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Chubby Not Chastity: Guess What? I’m Fat and Want Plan B

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September 8, 2016

During finals week this past April, I found myself slumped over a frequently dying PC, empty Starbucks double shots and a series of text messages about Plan B. My sole sexual partner at the time was trying to convince me that sex with condoms is lame and that au-naturale was the way to go. Now, of course the break from studying piqued my interest so I listened to his various arguments for why latex-less sex was what all the kids were doing. After a few misguided attempts to convince me, he offered up what I’m sure he saw as the winning argument: “how about I buy you Plan B afterwards.”

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There it was, the end all, be all of preventative methods. Except there was one flaw with this holy grail of contraception – I’m fat (And yes, I called myself fat). Therefore, most emergency contraception isn’t for me.

According to a Princeton University website dedicated to emergency contraception facts, there are currently several forms of EC pills offered in the United States. These include Ella, Plan B One-Step, Take Action, Next Choice One Dose and My Way. Of these pills, there is no viable option for an obese person (BMI of 30 or more).

Well, technically I already knew this information. I can vividly remember a 16-year-old me stumbling across random Tumblr posts, and one in particular caught my eye. It was a long thread with fat women complaining about their inability to use Plan B. So my history with this valuable information was vast and frankly not troubling.

But what is a sexually active fat girl to do?

The first step would be informing her eager sexual partner that Plan B loses virtually all of its effectiveness if the user is over 170 pounds. To which he might reply with the same almost childlike shock that you displayed at age 16. The second step would be silently scolding the universe because once again the reproductive health world has failed fat people.

Over 35% of adults in the United States are considered to be obese. This means that a significant portion of the population of sexually active adults are being denied reproductive health options because of the unwillingness of the reproductive health movement to include fat bodies.

Currently, the only effective method of emergency contraception for a person with a BMI over 30 (dismantling the BMI scale is a problem for another day) is to have a copper IUD inserted within 5 days of unprotected sex.

But that is better than nothing right? Wrong.

As Jazmin Walker of Rewire stated, despite the long term convenience of an IUD, it must be inserted and removed by a medical professional. This not only strips women of reproductive agency but it also reinforces the violent rhetoric that medical professions know what is best. Which is wrong for a multitude of reasons.

For as long as I can remember, medical professions have treated my weight as a cause with no correlation. Headache? Lose weight. Sore Throat? Lose weight. This attitude didn’t diminish when I started seeing gynecologists. My mother’s long-time OBGYN had me lay on his cold and uncomfortable table in a medical gown two sizes too small while he eagerly declared that he wouldn’t allow me to continue “at this rate,” a sentiment I can only assume meant “living while fat.” Long story short, medical professionals don’t always know best and fat people have every right to be disappointed with the medical world.

So the problem remains – how the heck are fat people supposed to feel completely protected from pregnancy if 95% of the emergency contraception methods that exist don’t exist in a world for them?

IUDs as a form of EC continue to be inaccessible, expensive and scary for many women living in poverty and women of color. Considering the history they have with the forced sterilization of black women, who have higher rates of obesity, IUDs seem almost violent.

It’s time for the medical world to admit that the exclusion of fat people from clinical trials for emergency contraception is unacceptable. We’re fat, we have sex, and a lot of us don’t want to get pregnant.

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17 Responses to “Chubby Not Chastity: Guess What? I’m Fat and Want Plan B”

  1. Courtney

    YES. GOOD SHIT GOOD SHIT THAT’S SOME GOOD GOOD SHIT.

    But seriously, I finally found a doc that can divorce my weight from some of my chronic issues and is finally treating those issues and I realized how much my physician’s have been writing me off over the years, and inflicting unnecessary guilt that just exacerbated my issues.

  2. Michelle

    And what was his solution for STIs? Just because he is your only partner right now does not mean he isn’t seeing someone else. Exactly how does a contraceptive pill of any description prevent STIs?

  3. Wendy

    I am big also. I use Ella. It is more effective than plan B for bigger girls but you have to get a prescription for it. But Planned parenthood is happy to give one.

  4. Anita Wagner Illig

    I am an older fat woman who is no longer fertile but who is and has been sexually active since puberty. Four months after the birth of my daughter in 1977, I got an IUD that did its job without fail until I entered menopause more then 30 years later and no longer needed it. I believe all women should have the option of having an IUD as it is an excellent method of preventing pregnancy long term. And it is probably the least expensive, even more so if we factor in the cost of raising a child conceived unintentionally. (Of course, unlike condoms, it will not serve as protection against STIs.) Funding via Planned Parenthood should be made available for those who don’t have the money for an IUD. Fiscal conservatives should be in favor of this since it would reduce the number of children dependent on welfare and similar benefits.

  5. Altair420

    You need to be assertive and have him wear a condom. The majority of birth control (whether it caters to your wants or not) does not reduce/prevent STIs.

  6. Kristina

    Wait. Your boyfriend tried to pressure you into having unprotected sex? And your biggest problem with this was that Plan B, a last ditch, emergency contraception, the Holy Fucking Shit I Cannot Get Pregnant Now, doesn’t work on fat women? Wat? And sexually transmittable diseases?
    Your boyfriend is an abusive asshole who pressured you into unprotected sex and made you feel like shit about it. I sincerely hope you dump him. That is what this article should have been about, not that Big Pharma are Big Meanies for not wanting to shove you so full of hormones your chance of bloodclots quadruple.

  7. KDC

    I would tell him that he has to wear a raincoat to play in the rain….

    Anyway, you make good points about the EC….nothing pisses me off more than the dr telling me to lose weight. Then I got sick and lost 50 pounds. Suddenly, the focus was on how much weight I had lost. My doctor does not talk about my weight anymore, he asks about exercise and healthy eating, about taking necessary medications, about stress levels.

    And you know what, I have kept off about 40 pounds, and at the end of the day, my weight is not my health, it’s not changed my ability to buy clothes etc.

    We just need to be more aggressive about calling people out on it.

  8. Bob McDowell

    The article makes no mention of birth control pills, which are available basically everywhere and work well even for ‘people of size’. They also have some beneficial side effects. You might look into it.

    Also note that pills do nothing to protect against STDs, so ‘latex-less’ sex isn’t something that one should be ‘convinced’ into. You’ll know when your relationship is ready.

    • MP

      Don’t condescend, friend. Assume that every woman has “looked into” birth control pills long before you did.

      • Kenyetta

        Thank you for mentioning this! A point I feel that I need to make after seeing some of these comments is that plenty of people take birth control and still want PlanB. Plenty of people also opt (by their own choice) to forego male external condoms because they are comfortable with their sexual partners. Accidents always happen and people should have the choice regardless of size, to use PlanB or any EC pill and be comfortable with its effectiveness. I think the lack of a pill with substantial effectiveness for “people of size” is a tremendous disservice for the repro health community. The point of this article was not to open a discussion about birth control because that is a topic in and of itself. The point was also not about STIs or belittling someone’s choices to forego contraception.

  9. DAr

    This guy’s a fuck. As punishment you should make him wear condoms on his head, arms, legs, AND penis every time. Tell him it makes sex better for you. Fuck him fuck that fucker.

    DO NOT LET HIM TELL YOU WHAT TO DO WITH YOUR BODY OR EVEN MAKE SUGGESTIONS. YOU ARE THE QUEEN, HE CAN BOW DOWN OR GET OUT

  10. Hannah

    Plan B is emergency contraception, not birth control. While it is still preventative care, it shouldn’t be a casual thing thrown out there.
    So the other misinformation your fuck-buddy has it that taking Plan B ain’t no thang when, in reality, it is. It makes a lot of people rather sick and it isn’t meant to be taken casually. While it has no long term effects, it still isn’t like simply popping an Advil.

    From, someone who works at a family planning clinic.

  11. Zoe G

    If the problem is efficacy above a certain weight, it seems to me that a effective dosage rate COULD be calculated. (Although no doubt they would then want to charge extra for Plus Size Plan B. Grrrr.)

  12. whoa there

    “BYE BOY” was the correct answer! Wow, loser with a capital LOSE.

    I have an idea – my fail-safe plan is to NOT HAVE SEX WITH ASSHOLES, once revealed as such! What a deal! Even cheaper than Plan B, WTF.

    Point taken about the ineffectiveness of Plan B for people larger than 170# (which is literally every woman I call a close friend, except one) , and the question remains. How can fat people be invisible when so many damn bozos are always chirping advice at us on how to live our lives. Angry!

  13. Danielle

    Firstly, thank you for speaking about this. It affects me too because of my weight. And medical fat-shaming in all its forms is dangerous and absolutely needs to stop. I love this: “It’s time for the medical world to admit that the exclusion of fat people from clinical trials for emergency contraception is unacceptable. We’re fat, we have sex, and a lot of us don’t want to get pregnant.”
    However, as a sexual health educator I have some concerns about the article that I feel I have to share. In particular, the beginning discusses using Plan B (and other emergency contraceptive pills) in a way it is not intended to be used for anyone, regardless of their weight – instead of ongoing birth control or condoms. Although this has not become widely publicized yet, we now know Plan B and other pills like it are only about 50% effective overall. Ullipristal (Ella) is only slightly higher at about 60%.

    This makes the distinction that it is meant only for emergencies like a condom breaking or missed pills etc. a pretty crucial one. The sooner it is taken the more likely it is to work, but many, many people using emergency contraceptive pills, especially those that use it often, have unintended pregnancies. Also, it could be hella expensive to use every time you have sex, at least here in Canada.

    What this means is that a Copper IUD is not only the only effective method of emergency contraception for people who weigh over 165 lbs, it is the only form of effective emergency contraception for anyone. In actual use, Plan B and EC pills like it= 50-60% effective and a Copper IUD = 99% effective. Also, yes, emergency IUDs are not super accessible (many of us are working on that) and can feel quite scary to some. And yes, they have to be put in by a health care provider which is a barrier for some. However, they are very safe and a really great choice for many people (although of course, like with anything, not everyone will have a good experience with them).

    I’m worried that this article, especially in using the word violent twice when referring to IUDs might add to a sense of fear and stigma that actually lessens choices for folks who want/need to prevent pregnancy. I think your overall point of the article is we need more choices, not less, which I wholeheartedly agree with. Yes, absolutely, if people are pressured or coerced into getting an IUD that is violent. That has happened at times, which is abhorrent, as has forced sterilization. Even so, it is important that people are able choose those options when they are not being pressured and coerced. What we need is readily available, accurate information about how people can effectively protect themselves against unintended pregnancy at any and all weights so that we can make informed choices. And health professionals who respect those choices regardless of someone’s weight or other social positioning.

    I offer this in that spirit: IUDs, along with the implant (which isn’t available in Canada) are currently the most effective method of preventing pregnancy ongoingly as well as in emergencies – the most effective method by far in fact. They also have fewer contraindications than the birth control pill, patch, ring and shot and overall fewer side effects. The progestin containing IUDs (Mirena, Skylar, Jaydess) can be lifechangers for people with heavy painful periods (or for people who want to bleed less for other reasons) as they lighten flow and cramping.

    And lastly, just as an FYI, my current understanding is that the warning about weight and Plan B is a “may be less effective” as they’re still studying it. Women of all weights can take it and ideally shouldn’t be discouraged by health care providers (although they often are, which is bullshit – we should simply be given accurate info and allowed to make our own choices).

    Again, totally on board with the core message here. But in the spirit of people having the info they need to make informed choices amongst those available to them, I hope this is helpful. The info I’ve provided is evidence-based and backed up by clinical experience in sex-positive organizations and sexual health clinics that operate with a feminist lens.