Ryan Brown

The pill without a prescription?

One expert says birth control should be offered over the counter, but in the meantime, we've got other options

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The pill without a prescription?Female hand holding contraceptives against a white background

I come from a generation of pill poppers. We take them at work, at school, on trains, in public bathrooms, before we go to sleep or with breakfast, under the eyes of parents, friends, significant others. For many young women like me, the birth control pill is so ubiquitous that it neither induces shame nor carries any shock value. And yet, access to the pill remains uneven, and some 3.1 million pregnancies in the United States each year are unintended. In a thoughtful New York Times Op-Ed, Kelly Blanchard, president of the nonprofit Ibis Reproductive Health, proposes a novel solution: make the pill available over the counter.

To anyone who has ever missed a pill because she couldn’t get to the pharmacy in time, or for women whose access to a doctor is sporadic or nonexistent, this is exactly the kind of holy-shit-why-did-no-one-think-of-this-before idea that we’ve been waiting for. As Blanchard points out, 50 years of use has proved that hormonal birth control meets the standards for OTC distribution: you don’t really require a doctor’s expertise to tell you if you need the pill (are you sexually active? Do you not want a baby? Check, check), you can’t become addicted, the side effects are mild and even the most severe are less dangerous than those of some medications already available over the counter.

But as Blanchard notes, selling the pill over the counter would probably drive up the price, throwing up another barrier to poor women who already struggle to afford birth control. She argues that Medicaid should pledge to cover the pill over the counter — a solution that is important but sadly distant.

If the FDA does approve the pill for over-the-counter use, it will probably take years, and as we wrote earlier, debates over the pill’s safety – and its morality – will likely stalk the race all the way to the finish line. In the meantime, though, American women do have another, oft-ignored option at their disposal, a birth control option that’s less expensive, safer and more effective than the pill: the intrauterine device.

The IUD, essentially a small metal rod inserted into the uterus to prevent sperm from fertilizing an egg, is the wunderkind of the birth control world. A woman need visit a doctor only once in the process — to have the device inserted — and protection can last up to 12 years. Because there’s no upkeep or chance of missed dosages, IUDs rank with sterilization and vasectomies (oh yeah, and that old standby, abstinence) as the most effective forms of birth control. Plus, they’re covered by Medicaid in several states and many family planning clinics will foot the $500 bill for low-income patients (although even if they don’t, 12 years of protection for that price comes out to about $3.50 a month).

IUDs have gotten a bad rap in America, where they’re often still associated with an older model called the Dalkon Shield, which was yanked from U.S. markets in 1976 after it caused uterine infections and sterility in thousands of women and killed dozens. Today’s models carry no such risk, and indeed are used by 85 million women worldwide, but in the U.S. we remain haunted by the ghosts of IUDs past — only 2 percent of women practicing contraception in this country use one.

That’s incredibly unfortunate, especially given the hurdles women currently have to clear to get access to the pill. If birth control is still the priority we’ve claimed it was for the last 50 years, we should be pushing IUDs — or at least disseminating the information to let women know what else is out there. The next birth control revolution will be one not only of access, but of options — over and behind the counter, hormonal and non-hormonal, swallowed, inserted, injected, imbibed. Give women choices; they can take it from there.

The politics of the World Cup

Why'd Glenn Beck hate soccer even before the U.S. got robbed of a win? An expert explains the game's hidden message

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The politics of the World CupThe US team celebrates after scoring during a 2010 World Cup match against England

Soccer is a simple game: Twenty-two men kick a ball around for 90 minutes, and the referee always wins. When Malian referee Koman Coulibaly erroneously pulled back a soaring 86th minute goal by American striker Maurice Edu in today’s U.S.-Slovenia match, the move drew instantaneous ire from the supposedly sleepy soccer backwaters of the United States. In a second, a nail-biting comeback from a 2-0 deficit to a 3-2 victory was reduced to the bland territory of a 2-2 tie. But the World Cup, like many things in life, has a curious habit of completely ignoring the laws of fairness. Sometimes a bumbled call, a lucky goal or a tiny blunder is all it takes to change the direction of a game — and reroute the hopes of an entire nation.

Perhaps the most interesting element of the World Cup is this bizarre shuffle of the global world order that it makes possible. In this space, tiny Senegal can best its former colonizer France, Mexico can roll over France (as it did just yesterday) and Germany can finally score a convincing victory against those damn Brits. With billions watching the tournament and most games decided by a single goal, soccer may just be the world’s most popular and unpredictable political stage.

In his fascinating and intelligent new book, “Soccer Empire: The World Cup and the Future of France,” historian Laurent Dubois untangles this often-overlooked linkage in one of the world’s perennial political and soccer powers, France. For an academic, Dubois has a surprisingly strong narrative voice as he sweeps through the country’s swashbuckling colonial history to scour the overlapping stories of empire and sport. But the book is more than just a narrative of soccer in France. It is also the tale of how even the most seemingly apolitical institutions in a society can become the battlegrounds for its most pressing questions of identity and ambition — and give us a really fun game to boot.

Salon talked with Dubois, prior to France’s disastrous 2-0 loss to Mexico, about the politics of the World Cup, Glenn Beck’s vendetta against soccer and the infernal racket of the vuvuzela. 

First question: Are you annoyed that I’m keeping you from watching this Brazil-North Korea game right now? Or do you secretly have it on in the corner?

No, I actually don’t. I’m being very responsible. It is an interesting match, though, because in 1966 North Korea came to the tournament basically on a fluke and then famously defeated Italy and a bunch of other very strong teams. So it’s possible they’ll defeat Brazil here. You can’t rule it out. [Editor’s note: Close, but no cigar. 2-1 victory to Brazil]

What makes soccer such a good way of looking at the politics of national identity?

In one basic sense, the national team actually becomes the nation in a very visceral and powerful way because the 11 people on the field literally decide if our country is the best in the world. At the same time, when you look at the case of France you see that people may feel like the team is not them, or wonder what it means that these certain people represent them — especially when it comes to immigrants and marginalized people in the society. So in many cases you have a team of people who are heroes of the nation also at the same time challenging what that nation is and means.

Could you write a similar book about politics in U.S. soccer? Has there ever been a U.S. soccer team with an important political role like the French team has?

I think that story in the U.S. is the story of the women’s team that won the World Cup in 1999 because it represented a political challenge in the sense that the team was insisting on the importance and equality of women’s sports in a country that still wasn’t quite there. They were very much addressing a situation of marginalization and discrimination, and because it was a victory for the whole country it gave the event a big symbolic weight. None of the people on that team necessarily made themselves into political symbols, but they were anyway. Just by playing and being visible, they had to be.

It’s a bit harder with the men’s team, because soccer is so marginal in American sports culture. At the same time, the U.S. team has more than a dozen players with at least one foreign-born parent, and it’s a very diverse squad. So if by some miracle the U.S. won the World Cup you could definitely imagine that team becoming a symbol of our country and the way it looks, and have people asking what that means, just like they have in France.

It’s true that soccer is on the fringe of American sports culture, but at the same time if you drive by any park on any weekend afternoon, you see that Americans do actually play a ton of soccer. So why don’t as many people watch the World Cup as watch the Super Bowl?

It’s not that soccer inherently couldn’t be popular in the United States as a spectator sport, but people learn to watch sports — it’s not some natural behavior. For instance, anybody who doesn’t understand baseball and watches a baseball game is totally lost, because if you don’t know what makes it interesting you don’t understand what the big fuss is all about when these men run around swinging bats. The same thing happens for soccer. People in the U.S. aren’t that familiar with it, especially at the professional level. Just having played or having watched your 6-year old play isn’t necessarily going to provide you with what you need to watch an Ivory Coast-Portugal game and get it.

But it seems that the U.S. reaction to the World Cup is more than just boredom or confusion. Glenn Beck said that he hated the tournament and that Americans should refuse to watch it.

Right. Soccer generates actual hostility in the United States in a way that few other sports do. For instance, people aren’t necessarily familiar with the luge, but when the winter Olympics comes along you don’t get conservative commentators complaining that it exists. But every single World Cup there’s this chorus of comments from the right ridiculing soccer. It would be one thing if there was just indifference — nobody should have to watch a sport — but the fact that it creates rage in the mind of someone like Glenn Beck is actually pretty interesting.

I think it has to do with the fact that soccer is a sport that has always been linked to immigrants in this country and at the same time tied to a certain cultural elite. And as we know, there’s a particular strand of American society that sees immigrants and the intellectual elite as dangerous forces. So looking at it that way, it’s not surprising that conservative commentators would fixate on soccer, since they’re obviously fixated on those other two things anyway. It’s an obvious leap — they feel like the growing popularity of soccer is just further proof of the decline of America.

What does it mean to have the World Cup in Africa for the first time?

It’s a big deal. There’s been a long and vexed relationship between the Confederation of African Football and FIFA. In 1966 the African continent actually boycotted the World Cup because at the time they didn’t even have a single guaranteed spot in the tournament. This World Cup comes from a long history of people pushing FIFA to make Africa a more equal partner in the football world. This tournament is in one sense people making good on those promises of equity.

And at the same time there’s also this complex history of political debate on the soccer field between South Africa and the rest of the continent. African football leaders pioneered the boycotts of South Africa during apartheid. South Africa refused to send integrated teams to the African Cup of Nations and the other teams in the tournament basically kicked them out of it and then FIFA followed suit. Now, 16 years after apartheid ended, that nation has a chance to show the world what they’ve become.

We’ve been getting a lot of Google hits to Salon recently from the search phrase “annoying world cup buzzing.” So on that note (or hum), what’s your take on the vuvuzela debate?

I think it’s funny how intense the reaction has been. Yes, I’m sure the vuvuzelas are annoying, but you don’t go to a soccer stadium to have peace and quiet. You could be irritated about almost every form of noisemaking. At some point I think you have to step back and say, you know what, the World Cup is in Africa, they have these horns they like, deal with it. But that’s what’s funny about sports fans, the intensity of the rage they can feel toward something that is by all accounts trivial. In part this is why debates, political or otherwise, around soccer can be so powerful — in the end there’s no empirical way to resolve them. Was the Mexico-South Africa game really good or really boring? Are these horns too loud? I don’t know, and no one else does either. But we’ll all keep asking.

You’re headed to South Africa in a couple weeks. Will you be a horn blower or an earplug wearer?

I don’t think I’ll wear earplugs or blow the horn. I’ll be neutral.

A cautious bystander.

Yeah, I’ll probably be busy tweeting.

Ryan Brown is an editorial fellow at Salon. You can follow Laurent Dubois’ continuing World Cup commentary on Twitter or via his blog, Soccer Politics 

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Remember the Women’s World Cup?

Buzz around the U.S. men's team brings to mind the female players who showed us in '99 what women's sports could be

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Remember the Women's World Cup?United States midfielder Brandi Chastain celebrates her winning penalty kick to defeat China 5-4 at the Women's World Cup soccer final between the two countries July 10 at the Rose Bowl. The United States women's national soccer team were named Sportswomen of the Year (1999) by Sports Illustrated magazine. FP/FMS/AA(Credit: © Reuters Photographer / Reuters)

If you’ve been casually following the current World Cup from the U.S., chances are you’ve heard a lot about two things: Shakira’s soul-crushing tournament anthem, “Waka Waka,” and the U.S.-England showdown this past weekend. If American commentators are to be believed, that game — much like the Shakira song, I hope — is the kind of thing that happens only once in a generation. The Wall Street Journal’s Matthew Kaminski went so far as to declare that the face-off was “the most anticipated soccer match in American history.”

Well, I don’t have a hype-o-meter on hand right now, but the TV ratings are in, and in fact Saturday’s game proved to be the most viewed match played by the U.S. men’s national team in more than 15 years. Notice, though, that I said the men’s team, because when you’re talking U.S. soccer, that’s a rather crucial distinction. This team may have outdone their own previous performances, but there’s still only one U.S. national team that’s ever gotten TV ratings to rival an “American Idol” finale, and that’s the women.

For U.S. soccer fans, it is easy to bemoan the country’s apathy toward the World Cup and the game in general. After all, this is a country that can’t even get on the same page as the rest of the world about what soccer — or is it football? — is called. But a decade ago, when the U.S. women’s national team made a blazing run through the 1999 World Cup, their final victory over China pulled in a staggering 19 million viewers (at least according to ABC — many estimates go as high as 40 million). In any case, that’s more than tuned in to the World Series or the Stanley Cup that same year and at least twice as many as watched the U.S.-England game this past weekend. In a single tournament, the team secured America its own peculiar and enduring soccer legacy, as the only country to have a women’s team more popular than its men’s team.

As the ’99 women’s team blazed through the tournament that summer, however, it became clear that this team wasn’t just interesting for being athletes on a run to the world championship. For at least some viewers, the intrigue came from watching a team of skilled multitaskers — they could play world-class soccer and have vaginas at the same time. A columnist for the San Francisco Chronicle voiced a widely circulated question when he wrote, “Is it acceptable to point out that the American women are very attractive?” And when one member of the squad, Brandi Chastain (she of the sports bra and six pack fame), posed nude for a men’s magazine, anger boiled up from the fan base — just what kind of role model for girls did she think she was, slutting herself out like that?

In 1999, however, I was 10 years old, and most of this discourse went straight over my head. Here’s what I saw: a female soccer player starring opposite Michael Jordan in a Gatorade commercial, a women’s sports team that drew 90,000 fans to a single game, screaming teenage boys in Mia Hamm jerseys. It was the golden age — albeit brief — of women’s soccer, when it was a real possibility that female athletes could draw more fans, more admiration, more awe than men playing the same game.

And you know what? My preteen mind bought it, hook, line and sinker. At the very age where I was beginning to wonder if maybe the boys who told me I wasn’t as fast or as strong or as brave were right, the world called back a resounding no. Here, it seemed to say, check this out: a team of world-champion female athletes who have no idea why anyone would ever think that way.

In retrospect, I don’t think it’s any coincidence that soccer was the vehicle for all of this. Soccer is perhaps the world’s most visible and egalitarian stage, where 11 players can become symbolic of a nation, and their presence can pose questions and demand discussion of the way that nation defines itself. It’s a place where a colonized country can defeat its colonizer, where an immigrant can prove her value to her country, and where a group of dazzlingly talented athletes can flip on its head the notion that women’s sports are just a novelty sideshow.

Women’s soccer has gone through a popularity slump since 1999, but for many women like me who are now in our early 20s, it’s been seared in our brains in a much more permanent way than the current World Cup ever will. Eleven years ago, in our most formative moments, we saw more than a great soccer tournament. We saw what women’s sports in this country could look like — and we still haven’t forgotten.

This summer, though, all eyes will be on the men’s team, and I for one am cheering for them, hoping that one day, maybe, they’ll be as good as our women.

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FDA: New “morning-after pill” is safe

Despite evidence that ellaOne is effective, it faces major challenges before being stocked in pharmacies

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Last week we reported on a new, more effective emergency birth control option making its way toward U.S. pharmacies. This morning, the Food and Drug Administration took another step forward when they released a set of documents showing that the morning-after pill ulipristal acetate—which moonlights under the name “ellaOne” in Europe—consistently prevents pregnancy without unexpected side effects.

That’s good news, since this latest iteration of the popular emergency contraception pill works longer—up to five days after unprotected sex—and, according to a study done by the British medical journal Lancet, may be twice as effective as Plan B at heading off unwanted pregnancies.

Seems pretty great, right? That’s probably why the drug is already approved for use in 44 countries. But in the notoriously thorny territory of the American birth control debate, critics are crying foul on the new pill, which they argue isn’t birth control at all—it’s abortion. These activists, led by the American Association of Pro-Life Obstetricians and Gynecologists, draw a direct link between ulipristal acetate, which works by preventing the ovulation of an egg, and RU-486, the so-called “abortion pill.”

“This is a thinly-veiled attempt to get an abortion drug over-the-counter,” Dr. Donna Harrison, president of the AAPLOG, told ABC News earlier this year.

The problem with that argument? RU-486 terminates an in-process pregnancy— ulipristal acetate prevents it from happening in the first place. You know, that thing that birth control normally does. In fact, no patient who suspected they were pregnant already would ever be prescribed an emergency contraceptive, so using the drug that way would be totally illegal.

As we know though, that won’t stop the antiabortionists from railing against the new pill. But hopefully the FDA will put a lid on it soon enough—a panel of experts will convene Thursday to review the findings on ulipristal acetate and decide whether to approve the drug for U.S. markets.

 

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The political zoo

Slide show: The most awkward encounters between politicians and the animal kingdom

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The political zoo

It was supposed to be a run-of-the-mill press conference on the wasteful subsidies of mohair goat farms, but events took a grisly turn Thursday as Rep. Anthony Weiner was nicked in the finger by one of the goats he had brought to Washington for the event. “I got a little bit too comfortable,” Weiner told the New York Daily News of his encounter with Lancelot the goat. “The damn thing slipped out of neutral at the worst time.”

With this encounter, Weiner joins a long line of politicians who have suffered unfortunate run-ins with the animal kingdom. From Benjamin Harrison chasing a goat-drawn cart down the streets of Washington to Jimmy Carter engaging in hand-to-hand combat with a demon “swamp rabbit,” the tradition of politician-beast guffaws is long and illustrious. Here are our favorite encounters between our finest political animals and, well…other animals.

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