Misogyny and medical research

Back in the 1980’s, I read a magazine article in Vogue about a research clinic in the US which attempted to study the possible applications of RU-486 (the “abortion pill”) in treating breast cancer. The results were promising. The research was shut down due to anti-abortion protests. For some companies, the desire not to be thought of as baby killers simply outweighed their concern for saving women’s lives. Other companies remained committed to the breast cancer research no matter what the protestors threatened, but couldn’t obtain sufficient quantities of the drug for study in the US, because the protestors had succeeded in making the drug very difficult to come by in the US.

Plus, the anti-abortion faction in the US is very powerful and well-funded. Let’s face it: if anyone could shut down a mega-powerful American pharmaceutical company, my money would be on these guys. Don’t get me wrong: I respect the views and the dedication of anti-abortionists. I just question a lot of their methods and priorities. In causing the shutdown of this research, they weren’t saving the unborn: they were squashing a potential life-saver for some of the born.

I was a teenager at the time, and I couldn’t understand the problem: didn’t the protestors understand that all sorts of medications can cause miscarriages as a side effect? How could anyone object to studying anything that might save the lives of women, just because the same drug can be used for another purpose they dislike? I mean, let’s say you have a moral objection to using anti-depressants. Would you try to shut down research into an anti-depressant’s coincidental ability to treat, say, leukemia? Or maybe the point here is that I should be asking about testicular cancer, or prostate. If RU-486 had demonstrated a potential to treat those things, would the anti-abortion crowd have been as determined to shut the research down?

More disturbing to me was the fact that I never saw wider reporting on this issue: just Vogue’s story. That was the end of my conditioned belief that the press existed to speak for those who can’t speak for themselves, to disseminate information we can’t obtain for ourselves. The press, I began to understand, existed to further certain corporate interests.

I had my own brush with “Better you die than have sex” when I developed polycystic ovaries as a teenager. One in four women will have this condition at some point in her life. The cure espoused by virtually every OB-GYN is the birth control pill – proven in clinical trials to reduce ovarian cysts. Left untreated, these cysts can lead to ovarian cancer – which remains undetectable until it’s too late to save your life. Do you think my parents’ insurance offered to cover the birth control pill for non-contraceptive use in treating me? Hell, no. If my family couldn’t afford to pay for the pill out of pocket, it was better I risk death than the insurance company be obliquely associated with promoting contraception. That was the end of my conditioned belief that the medical industry was based on caring rather than money and their public relations with groups powerful enough to affect their funding.

The insurance companies’ stated reasoning for why they cover Viagra but not birth control pills has been that they can only support the use of medications in treating disorders, and pregnancy is not a disorder. Erectile dysfunction is. The problem with that logic is that insurance companies still weren’t covering the pill even when it was clearly being used to treat a disorder. They also didn’t cover it for women for whom pregnancy would have been life-threatening.

Nothing much has changed since then. My current PPO does offer coverage for the pill, which reduces your monthly cost to a co-pay, or you can use their tri-monthly refill program for better discounts, so that’s an improvement, as long as it lasts. My cost is about $70 per month, and my primary reason for being on the pill remains non-contraceptive.

And the US has never done any significant research on RU-486 for its non-abortive usages, leaving that research to France and the UK. Here’s an article telling where things stood in 1991, and here’s the latest from ABC News: British researchers have remade RU-486 into a contraceptive pill that “could reduce the risk of breast cancer, thrombosis and heart disease”. Of course, that doesn’t mean the FDA will approve it, even if it passes reasonable safety trials. They may instead concern themselves primarily with how it might impact teenage sexuality, as they did in evaluating Plan B.

And in any case, none of this helps all the women who died of breast cancer while this research and development wasn’t getting done.

If you want to get even more angry or depressed about this topic, go read the inserts on any pharmaceuticals you have at home. You’ll quickly discover that the human trials for virtually any FDA-approved drug are conducted almost exclusively on young white men. For those of you thinking I’m crazy to be concerned that TV is developed exclusively for that demographic, this is why: the entertainment culture is just a microcosm of our entire white-male-centered culture. If a drug doesn’t harm young white men*, it’s good to go as far as the FDA is concerned. Unless it might potentially encourage women to have sex, which it is apparently the FDA’s mandate to prevent. Who knew?

*Except birth control pills. Those they test on women.

Comments

  1. scarlett says

    Recently in Australia there wsa a breakthrough in discovering an immunity shot (can’t think of the words right now – the same thing you get for stuff like MMR) against HPV, the STD that can lead to cervical cancer in women. HPV is highly tranmittable, possible the most easily transmittable of the STDs, I read one study which thought up to 80% of people had it. As it stands, very few women actually die from cervical cancer but this one little shot could make it preventable for most of us.

    Except, you know, according to some people, knowing they’ve had a shot which means they won’t get cervical cancer will make teenagers girls run out and sleep with as many boys as they can. Because apparantly there aren’t more pressing issues about having unprotected sex then the threat of cervical cancer. I can’t help but think that if the situation were reversed, that it was about testicular and not cervical cancer, they wouldn’t be able to keep track of the funding.

    Can’t believe the pill isn’t subsidised in the US. I pay about $A70 for a year supply, which includes the consultation, and from memory, it’s even cheaper in the not-too-long long run to get the implant or injections.

  2. scarlett says

    Thought I’d made this comment seperate ‘coz they’re kinda different topics…

    At the begining of the year there was a huge debate over RU486. Basically the (catholic) Health minister of our conservative govt wanted the drug to fall under the jurisdiction of the health dept to decide on its merits, even though all proposed drugs get sent to this Pharmasciticals board (I’m a crap speller and I can’t even think of what the board is actually called – but they basically control the legal drug industry in Aust and are independant of the govt) who decie the mertis of a drug based on its cost, effectiveness, contribution to the country etc, independant of the govt or religious influence. But Abbot couldn’t have that; he wanted RU486 under his jurisdiction, where he could sweep it under the carpet forever more. He blatantly overlooked the rules (although technically this board answers to the Health dept) because of his own Catholic, patriarchal values, because he knew damn well that the board would approve the drug. His main argument, apart from the one I kind of agreed with that eliminating compulsory councelling from abortion could be detrimental to the mother (or even father),was that it would crate teenage promiscuity.

    I had to laugh at that. I’ve never had an abortion, but I’ve heard they’re pretty gross things to go through, worse then the morning after pill. Combined with the trauma of aborting your child, I cannot imagine any woman relying on that as primary form of birth control. Meanwhile, women who are raped, women who get drunk and sleep with someone unprotected, women who’s regular protection has failed them – have an out.I fail to see how that’s anyone’s business, or right, then ours.

    At least there’s a happy ending; the pill got passed over to the board and has since been approved.

  3. Nialla says

    Just this past week I saw ads for the HPV vaccine, emphasizing it can prevent cancer. However, the drive to make this a normal vaccine given to young girls (and boys too) before they have sex is meeting the expected resistance from religious groups.

    “Abstinence is the best way to prevent HPV,” says Bridget Maher of the Family Research Council

    and

    “Giving the HPV vaccine to young women could be potentially harmful, because they may see it as a licence to engage in premarital sex,” Maher claims, though it is arguable how many young women have even heard of the virus.

    The article goes on to say that while pre-screening is helpful in developed countries, it’s not available in developing countries. Apparently Merck is going to combine the vaccine with one for genital warts, in the hopes that men will get that vaccine and therefore prevent them from spreading HPV to their sexual partners.

    Article

  4. Glaivester says

    Although I don’t know if I necessarily agree that every one of the things you mentioned is driven by an anti-sex agenda (some of them certainly are, though), I agree with you in general that research into RU-486 for non-abortifacient purposes should not be restricted, and that when a contraceptive is used, in part or in whole, for a non-contraceptive purpose, the insurance company should look at it the same way they would look at a similar treatment that did not prevent conception. (As for covering contraceptives for the purpose of contraception, I would generally leave that up to the insurance company to determine as long as the customer knows the policy in advance).

  5. Mecha says

    (This feels a little rough as I explore the idea, so bear with me.)

    Social good becomes the problem with that paranthetical idea, Glaiv (and becomes the biggest glaring hole in any insurance that wants to argue that not covering contraception is bad, as you will hopefully see in a little bit.) First, you don’t get to choose. Your job gets to choose. And since it’s not quite a ‘worker’s market’… well. I when workplaces care about women enough to pay them equally they will also care enough to not pick a healthplan that doesn’t cover this type of contraception.

    On the other front, which is better for a company which pays out money for every person that exists, and again for their deaths? Uncared for children to stress all of the social services (health care, food, quality of life) in such a way as to drive costs up, physical abortions which have possible health effects AND, as per the general rule of prevention versus surgery so they likely cost more, childbirth itself (somewhat costly and something they’ve driven down into the ground in terms of coverage), and using the fact women can get prengnant to be a scare campaign on public sexual morality (but not private sexual moralirty, unless the US is a nation where only 1 in 5 people have had sex outside of marraige?)… or cheap female contraception and morning-after pill availability? Doesn’t seem like a difficult business decision.

    Why is it that the reasons to not have the pill seem to have no actual benefit for insurance companies at all (likely a cost instead), and everything to do with benefiting the current social order? The cost-benefit analysis for an insurance company is well in favor of birth control for contraceptive purposes (among other purposes.) So I, and Beta, and no doubt countless others, have to ask why aren’t they doing it, if it’s not some sort of female (sexual) repression/lack of concern via patriarchy issue? I’d love to see the analysis that says that a child is more profitable to them than the pill. (Sadly, I bet the analysis can be done. Guaranteed clients for 18-22 years, that will always do the ‘cheap stuff’ of prevention, and not the ‘expensive stuff’ of surgery. I wonder if it really does tip the scales. Cold, cold world of insurance.)

    And I don’t even want to think about how the poor would figure into this worldview. Because I doubt it’d be anything but cold as ice.

    No, it seems the likelyhood is that the insurance companies either don’t care about women they insure on this front due to the profitability of knocking them up (especially now that they only get a day or two of post-natal care), or are trapped by/engaged in the moralizing. And none of that is much good at all.

    -Mecha

  6. Jennifer Kesler says

    It’s hard to distinguish an anti-sex agenda from a simple lack of concern for women’s lives in several of my examples, so I’ll grant they may not all be about the fear of being associated with contraceptives. But either way, the results are still problematic.

    I generally agree with the rest of what you said, though I do back Mecha on the fact that most of us can’t really choose our healthcare plans, since they’re employer-chosen. So the only option is for people to complain about the plans they have – fortunately, sometimes that works, and it’s a valid way to drive change in the market, too.

  7. Jennifer Kesler says

    You know, I’ve read articles that explain the importance of babies in free-market countries. Suppliers can never have enough folks on the demand side of the economy, you know? So governments freak (as France did recently) if the population’s not growing, and start offering incentives.

    But I agree with you: I can’t see why insurance companies prefer to incur the cost of pregnancy, child-bearing, potential complications, and then childhood ailments and all that jazz – compared to a maximum of $45/month for contraceptives. It doesn’t seem to me like this policy can truly be cost-driven or “good business”. Which is why I think there’s another reason for the policy, and the only reason I can imagine is the stigma attached to contraception.

    I also can’t imagine how my dying of ovarian cancer would have been cheaper for an insurance company than the cost of the pill. Or do they just rely on their ability to loophole their way out of providing coverage when something as expensive as cancer comes along?

  8. Glaivester says

    Why is it that the reasons to not have the pill seem to have no actual benefit for insurance companies at all (likely a cost instead), and everything to do with benefiting the current social order?

    That’s assuming that the two choices are “insurance covers the pill” or “no pill.” Probably in many cases, the woman has enough money and buys the birth control out of her own pocket, or buys a cheaper form of birth control (condoms). These cases, of course, represent a win-win for the insurance company, and perhaps according to the actuarial calculations, save it more than it has to pay out in child and pregnancy-related expenses for those who can’t afford the pill.

    I’m not saying that this is an admirable (or even necessarily ethical) way for insurance to behave, but it isn’t irrational from a profit-maximization standpoint.

  9. Jennifer Kesler says

    Condoms are less effective for birth control than the pill, but necessary for protection against disease, so smart women with means use both.

    Of course, there’s no law that a man can’t provide the condoms, or even offer to share the costs of birth control. In fact, I would encourage women to judge a man’s mate viability on the basis of his awareness of birth control, disease prevention, and the costs of it all. If he doesn’t get any of that, he probably has little concern for the welfare of others, doesn’t have the sense to think preventatively, and isn’t someone you’d want to mix finances with.

    I’m wandering a bit off-topic, but I just thought of something that’s on-topic: insurance will cover vasectomies, and those are clearly used for nothing but bc. So what gives there?

  10. scarlett says

    In Australia insurance has nothing to do with birth control, I assume its the govt that subsidises it. As I said, my pills cost me about $70 for a year’s supply (I am on the most common one, though, it may get more expensive for the more specialised ones) and the other common forms of bc are fairly cheap too. Maybe it has something to do with the fact we have a defalut mother-carer welfare system, so the less single mothers we have, the less $$$ the govt has to shell out – better the subsidise the pill then pay to raise a child.

  11. scarlett says

    As you probably could have told by my poor spelling and rambling argumemt, thet last post was made at 2am so may not have made much sense.

    Tony Abbot, the Minister for health, is a fairly orthodox Catholic in a convservative govt to boot. He personally is not a big believer in pre-marital sex or abortion. So he attempted to take control of the drug away from the pharmasutical(??) board, where it belonged, where it could be investigated solely on its merits as a drug and not patriarchal or religious ones, and keep it under his control, which he had no right to. Maybe it goes back to the whole invisible privlidge thing – that he, as a white christian male, thought he had the right to force his views to be accepted even though the whole thing really had nothing to do with him.
    Scarlett

    PS. And I’m certainly not saying that all conservatives, or all Catholics, are that closed-minded… we just have enough to ensure that society and the law never functions for the benefit of the greater amount of ppl.

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