That school that is implanting girls with hormonal contraception without their parents knowing...

[BasilRathbone]

... that is a feminist issue, is it not?

Hormonal contraception can have very serious side effects. They are having 13 year old girls injected with them, I'm not sure whether they ask these girls first, if they are actually having sex and wanting sex.

I feel very disturbed by this, it smacks of contracepting girls ready for boys to fuck them without having to negotiate other ways of sexual activity, contraception, consent issues etc. Also where is the protection from sexually transmitted diseases in this approach to tackling teen pregnancy, where is the regard for the girl's long term health, where is the discussion around whether they actually want to be penetrated by boys at this stage of their lives and whether the sex they are having is truly consensual?

Would they inject boys with hormonal contraception with such alacrity?

What do you lot think?

[BasilRathbone]

I haven't actually experienced any bullying about contraception from HCP's. But plenty of women have and I think that with its record on the treatment of women, we've got every right to have a good long gaze at anything the medical profession does with regards to the control of girl's and women's fertility.

No one is criticising you personally or implying that you are remotely dodgy MrsC.

[MsCorleone]

The majority of nurses are female, why would we want to bully anybody into having contraception? I'm not getting any bonus or financial incentive to push it. I thought that the introduction of contraception actually liberated and empowered women!

By all means have a good long gaze at the medical/nursing profession but like any other you get good and bad. I'm glad you don't think i'm dodgy and I don't take it personally. It does make me sad that a significant majority seem to believe what they read in the papers.

[KRITIQ]

I was just speaking with a colleague about this earlier today. It's a very tricky situation.

On one hand, I firmly believe that a 13 year old young woman should be able to obtain contraception without necessarily gaining consent of their parents. The health care practitioner must follow agreed guidelines to ensure the young person is capable of giving consent. I also believe contraceptive services need to be as accessible as possible for young people because at the moment, they can be difficult enough to get to even if you are an adult. Many young people feel intimidated about going to the family doctor or two a mainstream clinic - perhaps fearing (sometimes rightly) that they'll be judged harshly.

It is my understanding that most sexual health and healthy respect programmes set up for young people DO push condoms, both to prevent pregnancies and STIs but also recommend other forms of contraception (so long as these are suitable for the individual) both as a back up and in the realistic knowledge that condom usage can be erratic amongst young people - and frankly, people of all ages.

So if a young woman is having sex or is likely to have sex at least having access to reliable contraception will reduce the risk of unplanned pregnancy - the impact of which can be devastating physically, emotionally, socially, educationally and economically for a young woman.

But, there IS a problem with this. Evidence is increasingly emerging to indicate that young women are being pressured, coerced or actually forced to have sex not just with a "steady boyfriend," but often with multiple partners - like a boyfriend wanting her to "do favours" for his mates. This is happening with girls at younger and younger ages (12 or 13 isn't unusual, in my experience.)

So, while a young woman may be mature enough to understand the implications of and give consent to be prescribed contraception, she may be in a situation where she actually doesn't have genuine control over when, how and with whom she has sex.

In such circumstances, condoms are unlikely to be effective (i.e. if she doesn't feel she can say no to sex, it's not likely she'll feel able to insist on condom use either.) Injections or implants will reduce the chance she'll get pregnant, so that's something at least. But something just doesn't feel right about this scenario. Whether the health care practitioner does or doesn't offer contraception, the young woman will still be pressured/coerced/forced to have sex and be at risk of sexual exploitation.

If the "boyfriend" or other men involved are over 16, it's a child protection issue, but that's rarely picked up on because it can seem heavy handed to report the situ to the authorities where it's just a "slightly older boyfriend" and "consensual" sex. But "older boyfriends," can mean something else and "consensual sex" is nonsense where genuine informed consent isn't involved.

It just feels like we're seriously failing a whole generation of young women if we seem only concerned about keeping them from getting pregnant (yes, that is important for their sakes as well,) but not that bothered if they have little control over their own bodies or when, where, how and with whom they have sex.

[TeiTetua]

Just a quick note that someone using the holy name of Dworkin said "But so long as the boys get their shagging practise in we'll all ignore [harmful effects on girls]."

A feminist would think about girls' sexuality, wouldn't she? I mean, some of them are actually in control of their own lives and want to do what they're doing, including getting their shagging practise. Or is there always someone else who knows better?

[KRITIQ]

Tei, yes, there are some young women of 13 or 14 who are in control of their lives, including their sex lives. Not always, but most often, they have a positive, supportive relationship with their parents so are better equipped to understand and manage risks inolved. I'm not so worried about them.

Im on my phone so can't link, but there is pleenty of research out there to show a high proportion of women regretted their first experience of sex, particularly if they were very young. Their descriptiions of the first time often meet the legal definition of rape.

There is also more evidence coming out about the prevalence of violence, oercion and control in teen intimate relationships, and it is gendered and most common where the male partner is (from memory here) two or more years older. There is an accompanying trend towards young people in general seeing gendered abuse as normal.

I'd say it's very much a feminist issue to be concerned by this and the societal factors that generate and sustain these beliefs and practices.

[TheRhubarb]

I wonder about the description of a 13 year old as a young woman? To my mind, a 13 year old is a child.

And I second KRITIQ, I also read that a high proportion of young teenagers regretted their first sexual encounters and many of those sexual experiences could well have been classed as rape i.e. young teenagers getting pissed and unable therefore to give their full consent.

I find it very sad that so many young girls are having sex and deeply regretting it later and yet instead of addressing that point, the government just wants to ensure that teenage pregnancies are kept down so they can fall in line with the rest of Europe. However the rest of Europe doesn't have such a binge drinking culture and this, imo, is the problem we face. Not contraception but alcohol and its availability to children.

[BasilRathbone]

I don't think it's just alcohol.

I think it's resurgent sexism, the portrayal of women as fuck-toys in the media, the fact that many boys see hard-core porn on the internet long before they've even kissed a girl, the pathetic approach to real consent and continuing rape apologia in our society and the lack of genuine will to tackle male violence against females or even acknowledge it as a discrete problem separate from violence in general.

All this mixed with alcohol is not a good combination; but it's not the alcohol that is the cause of the widespread abuse of girls by boys. Of course the booze doesn't help though, that's clear.

[TheRhubarb]

Hmmm I think you are right there. A Newsbeat study found that boys actually admitted that viewing porn HAD effected their relationships with girls.

This society is a very sexual one with promiscuity almost actively encouraged, although it's interesting to note all the offensive terms for a woman who sleeps around as opposed to a man. Young girls (and boys) are under an enormous pressure to lose their virginity and whereas 50 years ago you might have slept with one or two people in your lifetime, now 20 or 30 in a lifetime is more common. Virginity is seen now as a dirty thing that must be got rid of as soon as possible and parents just accept that their children will be having underage sex.

Women and girls as you say, are more vulnerable to this pressure which coincides with the widespread, easy availability of porn which is much more hardcore and shocking these days and almost always depicts the woman in a variety of humiliating poses with the man taking the leading role.

Throw in plenty of alcohol, as this society also deems to be acceptable for young teens, and you have a flammable combination. No wonder so many young women regret their sexual encounters and no wonder there are so many unwanted pregnancies. I personally think the government are barking up the wrong tree.

[TheRhubarb]

This is again from the BBC, I think it was updated in 2010.

A boy who has sex with a girl under 16 (17 in NI) is breaking the law. Even if she agrees.
If she is 13-15, the boy could go to prison for two years.
If she is under 13 he could be sentenced to life imprisonment.
A girl age 16 or over who has sex with a boy under 16 can be prosecuted for indecent assault.

Surely if a child 13 years or under is having sex, that child cannot be deemed (in the eyes of the law) to have given consent, so what do you do as a nurse if a child came in and asked for contraception? If you know that child is potentially being abused? I suppose you would have to give them as much protection as you can against STIs and pregnancy, but I find it alarming that so many posters simply assume that children of this age will be having sex and should be given hormonal implants.

[BasilRathbone]

Maybe MsCorleone can shed some light on that. MsC, as with any professional who comes into contact with children, you are obviously obliged to report any suspicion of sexual abuse to SS, but does your remit stop at a girl actually telling you that she is being abused, or are you allowed to question them gently about the circumstances of why they need contraception? I'm guessing that that would be over-stepping the mark as you don't want to put girls off accessing the service by setting up what might feel to an adult like gentle probing and feels to teenagers like Gestapo-inspired nosey-parkerism?

I imagine that that is too hard a tight-rope to tread, and that therefore the nurses involved aren't allowed to question the girls? Or is that wrong?

If it is wrong, then how do you know that this particular girl needs working on with her self esteem so that she has some real sexual autonomy and what are the mechanisms to support her to do that?

It's a bloody minefield. And that's why there should be far more emphasis on teaching boys about respect for women, which of course is way beyond school's competence - it needs the whole of our culture to change, schools can't do it in a vacuum when in many homes, everything they are teaching in school is directly contradicted by the behaviour of their pupils' parents and on TV, film, music, literature etc., they are getting completely opposite messages.

[TheRhubarb]

Again I agree, the whole emphasis at the moment is on teaching girls how to protect themselves but boys need to brought into line too. Perhaps a hard line stance with them on where the law stands and what could happen to them might just stop them from taking advantage. Also the warning that having sex with a drunk girl does not imply consent and that the boy could legally be held up for rape.

I do think that boys need it drumming into them about respecting a girl's space and that she is not just a conquest for them to brag about to their mates. I think they get away far too lightly and it's not fair that our girls should be filling their bodies with chemical hormones whilst they just moan about not liking condoms.

Individual parents might well drum this into their boys, but schools need to take responsibility too. They cannot just focus on girls whilst teaching boys how to put a condom on a banana. It's hardly the same thing.

[LapsusLinguae]

Very much a feminist issue and something on which I have changed my mind as I have got older.

I query the ability of girls aged 13 to be make an informed choice on hormonal contraception. I would prefer to see services outside schools - a mature girl can seek out these services if required.

I think that making this available in school is normalising sexual behaviour in young teens.

I think that the strong driver behind this initiative is to drive down teen pregnancy in Southampton which iirc is at a very high rate compared to the national average.

I would love to know exactly what form of counselling and leaflets are given out and whether consent and domestic violence/coercion are discussed. Any one up for a FOI request?

As to the possible "bullying" from HCPs. Well I found it an awkward converstation to say that I wanted my Mirena out and a copper coil in and that it was my choice and since depression/anxiety are side effects I'd rather go non-hormonal etc. This is me as a degree educated professional mother blah blah and they would have loved to have talked me out of it.

Here is a link to the NSPCC report into domestic violence . I've not looked at it for a while so can't remember what the content was on sex/contraception etc.

[TheRhubarb]

Lapsus, every time I go into my GPs or to the nurse for a chat about contraception I always have to bring up my depression whilst on the combined pill and I also have to remind them about the bleeding whilst on the mini pill, they hardly ever seem to be bothered to read my notes, thinking that just taking my blood pressure would suffice. I never had it confirmed that it was microgynon which caused my depression and it was certainly never discussed with me.

I have in fact been recommended the mirena coil on more than one occasion and been told that depression is a very rare side effect - I gently reminded them that it was also supposedly rare whilst on the combined pill.

If this is my experience, I wonder how my dd would fare? If I didn't tell her about my own track record on the pill (and my sister is the same) she might not know and might well be prescribed a hormonal contraception that may well affect her in the same way as it affected me.

[bakingaddict]

Surely the main point about girls being given the implant instead of say the normal contraceptive pill and condoms is less about the moral neglience of the healthcare professionals and more to do with the fact that the contraceptive pill requires adhering to a certain regime i.e needs to be taken at the same time every day, young girls are probably less likely to do this therefore the implant imparts greater protection against unwanted pregnancies.

While we can debate the moral arguement of this till the cows come home, surely the healthcare professionals at the coal face are offering practical solutions to the fact that the UK has the highest underage pregnancy rates in Europe.

[silverfrog]

It is very hard to have to 'stand up' to medical professionals if they are (however gently) pushing a particular point of view.

and I agree that hormonal contraception seems to be the holy grail atm.

I also had depression as a side effect on microgynon. it was not pointed out to me before I started taking it. in fact, I was told that is was the one that 'most young girls seem to get on best with' - thus implanting the subconscious thought that I was freak if I didn't...

both times at 6 week post-natal check up I have had to educate (different) doctors on why the coil is not a suitable contraceptive for me since I have had previous ectopics (and yes, that does include the mirena too - wtf would the hormones make any difference at all?) - that is not my job. the doctor is supposed to know something as basic as that.

and the blank looks when they then realise there is no hormonal option - 'oh, you'll just have to proceed with caution' is the best advice I get. nothing about condoms, or diaphragms at all. if they can't give a full talk on all the options, then they shouldn't be in charge of giving the talk at all, imo.

and a 13 year old is supposed to handle all this (hopefully without the added previous ectopic history, but there could easily be other medical history to be taken into account)? hard enough as an adult.

[fossil97]

This discussion presupposes that girls have a concerned parent with their best interests at heart.

There was an interview regarding this on the radio yesterday. The speaker mentioned "vulnerable" girls and those in care, I think he was trying to avoid saying specifically that this often relates to girls who are being forced into sex because they are in an abusive or uncontrolled home or care environment, doing the only thing in their power to try and protect themselves.

I agree girls should not be having sex so young but the sad reality is that some of them are in very difficult circumstances and it would be a shame if the law was changed so they could not help themselves. It should not be like this but a whole load of things need to change before the safety net can be taken away. And yes the implant gives no protection against STIs.

[fossil97]

this is the link

It was Brook Advisory Centre who I quoted. They said the younger children are having sex the more at risk they are due to not being mature enough to organise contraception.

[TheRhubarb]

fossil, yes but giving them contraception is a bit like turning a blind eye to the fact that abuse goes on, and I don't just mean abusive families but girls who are coerced into sleeping with boys for whatever reason.

This may be providing a solution to high teenage pregnancies but it does nothing towards tackling the problem of vulnerable girls being taken advantage of by boys and men. We need to take a good look at what is happening within society itself and try to resolve the many social issues which may take longer, may cost more more but which will ultimately protect many other girls from abuse.

Contraception is treating the symptom but not the cause and as we've already discussed, giving teenage girls hormonal contraception may actually cause quite a lot of harm to their mental health.

[bakingaddict]

But rhubarb I dont think giving them contraception is turning a blind eye to the abuse, you seem to have some muddled thinking. Why cant the two be done in parallel, around the country there is taskforces set up to stop grooming of young girls. You stamp out the abuse and in the meantime stop vunreable underage girls from having babies, they dont have to be mutually exclusive and seems your arguement stems more from a mistrust of the medical profession. For the majority of women hormonal contraception is a safe viable option

[fossil97]

Rhubarb I agree except that - you can't solve those situations overnight and you don't know that those prescriptions were in isolation of any other help. Like many things in life it needs tackling on several levels. I am all for better education and resolving the social issues, believe me.

I imagine in some cases the possible side effects of the contraception are probably less worrying to a girl than whether her dad or boyfriend is going to beat her up or force her into sex tonight.

I looked a the report that Lapsuslinguae linked - it did find that a minority of girls as young as 13 are regularly coerced into sex, not really a surprise.

[TheRhubarb]

Just on this thread alone bakingaddict, there are 3 or more posters who have said about depression whilst on microgynon and a few more besides who said that the medical professional tried to encourage them to have the mirena coil despite it being unsuitable for these women.

Not all the medical profession is like this, no, but going from this thread alone, a lot more work needs to be done.

Of course stamping out abuse and contraception can and should work in parallel, but I'm talking about 13yo girls approaching nurses for contraception - if the nurse feels that the 13yo is being abused, what is the procedure for that?

I'm also talking about changing society's attitude towards sex and alcohol. Why do some parents simply presume that their children will be having underage sex and why is binge drinking amongst our young people also culturally accepted? There are a lot of issues here and my point is that contraception does not solve all of those issues, all it does is prevent pregnancies. Which I suspect is all the government is interested in.

[TheRhubarb]

fossil, fair point but if you are being abused, would not the side effect of depression be a major cause for concern? Esp if that child was already suffering low self esteem. I felt suicidal whilst on the pill and that's me, a healthy woman who had no abuse issues.

[fossil97]

Bit of a no-win situation really. What's worse, abuse, depression, being pregnant at 13, it all stinks TBH.

[fossil97]

Meant to say I'm sorry to hear of your experience too and the risks are not very well publicised it's true.