President Obama invoked the specter of 10- and 11-year-olds buying Plan B in order to justify keeping it out of the hands of the 15- and 16-year-olds currently banned from getting it without a prescription, and out of the hands of everyone 17 and older who has a broken condom but doesn't have an open pharmacy nearby. This, even though fewer than 1% of 11-year-olds are sexually active, and since the drug is taken after you have sperm inside you, withholding it can only be a punishment and not a preventive. Even if you believe that minor girls should be punished for sex, mandatory pregnancy strikes me as way too harsh. Anyway, one of the supposed justifications for this sort of thing is that it's not an undue burden on those with a legal right (those ages 17 and older---by the way, men can buy it, too), and that this is strictly about minors. Well, a recent study published in JAMA demonstrates that all this effort to keep this drug out of the hands of junior high school girls who aren't using it anyway (and who can use it safely, and certainly are better off not-pregnant than pregnant) is keeping it out of the hands of women who have a legal right to access this drug over-the-counter:


Female research assistants posing as 17-year-olds called every commercial pharmacy in Nashville, Tennessee; Philadelphia, Pennsylvania; Cleveland, Ohio; Austin, Texas; and Portland, Oregon. They found that 23.7 percent of pharmacies in low-income neighborhoods claimed that women could not obtain the morning-after pill under any circumstances regardless of age. This was only true of 14.6 percent of pharmacies in affluent neighborhoods.

Of the low-income pharmacies where the drug was not “hidden,” half gave the wrong age requirements for purchasing it, almost always indicating that callers would have to be older than legally necessary. In more affluent neighborhoods, pharmacies gave the correct age requirements 62.8 percent of the time.

To recap: One in five pharmacies overall basically said you couldn't get the drug from them over-the-counter, even if you were 17 or older. But even the ones who had it didn't necessarily realize that you could sell it to 17-year-olds. I can see people shrugging and saying, "What's the big deal? If a 16-year-old can't get it, then is it a big difference if a 17-year-old can't?" Actually, the answer to that question is yes, it is a big deal. Throughout adolescence, the percentage of teenagers that are sexually active rises rapidly each year of age, meaning you have a lot more 17-year-olds having sex than 16-year-olds. It's a huge gap. Only 13% of 15-year-olds are sexually active, but nearly half of 17-year-olds are. In fact, the average age for having first sexual intercourse in this country is 17, so by not respecting the rights of 17-year-olds, an enormous population of sexually active women are being cheated of their rights. Condoms are the favorite contraception of adolescents, and so Plan B is doubly necessary, because it's basically tailor-made as a back-up method to condoms. Errors in condom use are especially common with people who are just starting out, for the same reason that you make more mistakes the first few times you do anything. Access to EC couldn't be more critical for this group. 

Additionally, the fact that one in five pharmacies simply refused to sell the drug means all women of all ages are seeing their access seriously constrained. Not everyone lives in an area where they have easy access to three or four pharmacies. I suspect that the widespread myth that EC is the same thing as abortion doesn't help things, either. I'd bet some of these drugstores had the drug, but either because the person who answered the phone was anti-choice or because they didn't understand that it's available over-the-counter with an ID, they weren't able to sell it. Simply putting Plan B behind the counter gives it an aura of danger that raises the chances of these things happening. 

Ironically, these kinds of restrictions reward women for stockpiling this drug, which is what the opponents of it don't want, because that insinuates that you're---gasp!---planning to have sex. Just sayin'.

The good news is that the fight isn't over. The Center for Reproductive Rights is reopening their lawsuit against the feds for withholding emergency contraception access for political reasons, and now they're adding Kathleen Sebelius to the lawsuit, with the judge's blessing. What I ask of you guys out there as this goes forward is simple: please, please fight the misinformation about this drug. The main obstacle to getting it on pharmacy shelves is politicians correctly perceiving that the public thinks emergency contraception is an "abortion", which implies danger (even though actual abortion is relatively safe, especially compared to childbirth) and provokes hand-wringing. Talk to the people you know, and express these basic concepts:

1) Emergency contraception is not an abortion. It doesn't even work by killing fertilized eggs. Actual research into the drug demonstrates that the only way it works is suppressing ovulation, full stop. Since it's a single dose of the pill, it doesn't have enough influence on the uterine lining to matter one way or another. 

2) Emergency contraception is safer and easier to use than Tylenol, which is sold over-the-counter without age restrictions. It is a single dose pill that costs $35-$50, making it impossible to "overdose", if that's a concern. If they bring up the "it's a higher dose version of the birth control pill, scary!" argument, repeat, it's a single dose pill. What makes the birth control pill dangerous enough for a prescription is that you use it every day and it changes your body. EC simply can't do that. 

3) There has been no---I repeat no---research that indicates that the availability of emergency contraception encourages sexual activity. 

Rinse, and repeat. 100% of arguments against this pill being sold over-the-counter without age restrictions can be refuted with these talking points. If the conversation about this doesn't change, the policies guiding it probably won't, sadly.