UK Hurdles to Emergency Contraception

This is a post I wrote for scarleteen.com, to check it out in the original location click here ;)

It’s been a few months now since Heather posted “Back Up Your Birth Control Backup Day” making it crystal clear that, despite some pretty unethical misinformation given to young people seeking it, emergency contraception in the US is totally legal to sell to people 17+ without prescription.

It was few days later over here in the UK that I read a blog-post from a student in London that she had been refused emergency contraception, but not because of her age:

I went to a Boots pharmacy which said on the door come here for emergency contraception. So I went in and asked and the woman pharmacist told me that due to her religious beliefs she was unable to serve me the morning after pill.

Which had me asking myself what the law actually is in the UK.

Despite not having a uterus of my own, I’ve still bought emergency contraception with a partner and would appreciate knowing. After doing a bit of research, and with some help from the wonderful Dr. Petra Boynton, here’s what I found out:

Age:

The age you can legally consent to medical treatment and to sex are the same; 16 in the whole of the UK.

So: if you’re 16 you’re legally considered completely capable of making the decision to get contraceptives on your own. If you’re younger, then the law is flexible so that you can receive it if the pharmacists feel you’re mature enough to understand the treatment. In theory this just means the law recognises your maturity, as reflected in your ability to make decisions for yourself even if you’re under 16. Many pharmacies won’t serve under-16s without a prescription, but they are allowed to.

The policies on that are often standardised accross a local area. That given, if you’re under 16 and having sex it’s worth finding out whether, in your local area, you’ll need to get a prescription by going to your GP or an NHS Walk in centre, etc, or if you can just buy it over the counter. Being a young person can also mean you might be able to get it for free, but this varies around the country.

Basically, however: you can’t be told you’re too young if you’re over 16. If you’re under 16, being served is at the discretion of the pharmacy but it is not illegal. It often costs roughly £25 if you’re over 25, and is often free if you’re under 16, 16-25 it can vary. Where I live you can get it for free if you’re under 25.

Buying for someone else:

In the UK, pharmacies explain to you what the medication does and how to take it and they get you to sign something saying you understand. Unfortunately, that means it doesn’t allow for a friend or partner to go get it for you.

Refusal on Religious Grounds:

The pharmacists I spoke to on the phone who were pro-choice actually defended the main way in which UK regulation differs from US regulation. In the US, as outlined in Heather’s blog post, workers are legally obligated to serve you, whereas in the UK, the General Pharmaceutical Council (i.e. the GPhC, who control the registration of pharmacists) outline that on Religious Grounds you may be refused emergency contraception, however the pharmacist must inform you that this is why they are refusing you (they can’t tell you some other false reason) and they then must direct you to an alternative venue for buying it so long as it will be realistically accessible to you in the time frame, otherwise they’re guided to serve you.

This is all in the guidance and standards aimed at pharmacists and published by the GPhC.

You [ie the pharmacist] must:

2.2  Make sure that your professional judgement is not affected by personal or organisational interests, incentives, targets or similar measures

2.4  Be prepared to challenge the judgement of your colleagues and other  professionals if you have reason to believe that their decisions could affect the safety or care of others

2.5  In an emergency, consider all available options and do your best to provide care and reduce risks to patients and the public.

3.4  Make sure that if your religious or moral beliefs prevent you from providing a service, you tell the relevant people or authorities and refer patients and the public to other providers

The above exerpts are from the GPhC’s Standards of conduct. ethics and performance.

The following is from Guidance on the provision of pharmacy services affected by religious moral beliefs.

Remember

• If you do not supply Emergency Hormonal Contraception (EHC), (either over the counter or against a prescription) women should be referred to an alternative appropriate source of supply available within the time limits for EHC to be effective.

• If you do not supply Routine Hormonal Contraception, women should be referred to an alternative appropriate source of supply available within the time period which will not compromise the woman’s contraceptive cover.

• If you refer a patient to a doctor’s surgery or hospital you should think about whether  the patient will be seen by a doctor or other appropriate practitioner within the timeframe required for treatment to be effective (i.e. consider factors such as the practice’s opening hours and whether the patient will be able to get there).

• If you refer a patient to another pharmacy, check that there will be a pharmacist available there who can provide the service and that they have the relevant stock.

and

2.7 Patients should not be discouraged from seeking further information or advice.

This is the level of service you should expect if someone calls themself a pharmacist. No lectures, just a disclosure of their bias and the information you need to get the EC you need in time. Or if you’re out of time, the EC itself.

Perhaps we’d be better off if emergency contraception could be seen for what it is, a medical and societal necessity instrumental to equality and female empowerment, and plenty of people would like it to be mandatory part of the job. On the other hand, it might be better to have this official provision for refusal and a procedure for it, rather than for those opposed to EC within the profession to turn to tactics like lying about age restrictions.

Either way, at least in established policy, you should be able to get what you need when you need it.

If you’d like a similar printable fact sheet with a complaints phone number for the GPhC you can also download it here:

Contraception – parental consent??

On Thursday the 9th of Feb 2012 we heard the BBC Radio 4 debate with Conservative MP Nadine Dorries and Simon Blake, chief executive of the Brook Advisory Centre.

‘According to the NHS Confederation, 1,700 girls aged 13 to 14 around the country have had contraceptive implants and 800 others have received injections with the same effect, without their parents’ knowledge.

The claim is that it has helped to reduce teenage pregnancy levels, which are now at their lowest since the early 1980s.’

 – BBC the Today show

Dorries put forward an argument that these girls are too young and that it’s wrong to give them the contraceptive implant or injection without their parents’ consent; parents have the right to know about their children’s sexual activity at such a young age, especially due to the possibility that these girls may experience side effects, for example weight gain or depression.

Simon Blake explained that the issue is more complex than simply whether or not parents have the right to be informed. Brook’s experience in this area has taught them that it is more important that young people can access emotional and practical support if they are having sex and that younger people who do have sex are sometimes those in vulnerable situations. He says that although the health professionals at Brook would encourage young people to talk to their parents’ about contraception – this is not always possible or the best thing to do. Health professional are already making decisions about contraception for under 16’s based on strict guidelines (the Fraser guidelines) which take into account consent and understanding as well as the risk of pregnancy.

This debate is interesting because, for once, Dorries and Brook are not arguing from completely opposing sides. They are both bringing up important points about access to contraception and advice as well as the effects that they can have on young people.

But perhaps what we should be asking is ‘what are the priorities here?’

Is it stopping teenage pregnancy? Is it making it easier for young people who are having sex to get support and advice? Is it making sure parents don’t have to worry about what their children are doing? Or, should we be asking about the side effects of these kinds of contraception?

After all, the contraceptive implant or injection are pretty serious medical interventions which we should know more about as they are now some of the main contraceptive methods offered by the NHS. They also don’t protect against sexually transmitted infections or diseases and can have negative impacts on our health, which is especially a problem when information and advice is not available. For more information on the different kinds of contraception available see

http://www.brook.org.uk/contraception/types-of-contraception or http://www.nhs.uk/Livewell/Contraception/Pages/Guidetocontraception.aspx. or of course
http://www.scarleteen.com/article/sexuality/birth_control_bingo

-Joanna

 What are your experiences what do you think?

Little words

On those little words, as used by Nadine Dorries on Big Questions yesterday morning:

Relationships

Watch out for the word relationships being used to mean “only have sex with long term partners” or even more narrowly; marriage (quel horreur!)… I think there is nothing wrong with less long-term committed sex so long as everyone involved wants to be having it and and feels safe enough to use the extra precautions they may need for this type of sex. Relationships as far as I’m concerned are things that everyone has with everyone… friendships are relationships, sexual partners are a relationship, someone you had sex with once is still a relationship, people married for a million years are definitely in a relationship… so when we talk about it in sex and relationships education, we’re not talking about only one type of relationship, we’re talking about HOW you can handle all the relationships you’re in, which is something that is incredibly important when it comes to relationships where sex is involved. Relationships aren’t the alternative to sex.

Abstinence

Basically especially when used by politicians and people who know what’s-what in sex ed, abstinence refers to the ideology of “saving” sex… not just not-having-it, or choosing not to have it for now, but more than that. The tactics used in programs which call themselves abstinence are often engaged in making it clear that you are less of a valuable person if you have sexual interactions, and you’re a better stronger person if you don’t have it. The judgements about sexual choices are an established part of abstinence as a concept and as a word. So when you hear people use it, unless they don’t really know about this side of it, it’s important to remember “That means more than wanting not to have sex and saying no!”. It also seems to be very often concerned with ideas of purity and having “pure thoughts”, so you even have to feel bad for what you think apparently. This is a far cry from making choices, and understanding consent.

Empowerment

Now this is an interesting one. For a long time empowerment has been used by people like feminists to describe what it is to realise your own powers, and be able to feel as though you’re making your own choices. Empowerment in general terms isn’t about what choices people make, it’s about them realising that it isn’t not-their-place to make them. So when someone says a sentence like “Girls can be empowered to say no to sex”, they’re strangely not describing it as a choice but at the same time trying to make it sound like one.

If I say “I want to empower people to give me cake”… I’m not sure that’s really a good thing for anyone else but me, but it sounds a whole lot nicer than “I want to force people to give me cake”.

Sexualisation

Sexualisation seems to me to mean different things to different people but what seems to be agreed on to me is what it isn’t. We apparently talk about sex a lot more now, than apparently people did 80 years ago (80 years before that who knows!), we show more of our bodies, there is more sexually themed media available in all sorts of places now than there were before. Sexualisation seems for most people describe what they think the bad parts of that are.

Many people believe that talking about sex openly, to show images of happy sexual encounters and for people to make art with sexual imagery as central is fine, but that using people’s bodies and images of them which are sexually explicit to make money is a problem, and that the images send messages to people which make them unhappy and vulnerable to sexual abuse or sexual assault by those who’d see the images and regard the people they represent as not worth caring about, and very often this abusive side is what they describe as sexualisation. For others all sexual images and messages, including those in sex education are morally corrupting and make people dirty and damaged, they’re likely to call all of this development in society sexualisation. And plenty of people using the word sexualisation are in between.

What seems to me to be one tactic of using this word for those who are anti-sex education, especially when trying to be persuasive, is that people can think they agree with you without really knowing that they do… you could say this for all of language, but with sexualisation the definitions seem so broad that using it can get you popularity which might actually be based on a misunderstanding, by design or by accident. So it’s really worth, if you think “Yeah, I agree!” to ask “Do they really mean the same thing as me when they say sexualisation?”.

A totally unrelated image from the best (and funniest) tv show on education ever: Summer Heights High

Dorries’ Gambit

So on Friday Dorries’ Bill headed down the agenda for the days proceeding, it was apparently clear that it wouldn’t get a reading and then she withdrew it. What gives?

At the protest against it on Friday, outside parliament, we all cheered when it was announced the bill was to be withdrawn, because it means that (right now) it won’t become law. However, given that were it discussed, it probably would have been totally dismantled, it’s hard to know whether that it didn’t get it’s day in the sun is a good thing or not.

Right now politics feels a bit crazy to me, I’m not sure what’s going on, and so I was worried that beyond everyone’s expectations the bill could have passed and we would have ended up in a country where teenage girls only need to be taught not to have sex, and that this is all of sex education that would be compulsory besides anatomy and physical processes in biology.

It seems annoyingly convenient for me that a bill that was highly likely to fall managed to save face by not being read and subsequently being withdrawn, despite how glad I am that it won’t become policy just yet. The easy weak spots of the bill like that it has been largely spoken about by Dorries as only about girls may well disappear from future versions of it.

Like in a gambit in chess you sacrifice a piece to get your opponents to leave their defenses weak and then win the game. Hopefully that won’t happen, because really as far as this particular Bill and proposals like it are concerned, people who want to it not to happen, I hope, will have moved on, and will be prepared to refute more than just the “girls only” part.

I realise I so much prefer just taking part in sex ed and discussion than debate and parliamentary stuff. You can easily get wrapped up in being angry at some person you’ve never met, which when you think about it is a waste of energy. A few deep breaths can save your sanity.

I saw Nads on TV this morning’s “Big Questions” saying a lot of things that people who oppose her bill agree with… “girls are sexualised, there’s not enough focus on relationships.” and saying words like “empowerment”. I’m sceptical about all of this. She gives the impression that everything else BUT abstinence is being taught in schools, and identifies the issues of peer pressure when it comes to having sex before you feel ready. And also describes the difficult restrictions young mothers can often be made to endure.

Yet I really identify with the sentiments and the people I assume she’s trying to appeal to. Abstinence, which doesn’t really describe a choice any more as much as an ideology, really has failed at doing the things it set out to do… while completely obliterating what comprehensive sex ed would aim to do where it has been rolled out extensively and researched in the US. What we need to continue to do is clarify to ourselves what we would like sex education to be and why.

Here’s ours: http://s4sre.com/what-is-good-sre/

Protest Today, Go-Nads

Ooh protest!

I’ve just arrived in London ready to protest and meet some cool people outside parliament to show public dissapproval of the abstinence only for girls bill being submitted by my MP Nadine Dorries…

NadineDorries_1404254c.jpg (460×288)

Newsflash: "Don't have sex"

Nads, who not only has an abbreviated first name which is also shorthand for the sex/gender-non-specific description of reproductive cell producing glands (gonads means both testicles and ovaries), is also trying to get a bill passed tomorrow that would mandate schools to teach abstinence to teenage girls… and nothing else… at a time when here in the UK, sex education is not really mandetory in schools.

This means that if a school only did what was necessary, boys (if there are any there) would only indirectly learn some basics about reproduction from a purely biological perspective, in the middle of other science, whereas girls would get that, plus get told, apparently, how to say no to sex. A piece of information which on it’s own is really not a lifesaver… What you really need is to know that what you want and don’t want sexually is important, and that that you can be trusted to make such a decision for yourself, so that when you don’t want it you can say it proud, because you know what it is to want it as well.

Abstinence is also, not a word that has been plucked from no-where, it’s an established term which describes a certain type of “not having sex” that is taught in a number of programs and is especially used by groups who don’t think young people shouldn’t be taught ANYTHING bout sex… but can use all sorts of guilt tricks and scare tactics to encourage people to do things like write a contract or wear a ring to promise that they’ll be “abstinent”. The thing is, most people taught abstinence have as much sex as those who didn’t, which can be a healthy thing I think… but without having been taught the things that make that sex safe, the use of  condoms is way low, as are all the other things that make sex safer, and the effect of breaking those promises must have on people’s guilt just really worries me, and I imagine the effect on relationships is pretty difficult. Abstinence is also often taught as being bout “saving sex til marriage” which totally ignores all the queer students in the room at best, and at worst will make negative comments.

This is a totally new thing on a national scale… these sorts of things have been taught in some schools for a long time but for the schools in whom the problems thus far have been just awkwardness and unhelpfulness, this would introduce something completely new into the mix and give us years of work just to get us back to where we are now.

Nads of course is getting all sorts of bashing from everyone angry about this, so I’m guessing there’ll be some pretty angry responses to her voiced tomorrow… if you’ve only just heard of this please don’t be put off by that… she is probably not as much of a meany as her bill might suggest, but the bill really really really is dangerous, and the people who support her in this behind the scenes will always have something up their sleave… as parents for sre have said “it’s not all about you Dorries“.

A lot of people said it really wouldn’t pass but politics is unpredictable this year, who knows what can happen.

The protest is today, Friday, at 10:30 at Westminster, say Hi if you see a boy in a ridiculous faux-fur coat! If you’ve not been to  protest before, don’t worry this should be pretty civil and I know quite a few nice friendly people who are going to be there. Showing your support really will help everyone out.

-from Jacob

PS Exams over for me! I swear there’s a conspiracy to make these decisions fall right in the middle of exams, but I made it.

S4SRE

Hey all, welcome to s4sre!

This is our first entry, we’re just getting going, watch this space… we’re on twitter and facebook, and hopefully going to make an appearance at the say no to dorries protest. I might make a banner looking a bit like the one on this page!

If you’d like to become a contributor, drop us an email… anything you think that might help young people who want to campaign for good sex education is awesome and very wanted! We’re starting up here in the UK, but any information specific to other countries are also welcomed as we build the site…

So far I’ve written up a working manifesto type thing called What is good SRE? and am working on a guide for students looking for what to do to get the SRE we’re a’fighting for called What to do?.

I’m also working out how to run this, and keeping  the site and the website all nice and democratic.

Happy new year folks! If like me you’ve got a load of exams coming up, good luck!

-Jacob