The Curious Case Of ‘(In)Equality For All’ In Contraceptive Land
A friend (who identifies as a lesbian) once narrated an incident to me that had made quite an impression on her at the time. She was planning to get intimate with her partner at her own place and went to the pharmacy to get a pack of internal (female) condoms. To her surprise and the chemist’s wide-eyed stare, she learned that the pharmacy only sold condoms for penis-owners. Period. No exceptions. No variety.
This tale is no surprise to adult and adolescent women and intersex individuals, along with people from the marginalized sections of society, who have long been denied proper access to contraceptives, let alone sex education, compared to their more affluent neighbors living in urbanized environments. Here’s a look at the topic in greater detail.
The Paradox of ‘Equal’ Access To Contraceptives
For India, Independence Day has come and gone, but the day when adolescent girls and women from poor socioeconomic backgrounds gain the independence to have safe and informed access to contraceptives is still a long way out of our reach. Given the classic trope of men’s reluctance to buy or use contraceptives (damage to the fragile male ego is an apparent reason for this irrationality), which in turn is an extension with regards to lack of contribution to one’s own and their partner’s sexual health, make women in India and other developing countries highly vulnerable in terms of making informed choices about their sexual health. Upcoming movies and web series have done an exemplary job in showcasing women’s rights to their sexual autonomy. Still, very little has been done regarding gaining equal access to contraceptives compared to their urbanized penis-owning counterparts.
According to the RAND survey research, around 31 million women in India have an ‘unmet’ need for access to contraception. The ‘unmet’ need mentioned here refers to women wanting to avoid conception or STIs (Sexually Transmitted Infections) but failing to obtain the necessary contraception to fulfill this need. Prevalent in Latin America and many Asian countries as well, this global trend has snowballed into a severe threat to the reproductive health of women, with a study by the MSI (Mary Stopes International) showcasing the results of the lockdown measures brought about by the Covid pandemic- an estimate of 1.3 million women losing access to contraceptives and abortion procedures along with an additional 650,000 unwanted pregnancies, a million unsafe abortions and 2600 maternal deaths due to lack of MSI services in India, which provides contraception and abortion services on a global basis.
Barriers To Accessing Contraceptives: The Economic And Social Stigma
Taking a step away from the popular misconceptions inherent in porn about women not wanting to use contraceptives due to them wanting to ‘feel’ their partner inside them, several economic and social barriers hold women in a position that is akin to a bird in a cage in the field of sexual health. One significant issue here lies in the realm of gender. Popular culture has normalized the idea of men (or penis-owners) seeking contraceptives. Still, women and intersex individuals often find it tremendously challenging to seek access to contraceptives without judgment and stigma, whether it be from the snarky eyes of the chemist behind the counter or the sarcastic tone of the gynecologist in front of them. Adolescent and unmarried women are more likely to face this moral scrutiny, with assumptions of promiscuity and slut-shaming being used to degrade and discourage them for their choices.
Access to contraceptives and abortion services is also a must for all individuals from the queer community, especially those who can get pregnant- women who identify as queer, transmasculine, and nonbinary people- who are more likely to have an unintended pregnancy or an abortion before the age of 20, as indicated by research. A perception associated with minimized use of contraceptives leads lesbian, bisexual, and gay folks to perceive themselves as being less at risk of acquiring STIs, and the consequent gaps in knowledge that reproductive health caregivers have when dealing with clients identifying as queer make them more prone to risks concerning their sexual health. Considering the economic sphere, the increasing cost of contraceptive options like IUDs (Intra Uterine Devices) and pills can effectively deter women from poor socioeconomic backgrounds and patriarchal families from taking sexual health matters seriously. Less awareness and lack of education about sex can also propagate the rising number of STIs contracted by women in rural areas.
The Path Forward: How To Ensure Equal Access For Contraceptives To All
Empowering women to access contraceptive methods, especially those with a low income or no means of earning through subsidized means provided in the form of insurance or grants for contraceptive usage, can be a significant path-breaking achievement for driving equity for all in terms of contraceptive access. Identifying vulnerable groups- especially those belonging to poor socio-economic backgrounds, unmarried adults and adolescents, and members identifying as part of the queer community- collecting demographic data on the inequalities prevalent in accessing proper reproductive health care and using the data to develop interventions for proper access and satisfaction in the provision of sexual and reproductive health services is another way in which the government can team up with grassroots NGOs (Non-Governmental Organizations) and work on this issue. Sensitizing adolescents and adults alike through sexual health awareness campaigns provided at workplaces and schools also helps to promote a sense of equity- both in terms of gender sensitization and access to contraceptives- but most importantly, educating oneself about proper and correct information regarding sex, contraceptives, desire, consent and many other topics through the use of trusted online resources (or even a candid, honest talk with a non-judgemental and friendly reproductive health practitioner) can lead to a general change in the mindsets of people about contraceptives being a ‘hindrance’ during sex or family planning to a more mature and healthy understanding of the importance of contraceptives in promoting sexual satisfaction, preventing STDs and unwanted pregnancies, and by extension- greater respect for one’s own and their partner’s sexual health.
Barriers to gaining equalitarian access to contraceptives have, and continue to be, a major issue in India, and the ramifications are there for every millennial to see- unplanned pregnancies, contracting STDs, and most importantly, a lack of sexual autonomy or rights to make decisions regarding one’s own sexual and reproductive health. Racial and ethnic bias, cost of birth control, location, a lack of awareness due to almost no mention of sex education in our educational curriculum, or if so, an abstinence-oriented perspective on sex, religious beliefs- many factors can affect our access to contraceptives. An enhancement in funding for family planning programs undertaken by NGOs and governmental organizations, introducing mandatory sex education in schools as well as colleges alongside creating a non-judgemental atmosphere in the medical field regarding sexual health- especially in the case of unmarried women and queer folks can lead to a significant improvement in ensuring equal access to contraceptives for all people regardless of their socio-economic or marital status.
Cover Illustration by: everydayhealth