I got on the pill at 17. With zero guidance from my mother (who would’ve been appalled even discussing it), I went to my local Planned Parenthood and spoke to a doctor. Ortho Tri Cyclen was an obvious choice at the time. Without much personal reflection on the decision, I ingested a hormonal birth control pill every day for 11 years. While the doctor was excellent and helped me make an informed decision, I don’t think I was fully aware of the hormonal shift in my mental health that happened over that decade… at least until I went off of it. 

Suddenly, the proverbial fog lifted, causing me to look at my life with open eyes — and I realized I wanted to change almost everything about it. Eventually, I did, but it took a moment. If I had to do it all over again or face becoming pregnant, I would still go through that fog. But those shouldn’t be my only two choices.

There is a lot of Internet chatter these days about the adverse side effects of hormonal birth control. Severe depression, suicidal tendencies, weight gain, and mental fog all tend to be at the top of the list for those who consider it to be more of a hindrance than a benefit to the modern person with a uterus. But people are now questioning the toll these drugs have on their bodies… with good reason. Some even go as far as to say it’s a means of our patriarchal society to continue to control women, force us into the labor market, and refrain us from being our wild, true hormonal selves. 

A recent study by Danish researchers evaluated over a million Danish women and girls on different forms of birth control and found that, depending on the type of medication taken, 23%-34% of women were prescribed an antidepressant after going on birth control. Even though this study included over a million people, it’s hard to prove how it’s all related — because sadly, due to women’s hormonal cycles, we’re not the greatest test subjects. Our hormonal fluctuations are unique to each of us, so gauging how pills affect these shifts (and thus, our moods) is incredibly difficult. 

The majority of scientific research is done on men, so developing medicine for the female mind and body is dramatically underfunded.

So what’s our alternative? Maybe these alarmists have forgotten how hard women have fought for these rights? Just 60 years ago, the average American woman was birthing roughly four children. I can tell you with absolute certainty if I was a mother of four right now, I would be profoundly depressed, exhausted, not living the life that I want, and definitely not writing this article. Purporting that birth control (hormonal or otherwise) is a means to control women couldn’t be further from the truth. It’s outright dangerous as we face down countless anti-choice legislative bills all over the country. We’re lucky to live in a time where there seems to be an unending list of potential options to prevent pregnancy: the pill, IUDs, shots, rings, condoms, the method system, to name just a few. Some are more effective than others — but we do have options. 

Every person’s birth control decision should be made with their doctor, based on facts. Not every choice is right for everybody. If you struggle with depression or are a trans man, hormonal birth control probably isn’t a good option. If you’re super paranoid about getting pregnant, maybe you want to double up on a couple of options to be extra sure you have nothing to worry about. When we start on a new form, we should be journaling, looking for mood shifts, and gauging our exhaustion levels. Being body-aware is far easier to do now with period tracking apps and the like.

Ultimately, it comes down to this: 

Each of us responds to hormones uniquely, and we all need to be aware of how our minds and bodies react once we introduce new substances into our bodies. Sure, most birth control side effects aren’t ideal, but compare them to being pregnant in a country that is erasing abortion clinics left and right, and I’ll take my chances with the pills any day — especially if I’m body and mind aware of their effects on me. 

Until scientists come up with research methods that can take hormonal shifts of women and trans folks into account, we’ve got some pretty solid methods for keeping ourselves free from pregnancy. And if people are worried that birth control is a means to re-domesticate women, maybe they should invest in supporting scientists who are looking for a way to navigate our hormonal shifts in their research and stop attacking the most important tool we have to create the lives we want.

Ann Lewis is an artist, activist, and writer based in Detroit. Her artwork reflects upon social and environmental justice issues.

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