One percent solution

Pub date April 18, 2006


Dear Readers:

The column about the young woman who ceased having sex with her boyfriend after being terrified (not to say terrorized) by the antiabortion displays on their college campus got a lot of responses, not entirely unexpectedly. This letter bore the subject line: "Stop degrading women for protecting themselves," which, well, wow. Don’t spend much time on the Internet, do ya? If this woman thinks my mild dismissal counts as "degrading" women, then I do not think that word means what she thinks it means. Go Google "bukkake," honey, and then maybe we can talk.



Dear Andrea:

As a nurse, I was disgusted to have you dismiss using both the contraceptive pill and a condom as "borderline nutso overkill" for contraception purposes. When used absolutely perfectly, with no other drug, digestive, or weight considerations, the pill is at best only 99 percent effective. A 1 percent chance of getting pregnant should not be dismissed as "off-plumb." Patients on the pill can get pregnant even though they have not missed any pills, because every single factor that could decrease the pill’s effectiveness has not been studied.

As for your comments about antiabortion displays as "assaultive theatrics": Why would these displays be offensive and disturbing to you if there was absolutely nothing wrong with terminating the life of a fetus?

In the future, you should refrain from describing women as "nutty" for trying to eliminate the 1 percent risk. I would describe them as empowered and intelligent for taking every measure to avoid conceiving a child they do not want.


Stop Degrading …

Dear Stop:

Did you miss the fact that she wasn’t "protecting herself" by using a condom plus the pill; she was refusing to have sex, period? To be fair, I didn’t treat her previous insistence on doubling up birth control methods with the softest and supplest of kid gloves, but I did have my reasons. Would you like to hear them?

See, I talk to these kids constantly at San Francisco Sex Information, where I think the staff spends more time on these questions than they do at any other educational pursuit. "Can I get pregnant if I’m on the pill and he wore a condom and he didn’t come in me?" "… if I’m on my period and we don’t have intercourse but he rubs himself on my knee a little bit but doesn’t come?" "… if we’re in the hot tub and I’m on the pill and he’s wearing a condom …?"

After a while, one loses patience. Not with the teenagers, mind. It takes a lot to get me feeling grouchy toward kids who are just looking for a little trustworthy information. No, I have lost patience with their teachers, who ought to be teaching them some critical thinking skills so they can learn to do reasonable risk-assessment, but who are so afraid of getting into trouble that even in nonabstinence-only districts all they will say is, "There’s no such thing as safe sex." The kids who call and write are terrified. They have no idea how the menstrual cycle works (and not for lack of "learning" it over and over in sex ed). They have no concept of what it actually takes to get pregnant ("Can I get pregnant from oral sex?"). They know nothing, nothing at all, except "sex = pregnant." And they are not dumb kids, or even underprivileged kids. They are suburban, middle-class kids, and they can’t think their way out of a wet cardboard condom box, because nobody has bothered to teach them how. I get grouchy! Sue me.

I also get grouchy when people who ought to know better demonstrate a similar lack of critical-thinking skills. Where, for instance, does your 1 percent failure rate come from, and why are you so comfortable bandying it about? Most sources I can get my hands on put the reported "perfect use" failure rate of oral contraceptives at between 0.1 and 0.3 percent (charts usually just say "less than 1 percent"). The "typical use" figures, granted, put the failure rate as high as 5 percent, but keep in mind that by far the most common "typical" cause of failure is not taking the pill, followed by taking it wrong. One paper I read actually blamed oral contraceptive failure on going off the pill entirely during the year in question and failing to report that. So yes, while assorted physiological weirdness can cause pill failure, it’s a lot more effective than you give it credit for, provided one actually, you know, swallows the thing.

I have no problem, really, with people at no particular risk for STDs deciding that the 0.3 percent is not quite safe enough for them and choosing to add a barrier method, particularly during the midcycle danger zone. That is a matter of personal, albeit slightly nutty, choice. I do have a problem with scaremongering and willful ignorance. That goes for the fetus-poster panderers as well as for the teachers who can’t be bothered to check their facts before telling vulnerable young people to "be afraid, be very afraid."