Free The Pill

This week, the Food and Drug Administration (FDA) faced a decision to throw women a lifeline or leave their health and future at risk. For the first time, the FDA held a hearing to consider making a birth control pill available over the counter and an option for every person of reproductive age in America. 

The panel of advisers to the FDA voted unanimously to recommend that the contraceptive Opill be available without a prescription. Perrigo, the pharmaceutical company that created Opill, submitted its application for over-the-counter use just weeks after the Supreme Court overturned Roe v. Wade.

For Asian American and Pacific Islander (AAPI) communities, this week’s FDA hearing to consider this application cannot come a moment too soon.

AAPI women are more likely to use cheaper, less effective methods of birth control than other races and ethnicities. For instance, a 28-year study found that only 57 percent of Asian women have used birth control pills, compared to three-quarters of Black women and Latina women and 89 percent of white women. These disparities are no surprise when we consider the systemic and cultural barriers AAPI women face in accessing reproductive health care.

AAPI women are overrepresented among immigrants and frontline and low-wage workers, who are less likely than most to have health insurance or be able to afford preventative care. But even when we are able to access care, the interplay of cultural stigmas and language barriers can make having a discussion about reproductive care difficult and unmanageable.

In many ways, AAPI youth bear the brunt of these issues. Cultural and language dissonance within families, particularly between AAPI children and their immigrant parents, make conversations about sexual health rare and often fraught. Studies have also found that Asian American teenagers are less likely than other groups to use condoms or prescription contraceptives.

These data mirror the lived experiences of many AAPI Americans. Growing up in a Midwestern Vietnamese immigrant household, I knew better than to talk about or ask questions about my body or sexual health. I knew it was a topic better left to secrecy and assumption. Now, as a married adult woman, I see that AAPI youth continue to face similar shame that I dealt with as a teenager.

But we can make it better for everyone of reproductive age, including millions of Asian American and Pacific Islanders whose lives could be revolutionized by over-the-counter birth control pills.

When used correctly, birth control pills are up to 99 percent effective at preventing pregnancies — better than condoms. The pill also has health benefits, such as lightening periods and providing relief to the detrimental effects of menstrual cramps. Over-the-counter birth control pills would also go a long way toward ending stigmas against contraceptive use. Having more reproductive health care options also encourages open conversations about sexual health and shows AAPI youth — including those who are not yet sexually active — that their sexuality is not a shameful secret.

Making Opill available without a prescription will not fix every problem with reproductive care in the United States. But approving it for over-the-counter use represents a giant step forward in the march toward reproductive justice. This change would reverberate across generations — empowering Americans of all reproductive ages and backgrounds to pursue healthy, independent lives by getting the care they need and deserve.