
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Can I take you everywhere with me?

I'd claim that I was small and don't eat much, but neither would be true.


Posted by: LizardBreath | Link to this comment | 10-23-07 4:17 PM
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381: The thing about the side effects is that anecdotally from this thread, they're common and severe enough that the way BCPs get prescribed for adult women is pretty much malpractice.

I agree with you completely, except that I'd substitute "BCPs" with "medication" and "adult women" with "patients".


Posted by: Hamilton-Lovecraft | Link to this comment | 10-23-07 4:30 PM
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So all medicine is malpractice?


Posted by: Cryptic Ned | Link to this comment | 10-23-07 4:33 PM
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398

Far too much of it.


Posted by: Hamilton-Lovecraft | Link to this comment | 10-23-07 4:38 PM
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399

They say 50% of all doctors are below average.


Posted by: Not Prince Hamlet | Link to this comment | 10-23-07 5:19 PM
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400

400!


Posted by: apostropher | Link to this comment | 10-23-07 8:48 PM
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401

400!


Posted by: Sifu Tweety | Link to this comment | 10-23-07 8:49 PM
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402

Shit.


Posted by: Sifu Tweety | Link to this comment | 10-23-07 8:50 PM
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403

Mighty suspicious after 3 1/2 hours there, guys.


Posted by: Not Prince Hamlet | Link to this comment | 10-23-07 8:53 PM
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404

It's been established that Tweety and I share a frontal lobe.


Posted by: apostropher | Link to this comment | 10-23-07 9:00 PM
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Have just finished skimming this long thread, and I am surprised to see that no-one has yet made the obvious point that while bcps *can* have bad side-effects, nonetheless if you get the right version & dosage they will not only not do that, but will greatly decrease many of the side-effects of menstruation itself. For some of us, the pill is great - lower flow, fewer cramps, *and* no pregnancy.

great variety in the human body.


Posted by: mrmf | Link to this comment | 10-23-07 10:18 PM
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406

405, meet 101.


Posted by: Sifu Tweety | Link to this comment | 10-23-07 10:22 PM
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I've always been curious about what pregnancy is like for women who can't tolerate the side effects of the pill.

The friend referenced in the post who became suicidal on the pill said she never felt better in her life than when she was pregnant and nursing.


Posted by: Becks | Link to this comment | 10-23-07 10:44 PM
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Speaking of condoms (if anyone is still listening), I thought this column by Dan Savage was really weird. To a guy who writes in saying he has trouble staying hard during sex, he suggests:

On the condom front: If you're putting the condom on right before penetration, as so many dudes do, you're going to experience a sudden drop in sensitivity at the worst possible moment. Condoms are often cold when first applied, TDG, and we all know what cold does to boners. So put the condom on at least 10 minutes before intercourse. Roll it on your dick during foreplay, or have your girlfriend roll it on.

What? That doesn't seem at all right. I'd always learned that you were supposed to put condoms on right before intercourse, otherwise you could risk tearing it or other problems. This sounds completely wrong to me. Fooling around with a condom on for 10 minutes before sex? Maybe this explains some of that failure rate.


Posted by: Becks | Link to this comment | 10-23-07 11:17 PM
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And, Jesus Christ, reading this thread makes it sound like all of the people using only condoms for birth control (hello!) are completely irresponsible and begging to get pregnant. Not true!


Posted by: Becks | Link to this comment | 10-23-07 11:22 PM
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I hate being made to put condoms on boys. Don't they know best how to make it comfortable? Why do sex columnists always advise making putting condoms on a part of foreplay?

This is probably not unrelated to my handjob anxiety.


Posted by: A White Bear | Link to this comment | 10-23-07 11:27 PM
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410: it's just like milking a cow.

On condoms: the best way to make them feel comfortable is to have a girl grabbing your cock. This can't be that confusing.


Posted by: Sifu Tweety | Link to this comment | 10-23-07 11:30 PM
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Fooling around with a condom on for 10 minutes before sex?

Yeah, that's insanity.


Posted by: gswift | Link to this comment | 10-23-07 11:30 PM
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I can understand "have her put it on" or "put the condom on and then fool around a little bit more before having sex" but not where "a little bit more" equals "at least 10 minutes".


Posted by: Becks | Link to this comment | 10-23-07 11:31 PM
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What's next, fooling around wearing a couple of wetsuits?


Posted by: gswift | Link to this comment | 10-23-07 11:43 PM
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409: FWIW, I don't think that it's irresponsible to use condoms as birth control; everyone uses whatever method best suits them, and I assume that intelligent people do so with a reasonable sense of the risks involved (including the fact that no birth control is 100% effective, blah blah).

I was the one who used the word "irresponsible," I think, and what I meant by it is that I do think it's irresponsible to withhold, or argue for withholding, effective birth control from sexually active girls or women.


Posted by: bitchphd | Link to this comment | 10-23-07 11:45 PM
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How weird is it that I have 100% agreed with B in this thread?

So weird.


Posted by: Sifu Tweety | Link to this comment | 10-23-07 11:45 PM
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Maybe it's the shared smoke inhalation.


Posted by: gswift | Link to this comment | 10-23-07 11:47 PM
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Yeah, that's true, the smoke is definitely carrying pretty well over the Pacific, Asia, Europe, and the Atlantic until it gets to me.


Posted by: Sifu Tweety | Link to this comment | 10-23-07 11:52 PM
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418: Bird flu, dude! Get a mask!


Posted by: apostropher | Link to this comment | 10-24-07 12:13 AM
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419: don't worry, I'm wearing a condom.


Posted by: Sifu Tweety | Link to this comment | 10-24-07 12:14 AM
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I too agree 100% with bitch. good arguments have been made for why the doctors and nurses prescribing birth control to kids should warn them about possible side-effects, be conscious of the possibility that they may need to try several types to get the best results, and monitor their physical and mental health. I don't see that good arguments have been made that a free clinic which is likely to be the only avenue through which these kids can get birth control should withhold a cheap, reliable for of birth control from young girls. the sad fact is that an 11-year-old who's having sex is particularly unlikely to be in control of whether the dick that goes inside her is wearing a condom. this is just one of the many reasons why kids that age should not be having sex. since some of them actually are having sex, though, the question is whether it makes sense to consign them to a heightened risk of pregnancy just because hormonal birth control can have serious side-effects. everything I've heard sounds like a reason we should be urging greater awareness of mental health issues for women on birth control pills, not a reason to deny one powerless group of people BC and then just say the rest will be able to figure it out on their own.


Posted by: alameida | Link to this comment | 10-24-07 4:17 AM
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I have a sneaking suspicion there may be some correlation between the people here who actually had sex as teenagers and the side taken in this debate.


Posted by: apostropher | Link to this comment | 10-24-07 5:27 AM
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423

400!


Posted by: M/tch M/lls | Link to this comment | 10-24-07 9:23 AM
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Crap.

422: So since I agree with you, I take it that you had practically no sex as a teenager either?


Posted by: M/tch M/lls | Link to this comment | 10-24-07 9:24 AM
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425

M/tch, ever the outlier.


Posted by: apostropher | Link to this comment | 10-24-07 10:58 AM
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426

And then, from the Onion (of course), there's this.


Posted by: NCProsecutor | Link to this comment | 10-24-07 1:25 PM
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425: Actually, I'm thinking it's you who "outlied" me, although I think "lay" is the proper verb to use to describe said activities.


Posted by: M/tch M/lls | Link to this comment | 10-24-07 1:28 PM
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421: As always, I'm grateful that the bitchy woman with authority here showed up to CONFIRM THAT I WAS RIGHT ALL ALONG.


Posted by: bitchphd | Link to this comment | 10-24-07 1:29 PM
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BITCHPHD WAS RIGHT ALL ALONG!


Posted by: OP/N/ONATED GRAND/A | Link to this comment | 10-24-07 1:58 PM
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