Give Me A Damn Diaphragm

“One of my favorite moments is when a guy, at that certain point in a relationship, says something desperately hopeful like, ‘Are you on the pill?’ I simply say, ‘No, are you?” ― Roxane Gay

In the days following Donald Trump’s election to US President, women swarmed gynecological offices nationwide in pursuit of the IUD, a small, t-shaped device that is placed in the uterus to prevent pregnancy for anywhere from 3-12 years. This surge appears to stem from fears about how Trump’s administration will limit access to the co-pay free birth control options currently available under the Affordable Care Act. And although I too feel the winds of change a’coming, I recently had my IUD removed.

IUDs rank among the most effective of any available birth control method and come in two varieties: non-hormonal (copper) and hormonal (synthetic progestin). The Fraud and Deceit Administration (FDA) has approved five brands of IUDs for use in the United States. I have had two of them, one copper and one hormonal (Skyla), and I detested them both.

At the age of sixteen I was a sexually active teenager with a bit of acne (weren’t we all?). I was prescribed “the pill” without a blink of my doctor’s eye. There was no conversation about other birth control methods or the side-effects and long-term risks of synthetic hormones. It was more difficult for me to procure Sudafed than it was birth control pills.

In my early 20’s I realized that many of the symptoms I experienced on a daily basis were connected to oral contraceptives and the artificial hormones designed to suppress my body’s natural function. And so I ditched the pill and bought a big ol’ box of condoms. I would be lying if I said there was not a Plan B or two in those years, but I did not have a stable partner and was quite conscientious in my ‘no glove, no love’ philosophy.

When I finally stumbled into a serious adult relationship I got a copper IUD thinking it was the perfect solution to hormone-free and long-term birth control. I had my Paragard for 14 months and the intolerable side effects lasted just as long (and longer than my mostly intolerable relationship). In May of this year I swapped my Paragard for a Skyla. Despite my concerns about returning to a hormonal method of birth control, my doctor assured me that the amount of hormone was “so small it’s not noticeable.”

But I did notice that my period stopped completely. And while some women may find this appealing, I found it odd and unnatural. I felt disconnected from my body. While discussing non-hormonal birth control options with my gynecologist, she suggested that I “stop worrying so much” and said that I need to “get over” my concerns about using oral contraceptives.

The FDA approved the first oral contraceptive in 1960. In the over 50 years since its development, the serious and long-term risks of synthetic estrogen and progestin have been extremely well-documented and are widely accepted by the scientific community. Why is it, then, that hormonal contraceptives and manufactured devices are offered to women as if they are our only option to effectively avoid pregnancy?

Prior to 1960, humans avoided unwanted pregnancy naturally. In 3000 BC, condoms were made from fish bladders (still used in beer brewing). As early as 1500 BC people used linen cloth soaked in a solution that, once dried, killed sperm. In the early 1800’s, condoms and diaphragms were first manufactured from vulcanized rubber.

Of course I could once again rely on condoms as my primary birth control, but in a long-term and committed relationship such a method is expensive and can have a detrimental impact on intimacy. But a diaphragm? I knew very little about diaphragms but after extensive research, the thing started to sound pretty damn good.

A diaphragm is a contoured barrier device that blocks sperm from entering the uterus. It is used in conjunction with a spermicide and, when used correctly, is just slightly less effective than condoms at preventing pregnancy. The Internet led me to Caya, a recently marketed one-size-fits-most diaphragm, a ‘next generation’ model so to speak. Caya recently became available by prescription in the United States.

Excitedly I called my gynecologist to request a prescription. My request was less than politely denied. “That’s not a great thing to use, sweetie and we don’t even prescribe them anymore,” I was told. And when I called a different doctor with the same request, I was told, “There are methods far more effective than that. You really should do some research.”

To say that I was incensed that not one but two doctors who specialize in women’s health denied my request for a safe, effective and non-hormonal method of birth control is an understatement. Out of desperation I ordered a Caya from a woman in Germany (new, not used). It was confiscated by the FDA at customs. The third doctor I asked (not a gynecologist) finally wrote me a prescription for the Caya diaphragm.

When I picked up my Caya today, the young pharmacy technician commented, “I have never seen this before. It really peaked my interest so I looked into it and I am really happy to know this exists. I have been wanting to try something different.”

To the doctors who refused to give me a damn diaphragm I simply have to say that it is not your vagina, so shut your damn lips about my preferred method of birth control.

3 thoughts on “Give Me A Damn Diaphragm

  1. I guess I had missed this one, just found it (intrigued by title :-). I’m many years passed needing birth control, but my life as a social worker (and habits) were all very similar to yours, including my search for b.c. that wouldn’t make me sick and/or miserable. In those days diaphragms were at least available, I got myself prescribed and NEVER looked back! It’s not perfect: it’s never easy for those of us with that pre-existing condition of being female, but diaphragms are not that bad overall. I don’t know why men have it so easy.

  2. I’m going through the same thing right now and it’s an absolute nightmare. I literally felt like I was being pushed around by my gynecologist – made to feel stupid when I had done TONS of research. I’m newly married and don’t want to get pregnant for another few years – but my mother and her aunt were both recently diagnosed with breast cancer and both doctors attributed the tumors to the hormones the women has been prescribed. When I brought that up she happily told me that I’m very, very safe taking oral contraceptives and should continue doing show. She did slip up however and mentioned that she, herself won’t take them……..interesting….

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