How Feminism Shapes the Birth Control Conversation (Episode 478)

Full Transcript: Episode 478

Lisa: Today I’m sharing another episode on the theme of birth control and feminism. I wanted to follow up the previous two weeks’ episodes with a replay of my interview with Dr. Kissling. This conversation stands out for the way we discussed the pill, feminism, and how things have shifted across generations. I particularly appreciate her insights on pill marketing and how, despite the many options available, hormonal methods are ultimately variations of the same thing.

Dr. Kissling: I started writing about menstruation in graduate school. My PhD is in communication with an emphasis on feminist studies—what I now describe as feminist cultural studies. I was interested in how we experience the body through language. I wanted a topic that explored that mind-body relationship, especially for women.

I read Emily Martin’s book *The Woman in the Body* and it struck me how menstruation is experienced differently across class lines. Women in the working class described it experientially, while middle- and upper-class women talked about it more in clinical, textbook terms. That influenced my decision to study menarche—first periods.

I interviewed girls about their first periods—what they learned, where they learned it, and then looked at the sources of that information: textbooks, teen magazines, teachers, parents. One theme that emerged was the lack of practical information: how many pads to carry, what to expect when it starts, how to manage it at school. They had plenty of scientific info, but not the practical stuff.

Lisa: That makes so much sense. I remember my own experience, and I don’t think I even thought to ask about those practical things until I experienced it myself. Did anything else stand out?

Dr. Kissling: The language was interesting. There was a lot of euphemistic or coded talk—girls saying “I started” without ever naming what had started. Also, girls were mortified by the idea of boys knowing anything about their periods, including dads and brothers. And unfortunately, I don’t think that aspect has changed all that much.

I teach courses on sexuality now, and I still see significant gaps in knowledge. When I ask where menstruation begins in the body, students often say uterus or vagina. They’re surprised when I say it starts in the hypothalamus and pituitary. Even today, a lot of students don’t have that foundational understanding.

Lisa: That’s really revealing. And I feel like it ties into broader issues around how we’re educated about the menstrual cycle and fertility. For example, a lot of women don’t know about cervical fluid or how it relates to ovulation.

Dr. Kissling: Exactly. Even knowing that cervical fluid is linked to fertility could make a big difference in reducing unplanned pregnancies. And if we educated boys on condoms and responsibility, that would help too.

Lisa: Right. I’ve met so many women who chose the pill just to avoid being surprised by their period. There’s so much fear around it.

Dr. Kissling: And many young women are put on the pill without understanding how it works. It doesn’t regulate the cycle; it shuts it down. But that’s not how it’s presented. And even men don’t understand it—there’s just so much misinformation.

I once showed a clip from *Girls* where a character accuses someone of giving her HPV, and the person responds that her current boyfriend was tested—except, of course, there’s no test for men. My students were shocked. Many didn’t know that men don’t have cervixes and therefore aren’t tested for cervical cancer. These are college juniors and seniors.

Lisa: I’ve had similar experiences—basic stuff like not knowing you can’t use oil-based lubricants with condoms. There’s a huge lack of information.

Dr. Kissling: Yes, and some of that stems from the abstinence-only education programs in the U.S. that began in the ’90s. These often included misinformation like “condoms fail one out of six times.” It’s not true, but if that’s what you’re taught, of course you won’t trust condoms.

The stigma around being prepared for sex also contributes. Carrying condoms or a diaphragm can signal that you’re expecting sex, and that shame deters people from using them.

Lisa: It’s like not being on the pill equals being irresponsible. And that’s a belief built on misinformation—many women don’t understand how fertility actually works or how short the fertile window really is.

Dr. Kissling: Right. And hormonal birth control is marketed aggressively. My paper “Pills, Periods, and Postfeminism” looked at the marketing for Seasonale and Seasonique. These pills were promoted for menstrual suppression rather than contraception. The ads suggest that your period is a nuisance that interrupts your life.

The formulations keep changing—not because they’re more effective, but to secure new patents and marketing angles. Originally, the pill was only prescribed for married women. Now, girls are starting it at 13 or 14, often not for contraception, but for acne or irregular periods. That’s 40+ years of hormonal suppression.

Lisa: That’s a huge shift. And as you mentioned, we don’t know the long-term effects of suppressing ovulation for decades.

Dr. Kissling: There are concerns about bone health, for example. Ovulation plays a role in bone development. Dr. Jerilynn Prior’s work shows that suppressing ovulation in adolescence can affect peak bone mass, which isn’t reached until the 30s.

Lisa: And side effects are often dismissed. I’ve interviewed many women who experienced severe side effects like anxiety, depression, or even blood clots. But when they bring this up to their doctor, they’re offered another pill instead of considering stopping it.

Dr. Kissling: That’s common. Women spend years trying different formulations. Some forums I studied had thousands of comments from women sharing their experiences. They’re seeking help from each other because they’re not getting support from healthcare providers.

And when half of users report side effects, it’s not a minor issue. Yet there’s resistance to acknowledging the risks, even when research supports them.

Lisa: And women who raise these issues are often accused of fear-mongering or being anti-pill. But we’re just asking for full information and informed consent.

Dr. Kissling: Absolutely. We need to trust women to make informed decisions. My advice is: don’t let me or anyone else decide for you. But do ask questions, do your research, and make the choice that’s right for you.

Lisa: Thank you so much for being here, Dr. Kissling. This was such an important conversation. Where can listeners find you?

Dr. Kissling: I have a website—kissling.fyi—where I post articles, blog entries, and course info. Listeners can contact me there and find more resources.

Lisa: Wonderful. I’ll link that in the show notes. Thanks again for this powerful discussion.