Barbie's Gynecologist

And A Much-Needed Momentum Shift

Before I went on vacation, I told a friend that I felt like we were at the end of Act II in a classic come-from-behind champion movie. Think Rocky, Breaking Away, The Karate Kid, or Lucas (it is the year of the cicadas). The stakes were getting higher by the minute (Project 2025, anyone?), but our heroes were beset by a string of bad luck. A bad Supreme Court decision, a terrible debate performance, and a case of Covid had forced us to rock bottom. It looked like we were losing and felt like we were all waiting for something to happen that could shift the momentum and start Act III.

Thankfully, less than a day into my trip something did happen: Joe Biden selflessly stepped aside, the Dems fell quickly in line behind Kamala, and she came out smiling and swinging. (“I’m a courtroom prosecutor, I know Donald Trump’s type.”) Instead of the news blackout that I had promised myself, I began to devour stories about the campaign hitting the ground running and Trump not-so-quietly imploding under the weight of a new opponent.

The timing of Biden’s announcement was beautiful. While some say it was unintentional, I think Joe employed some old-fashioned strategery. Trump was already wedded to Vance, and the GOP had just spent three days genuflecting at the altar of Christian Nationalism, poking fun at old age, and referring to Hunter as the ringleader of some Biden crime syndicate (because all good mafia stories are based in Delaware). Instead of riding a post-convention surge, the media all-but ignored Trump for days, and he didn’t like it. (“I will not be ignored, Dems!”)

I’ll also give the Dems some credit for coalescing around not just one candidate but one message: these Trumpy folks are weird. As one who leans toward words like douchey, bat s**t crazy, and wannabe dictators, weird initially seemed too tame, but I’m coming around. I’ve read some great analysis that suggests it upends the GOP’s pretend monopoly on morality while also taking the wind out of their macho-man personas. Their obsession with women’s reproductive systems, porn, and where people go to the bathroom isn’t tough, it’s just plain creepy. As Monica Hesse put it in a column for the Washington Post, “When the go low, we go ew.”

J.D. Vance has certainly made it easy for us to say “ew,” even if the story about him f**king couches is entirely made up. His rants about the childless having no stake in the “physical future” of our country are rich coming from the party that actively denies climate change. Using “cat lady” as an insult may have been a mistake given that 44.5 million households have cats. (I’m waiting on the ultimate childless cat lady, one Ms. T. Swift, to speak up.) His stories praising his grandmother for staying in a clearly abusive marriage are disturbing, the audio tape of him calling rape and incest “inconvenient” is disgusting, and his seeming attempts to apologize for the fact that his wife isn’t white are just icky. Or should I say weird?

The architect of the weird message, Minnesota Governor Tim Walz, is now Harris’s VP pick. It seems like a great choice. He looks and talks like a Midwest Republican who served in the military and owns guns, but his record shows a progressive Democrat who wants to protect abortion rights and feed children.

I realize we’re in the honeymoon phase of the campaign. It won’t be all happy, happy, joy, joy for the next 90-some-odd days. I also realize that this election is not being scripted by Hollywood and the deus ex machina that brought us to the third act does not, in fact, guarantee that the good guys win (especially given the other guys’ penchant for cheating).

Still, the Harris campaign has managed to Make News Fun Again, and I’m here for it. I am more than ready for our national nightmare to end with an election night slow clap victory scene. 

Women Are Trying Desperate Home Abortion Techniques

Abortion rights advocates have been saying the same thing for decades: taking away access to safe and legal abortions won’t end abortion, it will only increase unsafe abortions. There is no fun in “I told you so” here, but a new research study from the Bixby Center for Global Reproductive Health can be boiled down to exactly that.

Researchers conducted cross-sectional surveys in the months before the Dobbs decision (December 2021 to January 2022) and then again, a year after the decision (June 14 to July 7, 2023). Each survey had approximately 7,000 participants between the ages of 18 and 49, all of whom were assigned female sex at birth. Participants were asked whether they had “ever taken or done something on their own, without medical assistance, to try to end a pregnancy.” The portion of participants who said yes to this question increased from 2.2% to 3.3%.

Not surprisingly, the researchers found that those in already marginalized groups were more likely to have experience with self-managed abortion (SMA). Specifically, 4.3% of Black participants said they had tried to end a pregnancy themselves compared with 2.7% of other racial and ethnic groups, and 5% of sexual and gender minority participants said they had done so compared to 2.5% of heterosexual or cisgender participants. Also not surprising, 4 in 10 SMA attempts occurred before age 20 years.

Among those who said they’d tried to end their own pregnancies, some took medications that they’d obtained without a prescription (including the mifepristone/misoprostol combination), others drank alcohol or used drugs, and others tried things like hitting themselves in the abdomen, eating herbs, lifting heavy things, or inserting objects into their bodies. (There’s a reason the coat hanger became the symbol of unsafe abortions.)

While it’s probably safe to take mifepristone and misoprostol without being under a provider’s supervision, it is never a good idea to punch yourself in the stomach or stick a sharp object into your uterus whether you’re pregnant or not.

The results varied. Some had a miscarriage, others went on to have an abortion at a clinic, and some carried the pregnancy to term. Some participants reported complications like bleeding and pain for which they had to seek medical care.  

The jump of 1.1% might not seem like a lot, but the researchers note that participants may have underreported SMA because it’s illegal where they live. The authors believe that if we adjust for underreporting, the projected lifetime experience with SMA is 10.1%.

A 10% chance that someone is going to kick themselves in the stomach, throw themselves down a flight of stairs, or stick a barbeque skewer into their vagina in the hopes of not being pregnant anymore should horrify us all.

A Dissolvable Birth Control Pill

At some point in most people’s lives, they stop taking liquid Tylenol and the milky pink version of amoxicillin in favor of swallowing pills and avoiding the hell that is fake grape flavoring. This came early for me because my father was obsessed with Vitamin C and made us take two pills every night. (I’m old enough that gummy vitamins didn’t exist, but I don’t know why he didn’t start us with the old-fashioned chewables like the Flintstone vitamins all my friends got to take.)

I think most people learn to swallow pills by the time they’re an adolescent, but I do remember one friend practicing on tic tacs in preparation for going on the birth control pill. Today, she wouldn’t have to that, because the FDA just approved a dissolvable version.  

It’s being sold under the brand name Femlyv and contains the same active ingredients as many other combined oral contraceptive pills. Instead of swallowing whole, users should let it dissolve on their tongue and then follow up with 8 oz of water.  In a statement, an FDA official said: “There are many variables that might cause someone to have difficulty swallowing. This drug provides another treatment option and expands access to this form of contraception for individuals who may have experienced those challenges."

Birth control pills are notoriously little, and non-pill-swallowers had choices already in the form of the shot, patch, and ring which all do roughly the same thing as the birth control pill while avoiding the mouth entirely. Still, it never hurts to have more options for staying not-pregnant. Flintstones-branded chewable birth control anyone?

Barbie Knows What a Gynecologist Is

Last year’s summer blockbuster Barbie ended not with America Ferraro’s Oscar-nominated speech about how hard it is to be a woman, but with Margot Robbie’s titular character walking into a non-descript, not-at-all pink office and saying, “I’m here to see my gynecologist.” Moviegoers laughed out loud, and then apparently looked up what a gynecologist is.

In a letter on JAMA Network Open, researchers at Harvard Medical School noted that online search volume rose by 51% for terms referring to gynecologists and 154% for the definition of the word gynecologist in the first week after the movie’s release. There was not a similar increase in searches for other health-related terms or medical specialties which suggested that the movie was the reason for the spike.

While the researchers point to this as further evidence that films and television can have an impact on health literacy, I’m left wondering what mojo dojo casa house people had to have been stuck under to not know what a gynecologist is. If it were her nephrologist, endocrinologist, hematologist, or oncologist, I might understand. Many people are lucky enough to never need a doctor who specializes in kidneys, hormones, blood disorders, or cancer, but half the population has a vagina, and we’re supposed to get them checked out pretty regularly.

I supposed some people might be confused because gynecologists are often also obstetricians (they deliver babies) and the abbreviation—OB /GYN—puts that part first. More likely, though, it’s just part of our general discomfort with all things vulva and vagina.

Leave it to uptight Americans to need a doll who is famously devoid of genitalia to teach us about gynecologists.