Episode 72: Transcript
Episode: 72: Birth Control of the Future
Transcription by Keffy
Annalee: [00:00:00] Welcome to Our Opinions Are Correct, a podcast about science fiction, society, science, and everything else. I'm Annalee Newitz. I'm the author of the forthcoming book Four Lost Cities: A Secret History of the Urban Age.
Charlie Jane: [00:00:17] I'm Charlie Jane Anders. I'm the author of Victories Greater Than Death, a young adult space opera novel coming out in April.
Annalee: [00:00:25] Which is gonna be really good.
Charlie Jane: [00:00:26] Aww, thank you.
Annalee: [00:00:29] Yeah, it’s gonna be great.
Charlie Jane: [00:00:28] Your book is also really great.
Annalee: [00:00:30] I know. We're gonna discover lost cities and future civilizations together in our books.
Charlie Jane: [00:00:34] Yay!
Annalee: [00:00:35] In this episode, we're gonna be talking about innovations that will change reproduction and birth control among humans. This is a topic that bridges science fiction and science and politics and ethics. So we're gonna be getting into all those areas. But we're really going to try to focus it around innovations, things that could change, things we could discover, that would really transform the way we understand reproduction and birth control as a society. And as individuals. Let's get started thinking about reproduction in the future.
[00:01:14] Intro music plays: Drums with a bass drop and more science fictional bells and percussion.
Charlie Jane: [00:01:41] So Annalee, what is a potential innovation with regards to birth control that could change things in the future?
Annalee: [00:01:48] So one thing that I think is really interesting, and that actually, both of us talked about a lot when we were coming up with ideas for this episode, and that is birth control for people with sperm. And I should note that in this episode, instead of trying to use terms like male and female, which are really messy and complicated, and can mean a whole bunch of different things, depending on whether you're talking about society or science. So we're just going to talk about people with sperm, and people with eggs, Okay, so you know, and you can call them sperm people and egg people. You can call them, you know, PWEs and PWSs, if you like acronyms.
[00:02:30] So anyway, birth control for people with sperm has been kind of a problem for the reproductive health community for a long time because there's really only a few methods available for those people. There's condoms, there's vasectomy, there's the rhythm method, and there's withdrawal. And I'm sure there's others, but those are the four main ones. And I'm getting those categories from an interesting paper that I read in the Journal of Biosocial Sciences from back in 2017, where a group of healthcare professionals kind of went over the data and did some surveys, and figured out that basically, those were the four methods that included participation from people with sperm.
[00:03:20] And in asking questions about what was being used in sexual encounters, they found that those methods are used 25% of the time, regardless of how many times the person is actually having sex. So in other words, if you only have sex four times a year, one of those times the birth control method will be something that relies on the person with sperm. If you have sex a million times a year 25% of a million will also be handed over to the person with sperm. So that means that 75% of the time people with eggs are the ones who are in charge of birth control, right?
Charlie Jane: [00:03:58] Right.
Annalee: [00:03:59] And there's a lot of different method, everything from hormonal methods to things like diaphragms or Norplant or surgeries, sterilization surgeries.
Charlie Jane: [00:04:12] IUDs.
Annalee: [00:04:13] IUDs. So it still means that people with eggs are doing the lion's share of thinking and purchasing and dealing with the messiness of having to set up birth control in order to have sex that could lead to conception. So people have been trying to come up with things like a “male pill,” something that would be simple and easy. And it's nicknamed a “male pill” because unfortunately out in the world people do not use are brilliant term, people with sperm.
Charlie Jane: [00:04:51] Right.
Annalee: [00:04:53] So researchers have been trying to come up with how could you have something for people with sperm that would be as simple as a pill, as simple as the birth control pill. There have been a number of different attempts. One of the most interesting ones is coming from a researcher at UCLA, Christina Wang, who is working with a team to develop a hormonal pill, which is also a gel. So you can use it as a gel, like kind of rub it on your leg or rub it on your arm and your body can absorb it that way. It interacts with testosterone and it renders sperm havers temporarily infertile. So sperm people can become fertile again, if they use this method. But while they're taking the pill, or while they're using the gel, they wouldn't get people with eggs pregnant.
[00:05:39] There have been a lot of issues around developing a pill for people with sperm, partly, I think, because of that 25% number, which suggests that people with sperm are just less interested in taking responsibility for birth control. But also because the hormonal situation for people with sperm is a little bit different. Hormonal pills can interfere with the ability to get an erection, which some people think is really important. Not everyone does, but it's one of the things that people like.
Charlie Jane: [00:06:07] Yeah.
Annalee: [00:06:07] And, you know, it's a feature, and you don't want to interfere with it. But Christina Wang and her colleagues are in clinical trials for this gel and have seen very few side effects. So this is a possibility.
[00:06:23] I think that you know, the more we have people who are in a position to actually conduct this research and actually have the power to run a clinical trial and do this, the more likely we are to see some kind of pill or gel for a sperm person to use so that the sperm person can take more responsibility for birth control. I think that would be a real change.
[00:06:50] And it's not just a technological change, or a medical change. It's a social change. It changes the dynamic between an egg person and a sperm person having sex, if you can have either person be able to have a rather simple method of birth control. So I like that idea a lot because I like the social effects, I'd love to see what the social effects would be. We know that the birth control pill had an enormous effect on people who have eggs. And so maybe it would have a similar kind of effect on people who have sperm, just people feeling more empowered and more able to take responsibility. So I love that idea. I'm excited for people with sperm to have their own birth control.
Charlie Jane: [00:07:41] Yeah, and I just feel like if we have a better conversation around this and a better understanding that it's both people, assuming that there's two people involved and not more than two people, that it's both people's responsibility to be concerned about this. To be in charge of this and it's not something that we're going to just offload to the egg having people.
Annalee: [00:07:59] I know the egg people are sick of your shit, sperm people.
Charlie Jane: [00:08:05] Exactly, I think that sperm—
Annalee: [00:08:06] Come on sperm people.
Charlie Jane: [00:08:07] I feel like the sperm people need to step up.
Annalee: [00:08:10] Yeah, exactly.
Charlie Jane: [00:08:10] [Crosstalk]
Annalee: [00:08:12] I keep thinking about when we had Emily Willingham on a few episodes ago, and she just wrote this great book Phallacy about penises and one of the things she pointed out was that human penises are these really soft, friendly organs. They're actually not combat organs. They have no like spikes or bones like other animals. And, I feel like even those sperm-havers may be able to get erections. There's also something really soft hearted about the sperm-haver. And I think that we can delve more into that maybe if the sperm-haver has their own kind of birth control. Like maybe there's a kind of, I don't know what I'm trying to say. I'm just trying to say that there's a way of reimagining what it means to be a person with sperm.
Charlie Jane: [00:08:58] Yeah, I think that that’s—
Annalee: [00:08:58] And it starts with taking responsibility for birth control, or maybe it ends with that. I don't know. Maybe that's in the middle.
Charlie Jane: [00:09:07] I think that maybe if people with sperm are more responsible for birth control, it will lead, in a way to people with sperm feeling more responsible for child rearing and more nurturing and more every part of the process, including once you have a kid.
Annalee: [00:09:21] That’s what I was trying to get at, yes.
Charlie Jane: [00:09:21] We'll just think about that organ and how it makes you a part of the reproductive cycle in a different way.
Annalee: [00:09:27] It’s a gentle, friendly organ. It’s a care-taking organ.
Charlie Jane: [00:09:30] Yeah. Exactly. It’s very—
Annalee: [00:09:33] Let’s revalue that organ.
[00:09:34] All right. So tell me about an innovation that you're really intrigued to see.
Charlie Jane: [00:09:37] The thing I feel like that has been talked about a lot the last few years, especially, that we're kind of in the very start of a conversation about is more access to emergency contraception, medication abortion, and just like thinking about abortion differently in general. And I feel like access and having better conversations go hand in hand. I feel like the more that we are able to talk about abortion in a kind of non-stigmatized fashion and have real conversations about abortion and emergency contraception, without this sense that it's something shameful or terrible.
[00:10:18] I feel like a lot of people have been really trying to push us in the direction of thinking about abortion differently and speaking about it differently. And I think that we need to have more informed conversations about what we're talking about. And when does the fetus become something that we consider to have any sense of personhood?
[00:10:37] This is a thing that we are really trying to debate as a society. And it's very difficult because nobody can agree on terms and the bioethicists are all arguing amongst themselves. But I feel like there are experiments going on right now that are pushing us in a really good direction. There's been experiments in the last few years to have vending machines on college campuses that will dispense emergency contraception. You can already get emergency contraception in pharmacies without a prescription, basically Plan B, the morning after pill that works up to 72 hours after conception. But making it accessible in vending machines. What if every bathroom had a vending machine with emergency contraception. Not just in college campuses, but everywhere, and it was just a thing where it's like, oh, yeah, okay. Nobody needs to know about this, I don't need to talk to a doctor, I can just do this.
[00:11:27] And we already have condom vending machines in a lot of places. So what if this was just a thing that we took for granted. And meanwhile, there have been some pilot projects in the last few years to have mail order delivery of medication abortions, which is the two pills that you can take up to about 10 weeks post-conception. And there have been pilot projects with, for example, you can have a tele-medicine visit with a doctor which especially is useful during a pandemic. You can see a doctor over video chat, and they will prescribe a pill and it will be sent to you in the mail.
Annalee: [00:12:02] I just wanted to break in for a second and say we are not medical professionals.
Charlie Jane: [00:12:07] Mm-hmm. That is true.
Annalee: [00:12:07] And we will put links to all of the stuff that we're talking about in the show notes. And if you want to have access to any of these medications, talk to a doctor.
Charlie Jane: [00:12:18] Yes, we are not medical professionals.e are not giving medical advice on this podcast. And any information we give, you should definitely double check for yourself, because we are not. We do not have white lab coats or anything of the other cool paraphenalia.
Annalee: [00:12:31] I have a white lab coat. I am actually a doctor, but I am a doctor of culture not of medicine.
Charlie Jane: [00:12:35] Right. So, slightly different.
Annalee: [00:12:40] Yeah, it is definitely.
Charlie Jane: [00:12:40] Point is, we are not medical professionals.
Annalee: [00:12:42] In an emergency, I can analyze a movie for you. But yeah, I can’t give you a morning after pill.
Charlie Jane: [00:12:46] I can think of many situations where that would be very useful. But anyway, so yeah, so that is a really important caveat that we probably should have mentioned at the start of the episode. But yes, not medical professionals.
[00:12:56] So basically there are all these experiments right now around greater access. And one of the two medication abortion pills recently became available as a generic, which made it more accessible as well. And I feel like we are moving in a direction, where increasingly, there are non-surgical options. And it's possible in 20 years, we'll have better options for non-surgical abortions or better surgical options too. We’ll have better ways of terminating pregnancies or emergency contraception options, which are widely accessible. And this whole debate will no longer be quite as fraught as it has been. But right now, we're just at the start of thinking about that. I think it does go hand in hand with being able to have a conversation about it. Being able to remove the stigma around abortion and emergency contraception. And remove this idea that it's something that we can't talk about, or that is not allowed in our discourse.
Annalee: [00:13:53] So I think really what we're talking about here is more access. People with sperm having access to birth control that would be easier, because it's just a pill you take or a gel you put on. People with eggs having access to different kinds of safe methods to terminate pregnancy.
[00:14:12] What’s interesting is that we have this tendency in our culture, to believe that those kinds of changes start with technology, or they start with some kind of scientific discovery, and then they change the culture. But I feel like what you're saying is sort of the opposite, that we need to change our culture and to become more open about talking about birth control and abortion, and that that might lead to greater access and greater availability of these kinds of technologies.
Charlie Jane: [00:14:48] I think it's both. I think that this is an area where technological and social change really go hand in hand. And you talked before about when the birth control was introduced, it really kind of caused a social change and it caused a change to women's roles.
Annalee: [00:14:59] Yeah, the pill.
Charlie Jane: [00:15:02] I think that if there was a really successful and easy to use birth control method for people with sperm, it would change the cultural conversation in a way. And it would change how we think about men's roles hopefully. Or it might just be a thing that nobody wants to use, because men are like that’s not my department, or whatever. So [crosstalk]
Annalee: [00:15:23] I don’t actually think that's true, though, because that same study that I was talking about where I found that sperm-havers are the ones participating 25% of the time in using birth control. In that same study, they found that when they asked people with sperm, if they could have access to some kind of pill or gel, almost 50% said they would use it.
[00:15:44] So it's not… I think that there's plenty of people out there with sperm who would be happy to be temporarily infertile, if it meant that they could have reproductive sex without reproducing.
Charlie Jane: [00:15:57] It would be obviously one less thing to worry about.
Annalee: [00:16:00] Yeah, exactly. I don't think anyone wants to have an unanticipated pregnancy, regardless of whether you're a sperm person or an egg person. An unwanted pregnancy is an unwanted pregnancy. And it's tough. It's an emotionally tough situation regardless, and it can be an economically difficult situation, too.
[00:16:19] So I think to wrap up talking about birth control. Really, I think the innovation that we'd like to see is something like sexual and reproductive health, being just part of our everyday health system, whatever that is.
[00:16:39] Because I was thinking, well, do we want to revamp the idea of sexual health clinics? Do we want to have more abortion clinics, for example, and of course we do. But what we also want is for that kind of health care to just be part of healthcare. So every year you get a reminder from your doctor to get a flu shot. And this would be like, every year, you get a reminder, here's the kinds of birth control available to you. Anytime you need X, Y, and Z, it's here for you. There's no difference. There's no fear of talking about one and fearlessness about talking about the other, it's just like it's all healthcare. And so I think that would be a huge innovation, if we stopped kind of carving out sexual and reproductive health as if they were some kind of separate thing. As if those parts of our body were somehow a whole other branch of medicine.
Charlie Jane: [00:17:35] Yeah.
Annalee: [00:17:36] And of course, they are a medical specialty, but that's very different from being their own, needing their own special clinics and their own special rules. They should just be part of everyday health.
Charlie Jane: [00:17:48] Yeah, I always think about like Angry Black Lady on Twitter. Her pinned tweet is “Abortion is healthcare,” basically. It's slightly longer but that's the gist of it. And it's like, yeah, abortion is healthcare. And it's a health care service, it should be treated like any other health care service. It should be part of your regular health care access. It shouldn't be a thing that we try to carve out into a separate category, absolutely.
Annalee: [00:18:10] Yeah and when you get health insurance, it should just be covered.
Charlie Jane: [00:18:13] Oh, yeah.
Annalee: [00:18:14] Birth control for people with sperm and for people with eggs should be covered. And, again, this is also bouncing off what Angry Black Lady said, I mean, this is also the position that Planned Parenthood has always taken, too, is that this is just healthcare. And unfortunately, it's been kind of marginalized and ghettoized. And it shouldn't be because it leads to a lot of really unhealthy situations.
[00:18:40] All right, we've solved birth control.
Charlie Jane: [00:18:43] And reproductive. Yeah.
Annalee: [00:18:45] We've solved birth control. So let's move on to talking about fertility and child rearing, which is the other part of this puzzle.
[00:18:54] Segment change music plays. Drums with a bass line including bass drops.
Annalee: [00:19:06] So Charlie, Jane, tell me about an innovation that would transform how we approach fertility and/or child rearing.
Charlie Jane: [00:19:17] One thing that we talked about previously, in our episode about technologies that could change the future was artificial wombs. And I feel like we should talk about that here again, because it's—
Annalee: [00:19:26] Yes.
Charlie Jane: [00:19:26] Such an important technology and it could actually make a huge difference if we could basically have a baby without a human being having to carry it inside their body for nine months or however long. Artificial wombs could make a huge difference, I think. And this is very science fictional idea, which obviously does not exist in the real world yet, but I think it's something that eventually will be a possibility once we understand more about that reproductive system.
[00:19:57] I also think, on a related note, The more we can do as a society to break down this idea of who is pregnant and who gets to be pregnant and what it means to be pregnant. And right now there is this assumption that women are pregnant and that men are not pregnant. Which is something that has already been becoming less and less relevant as we've seen trans men get pregnant and non-binary people get pregnant. And pregnancy is no longer something that is gendered to quite the same extent. But I think that we could go a lot further in terms of thinking of pregnancy as something that is not just for one group of people, or that doesn't denote a particular role in society, or a particular kind of gendered expectation.
[00:20:43] And also a thing from science fiction that has not become a reality yet, but I think that it could eventually, is people with sperm getting to be the ones who are pregnant and having it implanted in their bodies or creating a womb that they can carry on the inside of their bodies. And I think that that's the thing that Arnold Schwarzenegger obviously got pregnant in that one movie. So he was paving the way for the rest of us.
Annalee: [00:21:06] Don't forget John Ritter in Rabbit Test. [See show notes: Billy Crystal]
Charlie Jane: [00:21:09] How could I forget John Ritter. I mean, you know. It’s so important.
Annalee: [00:21:15] John Ritter and Arnold Schwarzenegger have both been pregnant, which is good to know.
Charlie Jane: [00:21:18] You know, those are basically—
Annalee: [00:21:19] They’re trendsetters. They are the two avatars of masculinity in our culture. So when do you think—when you ask people on the street who represents American masculinity, they would be like John Ritter and Arnold Schwarzenegger, for sure.
Annalee: [00:21:33] Right.
Charlie Jane: [00:21:32] No question.
Annalee: [00:21:35] Yeah.
Charlie Jane: [00:21:36] So I don't know. I mean, Annalee, what's an innovation around fertility in child rearing that you think could be game changing.
Annalee: [00:21:43] So I was thinking a lot about this essay by Rebecca Onion in Slate from a few months ago, where she talks about the idea of paying people to be parents. And she's specifically talking about it in the context of the coronavirus pandemic, where so many people's kids are at home, and they're struggling with how to do their jobs, and help their kids do schoolwork, and help their kids if they're not in school to just be kids, and doing childcare. And it's become this incredible burden on many, many families. And there's been a number of economic studies that have shown that women are leaving the workforce because of this. So our economy is shrinking, because women are being kind of forced to go back to playing these older kind of housewife roles, because that's just the most practical thing for the family to do during the pandemic.
[00:22:44] And there's a lot of different stories about how this happens. And it's not simple, it's not a kind of easy fix. But Rebecca Onion was saying, we could have an aid package that included money for families that have kids at home. And actually, although it sounds kind of futuristic, and she's talking about it in the context of this very new social problem, which is pandemic, this idea goes back decades in feminism. Where, especially in Europe, a lot of socialist feminists had proposed in the ‘60s and ‘70s, that maybe one way to achieve gender equity would be to grapple with the fact that housework and child rearing are labor, and if they’re labor, they should be compensated.
[00:23:37] And so if we can compensate, and these were mostly women who were doing these jobs, if we can compensate them adequately, then two things will happen. One, families will be better able to support themselves. But two, and more importantly, we take seriously how much work goes into child rearing and how it is actually a very important job worthy of respect and worthy of compensation at rates that are similar to the way we compensate a man who's doing bureaucratic work, or who's doing some kind of work that we that we all recognize as legitimate and deserving of some kind of paycheck.
[00:24:22] This idea, to me, makes a lot of sense. I think it seems radical on its face but once you think about it, it's actually just plain fair. Because all of these people who are doing childcare, they're working their butts off. It's a hard damn job and it's a job that's a 24/7 job without any kind of benefits or any kind of social acknowledgement of how difficult it is. That makes the job even harder.
[00:24:53] So I think that one of the things that we always forget about in discussions around fertility and the right to have children or the right to not have children is how much this is really about who's going to take care of the kids and how the kids are going to be taken care of. And this is like a very, in the United States where we have a lot of politics around abortion, typically the people who are conservative and are against abortion are also against social services for people who are raising kids. And my feeling is you have to have both. You have to have social services that provide family planning for people, that provide birth control, that provide pregnancy termination. But that also provides support if you want to keep your kid. And if you choose to keep your kid, if you choose to bring a pregnancy to term, then there needs to be some kind of social support that isn't just from your family and friends, but is actually the government or some other kind of agency that is coming in and paying for some of that labor.
[00:25:58] Because that that labor pays off, right? It's not like it's money going into a hole. Those kids grow up and become productive workers. They become productive caretakers on their own. And it's the same idea behind paying teachers, for example. And I think that's another piece of this, is that teachers and other caretakers, child care workers, are often compensated in ways that are just disgustingly small. They're given such disgustingly small salaries, considering how much work they're doing, and how much public good they're doing.
Charlie Jane: [00:26:30] It’s a huge problem.
Annalee: [00:26:30] If you had some social reform around the idea of compensating people who do child care, that that could also lead to social reform around how we compensate teachers and other kinds of caretakers.
Charlie Jane: [00:26:45] Yeah, and I feel like there's a common thread here to a lot of what we're talking about, which is equity. And this idea that people with eggs are generally expected to shoulder the vast majority of the burden of birth control, control over fertility, and also child rearing. And that there's some idea that being a person with eggs means that you are destined to fulfill a certain role in society that goes way beyond just pregnancy, but includes pregnancy. And I think that a combination of new technology and new social attitudes could make it possible for people with sperm to take an equal role in every step of this process. And that we would stop thinking of it as being something that's mostly on one half of the population and not on the other half. And that we would change the social meaning of our bodies, in a sense, to be something that's more equitable. And I think that is a thing where technology can help a lot. But it also has to go hand in hand with this conversation around child rearing as work. Being pregnant is in some ways work. It's like it's—
Annalee: [00:27:56] It’s totally work.
Charlie Jane: [00:27:59] And being responsible for whether or not there's going to be a baby is also work. It's also something that we need to respect and distribute evenly.
[00:28:08] And the other thing I wanted to mention really quickly, is just, getting rid of the taboos. We talked about taboos around abortion and how all this stigma around talking about abortion, but there's also weirdly, a stigma around talking about infertility.
Annalee: [00:28:23] There absolutely is, yeah.
Charlie Jane: [00:28:25] And people who are infertile or who are having trouble conceiving or who are doing infertility treatments are kind of not encouraged to talk about it, because there's something weird and shameful about it, which is weird. You would think that either abortion or infertility would be stigmatized, but they both are. Why do you think that is?
Annalee: [00:28:43] Well, I think some of it goes back to people who have eggs and everything that their bodies do is kind of off the table. It's marginal. It's something that's considered taboo to discuss. Any kind of health care for people with eggs specifically related to reproduction just becomes something that's unspeakable. I think that the taboos around infertility do take a slightly different shape. I think that there's a lot of rhetoric around what it means to be a woman and what it means to be feminine. And part of that going back way, way, way in history, going back to the Bronze Age, and before then.
Charlie Jane: [00:29:27] The Phoenicians.
Annalee: [00:29:29] The Phoenicians, exactly as we talked about in an audio extra. There's this idea that in order to be a real woman, you have to have babies. And I'm using the term woman very mindfully here as I did a little bit earlier, because this is a social construct. This is not a biological idea. This is a social idea of what people who identify as women are told that they should want and what they're told that they should do. And so many people who identify as women are ashamed when they can't have babies because they think it undermines their identity, when in fact, it's just a little health problem. And it should be treated as just a hiccup. I mean, it's a big hiccup. It's a health problem and it has to be dealt with through medicine. It's something that's solvable. And we know that it's solvable now, for most people, and there's all different ways to solve it, including things like adoption, or fertility treatments, or whatever.
[00:30:28] But yeah, I think that as much as you and I are asking for open discussions around abortion and birth control, we want open discussions around infertility and the difficulties of that. Different options for people. Having a more inclusive conversation about that, and talking about all the different things that go into becoming a parent. Because sometimes the issue isn't fertility, the issue is economics, or the issue is something social.
[00:31:00] And so all of that stuff, I think, needs to be part of a more open conversation and part of public policy. I think that's part of what we're talking about here. But I mean, just to circle back again, to this, what you were talking about, about how we kind of change the social meaning of our bodies. I love that idea. And I feel like we're trying to do that a little bit here by mostly referring to people with sperm and people in eggs. Because I think once you start thinking of it that way, then you start to peel away a lot of your expectations about what does it mean to be a man or a woman? And just start thinking about what are the actual mechanics here? How do we treat this as a health issue? How do we treat this as a technological problem, or a health problem, or a health solution? And it really is just about some people have one kind of plumbing, some people have another kind of plumbing, and we have a lot of social expectations that arise from that. And so we need to change our social expectations by kind of looking afresh at our bodies and kind of, thinking about, well, what's really going on here? Oh, it's literally just eggs and sperm. We can handle that. That’s not a taboo, that's just some cells, man.
Charlie Jane: [00:32:15] Just biology.
Annalee: [00:32:16] It's just a little biology. So when we come back, we're gonna have a final conversation where we do a little world building and think about the future of reproduction for people with eggs, people with sperm, and everyone in between.
[00:32:33] Segment change music plays. Drums with a bass line including bass drops.
Annalee: [00:32:44] Charlie Jane, we're gonna rev up our world building.
Charlie Jane: [00:32:47] Vroom! Vroom!vrooom.
Annalee: [00:32:48] Vroom vroom.
[00:32:52] I was, before we recorded this episode, I was doing a lot of revving. And I thought we agreed that I was gonna make the revving noise.
Charlie Jane: [00:32:59] Oh, I’m sorry.
Annalee: [00:33:00] But I guess you wanted to, also.
Charlie Jane: [00:33:01] I just got really excited.
Annalee: [00:33:03] I just want to put that out there, okay. Anyway.
Charlie Jane: [00:33:04] I feel like we should have an equal division of our revving labor.
Annalee: [00:33:07] Of revving? You know what I agree, I think that in the spirit of equity, we should do that.
[00:33:14] So, what is our future gonna look like? We sort of talked about a lot of the ingredients. We want to have greater access. We want to have a shift in the social meaning of our bodies. So what does that future world look like where some of these things have come to pass?
Charlie Jane: [00:33:32] Man. I mean, it's sort of hard to imagine, but I feel like, it would be a world in which there would be different messages everywhere. You would see different kinds of advertising and you would see the health care establishment, or like health care facilities would include, like you said earlier, they would include information and resources about fertility and emergency contraception and birth control, and options for terminating a pregnancy. And it would just be like a matter of fact thing. It would be like a thing that your doctor would be like, okay, any plans to have potentially reproductive sex and do you want to talk about that? And like, what are your options for controlling your fertility or ensuring your fertility if that's what you want.
[00:34:20] I feel like it would be a world in which we will be much more matter of fact about these things, and there will be a lot less euphemism and kind of tiptoeing around it and a lot less… it'd be something that would be just sort of more in our pop culture, in our kind of world.
[00:34:38] Ideally, it would be something where you would be able to control your fertility with the least gatekeeping and the least having to deal with stressful situations as possible. The more that it could be automated, almost, that you could just go talk to an AI about your fertility options if that's what you prefer. Something like that, and I think—
Annalee: [00:35:02] Or just the vending machine option like we were discussing earlier.
Charlie Jane: [00:35:04] Yeah, and the vending machine option for sure if we're talking about emergency contraception or birth control. This would be a world in which we would have a better understanding of the endocrine system in general, which is something that we're still learning a lot about. And we would, in addition to having easy accessible birth control, it will be part of a strategy for okay, what kind of hormonal balance do you want to have in your body? It would be a thing where okay, do you want your hormones to be more testosterone? Do you want it to be more estrogen? Do you want it to be more kind of progesterone? How do you want your hormones? How do you want to feel in your body? And how do you want your hormones? I feel like, as a trans person, I'm very used to the idea that hormones, and controlling the hormones I take in is not just a fertility issue, but it's part of my relationship to my body. And I feel like there could be a future where, I'm just spitballing now, I haven't really—
Annalee: [00:35:58] Mm-hmm. I love this. This is so interesting.
Charlie Jane: [00:36:01] I’m just spitballing now, but there could be a future where cisgender people, too, even though they don't want to transition, they identify as the gender that they were assigned at birth, they might be like, you know what, I'd like a little less testosterone, or I would like to control my testosterone a little bit more, or I would like to just have a slightly different balance of hormones.
Annalee: [00:36:21] Yeah, what you were saying made me think that, I mean, because also hormones have to do with mood. And I think, in this future, where we're viewing our bodies really differently, maybe you would have a doctor who was just in charge of your hormones. Or your general practitioner would be. Yeah, and you would say, like, I'm having some issues with anxiety and depression. And also I don't want to get pregnant. So what kind of concoction should I be taking. And it wouldn't be, again, it wouldn't be segregated out, like, oh there's special hormones for people who have gender and sex stuff, and other hormones for people who have mood issues or have energy level issues. It would all be just part of a balanced breakfast of hormones. So I think that's a really interesting idea.
[00:37:20] I could see two possible futures growing out of some of the topics that we've been talking about with greater access and with less stigma. I think one avenue is definitely what you were describing, Charlie Jane, where everything becomes kind of automated and depersonalized. So, birth control is just something you pick up at the drugstore, when you pick up a box of cookies, and some toilet paper. And that's just part of everyday life. Medicines for terminating pregnancy are similarly widely available.
[00:37:58] We live in an era where a lot of stuff related to the bodies of people who have eggs have been prescription and have recently become nonprescription. For example, I remember when medicines for yeast infections, you had to get a prescription for them.
Charlie Jane: [00:38:16] Oh my God.
Annalee: [00:38:17] And it's like, you’d just be sitting there for a week with your cooze on fire. Just itching and itching and itching, waiting for a goddamn doctor's appointment when you knew exactly what you needed to fix the problem. So now, medications for getting rid of yeast infections are over the counter, and you can get them anytime you want.
Charlie Jane: [00:38:34] That's insane.
Annalee: [00:38:35] It's insane. But if you have eggs, shouldn't medicine really just be regulating every part of your frickin’ reproductive tract? I guess so. But we're looking toward a future where that has been deregulated and just because you have eggs doesn't mean that the government and the medical industry get to regulate every part of you there. So I think there's that and I could see that being one path.
[00:39:02] The other path I could see is a way that we are making the process of giving birth or terminating pregnancy into something that's a lot more therapeutic, and that there's a lot more care and thought that goes into that. So, for example, right now we have places that people can go to have children where they have a doula and they give birth in a room that's kind of like a bedroom and it has soft lighting. And it's adjacent to a hospital so if anything goes wrong, of course, you can have medical professionals come in. But the place where you're actually giving birth, your family can be there. You can have soft music. It feels very homey and nice. And I could imagine in this future, something similar for people who want to terminate pregnancies or who want to learn more about birth control and that we extend that same kind of care and emotional caretaking to people who are struggling with questions around pregnancy and reproduction. And that it isn't just for people who are giving birth. It's also a way of taking care of people who, when they're having an abortion might be feeling a little scared or might be feeling sad and absolutely deserve the same kind of warm environment to reassure them.
[00:40:28] And so I guess what I'm saying is that some of these trends could result in in two very different ways of handling reproduction. One that's very depersonalized and very kind of just stripped of all…
Charlie Jane: [00:40:42] Matter of fact.
Annalee: [00:40:43] Yeah, very matter of fact, and one that is really almost new age-y, in a sense. That’s sort of based around like the ideals of a therapeutic culture. And there's no rule that says you can't have both.
Charlie Jane: [00:40:58] For sure.
Annalee: [00:41:00] You can have a more therapeutic approach right alongside a very matter of fact and pragmatic approach.
Charlie Jane: [00:41:08] I think that would be, the matter of factness and the kind of like, well, you can just get it done on your own time in your own way. But if you are trying to terminate your pregnancy after a certain point, or in a certain way, here's this nice alternative where you can go and there's candles and soft music and like someone massages your feet.
Annalee: [00:41:27] Yeah, exactly.
Charlie Jane: [00:41:29] And I think that that goes along with the idea of a world where maybe there are artificial wombs. Maybe there's, like, everybody can get pregnant, and everybody can choose not to be pregnant, and everybody can control their fertility. And it's basically just not a thing. It's a thing we all have in common. And it's a thing that it's like, oh, you know, we're having a baby. Oh, which one of you is having a baby? Or oh, no, is it? Is it one of you? Or is it your robot? You know? Like, it's just if you have friends who are a married couple, you would just be like, okay, oh, gosh, well, did you decide which one of you is going to be carrying the baby?
Annalee: [00:42:06] And also you can have babies that have genetic material from three parents.
Charlie Jane: [00:42:11] Right!
Annalee: [00:42:13] So it doesn't have to just be two parents.
Charlie Jane: [00:42:14] Yes. That is really good.
Annalee: [00:42:14] And I think this also goes hand in hand with a lot of the stuff we were talking about in regards to child rearing as well, because when pregnancy is something that anyone can experience, then child rearing starts to also be something that everyone participates in. And you could have two parents, you could have five parents. The point is that child rearing gets revalued as something that's really important labor. It's hard work. It's important. It deserves recognition and compensation. It's something we take very seriously and it's something that's also fun in a new way too, because it's not a burden. It's something that becomes an honor. And something that is, like I said, widely recognized as valuable.
Charlie Jane: [00:43:06] Yay.
Annalee: [00:43:06] So okay, there's our utopian world.
Charlie Jane: [00:43:09] Nice.
Annalee: [00:43:10] We’ve got better hormone regime, we have therapeutic clinics for pregnancy termination. And we have equitable childcare. And we leave it up to you guys to write the stories that are set in that world and write the stories about how we get to that world because we need as many stories as possible about that.
[00:43:35] I was racking my brains to come up with an example of a science fiction story that has a positive representation of terminating a pregnancy and I could not come up with a single one. We need it.
Charlie Jane: [00:43:49] Man. We definitely need that, yes.
Annalee: [00:43:51] Plenty of really negative scary representations of terminating a pregnancy. But nothing where it's ever portrayed as oh, you're having a tough time. We're gonna rub your feet. You're gonna go through this, and it’s gonna be fine and the community still loves you. And you're a good person, and this just wasn't your time yet. But you know, next time, maybe it will be your time.
Charlie Jane: [00:44:18] Mm-hmm. I love that. Yeah, I would love—
Annalee: [00:44:22] I do, too.
Charlie Jane: [00:44:22] More utopian stories about all of this stuff. I feel like there was some of it in the ‘70s. There was like a whole strand of wave of feminist science fiction in the ‘70s. That included Marge Piercy and people like that kind of speculating about some of this stuff. But I feel like we definitely need more of that now. For sure, more than ever.
Annalee: [00:44:43] Yeah.
Charlie Jane: [00:44:43] Hell yeah.
Annalee: [00:44:45] And especially stories that embrace all of the choices that you can make about reproduction, that allow for many, many pathways through reproduction.
Annalee: [00:44:56] So all right. Well, thanks so much for listening to Our Opinions Are Correct. This has been a really interesting conversation and you can find our podcast wherever fine podcasts or podcasted. Are birthed. You can go to the podcast birthing clinic. You can find it on Apple Podcasts where we would love it if you'd leave us a review. You can find it on Stitcher, you can find it in some kind of dank hole where they just pile podcasts up willy nilly.
Charlie Jane: [00:45:31] No.
Annalee: [00:45:34] You can support us on Patreon, please. We're on patreon.com/ouropinionsarecorrect. If you become a patron, you get lots of essays and writing prompts. And we will reveal to you our works in progress. We'll send you free books. It's great. It's a good deal.
[00:45:53] You can find us on Twitter at @OOACpod. And thank you so much to our producer Veronica Simonetti at Women's Audio Mission. And thank you to Chris Palmer for the music and thank you for supporting us and for listening. So we'll talk to you in a week or so.
[00:46:12] Bye!
Charlie Jane: [00:46:12] Bye!
[00:46:15] Outro music plays. Drums with a bass line including bass drops.