Colorado’s Effort Against Teenage Pregnancies Is a Startling Success
nytimes.com
nytimes.com
Everyone knew this would happen, but some believe that giving teens birth control is encouraging them to have sex, so initiatives like this are almost always blocked. It's very much a political problem.
I don't understand, encouraging them to use contraception while having sex (and perhaps lead to more intercourse)? or encourage more unprotected sex?
Look in this very thread and you will see much hang-wringing about STI rates, which is a code-word for OMG-the-youth-are-getting-it-on. As if they weren't already (pregnancy rates are dropping ...), as if this was somehow wrong (if anything is natural, sex is), as if there were huge surges of STI rates in countries without these hangups about sex, and so on.
The logic certain politicians in the US use is that the only acceptable form of birth control the government can support is abstinence. This is often tied to Judeo-christian beliefs, and often used to gain favor with the conservative base.
If the consequences of sex (i.e. pregnancy) are mitigated, it will encourage teenagers to have sex.
Typically there is some form of slut shaming that happens during the debate on birth control.
In America, the popular public society-wide meme opinion is "sex is bad outside of procreation." You're not allowed to encourage it, you're not allowed to make it safer, and many doctors aren't even comfortable talking about it.
Running a "birth-free sex" program is an affront to the victorian sensibilities of genital shame and a general war on happiness. The one true path is dedication to god and hard work, not personal enjoyment of anything. And we're going to have our 80 year old half-senile business moguls fund all politicians to ensure sex is always dangerous, unsafe, and bad for you.
"Back home" they were sharing a bed and sleeping in their undies each night.
While visiting it was pajamas and sleeping in different ends of the house.
Doesn't matter if it's 20/30/40, you still need to be protected from the temptation of living in sin.
True, and something that transcends cultures.
My house, my rules. You're welcome to stay at the hotel down the street if you can't handle sleeping apart from each other and we'll cheerfully roll out the red carpet and provide chauffeur service for you.
Do the criteria require one of a civic marriage, a religious marriage or both? If the latter in isolation is acceptable, as it has no legal power, would domestic partnerships then also be an acceptable alternative?
I don't draw a distinction between and civil and religious marriage ceremony though and I have no clue what a domestic partnership is... :-)
The issue is that acknowledgement of birth control as a valid form of contraception also acknowledges that a significant number of teens have sex. The conservative religious crowd feel that this isn't the right solution. They don't want "underage sex" to be seen as something that's so commonplace that contraceptive is readily available. They feel it's taboo and offering tools that lessen the risk of underage sex is also taboo.
As another person stated, some aren't interested in fighting teen pregnancy and poverty. They are interested in fighting teen sex. Two very different things.
This probably does increase the levels of total sex-having somewhat, but it also allows for much much higher levels of safe and informed sex having. Apparently this is not always considered an acceptable trade off.
Then they proceed to have higher rates of every negative outcome.
Then you say higher rates of negative outcome, without mentioning whether you consider rate of sex having to be a negative outcome.
(I don't disagree with the assessment, it follows the exact logic I posited. I'm not sure why you're taking my comment as being in support of abstinence - it clearly isn't)
I don't see the problem.
As a happily, permanently monogamous individual who knows nothing about this... could I get some sources on that?
It's just that optimizing over "minimizing sex" is idiotic compared to optimizing over "minimizing unsafe sex."
For most religious folk, teens having sex is bad regardless of whether it's safe or not, so it makes sense to push for abstinence-only education. Giving out condoms is like giving up. Or maybe even slightly worse than giving up - implicitly encouraging kids to go out and have sex.
Of course, this doesn't stop kids from having sex, but it does make it so that when they do they're generally unprotected.
Where I'm from, France, you need a state certificate to work as an educator (BAFA), which is issued after a few weeks of training.
In my first week of training, which is mostly "theoretical", we had a debate about whether to carry condoms in the camp's sanitary supplies, to give them to teenagers if they ask for them. There is no legal imperative in France - it's mostly at the discretion of the camp director/organizer. I was against, because I was a 17 year old teenager full of convictions (albeit not religious ones) that having condoms available was implicitly encouraging teenagers to have sex.
Then I worked in actual teenage camps and realized how much of an idiot I was. No matter how vigilant and organized the educators are, the fact is that you have 40 teenagers full of hormones living together for 3 weeks. If you don't want STDs/pregnancies, you need condoms.
Anytime I hear people advocating the opposite, it becomes clear to me that they are deluded idealists and that they've never had to manage a community of teenagers.
The religious right in the US has this strange obsession with other people's sex life. I think after roughly two millenia of Christians trying to prevent their kids from having extramarital sex it's safe to say that the exercise is ultimately futile and the only thing it's accomplishing is worse outcomes (e.g. STDs, pregnancies and bad decisions).
Of course debating that point is entirely useless when the underlying idea is that extramarital (and therefore also teenage) sex is the worst possible outcome in and of itself. It's a failure of humanity that 40-odd thousand years into civilization we still haven't overcome our obsessions with valuing scripture over rational thought.
It's okay to have consensual sex. If kids aren't properly educated about sex (and the consequences having sex can bring, from biological to social), they can't have consensual sex -- but that doesn't mean they won't have sex at all.
So no, sex education does not infringe on religious rights. And making condoms available to teenagers who intend on having sex doesn't either.
We're not talking about teachers throwing condoms at their students yelling "Fornicate! All of you! With each other! All the time!". We're talking about making condoms available to teenagers who ask for them and letting them know they don't have to expect any invasions of their privacy as a consequence (because doing so would discourage them from asking, thus encouraging unsafe sex).
Again: kids are going to have sex. Uneducated kids are going to have more dangerous sex. Educated kids are going to have safer sex.
Nobody has the right to deny the kid's independent decision whether to have sex or not. But this goes both ways: not only can't teachers tell a kid whether to have sex or not, but neither can the parents.
It's ridiculous that the people who fight against abortion because it infringes upon the rights of the unborn child are often the same people who then raise moral panic about children having sex and try to deny them the right to sex education (and access to things like condoms for when they decide to have sex). Especially if you consider that access to condoms and education also has a positive effect on when those kids decide to have sex, with whom and in what kind of situations -- i.e. if you properly educate kids about sex, they may even come to the realization that they are not actually ready yet and that it's okay to say "no" to horny peers.
Unless, of course, their partner is older than they are.
Now, an adult having sex with a child on the other hand is obviously acting criminally. It's the adult's responsibility to act in the child's best interests due to the child's lack of ability to give consent -- even if the child (for whatever reason) engages it, it's against their best interests to follow through.
As for sexually active "minors" and very young adults, especially at very narrow age ranges, that's not as trivial to answer. A hard cut-off seems the most straightforward answer but creates absurd outcomes in edge cases (e.g. someone who just turned 18 having sex with someone about to turn 18 in a country where 18 is the age of consent would be considered a rapist but not if both of them were just a tiny bit younger or older). I guess it's best to have case law deal with these situations individually.
Maybe I should clarify that the reason I used the word "kids" was to make it clear we're not specifically talking about "children" in the intuitive sense. The danger that six year olds will randomly decide to have sex with each other is relatively low (if we ignore "sex play", which is a different can of worms). That's not what the article is about. We're specifically talking about "kids" (i.e. minors, which depending on where you live can include anyone between 12 and 21) who are fairly likely to be already sexually active without any external motivation/dissuasion.
I remember Christian teachers telling me long ago that I must
hate a bad man's actions but not hate the bad man: or,
as they would say, hate the sin but not the sinner. [...]
I used to think this a silly, straw-splitting distinction:
how could you hate what a man did and not hate the man?
But years later it occurred to me that there was one man
to whom I had been doing this all my life -- namely myself.
However much I might dislike my own cowardice or conceit
or greed, I went on loving myself. There had never been
the slightest difficulty about it. In fact the very reason why
I hated the things was that I loved the man.
Just because I loved myself, I was sorry to find that
I was the sort of man who did those things.
I mean it comes down to a definition of the word belief which we seem to disagree on. There are probably only a handful of people in this world for which our differing definitions of belief would provide the same sets of beliefs.
How do you know which is which? I definitely haven't said "it's your belief if you claim it aloud, no matter what you really think about it".
Consider the population of wives cheating on their husbands. Do you really believe that only an insignificant number of them think what they're doing is wrong?
> There are probably only a handful of people in this world for which our differing definitions of belief would provide the same sets of beliefs.
First, you need to establish that we differ in our definitions.
To me people use what they believe to be true to make that decision. To me all decisions demonstrate a persons actual beliefs, as why would they decide to do something if they did not honestly believe it would yield a desirable outcome. (that outcome does not have to be viewed as desirable to anyone but them, for instance suicide. Nor does it have to be the immediate outcome which is desirable, it could be part of a long con.)
>Consider the population of wives cheating on their husbands. Do you really believe that only an insignificant number of them think what they're doing is wrong?
Yes, I believe that all cheating spouses, people who commit crimes, and sociopaths have developed an internal belief structure which lets them justify actions that may come at a cost to themselves or others as being probable of a desirable outcome for them.
>First, you need to establish that we differ in our definitions.
Have I done so to your satisfaction? I thought it was common knowledge that people often echo views they do not actually adhere to so that they will appear to conform to societal norms, which represents the crux of my definition. Politicians frequently offer a very obvious example of such a tendency, but if you know anyone well enough you can see the inconsistencies in what they say and what they do. Their actions demonstrate how they actually make decisions and what they believe in my opinion, not what they say.
You will know which are which by being introspective about the decisions you have made in the past and are considering making currently, and try to understand what basis you are truly using for that decision, besides the surface 'Well this feels right' reason.
> There are multiple cases where someone commits an offense on orders from a superior member of his extended family; the attitude of the court seems to be that although he must obey the order he is still criminally liable for the act; there appears to be no assumption in the legal system that an individual always has the option of acting in a way that does not violate one rule or another.
When I read this, it was more interesting to me that American society is fairly committed to the fiction that such an option always exists.
I don't believe that the mere fact that a person took some action itself demonstrates that the person believed that action to be morally blameless. Of two paths, both can be wrong. Of many paths, all can be wrong -- or the conseqences of staying on the "right" one might be personally unbearable. I imagine that a mother who opted not to rescue her child from a burning building might be haunted by the thought that this was wrong, regardless of a generally positive message from society.
Also, I've tried really hard to read your comment in a way that allows for the existence of guilt. I can't see it. Do you believe people can feel guilt? Why would C. S. Lewis feel sorrow, in the privacy of his own mind, to discover that he is the kind of person who would do certain things?
Guilt to me is what people feel when they realize they made decisions with incorrect or incomplete information, and would of made them differently had they known. Even when the person had no way of knowing the correct or complete information at the time of decision making, in this edge case society has developed a term to attempt to remove guilt from the person by calling it an 'accident'. Often I find the source of guilt to be not looking very far ahead on the decision trees which I eliminate early on as not effecting me. (Guilt can also be simply an act, as demonstrating guilt often leads to fewer negative consequences in our society. Think of all the people convicted where not demonstrating remorse was used as a factor in sentencing or parole denial.)
That's wrong. This is regret.
> I can not perceive of right and wrong as absolute concepts.
That's fine. But you're here denying that other people can and do. You're wrong about that.
Can they though? Or are people just too arrogant to admit that they can not define them in absolute terms, and if they can what could the definition of right be besides 'what is most beneficial among possible outcomes' and wrong be 'what is not most beneficial among possible outcomes'? That can not in my opinion be a definition of anything absolute as it varies based on the circumstances and individual values.
Feel free to propose an absolute version of right and wrong, to me it seems like an impossible task, but perhaps you could enlighten me. Until this last reply you had asked very good questions, showing that you welcome discourse on the subject, and I hope you can return to doing so rather than simply stating that I am wrong.
> a bad feeling caused by knowing or thinking that you have done something bad or wrong
Here it is from Cambridge:
> Guilt is also a feeling of anxiety or unhappiness that you have done something immoral or wrong, such as causing harm to another person: She was tormented by feelings of guilt after putting her mother in a nursing home.
There is no requirement that things could have gone differently, or that if they could have gone differently a different outcome would have been better.
Your definition is not compatible with this, or even related to this. You've stated fairly clearly that you don't believe guilt exists. That's odd, but defensible. (Though trust me, you're wrong.) Pretending it means something other than what everyone but you thinks it means isn't defensible.
> Feel free to propose an absolute version of right and wrong, to me it seems like an impossible task
I didn't say there was an absolute definition of right and wrong. I said there are people who conceive of the world this way, and that's true; they are quite numerous. By weakening to just the idea that certain actions in a definite fixed context could be correctly labeled "right" or "wrong", you pick up many, many more believers, practically the entire world.
I mean how can you be aware you have done something wrong or bad if you do see what could of been a better outcome? If everything you have to compare it to as possible outcomes is worse than what happened then you did nothing wrong or bad, you did the best that was possible.
I was never intending to say guilt does not exist just that it simply as Webster has defined and that choosing solutions which you later realize are sub-optimal are what Webster describes as something bad or wrong. I am not pretending it means anything other than what you have provided here as the definition. How can one recognize bad without good? These things are inherently relative as one can not exist without the other also existing.
>I didn't say there was an absolute definition of right and wrong. I said there are people who conceive of the world this way, and that's true; they are quite numerous.
How does one conceive of something which can not be defined? To me that seems like being able to visualize the concept of infinity. It can be defined in a relative sense, so I stand by my view that the relative sense is the only one that matters.
>By weakening to just the idea that certain actions in a definite fixed context could be correctly labeled "right" or "wrong", you pick up many, many more believers, practically the entire world.
I think you underestimate the cultural differences present in the world and the ability of anyone to actually define a fixed context which 'practically the entire world' will be able to relate to.
Any scenario you did manage to get 'practically the entire world' to agree on would be so vague and hypothetical as to be virtually meaningless. Like 'would you give everyone in the world cancer or ice cream', although the example I have provided itself is flawed I think most examples will have flaws. In my example if people have a violent enough allergy to ice cream they may in fact choose cancer as being "right".
This has been a rather long way about this but do you at least concede that we do indeed have different ideas of what a belief is and that only a small number of people if any would have beliefs which were consistent with both our definitions?
You don't have a right to forbid your child's access to the health care, justice, etc.
For example, in Iowa somebody 14 or 15 can have sex with somebody less than 4 years older than them.
Source: https://en.wikipedia.org/wiki/Ages_of_consent_in_North_Ameri...
It's not like teens (and the poor, etc) are saving up to afford condoms and only having sex when they can afford them. The profusion of unplanned babies and the well-known tendency of the poor to have more children than they can support should prove this.
Empiricism, however, is a stronger basis for policy making than personal anecdote and untested theories.
Hoofbeats, horses, etc. Also, when we deal with the horses we'll have a chance to check for any odd zebra.
(ie, even if you're right, the way to check is deal with the other 99% of the problem first...)
Also, a nit: the butterfly effect has nothing to do with this discussion. It's an effect in chaotic systems where a small perturbation in initial conditions leads to large, unpredictable, non-linear differences in later states. I'm arguing that it's not crazy to think a small perturbation in policy (an x% decrease in the total cost of having sex) would likely lead to a small and proportionate response in behavior (a roughly x% increase in the amount of sex had).
Resolution of the truth-value of that requires, yes, actual scientific studies (which have almost certainly already been done already). The fact that some religiously-inclined folk might come to the "wrong" conclusion from a confirmation of this effect doesn't obviate the value of studying it.
ETA: Just as an example of such a study, look at this one [0]. It's about how certain abstinence-only programs, which presumably doesn't include access to contraceptives, can legitimately prevent the onset of teenage sexual activity. I'm sure there's plenty of room for methodological critiques, and there are also plenty of studies that come to other conclusions, naturally. I personally still would expect those to be confirmed in the end. But this isn't a question that you can resolve by loudly proclaiming that anyone who asks for evidence is an idiot.
[0] http://archpedi.jamanetwork.com/article.aspx?articleid=38279...
Sorry, I had assumed it as an idiom without establishing a shared lexicon. I mean, an effect so small as to only possibly be significant via an appeal to the butterfly effect. As in, ultimately we can't rule out that assassinating Hitler when he was a teen would have caused the sun to go supernova, because X, but it's vanishingly unlikely.
> I'm arguing that it's not crazy to think a small perturbation in policy (an x% decrease in the total cost of having sex) would likely lead to a small and proportionate response in behavior [...]
Sure, this can always happen. We always need to have our eye on the metric (the 21st century "ball").
But unless you've actually got a good argument for why it's likely that this program will go wrong, you're more likely to cause harm by kvetching than by letting change happen.
> [...] as an example of such a study, look at this one [0]. It's about how certain abstinence-only programs [...]
Sure, if the alternative is emulating reality shows then anything, including _Catholic Hour in the Nursery_ would probably be better. Thankfully we don't live in a black and white world.
And of course any classes should include a huge dose of self-esteem and other training supporting the right/desire to say "No", but when a couple want to have sex do we really want to punish their offspring? Sins of the father? Srs?
Or do you really deny the plight of the unwanted/required (high death-rate) child?
TL;DR What I'm saying is that we know people will have sex despite it being wise. (Do you really require a cite? If so, list the keywords you've searched and I'll help you use the internet.) So when they do, though we may wish/help to delay that a while, lets help them do so safely when they inevitable do.
Do teenagers really need to be encouraged to have sex? An absence of discouragement should be sufficient, for mutually attracted pairs.
High-availability abortions and contraceptives given out in schools are just examples of governments giving people what they want. However many in the anti-abortion and abstinence movements are engaged in an ambitious social engineering effort, telling teens to resist their strong biological urges to have sex, in favor of marriage and monogamy, because they believe this leads to a more spiritually healthy outcome, long-term.
There is surprisingly little innovation in this space. It's taken for granted that teenage-pregnancy is a bad word, that 30-40 year olds make better parents because they have more money. Society could choose to support early marriage and childbirth. Parenting requires a lot of energy, something that youth have in abundance. Also, young people remember what it's like to be a child, and make more empathetic parents.
As a dad to 2 kids (became a father at 28) I would strongly urge people to wait until they were 30-38 before having kids.
Given the great innovations in this space I'd even say 40 is a great age to have kids - though it gets harder with age beyond this imho.
And grandparents are a major factor, too. They are a great help, and also they really enjoy being with their children. Supposing my kids also wait until they are 38 to have kids, my odds at enjoying quality time with grandchildren are greatly reduced.
I'll probably be almost of pension age when my kids finish their education. That's another thing where I worry I might not be able to help them out as much as I could if I would still be earning money and connected in the business world.
It would perhaps be different if I had toiled and saved money all the time up to age 38, but I didn't. If you have kids, odds are you get more serious about those things.
I do take issue with the statement that young people (people in their 20s) have energy "in abundance."
Government giving people what they want? Please. Teenagers can't even vote, so they aren't voting themselves contraceptives. This is adults imposing yet another view on their children. It just so happens that this is a differing view than the traditional religious view of teaching abstinence. (Or of teaching that teenagers who get pregnant should then immediately get married and the dad get a job.)
Let's trap women in an unending economic and social perdition because they'll have empathy!
Were you inferring that I meant that abortions and birth control are always freely available? I did not state that.
In fact, discouragement has been proven time and again not to work (or worse: to result in more erratic behaviour as a consequence of the cognitive dissonance of enjoying something you've been vehemently taught to think of as evil).
Everything needs to be tested. How many treatments, therapies, and drugs seem like pure common sense and then turn out to be useless when rigorously examined or outright harmful?
Questionable source, but data and linked study appear correct: http://www.nationalreview.com/agenda/385884/no-one-program-d...
"But these “linear trend lines” based on the three previous years of data aren’t really useful. The authors’ projection shows that births would actually increase a bit during the period CFPI was put in place, despite the fact that, like the abortion rate, the teen birth rate is declining nationally, noticeably and steadily."
are somewhat bizarre. The entire point of using the trend lines is to take into account, well, the trend. Still, good to know the counterarguments, otherwise you're just listening to the echo chamber of "Well, of COURSE the program would work!"
http://www.cdc.gov/teenpregnancy/about/birth-rates-chart-200...
Ultimately, what's cheaper? Having a baby or taking care of an STD? Perhaps the benefits outweigh the costs.
The long term effects of certain STD's will require hospitalization, doctor's visits, and medication. If these programs target teens and poor people, this demographic would also struggle to pay for those things as well -- and they would need to use them for a more protracted period than 10-18 years.
Also: Birth control might give a false sense of security leading to more casual sex and a surging rate of STDs. That last theory makes STDs noticeably absent from the article.
Without a "think of the children" argument, is that necessarily bad, if poor judgment has consequences? Shouldn't poor judgement have negative lifestyle outcomes?
My hiking hobby exposes me to some medical risk of lyme disease, skin cancer, ankle and knee damage, but its not like I'm about to stop. Now that you're done yawning about my dangerous lifestyle choices, likewise if casual sex is medically dangerous then ... why exactly should anyone care?
That's absurd. Having unprotected sex would not constitute "poor judgement" if there were no possible negative outcomes.
The UK is having this problem, but mostly from women putting off pregnancies until their 30's or 40's.
The preoccupation with STDs in this thread seems a bit weird and irrational.
It seems likely that some fraction of those will use condoms less when other forms of birth control become widely available. Among this group, this will still likely lower pregnancy rates, since condoms have a lower efficacy than other forms of birth control, but it could potentially raise STD rates.
My intuition is that the increase will be negligible, but others' intuition is different. It would be good to have some numbers on this so that we aren't guessing.
Really we need non-invasive male birth control, as soon as possible.
Isn't the dumping of antibiotics causing similar problems? The problem doesn't seem to be birth control itself, but improper disposal of household chemicals, really.
Also, do you have a citation for the cancer thing you mentioned?
Also, the problem is literally in urine. I don't understand your line about disposal. You want all women on the pill to always pee and poop into jars for proper permanent disposal? And no, "disposal" of antibiotics is not a big ecological problem whereas pharmaceutical hormones clearly are.
Also, that link mostly talks about hormonal menopause therapy, and oddly only mentions the BC pill in passing, noting that only high-dosage pills seem to be linked to cancer.
In the end, tbh, it's up to a woman and her doctor to decide how to balance the risks of pregnancy and cancer.
Cigarettes are a far more potent carcinogen than estrogen and progestogen (the Pill). However when it comes to smoking, conservatives believe the government shouldn't interfere and say it's "Personal Choice."
When it comes to birth control, they want government to limit access on the grounds of morality, and (dubious) health claims.
The Public Research Institute is an anti-abortion, anti birth-control group in leagues with the Catholic Church and thinly veiled under the guise of "Humans Rights Advocate" for Chinese.
I could also point out that my church would consider 2-3 partners something akin to "running wild". One partner, one time could be a lapse in judgement. Multiple partners or one partner multiple times indicates a pattern.
Thankfully, this type of puritanical thinking is on the decline in America.
Any time I see a headline like this, I have to look for the discussion about what unintended consequences were observed. There usually are some, there is no such thing as a free lunch. Some commenters have already mentioned negative health effects, spread of STDs, environmental impact, social consequences. I found no such discussion in this article.
It's not like IUDs suddenly stop other safe sex practices. It's not Sex MMO where your "Contraceptive Equipment Slot" only can fit one item per party.
Consider that IUD usage overlaps only partially with other practices for starters.
> But the experiment in Colorado is entering an uncertain new phase that will test a central promise of the Affordable Care Act: free contraception.
Out of 100 couples using a condom as birth control, 55 will have an unplanned pregnancy in 4 years with typical usage (8 out of 100 with perfect usage).
http://www.nytimes.com/interactive/2014/09/14/sunday-review/...
you're coming dangerously close to quoting the vogon from hitchhiker's guide to the galaxy:
> There’s no point in acting all surprised about it. All the planning charts and demolition orders have been on display at your local planning department in Alpha Centauri for fifty of your Earth years so you’ve had plenty of time to lodge any formal complaints and its far too late to start making a fuss about it now.
> What do you mean you’ve never been to Alpha Centauri? Oh for heaven sake mankind it’s only four light years away you know! I’m sorry but if you can’t be bothered to take an interest in local affairs that’s your own regard. Energise the demolition beams! God I don’t know…apathetic bloody planet, I’ve no sympathy at all…
Competing anecdote: when I was a teen, I had no idea what the health department was, or what it did, and I never met an employee of the health department.
I'm sorry you didn't have access to taxpayer funded condoms when you were a teenager. Why so much criticism? Do you feel somehow that you were treated unfairly? If so, by whom?
When I said where and why, I meant in what context does a health department employee hand out condoms?
Like, does she wander around the area shopping malls with overflowing pockets, handing them out to anyone who looks like a teenager? I'm just trying to figure out how what you described works.
It doesn't matter what direction the arrow on the graph is pointing if the way you got there is by potentially hurting people.
It's such a pronounced effect that doctors use certain types of IUDs to help stabilize certain conditions. It doesn't help everyone with this, but it helps enough people that it's worth trying.
Is it OK for a large body of authority to support something that will harm you as long as they leave it to the individual's choice to use it or not? Where do we draw the line on this?
Update: for example, a paper on the psychological damage done by jailing people: http://aspe.hhs.gov/hsp/prison2home02/haney.htm
You argue "isn't it a bit irresponsible for something as large/respected as an entire State to put their backing behind something with pretty well known, negative tradeoffs?"
The state supports many things with that have negative aspects. I listed a few obvious ones in my previous comments. In fact everything in life involves a tradeoff. One can study these things and develop some quantitative measure of the negative and positive effect.
Here are some studies on IUD complications: http://www.popline.org/node/490794 (youths) http://www.sciencedirect.com/science/article/pii/S0010782406... (following birth) http://www.sciencedirect.com/science/article/pii/S0140673600... (UIT infection specifically) http://www.medscape.com/viewarticle/718183_5 (general)
You can see that the complications are generally regarded as being quite minor or low probability. For many people this is a tradeoff worth making, given the near 100% success rate in prevent pregnancy.
Now this refers to IUDs. The Colorado program also provides hormonal birth control, via a long lasting implant. I'll let you do your own research on these.
In the US, the Federal Government has jurisdiction over drugs such as birth control.
Your argument suggests that negative side effects are harmful, and certain. In the teeny amount of research I've done, it doesn't appear that this is the case.
There is no such thing as tradeoff free medicine. Things we can ingest without unusual side effects have a special name in medicine: food.
IUDs are, on balance, considered a much safer form of birth control. They do not flood the user's bloodstream entirely with hormones (rather delivering it directly to the area of effect), and the treatment can be quickly discontinued in the case of the rare negative reaction.
In many cases, negative reactions to IUDs are indicators of other more severe reproductive organ issues like Endometriosis. For other reproductive issues, IUDs can actually be proscribed as a treatment.
The actual risk profile for IUDs is quite favorable. The actual risks of pregnancy are much larger than people like to talk about, and most women (even young women) take over a year to physically heal from their ordeal carrying and delivering a child and that's entirely ignoring the social and economic impacts of said pregnancy.
Most importantly, IUDs have fantastically high compliance rates because they are always on and most of their failure conditions are obvious (results in falling out). By contrast, the mechanical failure of a condom or diaphragm is often difficult to catch in the heat of the moment and human factors come into play with pill compliance.
Of course, knowingly or not, your actual cause here is to be Sargent Rubiquity of the Womb Police. I don't believe for an instant that any logic or compassion motivates your post.
The parent commenter is asking the risks of intrauterine birth control.
In the US, the FDA polices all medical drugs for safety and efficacy, regardless if they are for reproductive health or not.
The traveling health care fair came to my employer recently and I remember pretty much "everything" required a similar boilerplate consent form, even just pricking your finger for blood sugar screening.
For consistencies sake, 18 yrs sounds reasonable. If we're going to apply boilerplate almost everywhere, why not simply apply it everywhere?
There is no particular reason 18 is a good age. Eighteen and a day passes for all medical decisions but weirdly enough not to drink a simple beer, and some states have really weird legislation about exactly which vegetation is permitted to possess / smoke. Somewhere in the range of 13 to 22 for all of the above sounds about right.
In England we have Gillick and Fraser competence.
http://www.nspcc.org.uk/preventing-abuse/child-protection-sy...
So 18 then. There are exceptions that allow less, but the 'no restrictions' is 18.
It's a tough choice to make, but I would say that your right to know is less important than a young woman's access to good contraception in the face of parental disapproval.
Quoting from http://www.plannedparenthood.org/learn/birth-control/iud in the section about disadvantages:
> You may have:
- mild to moderate pain when the IUD is put in
- cramping or backache for a few days
- spotting between periods in the first 3–6 months
- irregular periods in the first 3–6 months — with Mirena or Skyla
- heavier periods and worse menstrual cramps — with ParaGard
> Serious problems with the IUD are rare. ... In rare situations, a woman could develop an infection when using the IUD. This happens if bacteria get into the uterus when the IUD is inserted.
Edit: s/15/10/ as per [1]
Here's a Vox article about it: http://www.vox.com/2015/2/23/8092483/birth-control-iud
IUDs are classified as "pretty safe" for most users. They are also easily removed if undesired side effects are noted. They almost certainly are safer than pregnancy for most users. Individual users have contraindications that prevent IUD use or make IUD use riskier, that is why they are a prescription medical device and users are advised of the risks and their other options.
IUDs also have some benefits.
>I seem to remember there was a study about bleeding, irregular menstral periods, and an increase in urine tract infections.
There are two types of IUDs, hormonal and copper. ANY hormonal contraception "messes" with periods in ways that aren't predictable. If side effects are not bearable you can simply get the IUD removed, it is easily reversible. Irregular bleeding is not harmful in any way but can be a huge nuance. Copper IUDs can cause increased bleeding but aren't hormonal. If UTIs or other complications are a problem then the IUD can be removed.
>It seems irresponsible to give a device like that out to any teenager that wants one.
It seems irresponsible to not offer teenagers a very effective contraceptive. All medical interventions have a risk of side effects. We would like the user to be aware of such risks and make an informed choice.
UIDs (in general) got a bad rap because of the Dalkon Shield in the 1970s. It had a design flaw that harmed a large number of users. Modern IUDs are much safer.
I do not think it should replace teaching abstinence. But I also don't think that teaching abstinence using scare tactics in school is all that effective. Religious and moral teachings are much more so. So it still comes down to the responsibility of parents to teach their children correct life principles.
Let the government give free contraceptives to at-risk populations. But also encourage parents to teach good morals.