“Sweetening the Pill” by Holly Grigg-Spall, reviewed.

A New Book Argues That the Pill Is Sexist and Dangerous. Don’t Believe It.

A New Book Argues That the Pill Is Sexist and Dangerous. Don’t Believe It.

What women really think about news, politics, and culture.
Sept. 3 2013 8:04 AM

The Truth About the Pill

A new book argues that hormonal birth control is sexist and dangerous. Don’t believe it.

(Continued from Page 1)

She complains that sex-positive feminists push the pill in a nefarious bid to make women more “sexually available” to men. This is an old feminist argument that has never made any sense. You could just as well say that the pill makes men more sexually available to women, because it allows us to enjoy their charms whenever we want. Sure, if a woman is on the pill and chooses to tell her boyfriend, she can’t beg off sex with the excuse that she might get pregnant. But so what? Any method of birth control makes women “sexually available” to men by taking the pregnancy excuse off the table, even the combo of fertility awareness and condoms that Grigg-Spall advocates as an alternative to the pill. If women are being pressured into sex they don’t want, the problem is rape, not birth control.

Sweetening the Pill offers an insultingly reductive account of what it means to be female: “If we shut down the essential biological center of femaleness, the primary sexual characteristics, then can we say that women on the pill are still ‘female’?” Grigg-Spall muses, casting ovulation as the sine qua non of femaleness. If so, postmenopausal women, pregnant women, girls, ovarian cancer survivors, and transwomen aren’t really female.

Grigg-Spall notes that men have been reluctant to embrace vasectomies and other forms of birth control that block the production or release of sperm because they regard them as a threat to their masculine identity. She wonders why women are willing to accept drugs that block ovulation without complaint. The answer, of course, is that men who define masculinity in terms of their ability to sire hypothetical unwanted children are pathetic and women shouldn’t emulate them.


Grigg-Spall claims that hormonal birth control has become the only socially acceptable option for women, thanks to the collusion of greedy pharmaceutical companies and sex-positive feminists, but the statistics refute her. About 80 percent  of American women will try the pill, but only 17 percent of U.S. women of reproductive age are on the pill at any given time. According to Grigg-Spall’s own statistics, only 28 percent of women who use birth control are on the pill. That’s a healthy plurality, but it’s nowhere near a majority, even if you factor in other kinds of hormonal contraception.

Stripped of feminist jargon—because, remember, she’s arguing from a feminist perspective—Grigg-Spall’s health case against the pill comes down to this: The pill is bad because it suppresses our natural ovulatory cycles, which must remain undisturbed. “On the pill no woman’s body is capable of functioning at its optimum level,” Grigg-Spall claims. She is aghast that some women use the pill to suppress their periods altogether. In her view, women who don’t want periods are victims of internalized misogyny who reject an authentic feminine identity rooted in ovulation. It’s ironic that in the 1950s, women who complained of period pain were told that their misery was a purely psychosomatic affliction born of their rejection of the female role. Grigg-Spall has recycled the same sexist reasoning under the guise of feminism.

Grigg-Spall relies heavily on Miranda Gray, a “life coach” who offers “womb blessing attunements” and lectures on tarot cards and the healing power of crystals. Gray claims that women have dramatically different cognitive and emotional capacities at different stages of the menstrual cycle. In fact, even after decades of research, scientists have had a surprisingly difficult time pinning down consistent relationships between the normal menstrual cycle and mood or performance. But no matter: Gray urges women to tailor their work schedules to match their menstrual cycles and not push themselves to excel at tasks that are at odds with their cycle. For example, she says women should take advantage of their preovulation phase to “understand complex ideas,” because that’s when our frail and inconstant lady brains are best suited to the task. Grigg-Spall reports that she takes two days off every month for the worst of her period, during which time she is “intolerant of any pressures on [her] to do anything [she doesn’t] enjoy or personally choose to do.” How nice.

Grigg-Spall argues that the capitalist system is sexist for not letting all women organize their lives around their menstrual cycles without penalty. If the natural menstrual cycle made women as inconsistent as Grigg-Spall says, that would be a good reason to exclude women from occupations that require consistent focus and attention to detail. Do you want a surgeon who’s only at the top of her game at certain times of the month or a diplomat whose emotional intelligence might be “off” the week of a missile crisis? You can see why her claim that hormones rule women's brains has profoundly anti-feminist implications.

Some of Grigg-Spall’s assertions about the pill’s health risks are downright dishonest. She mentions that combination pills have been designated as a Level 1 carcinogen by the World Health Organization, on the same list as asbestos and tobacco. But she doesn’t tell you that the same list includes sunlight and dried fish or that being on the list says nothing about how likely a substance is to cause cancer or whether we should avoid it. The list is based on the strength of the evidence, not the strength of the carcinogen. Sometimes we’re very sure that a substance is a very weak carcinogen. Some studies have found that long-term birth control pill usage slightly increases a woman’s risk of breast cancer, but other studies have found no association. If there is an increased risk, it only lasts as long as a woman is taking the pill; this is significant because breast cancer is rare in premenopausal women, so a small increase in relative risk translates into a very small increase in absolute risk. Whereas long-term pill use before menopause cuts a woman’s risk of ovarian cancer by up to half for the rest of her life. Grigg-Spall tries to dismiss the ovarian cancer benefits on the grounds that breast cancer is more common than ovarian cancer, but she fails to note that premenopausal breast cancer is also rare: 95 percent of first-time breast cancer diagnoses are in women over 40.

If the pill is so miserable, why is it so popular? Grigg-Spall is forced to posit a conspiracy between feminists and health care providers to keep women ignorant of nonhormonal birth control. She claims that leading women’s health organizations such as Planned Parenthood fail women by not teaching about alternatives to hormonal contraception. This is untrue. You can read about fertility awareness, surgical sterilization, copper IUDs, and other nonhormonal contraceptive options on Planned Parenthood’s website. If Planned Parenthood hates nonhormonal contraception, why are they always handing out condoms?

Grigg-Spall also claims that there’s a feminist omerta in effect that prohibits criticism of hormonal birth control. Yet, by her own admission, feminist organizations such as Our Bodies Ourselves and the National Women’s Health Network begged the Food and Drug Administration to take Bayer’s Yaz and Yasmin off the market because of their propensity to cause blood clots.

Sweetening the Pill is poorly researched, shoddily argued, and fundamentally incoherent. So why am I even expending energy addressing it? Because a feminism based on the fetishization of bodily functions is no feminism at all. Grigg-Spall condescends to the millions of women who take the pill, claiming that we are dupes of pharma and feminism. The question is not whether there are trade-offs to the birth control pill, but whether the benefits justify the risks. Hormonal birth control isn’t for everyone, but for many women, the benefits of reliable, convenient, female-controlled contraception and the spontaneous sex life it allows are well worth the small potential downsides. The choice should be left to women and their doctors, not hijacked by ideologues.