By Micaela Gaviola
I was 20 years old the first time I had a conversation with my parents about making an appointment to go to the OB-GYN. My parents were confused and not keen to talk about it—making an appointment didn’t seem necessary in their eyes since I wasn’t sexually active. I wanted to get more information, to take charge of my health, and to plan ahead, so I made the appointment myself. In all other areas of my life, I had been encouraged to be thoughtful, a critical thinker, and to ask questions. But when it came to making an informed decision about my body or to understand anything about my sexual health, it felt like everyone just wanted to keep me in the dark.
Several of my other friends—who are also from Filipino families—shared similar experiences when it came to conversations about sexual health with their parents. School certainly wasn’t doing enough to provide us with the knowledge we needed to make informed decisions about our reproductive health. All I remember from my high school sex ed class was performing a song I wrote about vaginitis, to the tune of Rupert Holmes’ “The Piña Colada Song” for extra credit. We aren’t alone in these experiences: One-third of women ages 18-25 have never had a gynecological exam. Young people of color in particular face disproportionate barriers to health care, many of which are rooted in systemic racism, such as cost, lack of health insurance, parental permission regardless of the risk it may pose to their safety, and lack of knowledge about where to get health care.
When I found myself pursuing academic research in adolescent reproductive health, it was as much as a crash course in sex ed for me as it was for the young people I was working with. But I learned that if we want young people to develop into healthy, thriving adults who make decisions that are best for their health and well-being, we need more information, choices, and availability—not less. We need more sex ed and we need better access to birth control, and part of that work is advocating for over-the-counter birth control pills that are available to people of all ages. For young people of color, this is about more than contraception—it’s about eliminating racist barriers that block access to health care and having the freedom to make decisions about their lives with dignity and respect.
Over-the-counter birth control is a new concept for many people in the United States, but over 100 countries already have birth control available without a prescription. Decades of research confirm that birth control is safe and effective. Major medical organizations like the American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and the Society for Adolescent Health and Medicine all support making over-the-county birth control available because it will help break down these barriers and benefit the overall health and wellness of all people—especially young people.
Despite not getting enough of what we need from our families and schools, research has shown that adolescents can make the right choices when it comes to taking birth control without a prescription. Studies show that when it comes to self-screening for any negative side effects of birth control and talking to a doctor when they need one, young people have similar capacity to make those judgment calls as adults. Young people also overwhelmingly support birth control being available without a prescription.
In my research, I study who young people talk to when it comes to making decisions about their birth control. Who do they talk to the most? Their family. Therefore, parents also need to be open to conversations about sexual health with their children. My parents, for all of their love and affection toward me growing up, were unable to teach me about the birds and the bees, much less sexual and reproductive health in general. I don’t know if it was the strong Catholic influences, Filipino roots, or just plain awkwardness of having to teach your children about sexual health, but they said they would leave it up to the school to educate me. This stigma from our families, friends, and the media leads young people to believe that there is something shameful about contraception, but I want young people to know that’s not the case. Birth control gives us the freedom to control our reproductive and sexual health, and there is nothing shameful about that.
Through my own research and personal experience, I have learned that young people are capable of choosing what’s best for their reproductive health, even on their own, and should be treated that way—including having options to get birth control without facing barriers. Over-the-counter birth control pills will make us more empowered, healthier, and give us the ability to control our reproductive health without shame or stigma.
Micaela Gaviola (she/her) is a graduate of the Fairbanks School of Public Health and first-year medical student at the Indiana University School of Medicine. She is an advocate for healthcare access for all and serves on the OCs OTC Working Group’s Steering Committee and the Advocates for Youth’s Free the Pill Council.
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