Friday, December 9, 2011

What Was Plan A?

Kathleen Sebelius does not strike me as an intolerant or ignorant person. Surely, being Secretary of Health and Human Services, President Obama had faith in her knowledge and ability. Why then did she feel the need to block the FDA's plan to push the Plan B pill to over-the-counter status? Further, why did she feel the need to engage the President on this issue, when he has more pressing matters to attend to, such as high unemployment and a sluggish economy?

The suggestion is that is was done for political reasons, and there might be some truth to that. A second term for President Obama rests in the hands of independents, especially those in key swing states, and to be seen erring on the side of caution would no doubt grease the wheels with some more conservative independents. But surely, there are not really enough of them to cater to in this regard, and as sex, sexuality, and teen pregnancy are polarizing issues, the dividing line is pretty firm. There is really no hay to be made through making this decision for political reasons.

Perhaps, the truth lies, as always, somewhere in between what we see and what we know

There is no question that young girls, 16 or under, are sexually active, though the rates do not suggest some "epidemic" of sexual activity. Furthermore, teen pregnancy rates are the lowest they've been in two decades, suggesting that inroads have been made in teaching boys and girls about sex and its role. Though many still scream incessantly about sex education in schools -- or lack thereof -- the statistics bear out that teen sex, while problematic, is not an overarching problem.

What is it then, that brings such a decision to the forefront of our consciousness, and puts froth on the lips of the Liberal mouth while simultaneously placing a smile on the lips of the Conservative?

The fissure in society's treatment of sexuality that began to open during the 1960's has continued to widen into a gaping chasm here in the next century. An American society hell bent on keeping talk of sex in the bedroom and off the table, even as it celebrated women as sex objects, is now stretched into a new and distended position, where the divisions and dynamics in how sex and sexuality are treated are mixed with the growing combat over abortion, the rise of homosexuals making inroads in claiming their due civil rights, and the transgendered fighting to be recognized. It is no longer a simple subject, and within the milieu of topics, teen pregnancy is being swallowed up by a culture that now is trying to deal simultaneously with so many of these other issues.

In essence, proponents and opponents of the plan to put Plan B over-the-counter are not doing so for a singular reason, but for a multitude of reasons, and those many and varied reasons cloud and distort the basic issue: providing emergency contraception to teenagers. Statistics and science and bureaucracy and morality and politics are all being stirred into a witches brew that poisons the potential for a constructive debate on the topic. Riding various lines of thought, creating specious, straw man arguments, and muddying the waters, only serves to prevent a thorough, logical, and reasonable approach to handling the issue.

Broken down, the issue is simple: girls are entering puberty and becoming sexually active far earlier than they have in centuries. Previously, it was so, mainly due to a retarded lifespan, wherein fifty might be considered old and a girl in her early teens was considered suitable material for marriage and pregnancy. Even with the advance of time and medicine, while the rate of miscarriage and labor-induced death has decreased, a teenage girl is still at a very high risk of suffering complications from a pregnancy. It is something best avoided until she has developed sufficiently to bear the strain that carrying a fetus will put on her body.

It is quite clear that, even as low as teen pregnancy rates are, teens are still having sex, and unprotected sex at that. There can be no clear picture of the actual rates; anecdotal, self-reported evidence is to be looked upon with great hesitancy when it comes to teens reporting their actual sexual experiences. As such, it is important that teens receive regular health screenings, to detect and treat the complications that may come from unprotected sex, not the least of which is pregnancy, but more importantly, the possible transmission of STDs.

Now, of course, the best plan would be to ensure teens have adequate and accurate sex education. This starts in the home; parents have to get over whatever hesitancy they may have in discussing the subject if they want to ensure their teenage children are well-informed. Where that cannot be counted on one hundred percent, it is important that schools provide sex education at an early enough age to give teens the information they will require to make informed and reasonable decisions about their sexuality. This is not limited to the sex act itself, but also teaching teens about their bodies and their bodily autonomy when it comes to sex, especially for girls. Girls need to know that the sexual appetites of boys do not override the right of a girl to refuse sexual contact on any level, and boys need to know that a girl's refusal to have sex is an absolute, at any time, at any age, and for any reason, and that tacit consent in some form is required to avoid committing rape.

In a perfect world, if our society could get past its hangups over sexuality, admit that even the most pious among us knew of, and perhaps had, sex before wedlock, we might not only reduce teen pregnancy but ensure a healthier and happier teenage experience. Where we continue to lock horns over the style and substance of sex education, and where we shirk our responsibility as parents, educators, and governors, we leave our teens exposed to a vacuum into which they will fall unprepared.

To that end, this desire to keep Plan B behind the pharmacist's counter is short-sighted. Yes, there are risks, yes, this is an end-around around parents and doctors, and yes, this is an admission that teens are having unprotected sex and making bad mistakes due to ignorance or incautiousness. None of this obviates the fact that, given the facts at hand and state of sexual education in the nation, there can be no good in keeping such a tool out of the hands of those who need it. As usual, this decision is treating a symptom and not the disease, and nothing good can come of it. If there a risks to using Plan B, they are over-shadowed by the risks to a teenage girl not using it when she needs to. Does condemning a girl to a pregnancy that may harm her or lead to her death really cost less?

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