The White House Policy Wish List recently leaked by Crooked reveals a maniacal focus on fertility awareness methods (FAM) as the best, most tremendous sex ed strategy ever, according to Trump and his aides. Our first reaction was to wonder how Trump knew of the scientific fertility awareness method, being as outwardly anti-science as he is. Our second was to ask, “Oh God, what does he THINK it means?”
In March, 2016, we left on a three-month, 15,000 mile road trip across the US to teach over sixty free reproductive health classes on body literacy and how to make informed choices about contraception. We spent half an hour each class discussing fertility awareness, because it can be both birth control and an empowering tool with which to get to know your body. But you know what’s not empowering? Limited access to other forms of contraception and critical information about them. According to the Wish List, abroad "no other family planning programming for girls should be provided except fertility awareness methods." We can simultaneously claim fertility awareness for what it’s worth to each of us and reject Trump’s attack on informed choice.
What is fertility awareness anyway? On our road trip, we met thousands of people, many of whom had never heard of it. Fertility awareness is an umbrella term for several types of methods. It’s not just another term for the rhythm method. Rhythm or calendar methods are focused on preventing or achieving pregnancy and assume most people ovulate around the same time. Modern methods acknowledge our human variation and value body literacy, in addition to fertility. While it’s unclear which type Trump’s wish list refers to, it’s highly likely, because of who’s at the table, that his version of FAM won’t include barrier methods during fertile times or a focus on knowing your body, but will include abstinence only.
In our classes, we teach the sympto-thermal method of fertility awareness. By charting basal body temperature and checking cervical fluid and positioning daily, it’s possible to identify the day of ovulation, a fertile window, anovulatory cycles, some vaginal infections or STIs, signs of hypothyroidism and polycystic ovarian syndrome, pregnancy, miscarriage, perimenopause, and more. It’s an invitation to listen to and connect with your body throughout your life. Don’t let Trump and the Christian right use a powerful tool for body literacy against us to control our bodies.
We would have loved to know about fertility awareness as adolescents. People with vaginas, when you reached puberty, how many of you knew what that fluid in your underwear was about? Did you think something was wrong? Did you wonder why it was there or where it came from? One class attendee told us about how learning to monitor her cervical fluid saved her life. When she recognized her cervical fluid was abnormal for her, she went to her OB-GYN and was diagnosed with stage 1 cervical cancer at age 25. Fortunately, It was caught early enough to be eradicated through a procedure. Through learning about fertility awareness, another attendee felt confident to transition off of a hormonal birth control method that was causing serious mental health side effects. These are examples of informed decisions that could only be made with access to information about multiple forms of contraception and knowledge of their own bodies.
So, fertility awareness can provide valuable body knowledge that is our right, and it can be used as a form of contraception that can be up to 99.6% effective at preventing pregnancy if used consistently and correctly and 74% effective if used inconsistently and incorrectly. Sweetening the Pill author Holly Grigg Spall says, "its an important precursor to informed consent on all reproductive health related decisions, including which form of contraception is best for you." But none of that is important if fertility awareness is the only option presented to adolescents, because no single contraceptive is a one-size-fits-all solution.
Informed choice is the only ethical alternative to a one-size-fits-all approach that dangerously insists all our bodies, needs, and desires are the same. This wish list not only blinds adolescents to all but one contraceptive method, it also denies them critical information about which and how to choose. To make an informed choice about birth control, we first need a comprehensive list of options. Then, it's important to know the risks and benefits of each option, their efficacy rates in preventing pregnancy and STI transmission, accessibility, affordability, and knowledge of how each method works, and our family history of blood clotting disorders. Next, we have to see if our choice physically and emotionally works for us. Many hormonal birth control options really work for people and many do not, and when they don’t, the side effects range from headaches to mood swings to death. So, do we think that championing only fertility awareness methods will fix this? No. It will further deny individuals the right to make the best decisions for their bodies. An attack on options creates an urgency to choose that can obliterate the process of an informed decision. Our Facebook inbox is full of time-pressed questions regarding concern over continued contraception availability, and Planned Parenthood’s 900% reported increase in IUD insertion post-election is a testament to this.
We need more choices and information, not less. We know what it means for policies to impact our bodies. Don’t come for us, don’t come for our knowledge, don’t come for our choices, and don’t come for our bodies.