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Contraception

Dear Sister Veit, does your health plan cover Viagra for non procreative sex?

Dear Sister Veit,

As an OB/GYN I have been following with some interest your challenge to the Affordable Care Act’s contraception mandate, Zubik v. Burwell

I read your impassioned Op-Ed in the New York Times about your position in which you say contraception is “wrong.” That to even allow a 3rd party to handle contraception for your employees health care needs is not good enough as it would violate your orders’ “religious beliefs.” A degree of separation (or many degrees) being tantamount to complicit. You used a soda analogy. It would be the same, you wrote, as a school not selling soda because it’s bad for kids, but allowing a 3rd party vendor in the building with a machine. Kids shouldn’t have soda and women shouldn’t have contraception.

Except contraception isn’t wrong or bad, it’s health care and while we’re at it soda is a terrible analogy. Contraception is, according to the United Nations, a human right just like the right to practice religion. Soda is not on the list of human rights.

Many defenders of contraception talk about how birth control pills help women with pelvic pain (they do), women with migraines (also true), and reduce the risk of endometrial cancer (yes again). And while I do not mean to diminish the impact of hormonal contraception for these women, that’s really not the issue so let’s not pretend that it is. Let’s dispense with the pleasantries and get to the meat of the matter, sex. Most women use contraception because they are having sex and do not want to get pregnant.

Planning a pregnancy is a human right (I know I mentioned that earlier, but it bears repeating). It is also really important medically. Unplanned pregnancies have higher complications for mom and baby. Pregnancies that happen sooner than every 18 months have more risks for both mother and baby.  Also, under the age of 18 and over the age of 35 maternal risks rise. So contraception helps women plan pregnancies so they can have the best outcomes. Contraception also allows women with serious medical conditions to optimize their health so they have the lowest risk of dying in pregnancy. Maybe you haven’t looked at it this way, but contraception sounds awfully pro-life to me!

Then there is the fact that unplanned pregnancies often set women on a path of poverty. I would think that would matter to someone who has devoted her life to caring for the poor.

Finally, some women just don’t want to be pregnant. Perhaps they have completed their childbearing, but still want to make love to their husbands regularly to strengthen their marital bond or maybe they just never ever want to be pregnant or maybe they do one day just not now and they like sex. Sex feels good and makes women (and men) happier and healthier, so as a doctor I say that’s a healthy thing.

So all of this leads me to ask you one question. Does your health plan cover drugs for erectile dysfunction for non procreative sex and do you require that all men on your health plan provide some kind of proof that the intended sex is indeed marital? I ask because adultery is breaking one of the Ten Commandments. I know you know that, but I think it’s important to emphasize because birth control has only been a mortal sin since 1930 and I would like to think breaking one of the “big ten” that was carved in stone by God himself a few thousand years ago would be way worse.

I’m only an OB/GYN so while I sure know my birth control I admit I’m no biblical scholar. However, I do understand logic, fair play, and misogyny.  If the only Catholic Church worthy sexual love is between a married man and woman for procreation for your court case to be about religion and not about misogyny and power you’d have to be holding men and women to the same sexual standards, either abstinence or baby making.

I eagerly await your reply.

Yours sincerely,

 

Dr. Jen Gunter MD, FRCSC, FACOG, DABPM, ABPMR (pain)

 

By 350z33 at English Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=41018210

By 350z33 at English Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=41018210

Discussion

12 thoughts on “Dear Sister Veit, does your health plan cover Viagra for non procreative sex?

  1. Hi Dr, Gunter I am writing from the Caribbean…Trinidad and Tobago and I would like to get much need clarification on a medical matter regarding IgM testing. What is the best way to contact you?

    Posted by SS | March 23, 2016, 8:27 pm
  2. This, very much this.

    Posted by mkaufmann2009 | March 23, 2016, 8:49 pm
  3. The Cardinal Archbishop of Westminster (England) recently affirmed the Catholic Church’s position:

    “The moral teaching of the church is that ‘proper use of our sexual faculty is within a marriage, between a man and a woman, open to the procreation and nurturing of new human life’. ”

    Sex, in this view, is for procreation; and procreation is necessary to increase the population of Heaven, specially of the virginal chaste and pure.

    However, a ‘side effect’ of hysterectomy is birth control, not that we usually think of it in that way. In Ireland, until quite late in the 20th century, when a woman was advised a hysterectomy by her gynaecologist, she had to seek permission for the operation from her parish priest. This permission wasn’t always given.

    Posted by korhomme | March 24, 2016, 2:22 am
  4. Why is religious freedom only the prerogative of the employer? Why doesn’t the religious freedom of the employee count?

    Posted by Cyranetta (@Cyranetta) | March 24, 2016, 1:11 pm
    • First up is that there is a ‘Conservative Christian’ movement underfoot in the US that is slowly trying to turn the secular US government into a theocracy. A nation ruled by religious laws much like it is in Saudi Arabia or Iran. Different name for their god but the same idea.

      Secondly, because of this ‘conservative’ movement, by electing religiously oriented lawmakers at all levels of government, SCOTUS basically has said that corporations are viable living entities; see the Hobby Lobby decision. I guess the moral of this is that corporations have more people than the individual so their religiosity is has more sway when it comes to forcing their will on the individual.

      Posted by Joni | April 3, 2016, 8:27 am
      • If you want to see what a ‘Christian’ theocracy is like in action, try Ireland. True, in the ‘south’, the Republic, the power of the Catholic church is waning; but even now the hierarchy controls about 95% of schools; no baptism, no entry. And in the ‘North’, still a part of the UK, the Democratic Unionist Party makes no real effort to disguise its homophobia or intolerance of any deviation from the sexual norm – only marriage is acceptable. Gay or equal marriage isn’t possible, though it is elsewhere in the UK; abortion is essentially illegal in all forms, again quite unlike the rest of the UK; and there is no appetite to enter the 20th century, let alone the 21st. And only in N Ireland could there be a Court case about a ‘gay cake’.

        Posted by korhomme | April 3, 2016, 9:42 am
  5. Furthermore, the soda analogy fails because the Catholic church is trying to prevent women from getting contraception ANYWHERE, whereas in the soda analogy kids are free to have soda after school as they and/or their parents see fit. Also, kids are, like, kids, whereas women are grown-ass adults and deserve to make our own medical decisions. Plus soda is likely to raise your risk of health problems (e.g. diabetes) whereas birth control will protect you from health problems (including diabetes, insofar as gestation-induced cases go!). Finally, contraception is used IN THE EMPLOYEE’S BODY, whereas the soda example refers to school grounds–to make the analogy work, this inescapably shows that the Catholic church considers their employees’ bodies to be the Catholic church’s grounds/property.

    Posted by satiricalifragilistic | March 24, 2016, 6:41 pm
  6. Wonderful essay, have you considered submitting to Kevin MD or Huffpost?

    Posted by genmedmom | March 24, 2016, 7:33 pm
  7. I love your blog. You are a genius and should be mandatory reading for the prudes who are poking their noes in our bedrooms.

    Posted by chris a | March 27, 2016, 8:46 am
  8. By their own logic, they shouldn’t be paying their employees anything, because their employees might go out and buy birth control.
    I have the suspicion that the nuns have been ordered by the (male) hierarchy to be plaintiffs in this case. This case of refusing to sign a form seems too silly for most nuns to bother pursuing of their own accord. Normally an elder-care order is more concerned about end-of-life care, and are glad just to have reliable nurse’s aides (the great bulk of the day to day patient care is performed by non-degreed short-course “practical nurses”. The nuns do a little bit of the administrative work and are chaplains, at least in the one Catholic order nursing home I am very familiar with. Nuns are about the same age as the elderly patients.).

    Posted by NancyP | April 4, 2016, 4:33 pm

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