Birth control as a non-binary person: I just want to fuck
By: Lore White
I have never wanted to have children, and I dare to say that I never will.
It’s unfortunate then that all hormonal contraceptives come with terrible potential side effects. All this risk, and there’s still a chance that a pesky egg gets fertilised.
To me, the clear answer is going the whole hog and getting surgically sterilised. This right to bodily autonomy should be straightforward, but navigating the medical system as a non-binary person without private health insurance is no easy feat – especially when it comes to reproductive issues.
Image by: Reproductive Health Supplies Coalition
I’m fortunate enough to not need to see a GP that often, and as my legal name is still [REDACTED], I tend to just grin and bear it when I visit my local bulk billing medical centre. The doctor I see does not understand what being non-binary means.
On this particular day, I am here about birth control. Specifically, I want more information about a sterilisation procedure called a tubal ligation. I am immediately dismissed. The doctor wants me to think about some future man I could be with – what if he wants to have kids? But I would not be in a relationship with someone who wants to have kids.
It is difficult to explain the dysphoria I have surrounding pregnancy to someone who would fail a gender studies class. Carrying a pregnancy to term is unthinkable to me – it is completely off the table.
I don’t tell the doctor this. I don’t trust the doctor with this.
Instead, I switch tracks. I have done a tiny bit of Googling beforehand, so I ask about getting the birth control shot. The Depo Provera injection, also known as the Depo shot, is manufactured by Pfizer, the same company that makes Viagra. I have ADHD, so a ‘set and forget’ contraceptive sounds like a good option.
All the doctor mentions is that there is a chance of losing bone density with continued use, and that I might have “irregular periods”, which I soon learn is the understatement of the millennium.
Hell is empty and the devil is in the Depo shot.
Listen, if you’ve had a fine experience with this stuff, I am over the moon for you, babe. If you are thinking about trying it, for Christ’s sake, read some of the reviews first. If you have a bad experience on the shot, there is nothing you can do but wait it out.
I’ve read some true horror stories that make my own experiences comparatively tame. The shot is active in your system for three months. For each of those months, my periods lasted 22 days on average. I also dealt with water retention, headaches, acute depression, and I swear it affected the potency of my orgasms.
I go back to the doctor about the excessive bleeding, and am dismissed again. The doctor tells me to just keep getting the shot, and that after a year or so my period will stop completely.
We are talking about spending a year of my life bleeding for 22 days out of the month. At this point, I half-believe that the shot works as a contraceptive by making you feel too disgusting to ever want to have sex.
I cancel the appointment for my next injection.
Meanwhile, I’m still keen to get a tubal ligation, so I do more research. I’m a freelancer and I don’t have private healthcare, so Medicare will have to do. But Medicare apparently won’t help, as elective surgeries like this aren’t covered.
Regardless, the financial hurdle is second to the denial of bodily autonomy for anyone fighting to get a simple referral.
During the unpleasantness of being on Depo, I learnt that coming off the shot is where the real horror starts for a lot of people.
These are just some of the withdrawal symptoms I experienced: body aches and pains, migraines, heart palpitations, mood swings, anxiety, insomnia, fatigue, and the all-encompassing fear that I was pregnant. My symptoms matched early pregnancy so closely that every article I read told me to take a test.
None of these things were mentioned by my doctor, or on basic fact sheets about the shot.
There’s a great irony in all the medical websites having the health disclaimer of “go and see your doctor”, when I have learnt more about my symptoms from the internet than from the guy with a medical degree.
Our public healthcare system is overloaded, overcomplicated and underfunded. Healthcare professionals hardly have the time to stay up-to-date with the medical world, let alone understand the nuances of its intersection with gender and sexuality.
I have friends who have put hours of work into educating doctors about inclusive health care for trans people. There are Facebook groups full of posts asking for recommendations of doctors in whose care we will feel safe; or even better, doctors who can provide affirming care for us.
Reader, the list of those names is short.
If you take a moment to compare hormonal birth control to hormonal replacement therapy (HRT), you realise the huge role hormones play in each of the body’s processes. So, it makes sense that fucking with them in such a significant way may cause changes to those processes.
In the case of HRT, most of these changes are the point of the treatment. With birth control though, it’s just one change you’re looking for – protection from pregnancy.
Many of you will be all too aware of the hoops a person has to jump through to start HRT, and then the amount of monitoring and stabilising of hormonal levels needed once you’re on it. To start birth control, there are no such hoops.
Don’t get me wrong, I am thankful that we have access to contraception, but the issue arises when that access occurs without informed consent. A one-size-fits-all approach to hormonal birth control is almost guaranteed to cause unintended harm, but we’re told that it’s unavoidable.
This is systemic misogyny at work.
Transphobia makes starting HRT a bureaucratic ordeal, while misogyny hands you birth control with a side effect list you could use as a quilt, and tells you to grin and bear it.
Thanks to the patriarchal society we live in, the onus of hormonal birth control is placed on people with uteruses to the benefit of cis men – whose bodily autonomy is rarely up for debate, who don’t have to suffer the same side effects, who can generally access sterilisation surgeries easily and affordably, who are more likely to be heard and believed by doctors, and whose hypothetical want for children overrides the rights of others over their own bodies.
It can be argued that access to birth control exists because it benefits cis men. The more ‘extreme’ surgical sterilisation options, which provide autonomy and control solely to people capable of pregnancy, are gatekept.
After all, I was explicitly told that a cis man might want me to give birth someday, so I shouldn’t be able to remove that option from him. But I can jump on the Depo shot in the meantime, and lose my bone density for the hell of it.
It’s all a bit pop feminism for my taste.
Contraceptive healthcare is a minefield at the best of times, and finding an option that works is a challenge even for healthy, abled cis women. For non-binary people like me, navigating the system requires much more effort – and it only gets more complicated when there are other factors at play, like disabilities or chronic health conditions.
For the time being, it seems like there’s no easy fix to be found here. But at least condoms are cheap.
Lore is a nonbinary artist based on Dharawal land in Wollongong NSW. They are the Founder & EIC of Baby Teeth, and co-editor of Heroines Anthology & Writing Prize. Their personal work has appeared in zines and indie journals from all over. They’ve featured as a performance poet for Girls On Key, Enough Said Poetry Slam, and on stage at Yours & Owls Festival.
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