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> I have in the past commented on the fact that insurance typically did not cover female birth control, but often did cover Viagra.

Not trying to disagree with you but I think this isn't a fair comparison.

Erectile dysfunction is a medical issue in the sense that you're actually broken. Birth control is different in that you can (mostly) live your life without birth control.

I say mostly because there are women that need to be on birth control for actual medical reasons in that they have complications with PMS and this mitigates things.

A more fair comparison would be male vs female sterilization or condoms.

If condoms were free for men but not for women then that would be a great point.

Again. Not saying I disagree with you just that this isn't an apples to oranges comparison.

I agree about the apples to oranges comparison. ED is, as you say, a medical condition. The "dysfunction" in the name indicates that things aren't working properly. In contrast, no one has ever been diagnosed with being fertile, because being fertile is not a dysfunction.

I do want to suggest, however, that a change of language is warranted around this issue.

You write: "there are women that need to be on birth control for actual medical reasons in that they have complications with PMS and this mitigates things."

These women do not need to be on birth control. They need to receive hormone therapy, which happens to be, in a lot of cases, the same medication used for birth control.

I know it sounds like a distinction without a difference, but it's actually quite a meaningful distinction.

I would not say that a newborn girl with chronic pulmonary hypertension needs to be on erectile dysfunction medication. Rather, I would say that she can be treated with sildenafil, which happens to also be the active ingredient in Viagra.

Similarly, a woman might use hormone therapy to avoid menorrhagia, and a side effect might be that it decreases her ability to become pregnant, and she may or may not be happy with that side effect.

When you make this language shift -- "birth control" applies to contraception, which disrupts the body's natural fertility, and "hormone therapy" applies to treatment of medical conditions and dysfunctions -- it helps resolve some hot-button issues.

For instance, if a woman works for a religious employer that does not cover contraception, I would imagine that employer would have no issue with her receiving appropriate hormone therapy for a medical condition such as menorrhagia, even if a decrease in fertility is a known side effect.

Women generally make less money than men. Raising a child alone when you can barely support yourself is a serious hardship. These stats are out of date and for illustration purposes only:

If a woman makes 2/3 what a man makes, he makes 1 1/2 times what she makes. If it takes 90% of what she earns to just scrape by and only 10% of her income is discretionary funds, he has many times as much discretionary money as her. If she has a child out of wedlock and has to raise it alone, childcare will be far more than her current "fun money." So having a child out of wedlock can ruin a woman's life, even before we get into potential medical complications, what if the child has special needs? etc.

If you have a one night stand with a stranger and a pregnancy results, he may never know he fathered a child. She may find herself pregnant out of wedlock with no means to contact the father, thus no hope of even asking for child support.

Women generally worry quite a lot about unintended pregnancy because it can so completely derail their lives in an unrecoverable fashion. (IIRC) Getting pregnant unexpectedly is one of the three biggest risk factors for plunging a woman into poverty, even if she's always been middle class, is well educated, etc. The other two are divorce and widowhood.

The best choice to make when you don't have birth control and don't want to have a child is to not have sex, since even having sex using condoms and similar protection are not completely effective. Are you saying that birth control should be covered because women are incapable of making objectively good decisions when they don't have birth control?

That's definitely not the experience I have. Viagra, even generic, is over $1000 a month due to not being covered by an topped out health plan that even covers things like IVF. Doctor also said it's usually not covered for any of his patients. Meanwhile my wife's birth control is free from planned parenthood.

>Society is generally okay with men having sex outside of marriage.

"Okay" is a curious word to choose. There is a good reason why almost every culture on Earth has shamed female promiscuity: women get pregnant and men do not, making premarital sex far more risky for women than for men. Culture hasn't caught up with the invention of the birth control pill, but that does not mean that it's all part of a patriarchal scheme (as people imply).

Men are also shamed to a lesser degree depending on the culture for rampant premarital sex but also get respect for it too, which makes sense. A male's sexual success is very closely tied to his status, wealth, and position in a social hierarchy (this is observed across diverse cultures). You can take it as an indicator of a male's success in his society.

>Did not cover female birth control

Erectile dysfunction is a medical dysfunction. Not wanting to have children is not a medical dysfunction. It's more complicated than the stories people are told.

Not wanting to have kids is, in fact, a medical issue for many women. Pregnancy is dangerous for many women, especially those with pre-existing conditions.

It is not a medical dysfunction. "Not wanting to have children" is not a medical disorder, it's a preference. It's not necessary to use birth control if you don't want to have kids. You could instead just not have sex.

> Society is generally okay with men having sex outside of marriage.

Never in my life has this been acceptable to anyone I know.

I think she is complaining about sex before marriage having a double standard, not cheating during marriage. Women are sometimes expected to "save themselves" by the religious, I think, although I've never met a fellow millennial who believed in that rot.

Millennial man here who saved himself for marriage. First thing I said to my now wife on our first date: I am not having sex with you tonight. She said 'great', which is why I bothered continuing with the evening

Maybe if you met more people like me, you would not be so incredulous. The catholic church has several groups and iniatives dedicated to young mens chastity

In our provincial puddle of spectacular society, it's (almost) never acceptable. But of course we live under the spectre of being mammals with a harem-type arrangement, of chief/king figures and noble figures having many partners for recorded human history, and of the awe males are given for having massive amounts of sex partners.

In private society, we encourage our own particular vices and virtues as long as they don't lead to a critical point of instability and dissolution.

> I have in the past commented on the fact that insurance typically did not cover female birth control, but often did cover Viagra.

Total opposite in Canada across public and private plans.

Never saw a private or public plan refuse to cover BC. Many would pay several hundred for an IUD as well. Rarely saw a plan cover ED drugs outside of self-insured or executive plans.

Any vaguely rational insurance plan which covers maternity will cover birth control, since it’s so much cheaper. But there were a lot of plans that didn’t cover maternity, and some people have irrational objections to covering birth control.

It's not cheaper to sponsor population decline

Back when Microsoft's insurance covered everything ("co-pay? What's a 'co-pay'?"), they didn't cover birth control. That changed later (early 2000s?). But even what was once the gold standard of company health insurance plans didn't cover it at one time (they didn't cover ED drugs, either).

In a way it's ironic, too, in terms of the insurer saving money. A pregnancy and birth is far more expensive any birth control method I can think of... other than perhaps abortion - which (get this, religious fundamentalists) inexpensive birth control helps prevent.

The cost of birth control is not expensive. Multiple different formulations of the pill are available for $10/month without insurance. Condoms are less than a buck each. Someone talking about birth control being expensive is either ignorant or intentionally misleading.

Right. What I'm saying is that from the insurer's POV, it's far more cost effective to cover birth control than not to.

NuvaRing? Implant? IUD? Patch? Pills? Which birth control methods are not being covered? How old is this birth control coverage data? Viagra is a heart medication first and boner pill second, Were the data sources clear on why someone got viagra approved in any given case? I'm willing to buy it but not at face value.

I only doubt the birth control assertion for the most American of all reasons; Corporate Profits. Insurers would(do?) save BILLIONS in coverage for pregnant women by giving out the pill. It's against their own self interest.

> Viagra is a heart medication first and boner pill second

No, sildenafil was discovered _while_ trying to find a cardiac medicine.

The primary indication for Viagra is sexual dysfunction, per the manufacturer. So much so that they market the pulmonary anti-hypertensive focused variant as Revatio.

And even in that, it's not shown to be amazingly effective:

"Sildenafil therapy lasting 12 weeks improves multiple clinical and hemodynamic outcomes in patients with PAH, but it appears to have no effect on mortality or serious adverse events." -- "Respiratory Medicine" journal