Why sex is about to get a lot less fun

Trump's HHS pick hates Obamacare
Trump's HHS pick hates Obamacare

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Story highlights

  • Jill Filipovic: As nominee to lead HHS, Tom Price's antipathy for ACA is likely to hurt women seeking birth control
  • Those who oppose greater access ignore fact that controlling fertility yields healthier, stronger families, she writes

Jill Filipovic is a journalist based in New York and Nairobi and the author of the forthcoming book, "The H-Spot: The Feminist Pursuit of Happiness." Follow her on Twitter. The opinions expressed in this commentary are solely those of the author.

(CNN)Under a Donald Trump presidency, sex is about to get a lot less fun.

Jill Filipovic
That's because Trump has tapped Tom Price, an anti-abortion and anti-contraception congressman from Georgia, as his director of Health and Human Services. Price is an opponent of the Affordable Care Act and a proponent of defunding Planned Parenthood, an organization that serves more than 2.5 million patients, many of them low-income, every year.
    Birth control and STI testing and treatment make up the majority of services Planned Parenthood provides, and federal funds are already blocked from paying for abortion. Federal funding mostly goes to Planned Parenthood in the form of Medicaid dollars, which are set aside to provide health care for poor Americans, and that's who these funding cuts will largely affect.
    With Price at the helm of HHS, even women who don't rely on Planned Parenthood for health care will have a harder time getting contraception. According to Price, "there is not one" woman who has been left behind by unaffordable birth control costs, and so his proposed gutting of the ACA would pull the provision that fully covers contraception.
    Price suggests that birth control was perfectly affordable before the ACA, and there simply were not American women who couldn't pay for it; he and I must hang out in different circles, because few women I know can comfortably shell out more than $1,000 at the gynecologist's office, especially when they're already paying for health care via their insurance plans.
    If Price has his way, birth control coverage will once again depend on the whims of insurance companies and doctors, not to mention government. The example of long-acting contraception illustrates how shortsighted this is. An increasingly large body of research shows that long-acting contraceptive methods, like IUDs, are the most effective at preventing unintended pregnancy, because unlike the birth control pill or condoms, they are less vulnerable to human error (a missed pill, a broken condom).
    But long-acting methods are also the most expensive, and the fact that so few women used them pre-ACA can be partly attributed to their cost. An IUD routinely costs between $600 and $900, and can be as much as $2,600. There's often an insertion fee, which, under Price's plan, health care providers could simply draw up out of thin air, costing women even more.
    Even if women rely on more affordable methods, like the birth control pill, they're still looking at a $50 a month payment without ACA coverage. That may not be much to the Trump women sporting $10,000 bangles or the patients Price sees in his tony Atlanta suburb, but to a single mother stretching every dollar to feed her children, or a first-generation college student taking out debt and paying her own tuition for a chance to claw into the middle class, $50 is not pocket change.
    For those same women, an unintended pregnancy can mean the difference between staying afloat and going under. Before the ACA, a $50 pack of birth control pills was a full day's work for a woman making minimum wage. An IUD could cost more than a full month's pay. That's what Price's plan would return to.
    The GOP line is that birth control is optional, and so women should take responsibility for paying for it themselves. It's worth noting that for many women, "optional" is a bit of a stretch. Certain forms of contraception combat painful fibroids or cysts; other women face life- or health-threatening complications from pregnancy and use birth control to prevent a condition that could kill or maim them. Part of the role of government is to cultivate conditions for a healthy citizenry, and birth control falls squarely in that purview. It lowers maternal and infant mortality rates, improves women's health, and prevents abortions -- and funding it is responsible public health policy.
    Yet despite its efficacy at preventing abortion, not a single national pro-life organization supports broader contraception access. That's because at its heart, hostility to birth control coverage, Planned Parenthood, and abortion rights aren't about "life" or "religious freedom" or any other right-wing buzzwords. Price and pro-life advocates like him easily disregard the health benefits contraception brings because they care more about women having sex than they do about women being healthy. From their vantage point, covering contraception gives women more freedom to enjoy recreational sex without suffering economically, professionally or medically from an unwanted pregnancy.
    In that, they are correct. The ideological divide comes from whether you think this is a good thing or a bad one. The health and development data, at least, gives a clear answer: As a consequence of having control over our fertility, women around the world have seen our rights and status skyrocket. Fewer of us die in childbirth, fewer of our children die, more of us are in school, more of us make our own money, more of us are able to leave abusive partners and support ourselves and feed our families and marry for love. These are enormous gains. These are moral, social and political victories.
    And yes, more of us are able to have sex without the anxiety of pregnancy, to enjoy the unique and fundamentally human pleasure that sex creates, and to tend to our relationships without the interruption and emotional devastation that an unintended pregnancy can bring. This makes women, men and children happier. It makes our relationships and our marriages stronger. It makes us better mothers and fathers. This, too, is an enormous gain, and a moral, social and political good.
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    These things -- good health, strong relationships, healthier children, pleasurable experiences -- should be on offer for all women, not just those who can afford to plan their pregnancies. But the future of women's health under President Trump, and HHS Secretary Price, looks grim: Price's plan turns sex for pleasure into a luxury item and puts our health at risk. And it sends women a clear message: That partaking in a full range of human enjoyment and physical experience isn't for us, and that we exist instead to reproduce.
    Should we be surprised? Trump's own behavior implies our role as women is to be professional beauties he can ogle and rate onstage, or simply bodies he can grab if he feels like it. Women's sovereignty over our own bodies, let alone our pleasure, has never seemed to matter to Trump, personally, professionally or politically. Price's nomination is just one peek at what Trump's notorious misogyny will look like when it's translated into policy.