Politics over girls
(Original publication: August 6, 2006)
After first denying any political motives, the Food and Drug Administration last week finally gave up all pretenses surrounding the eyebrow-raising move last year wherein it rejected the advice of its own medical panel to make the so-called "morning-after" contraception pill more easily accessible to girls and women.
First came an about-face, smack dab in the middle of the Senate confirmation hearing for acting Commissioner Dr. Andrew von Eschenbach, up for the permanent commissioner's post. Upon further review, the FDA said the after-sex contraceptive pill would indeed be sold without a prescription, at least for women 18 and over.
At week's end came the revelation, out of a related lawsuit, that a top FDA official in 2004 said the idea of making the pill non-prescriptive had to be rejected to "appease'' Bush administration constituents, Bloomberg News reported.
Such are the compromises made where female health is concerned. Coming this week: Officials of the FDA and Barr Pharmaceuticals, maker of the so-called Plan B pill, meet Tuesday to discuss how to sell the pill — just not to teens.
Several senators, including New York's Hillary Clinton, called the agency's change-of-heart "politicizing the FDA.'' Our view: It's nothing new from the FDA, just a rare glimpse at transparent politics.
But there remain some facts for policy-makers to consider, in both Albany and Washington, in light of the continued restrictions on sales to females under 18
• Ovulating girls under 18 who have sex, willingly or not, can get pregnant, willingly or not.
• Before having sex, girls under 18 rarely ask for parental permission. Most rare is their asking permission to decline sex with those who force themselves upon them.
• Once pregnant, girls under 18 have limited options, many of them poor.
The FDA could certainly afford them more leeway, by allowing all females easier access to the morning-after pill. When administered within 72 hours of unprotected sex, it stops ovulation, fertilization or egg implantation, reducing the risk of pregnancy by up to 89 percent. Obviously, with time being of the essence, requiring a prescription can cause unwarranted delay. The medication, which contains hormones similar to those in birth-control pills, reacts biologically on females, including girls under 18. It is not ageist.
Assemblywoman Amy Paulin, D-Scarsdale, sponsor of a bill that would reduce the number of unintended pregnancies in New York by providing access to emergency contraception to females through a registered nurse or pharmacist, without requiring a doctor's prescription, told the Editorial Board:
"The fact that (the FDA is) drawing a line between women 18 and older and younger women makes it clear that they continue to base their deliberations on political motivations. There is simply no health-related reason to make this distinction.''
Policy-making, we know, can be ageist, it can be sexist, it can be obstructionist, it can be delusional. Those adolescents fortunate enough to have close relationships with their parents — especially those with daughters who become pregnant — don't necessarily need Albany and Washington policy-makers to act on their behalf. It is the other teens — the ones without such parental supports — who do.
Relatedly, New York, one of the allegedly most liberal states, has been unable to pass legislation or regulate through its Board of Regents an age-appropriate and medically accurate public-school curriculum about sexuality. While students must be taught about AIDS and HIV, sex education is not required. A bill that would do so failed again in the last legislative session.
The Bush administration, meanwhile, has made federal money available to the state for abstinence-only education for teens. So much for wishful thinking. In 2000, 44,000 New York teens became pregnant, and rates for gonorrhea infection are the highest among young people ages 15 to 24. We can do better, by being realistic about the conduct in which young people engage, and by being honest about the real dilemmas they encounter.
This page last updated May 8, 2008 16:32 .