Content Warning: medical mistreatment

Positionally Statement: This post is written by Ojuswani Phogat, a second-year student at UMBC and a student-staff member at the Women’s Center. In writing this blog, I hope to shed light on one of the many ways in which individuals who experience menstruation are disenfranchised by the medical community, who so often fail to effectively diagnose menstrual irregularities in favor of prescribing the “birth control band aid” because they fail to believe and understand their patients’ issues. The following blog speculates as to how and why birth control is seen as the holy grail of menstruation issues when it, in fact, does not treat the problems at hand. I do not claim to be an expert on the uses or effects of birth control, nor am I situated in any position within the medical field myself, meaning my qualifications for discussing such issues are only through the lens of a patient. I aim not to blame providers but rather to expose the inefficiencies present in obtaining medical care for gynecological issues. This piece in no way aims to negate the necessity of birth control and its role as a contraceptive, as it should be accessible to all I with stand all those who are fighting for access to healthcare and autonomy over their bodies. Note: this piece uses the terms: The Pill, birth control, hormonal birth control, and contraception interchangeably to refer to the hormonal birth control pill. 

ID: Someone looking at a calendar filled in with three weeks of blue squares and one week of yellow squares. The calendar rests against a blue background.

I was 12 years old the first time I experienced irregularities in my menstrual cycle. I had gone through a six-week period of continuous heavy bleeding with no indication of nearing an end. I knew as much about menstruation as a child who had experienced their first period could, and as such I was more embarrassed than concerned by my condition. It wasn’t until the bags under my eyes looked like craters, and the brown of my skin gave way to a ghostly gray that I took steps to get help.

The medical care that ensued consisted of blood work, ultrasounds, and multiple gynecological visits before I was given some “remedy” to my apparently undiagnosable problem. A remedy that promised not only to “regularize” my cycle but also one that allowed the doctors to put the diagnosing efforts on the back burner as they congratulated themselves for a job well done. When these same symptoms resurfaced in my junior year of high school (approximately five years later), I was again given this same magical quick fix: a surface-level solution that hid rather than resolved my issue. That solution being none other than hormonal birth control. 

ID: The image displays the chemistry behind oral contraceptives, particularly the different hormones present in the body and how they are impacted by the use of contraceptives. The top left discusses the natural hormones 

If you aren’t yet aware of the absolute agony that hormonal birth control can be for some, allow me to open your eyes. Here are just some side effects of The Pill: nausea, vomiting, stomach cramps, bloating, fluctuations in appetite and weight, depression, blood clots, and strokes. I call on these primarily to situate your understanding of the immense impact that these tiny 15mm pills can have on the body and the mind.       

I know my story is not dissimilar to others in my life—both friends and colleagues—who resonated with an experience where insufficient health solutions facilitated the loss of well-being and health. The unfortunate reality is that a lack of effective medical care is pervasive, particularly when discussing menstrual issues. The long road to diagnosis and helpful treatment is one that I recognize many people are forced to take, the consequences of which have altered their ability to live a life they deem to be acceptable. 

It is important to note that this phenomenon is not new. Persons with menstrual ailments, whether or not they are related to chronic illness, have always been met with resistance when attempting to access proper health care in which their symptoms are clearly addressed. Such poor treatment by medical providers is an everyday struggle in the world of disability and chronic illness, in which people and their pain are ignored. 

The world of menstruation is complex. It is a bodily phenomenon that is all-consuming and one that leaves no area of the body or mind untouched. When one experiences this phenomenon abnormally, as  many do, their needs are habitually diminished and care foregone in place of a single band-aid solution: hormonal birth control. Whether it be polycystic ovarian syndrome (PCOS), endometriosis, menorrhagia, etc. (all very different conditions), or even when lacking a clear diagnosis, the answer always seems to be The Pill. 

The Pill as a Cycle Regulator

I often ask myself: why it is that the medical community could even fathom such an intricate and enigmatic cycle (that differs from person to person) to be regulated by what is essentially a single remedy, especially when the remedy in question can have so many negative side effects?

In researching this further, I find the blame to lie in part with the medical community but more so on marketing and political agencies that have come to control the narratives of The Pill as medication and its uses. I speculate that this standard of care for menstrual issues has to do primarily with cultural stigmas surrounding menstruation and contraception and the way they have been handled in the legal-political sphere. 

The historical rhetoric surrounding both contraceptives and menstruation seems to be resoundingly negative and rooted in pervasive cultural stigmas that deem those seeking sexual health care to be shameful and promiscuous. The irrational fear is that increased access to contraceptives allows individuals to be sexually irresponsible which promotes vice. Even Gregory Pincus (the scientist responsible for the research and development of birth control) concerned himself with it as a scientific quest and not one rooted in sexual freedom for women (which he too strongly opposed). 

The origin of birth control was always marked by the stigmatization of any attempts to control conception, so much so that the form of The Pill on the market at the time was marked as an “obscene and illicit” material by law and therefore prohibited to be used for the purpose of preventing pregnancy. In the United States, the Comstock law of 1873 expressly forbade the distribution, discussion, research, or advertisement of contraceptives which encompassed a stronger version of today’s birth control pills. 

You might be asking, “Well, with all this red tape, how on earth did they come to create and distribute The Pill?” In answer,  birth control was marketed primarily as a mechanism for menstrual cycle control, as opposed to as a contraceptive, and could only be prescribed as such, mainly to married women. A similar phenomenon occurred in Canada with the 1892 Criminal Code which criminalized the sale or distribution of birth control since it was considered “illicit” material. As laws were adapted, birth control became available for use solely as a cycle regulator in 1960 and that practice accelerated its popularity as a prescription drug in the medical world.  

The standard of care that remains in the modern-day continues to “regulate” menstrual cycles by administering birth control.

Since its arrival on the market, The Pill has been used for the process of cycle regulation, when it was developed and intended to be a temporary mechanism for controlling whether one conceived or not. Even today, it remains unlike other modern medicine as it is “prescribed routinely and by default”. 

I can only speak as an individual on the patient end of the health care process who is dissatisfied with the medical care I have received thus far. It is disheartening to experience the sheer lack of options held by persons with menstrual issues when it comes to claiming agency over their health and to be poked and prodded for years only to remain in a state of unknowingness.  

The incorrect notion perpetuated by ineffective gynecological health care remains: menstruating individuals’ health matters less and will be treated as such. Because of this sentiment, the burden of care falls on individuals. It is critical to take note of the patterns and behaviors of your body. In doing so you may know how to better recognize and approach signs that may indicate menstrual disorders.

https://www.contemporarypediatrics.com/view/menses-vital-sign-teenaged-girls

ID: The image is an infographic titled “Key Issues to keep in mind when assessing menses”. The bullets are as follows: remember to use menstrual cycle as a vital sign; even in the first year of menarche most girls have a period every 90 days; irregular periods even those resulting in anemia may be a sign of polycystic ovary syndrome; remember to screen for chlamydia in patients with heavy or irregular menstrual bleeding, teenagers with heavy bleeding should be screened for a bleeding disorder with at least a complete blood count (CBC), ferritin and thyroid-stimulating hormone level; the most common bleeding disorders associated with heavy menstrual bleeding include platelet function disorders and Willebrand disease; only draw von Willebrand testing during the first 3 days of a menstrual cycle when estrogen levels are at the nadir) 

If you are facing menstruation-related issues, I urge you to stand your ground in the exam room. While it is likely that your journey to diagnosis and productive help may not be easy, it is critical to actively protect your physical and mental self. You deserve appropriate care that works to treat rather than hide your ailments. Knowing the ways in which you may advocate for yourself in medical practices is key. 

In looking for further resources and information on this matter be sure to check out the links below: 

Menstruation and Menstrual Problems | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development 

Medline Plus Estrogen and Progestin (Oral Contraceptives) 

PBS The Side Effects of the Pill 

NIH Half a century of the oral contraceptive pill 

NIH How the Pill Became a Lifestyle Drug: The Pharmaceutical Industry and Birth Control in the United States Since 1960 

Figuring the Population Explosion: Demography in the Mid-Twentieth Century 

This episode features the remarkable work of the UMBC doctoral program in Gerontology.

First we hear from Dr. John Schumacher, co-director of the program and Associate Professor in the Department of Sociology, Anthropology, and Public Health.

In the episode, we also hear from three current Ph.D. students working on dissertations in gerontology:

• Min-Kyoung Park
• Rachel McPherson
• Jenn Haddock Kirk

And finally, we hear from Dr. Rob Millar, Policy Analyst Advanced at the Hilltop Institute, and Dr. Sarah Holmes, Assistant Professor in the University of Maryland School of Nursing.

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About The Series

POLI 443 Urban Policy Analysis 

Fall '22 Wednesday's 4:30pm to 7:30pm 

Dr. Eric Stokan

How should our cities and regions grapple with issues around public health, crime, economic development, housing, education, segregation, gentrification, and transportation access and equity?

POLI 443: Urban Problems and Policy Analysis asks you to join me in understanding these issues, how we got here, and where we are going.

This course will feature a mix of discussions (seminar style course), simulations (Fun activities where you get to experience first-hand how to address these issues from different perspectives), and guest lectures from those in the community grappling with these challenges.

This course is great preparation for students considering Public Policy grad programs.  It also provides great training in policy analysis. Skills that are incredibly marketable and relevant in the workforce.  

Previous guest speakers include: 

Steven M. Bieda, Former State Representative and State Senator of Michigan

John Bullock, Ph.D. Baltimore City Councilmember

Meredith Cohn, Baltimore Sun Reporter

Brett Theodos, Ph.D., Senior Fellow, Urban Institute

Jeff Finkle, President of the International Economic Development Council

Nick Hart, Ph.D. President of the DataFoundation

Marie Johns, CEO of PPC-Leftwich

Nicole Turner-Lee, Ph.D., Senior Fellow and Director Center for Technology Innovation at Brookings Institute

Bill Wells, Senior Vice President for Business Strategy at the Housing Authority of Baltimore City

POLI 469: Citizens and Democracy

What do American people think of the most contested issues facing our society today and how have those opinions changed over time? Furthermore, how do people around the democratized world think about these same issues, issues like abortion, immigration, income inequality, capital punishment, the role of science in our lives, and environmental protection? Finally, how satisfied are people with their own democracies and with their own lives?

The ambition of this special sessions course is to give students an opportunity to study publicly available public opinion data from the United States and around the world to understand how people think about important and highly controversial topics that are facing our societies. It is also an opportunity for students to learn about or apply existing skills in quantitative data analysis. But don't worry if you haven't had any formal training in statistics. No background in statistical analysis required. As such, the course is open to everyone, both those who have had a background in statistics and those who are new to statistical analysis.

There is no central text for this course. After I provide a brief introduction to the types of basic statistical analysis we will utilize, we will treat each issue area listed above as a course module. For each module, there will be short readings and/or videos to watch, a lecture (by me) about the topic, and short homework assignments, including 1-paged reaction and analysis papers and problem sets based on data. By the end of the course, it is hoped you will improve your skills in writing, critical reasoning, and data analysis and interpretation.

Still looking for an elective next fall? From media theory to marketing, MCS has a wide selection of courses that will equip you well with media literacy and communication skill sets valuable in any professional environment. While this broad array may seem overwhelming at first, I encourage you to take advantage of it and explore through media topics you may be unfamiliar with or even just slightly interested in! With any course you take with MCS, it’s never a matter of if it will be applicable, but just a matter of when — hence the reason you’ll find many UMBC scholars adding MCS as a double major to enhance their other degree. As you learn how media is woven through every aspect of society, you’ll be surprised to find how easily applicable the coursework is throughout seemingly unrelated aspects of your career and personal life. MCS 355 (Social Media: Networking) sparked my initial interest in the field of marketing and introduced the career option of social media marketing — something I hadn’t previously known existed at all; furthermore, the social media marketing campaign in MCS 355 (Social Media: Networking) definitely came in use as I proposed a rebranding project at my current job as a social media manager. All the research I’m currently doing on the westernization of Chinese food in MCS 499 (Senior Seminar) has me reconsidering a career of food journalism — something I’d previously written off. So take a look at what the MCS department has to offer, whether you’re an MCS major or not! 

Positionality Statement: This post is written by Marybeth Mareski, a Returning Women’s Scholar and social work intern at the Women’s Center in her final year at UMBC. I am a gender nonconforming lesbian in the queer and trans community, and I am in social work school with the professional goal of providing therapy to primarily queer and trans clients. I write this post as a summary of the recent anti-trans legislation, to draw attention to some of the underlying motivations, and to offer suggestions on how to support the queer and trans community.

Almost as if they had no intentions or ideas about how to solve any of America’s actual problems, lawmakers have made this the worst year in American history so far for anti-trans legislation, with more than three anti LGBTQ laws being filed each day in 2022. 

These bills tend to fall into three main categories:

1. The first is school policies, such as Florida’s controversial so-called “Don’t Say Gay” bill, recently signed into law by Ron DeSantis, which forbids teachers from discussing the topic of LGBTQ people with students before fourth grade, even though 1% of 9-year olds already self-identify as gay or trans. 
2. The second is youth healthcare bans, the most of extreme of which attempted to criminalize helping a child cross state lines to seek care (in Idaho, though passed by their State House mercifully killed by their State Senate). 
3. The third is youth sports bans, like the recent Utah bill banning trans students from playing on women’s school teams, which the governor vetoed but the state legislature overturned to force into law. Reader, there is one transgender girl playing on a women’s K-12 team in all of Utah. All of this legislative effort spent to prevent one girl from playing sports. Perhaps this is about something else, then?

When society is suddenly up in arms about something that presents very little if any actual harm, it is time to wonder if we have a moral panic on our hands.

Moral Panics

Moral panics are a phenomenon where a behavior or group of individuals is targeted for public concern that is far in excess of the actual danger presented. Moral panics are beneficial to the state, because they amplify the powers of the law, and beneficial to the news media, because coverage of these moral panics drive viewership and advertising revenue. For instance, as the the US legislative apparatus spends its time keeping trans kids out of the sports of their choice in late March and early April, Fox news aired 170 segments discussing trans people over those three weeks, including Tucker Carlson’s lie that kids are trans because of adult predators. What is the outcome of programming like this? Increased viewership and ad revenue to Fox News, and increased public attacks against LGBTQ people: a recent example includes a family with two dads who endured a man screaming at them on a train that they were pedophiles who had had stolen their own children.

Republicans hammer on moral panics like trans issues and Critical Race Theory to mobilize their base. This sort of outrage is very effective at bringing voters to the polls, but it leads to uncertain outcomes: 67% of national voters oppose legislation that prohibits trans athletes from playing on their team of choice. Fascinatingly, it is not because most Republicans support trans athletes – it seems to be because voters find the involvement of the law itself in this issue to be distasteful.

At the risk of giving too much credit to the American voter, is it not also clear that spending effort on legislating this issue is a huge waste of time? Nearly one million Americans are dead from Covid. Inflation is the highest it’s been in forty years. Housing costs have gone up more than 25% since March 2020. How is keeping trans kids out of sports improving the lives of Americans?

Transness is Not New

The notion that children who believe themselves to be trans are being ‘groomed’ by LGBTQ adults is an age-old fearmongering tactic. It stems from the right-wing ideology that being LGBTQ is unnatural, and therefore queer kids must have been indoctrinated into being queer, which is absurd on its face: one of the biggest mental health threats that LGBTQ people face is rejection from their own families. It is not seeing representations of the sinful urban lifestyle that converts innocent children into being queer – young people discover their own LGBTQ tendencies, do not feel safe in their own communities, and move to the diverse urban centers where they are free to be fully themselves.

What about concerns that such an increasing number of young people are transitioning that it must be a trend? 

Obstacles to transgender care have been immense. The psychiatric community has controlled access to gender-affirming services, and the terms of that access has been giving the answers that caregivers demanded to hear. Once barriers are lowered and the stigma is decreased, the natural incidence can be allowed to emerge. Take the history of left-handedness, for instance. In the early 20th century, left-handedness was seen as unnatural and punished, and rates of left-handedness were artificially suppressed. Once that stigma faded, rates rose more than ten percent in the population to their natural level, and remained there. Has being trans been vanishingly rare, or has being able to be trans been vanishingly rare?

Being trans is not new. People with a gender expression beyond biological male and female have always existed:

“… cultures worldwide have often recognized genders other than “male” and “female.” India’s hijra, which has existed for millennia, has an essential place in Hinduism and a socio-cultural role as performers. Judaism recognizes no fewer than six distinct sex¹ categories in its classical texts and tradition. In Oaxaca, Mexico, the third gender muxe dates back to the pre-Columbian era. The South Sulawesi Bugis people recognize five genders which have been crucial to their society for at least 600 years. – The Gender Binary Is a Tool of White Supremacy

And just as people throughout millenia have expressed their identity beyond the gender binary, researcher Jules Gill-Peterson found evidence that young people have been socially transitioning throughout the twentieth century, and attempting to transition medically for as long as medical transition as existed:

“I found handwritten letters from trans kids to a famous endocrinologist, Harry Benjamin, who was known for providing trans healthcare. In the 60s and 70s, they would say, “I’m X years old. I’m a transsexual. I read about that in the news” or “I looked up your work at a library, and it describes who I am”. They were from all over the country and they would ask if Dr Benjamin could see them, send them hormones, give them a permit to wear the clothes they wanted, talk to their family or teacher. It was young kids knowing really clearly that they were trans and going toe-to-toe with medical professionals. Suddenly, I had not only proof that kids were trans, but that they contacted doctors and tried to transition the best they could. It speaks to the remarkable ingenuity and resilience that trans young people have had for a really long time. And it’s pretty unimpeachable evidence that this is not a new social phenomenon. It’s not some trendy thing that kids are picking up now.” – ‘Trans kids are not new’: a historian on the long record of youth transitioning in America

What Can You Do?

ACLU lawyer Chase Strangio and writer and activist Raquel Willis used the occasion of the Trans Day of Visibility to devote an entire week to activism against these bills. They created a website called Trans Week of Visibility and Action which outlines many of the bills in question, some of which are still in session, with links to scripts to write to lawmakers, as well as links to local, trans-led grassroots organizations that are helping trans kids in each state. In Maryland, Trans Maryland is a “multi-racial, multi-gender, trans-led community power building organization dedicated to Maryland’s trans community” which works to pass trans-affirming bills in Annapolis and promote trans-inclusive health care in Maryland, as well as offering legal and financial support for name changes for trans people and a weekly digital support group – follow them online for action alerts for Maryland-based trans-related legislation, or donate to help support their cause.

Baltimore Safe Haven is a trans-led organization that provides services to the trans community members in survival mode. They offer a drop-in center, transitional housing, youth housing, meal services, and more. They are seeking volunteers, donations, and wish list purchases.

Trans people have always been on the forefront of LGBTQ+ rights, because society is so hostile to trans people that they so often have to fight to simply survive. We can call this bravery or resilience, and it is, but it is also the result of trans people being forced to constantly advocate for themselves, with little help from other, less marginalized groups. If you are cis, what about helping the trans people in your life, or clearly identifying yourself as an ally to them? 

Modeling trans-inclusive behavior increases the safety, comfort, and well-being of trans people around you. The National Center of Transgender Equality has a list of actions you can take that include challenging anti-transgender remarks, supporting trans people who experience discrimination, ensuring non-gendered bathrooms in your spaces, crafting anti-discrimination policies for trans people in your workplace, writing your representatives about laws related to trans people, and working to make sure that systems you are involved in are trans-inclusive. 

Does none of this sound direct or effective enough? Are you a financially stable person with privilege? The most immediate way to make an impact for young trans people fighting for their survival is to give money to them directly. Here are some twitter accounts that crowdsource black trans people who need help paying their bills:

Black Trans Futures

Trans hoodoo funds

Pay Black Trans Women

Keep an eye out for trans people in your social media network who are crowdsourcing for their survival, and make a point to donate to them. More than signing a petition, you can be sure that you had a part in taking care of a trans member in your community.

Survival in America is difficult enough these days. Making the existence of trans children into a moral panic is a cynical and cowardly move by transphobic lawmakers who are attempting to draw focus away from failures of governance. But at the end of the day, we are all suffering from these failures of governance, and the best way to continue to move forward is to dedicate ourselves to the notion that every life has value by supporting each other.

Resources:

Moral Panic: Who Benefits From Public Fear?

The Gender Binary Is a Tool of White Supremacy

 ‘Trans kids are not new’: a historian on the long record of youth transitioning in America

Trans Week of Visibility and Action

Supporting the Transgender People in Your Life: A Guide to Being a Good Ally