I like to tell myself that, if I put my mind to it, I can make sense of the world. Or maybe not The World, but most aspects of it when viewed discretely without too many confounding variables. Perhaps it is a happy lie, but it is one I tell myself with enough frequency to give it the patina of truth.
So it was deeply unsettling to my sense of balance when I could find no even vaguely plausible explanation for this:
The Obama administration announced late Wednesday that it will challenge a decision by a federal judge to eliminate all age restrictions on over-the-counter sales of morning-after birth control pills — a continuation of a rare split with women’s rights advocates that has created unusual animosity toward a Democratic White House.
Late in 2011, Health and Human Services Secretary Kathleen Sebelius blocked the Food and Drug Administration’s effort to approve over-the-counter sale of the morning-after pill without age limits. President Obama supported her decision. Last month, Korman overturned the decision, accusing the administration of acting on the basis of politics and not science. Citing scientific data, he ordered that the pill be available to women and girls of all ages.
Late in 2011, you say? Why, I wonder if I might have had something to say then!
Whether or not you think younger adolescents would use the medication right, one thing that is not open to serious question is whether the medication is safe: it is. It is safer than a great many medications that are sold without a prescription, including Tylenol, Benadryl and aspirin. If (as he said when defending the Secretary) the President is worried about selling medications to young girls that may “have an adverse effect,” he should probably start with those. Having dispensed Plan B personally to hundreds of patients, I have never seen a single case of a serious adverse side effect. By way of contrast, I have taken care of at least three cases of near-fatal Tylenol overdose.
Ms. Sebelius’s statement is a canard. Gesturing toward the vanishingly small number of 11-year-old girls who would seek non-prescription emergency contraception (and who, assuming they were genuinely capable of becoming pregnant, have reproductive systems similar to older adolescent girls) is handy way of putting off this politically unpalatable decision until the 17th of Never. Ms. Sebelius surely knows that getting a sufficient number of fertile 11-year-olds to power a high-quality efficacy and safety study is nigh impossible, as would be getting any institutional review board to approve a study of sexually-active 11-year-olds that didn’t also include lots of very complicated safeguards to determine why these girls were sexually active in the first place.
I see no reason to revise my previous opinion. I believed then and believe now that the decision to keep an age limit on non-prescription emergency contraception was and is entirely political. There is absolutely no scientific basis for questioning the safety of the medication for a thirteen-year-old but not a fifteen-year-old. (In another transparently political compromise, the administration is allowing OTC sales for young women 15 and above.)
However, as unpalatable as I found Sec. Sebelius’s political calculations, I could at least understand them. I could wrap my mind around not wanting to be seen as “allowing” teenagers to have sex with each other with a lower risk of unintended pregnancy. As short-sighted and self-defeating as I found the logic, I could discern it.
What I simply cannot grasp is why the administration would fight this decision. It seems to provide remarkably good political cover in a rare theoretical win-win. The President can express some kind of half-hearted objection to the decision but shrug and say it’s out of his hands, and allow the medication to be sold as per the judicial order. The people who most stridently object to emergency contraception, either because they (mistakenly) consider it an abortifacient or because they don’t like the idea of consequence-free sex for teenagers, aren’t going to support the President anyway. And people like me who are ostensibly on his side and broadly in favor of expanded reproductive health choices for women will be glad to see unfettered access.
But no! No, they’re appealing the decision. And I really don’t grok why. Perhaps I am too stupid to see the reasoning behind this move on the administration’s part, which seems like the political equivalent of striking out in T-ball. If anyone would like to explain this to me in comments such that my pea-brain can understand it, I’d be all ears.