Isabella doesn’t blame the birth control, but she needs a break from it.
The 19-year-old Texan has spent the past year mired in isolation, anxiety, and depression. She barely made any friends in her first semester at college; the coronavirus pandemic had destroyed her chance at a normal university experience. Having struggled her whole adolescence with a binge-eating disorder, Isabella relapsed. She gained 50 pounds. She rarely left her room during her second semester.
“I was always feeling anxiety and I just hated myself. I was treating others in a poor way,” recalled Isabella, whom VICE has agreed to identify by her middle name. “For a good four months, I pretty much dissociated from my body. I was pretty much on auto-pilot. I was failing all of my classes. I felt like I was in a simulation. Everything around me felt unreal.”
“If the possibility of pregnancy does happen, I kind of feel like my life would be over.”
Throughout that year, Isabella had a Nexplanon implant embedded in her arm. She knows that she can’t pin all her mental health on the hormonal birth control, but she’s well aware that it can shape moods. Once the implant expires, next summer, she’s determined to spend a few months without it or any kind of hormonal birth control. She wants to gauge who she might be without it, how her mental health might fare. She’s prepared to make sacrifices to find that out—including, potentially, no longer having sex with her longtime boyfriend.
“Both of us are pretty anxious about doing it off birth control. Even with a condom, I think it just poses a lot of risks,” Isabella said. “If I did get pregnant at this age—which, I hope not and I do practice safe sex methods so that doesn’t happen—I would opt for abortion. Although it is not an easy decision to make, I’ve always known that’s what I would do. But now, knowing that I wouldn’t have that option, it’s really scary.”
“That option” is now endangered in Texas, thanks to recent legislation that not only bans abortion as early as six weeks into pregnancy, but also lets individuals—anyone at all—sue someone who they suspect “knowingly engages in conduct that aids or abets the performance or inducement of an abortion.” Although an abortion patient is shielded from these lawsuits, people who drive the patient to a clinic, give them money for an abortion, or assist in the procedure at all could be forced to contend with wildly expensive lawsuits. It’s an unprecedented law that will hand complete strangers the power to become, essentially, anti-abortion vigilantes.
Texas abortion providers sued to halt the law, but the Supreme Court didn’t stop the law from taking effect early Wednesday morning. Overnight, access to abortion basically evaporated. Then, in a 5-4 vote released just before midnight, the Supreme Court officially announced that it would not be blocking the ban, because the providers hadn’t made their case when it came to the “complex and novel antecedent procedural questions” raised by the law. The justices didn’t decide on whether the law itself was constitutional, but their inaction will leave Texas abortion patients and providers—as well as abortion rights writ large—in an existential lurch.
“If the possibility of pregnancy does happen,” Isabella said, “I kind of feel like my life would be over.”
This was supposed to be Slutty Summer, Hot Vax Summer, the second coming of the Summer of Love. People were horny and hoping for sex, the lore went, after spending more than a year trapped indoors. But it was also, perhaps, the last summer of Roe v. Wade. Regardless of how the battle in Texas turns out, the Supreme Court has agreed to rule on the legality of a Mississippi abortion ban. That case could deeply wound, if not kill, the landmark ruling that legalized abortion nationwide.
Even before the Texas ban took effect, Isabella and a handful of her fellow Texans had already started to process how the end of the legal right to abortion could force them to rethink their approach to sex and relationships. But many Americans, it seems, have failed to grasp the severity of what’s coming: More than a dozen sex therapists and educators, scattered across the country, in states that fully recognize abortion rights and in states that definitely do not, told VICE that most of their clients are pretty unconcerned about the threat to the availability of the procedure.
And while public apathy toward abortion rights is nothing new—it may be the force that has allowed conservatives to spend the past decade demolishing abortion access in the United States—people apparently aren’t ready for the reality that sex, and its by-products, could soon become far more risky.
“We’re two countries, and that’s happening more in the other one.”
Sure, some are bringing it up in therapy. They’re angry about it. But, for the most part, it’s the kind of rage that happens when an injustice strikes somewhere else in the world. It lacks urgency.
“They’re talking about it in a foreign way,” Amanda Pasciucco, a sex therapist in West Hartford, Connecticut, said of her clients. “They’re like, ‘Oh my goodness, could you imagine if you were in Texas? Could you imagine?’ But they’re not, like, dating someone down South.”
Jennifer Aull, a sex therapist in New York City, put her clients’ philosophy more bluntly: “We’re two countries, and that’s happening more in the other one.”
The threat to abortion—and, by extension, to people’s sex lives—stretches far beyond the Lone Star State. Sometime next year, the Supreme Court will hear arguments in Dobbs v. Jackson Women’s Health Organization, a case that promises to be the most pivotal abortion case in a generation, if not since Roe v. Wade itself was decided in 1973. The case turns on a 2018 Mississippi law that banned most abortions after 15 weeks of pregnancy—that is, before the fetus can be expected to survive outside the womb, a benchmark that typically occurs at around 24 weeks into pregnancy. Under Roe, states are blocked from prohibiting abortions before fetal viability.
Now, though, the majority-conservative Supreme Court will officially reevaluate whether states should be able to enact such bans, and its vote in the Texas isn’t particularly reassuring for abortion rights advocates. The justices could allow states to outlaw abortion so early on in pregnancy that Roe becomes essentially meaningless, or even overturn the landmark decision outright—a goal the right has spent five decades salivating over, and one that’s finally set to come true just months after pandemic lockdowns have begun to ease. Although the Supreme Court has not yet scheduled a date to hear the case, the justices’ ruling will be out by summer 2022.
“The time to have acted and prevented what is about to happen was 10 years ago.”
Abortion rights supporters who spoke to VICE about the case, even before the Texas vote came down, were not exactly hopeful that it would go their way.
“People have thought that we’re this Chicken Little, screaming that the sky is falling, the sky is falling,” said Renee Bracey Sherman, the founder and executive director of We Testify, which works to promote the representation of people who have had abortions. “The time to have acted and prevented what is about to happen was 10 years ago.”
Over the last decade, the response to conservatives’ coordinated attack on abortion has been, at best, muted, even though anti-abortion activists have managed to pass at least 566 abortion restrictions since 2011. So many of these restrictions are tedious, mired in the kind of mind-boggling bureaucracy that makes people reflexively look away. They have required abortion clinics to have extra-wide hallways, for example, or mandated that they maintain particular agreements with nearby hospitals, such as making sure that abortion providers can admit patients.
Anti-abortion activists say that these restrictions are meant to protect women—which, theoretically, everybody wants to do. So it can be easy for untrained observers to buy into the hype and miss the fact that these regulations have not only largely been deemed medically unnecessary by experts, but are often so onerous that they force abortion clinics to close.
Now that the Texas law has proven, at least so far, successful, anti-abortion advocates across the country are almost certainly going to bring a version of it to other red states. And if Roe is ultimately overturned, abortion rights would be protected in less than half of the U.S., according to an analysis by the Center for Reproductive Rights. While states on the coasts have moved to shield and even expand access to abortion, much of the South and Midwest have rushed to restrict it as much as possible.
If Roe is overturned, abortion rights would be protected in less than half of the U.S.
One sex therapist who said her clients are starting to change their behavior lives in the swath of the country where access to legal abortion is on the verge of vanishing. De-Andrea Blaylock-Johnson, who works in St. Louis, said that her clients and her local community are starting to get antsy about the future of abortion. One nonbinary client is struggling with whether and how to go on hormonal birth control; they’re weighing the fear that contraception will interfere with their hormones against the danger that they may soon be without a legal way to end a pregnancy.
“More people who were more resistant to hormonal birth control, just because of all the side effects—they’re now considering it, because of the limited access that may happen,” Blaylock-Johnson said. If Roe falls, Missouri already has a law on the books that would ban abortion immediately, as do nine other states. “It’s not that people were using abortion as birth control. They just knew it was an option that was available if and when a pregnancy came about.”
“It’s not that people were using abortion as birth control. They just knew it was an option that was available if and when a pregnancy came about.”
But sex therapy clients’ distant attitude toward abortion rights isn’t just a matter of geography, even if that’s what clients are telling their therapists, or themselves. The clients who do remain frustrated don’t seem to believe that their own ability to end a pregnancy will be threatened. And they’re not wrong about that assumption, given that they’re at least wealthy enough to afford a sex therapist.
Ask anyone who works in reproductive healthcare: People with money will always be able to find an abortion, regardless of where they live. As of 2012, people who got first-trimester surgical abortions paid, on average, $480 for the procedure, according to a 2018 study by the Guttmacher Insitute, which tracks reproductive healthcare policy. Most paid out of pocket; dozens of states restrict people’s ability to use their insurance to cover abortions, while the federal Hyde Amendment bars people from using federal dollars to pay for most abortions.
Therapists said their clients’ anger over reproductive rights has largely dwindled since President Joe Biden took over, even though Biden can do very little to protect the legal right to abortion, since almost all abortion policy is decided at the state level and Congress will almost certainly never codify Roe into federal legislation. (Not that Biden would necessarily act even if he could: As president, he avoided saying the word “abortion” until he put out a statement condemning the Texas law.)
After enduring the four-year-long hostage crisis that was the Trump administration, people are tired of having to care so much about politics, according to educators and therapists. And navigating the pandemic took the rest of their energy.
“We’re tired. We’ve just been through lockdown. It’s hard to have all the emotions at once right now, and why not choose the fun emotions?”
“There was a real fear, and now people are like, I’m alive! Let’s go have fun!’ Cool, go have fun, be safe. You do realize that there’s this possible decision that’s looming on the horizon that could really impact you if you happen to get pregnant when you didn’t want to be?” said Susan Milstein, a clinical assistant professor at Texas A&M University who teaches about human sexuality and women’s health. “I think people don’t realize that. We’re tired. We’ve just been through lockdown. It’s hard to have all the emotions at once right now, and why not choose the fun emotions?”
Melissa Deckman, a political science professor at Washington College who’s studied young women’s political beliefs, said that, in the wake of Trump’s presidency, Gen Z did start to pay more attention to gender equality and sexual violence.
“But certainly abortion rights are not necessarily at the top of the list, in terms of what Gen Z women care about,” she said. Instead, issues like climate change, preventing gun violence, and racial equality are higher priorities for young women, according to Deckman’s research. Abortion has been legal for the entirety of Gen Z’s lives, so reproductive rights can feel like their mothers’—or even their grandmothers’—fight.
To be sure, there have been some spikes over the last few years in collective outcry and action when it comes to reproductive health. In the weeks following Trump’s election, insertions of IUDs, which last for years, rose by nearly 22 percent, according to a 2019 study published in JAMA Internal Medicine.
Abortion has been legal for the entirety of Gen Z’s lives, so reproductive rights can feel like their mothers’—or even their grandmothers’—fight.
A moderator of r/abortion, a subreddit where people frequently discuss how to obtain abortions, told VICE over email that when prominent new abortion restrictions are passed, they routinely see spikes in “posts discussing things like getting an IUD or other LARC, having Plan B and/or mife/miso at home just in case, and/or moving to Canada” on subreddits dedicated to talking about abortion. (Plan B is the so-called morning after pill, while “mife/miso” is a reference to mifepristone and misoprostol, the two drugs commonly used to conduct medication abortions. Medical experts widely agree that this kind of abortion can be performed safely at home.) But a representative of the American College of Obstetricians and Gynecologists said that, so far, their members aren’t really seeing patients who ask questions about preparing for a post-Roe world.
“I do think that we are starting to see, among Gen Z women, more support for abortion rights—a little bit of an uptick in support for abortion rights, compared with millennials and older Americans,” Deckman said. “How that gets activated into their activism, though, has yet to be determined.”
If Mary, another 19-year-old college student in Texas, needed to get an abortion, she thinks she could afford to pay for the procedure. But she’s not sure how she could find the time to go out of state, which she would almost certainly need to do now that Texas’ six-week abortion ban is in effect.
“I’ve really had to think like, ‘Oh if this were to happen to me, I would have to travel.’ If I were to get pregnant and need an abortion, I would have to travel to go do that, and being a college student, I can’t do a little trip or getaway to another state,” Mary said. (A friend of Isabella’s, Mary asked VICE to identify her by a nickname.) “It’s something that I have been more worried about and more conscious of in my sex life.”
Before Texas passed its ban, Mary wasn’t always vigilant about taking her birth control pill at the same time of day. But now she’s far more fastidious about it; she also uses condoms every single time she has sex, even though she has a longterm partner. “The fact that I’m being more careful around my contraception is, I guess, probably a good thing. The reason why is just very sad,” Mary said. She has always worried about being able to get an abortion, but, “now, that has increased by tenfold. So it’s upsetting, obviously, needing to take all of these precautions—and just the reality of it all.”
“I’ve really had to think like, ‘Oh if this were to happen to me, I would have to travel.’ If I were to get pregnant and need an abortion, I would have to travel to go do that, and being a college student, I can’t do a little trip or getaway to another state.”
Mary and her friends seem to be in the minority, despite the growing likelihood that abortion rights will disappear—or perhaps because of it. When Alabama passed a law to ban almost all abortions in 2019, the country erupted. Thousands of dollars poured into funds meant to help people pay for abortions. Rihanna even tweeted a photo of the white, male state legislators who’d backed the ban. “These are the idiots making decisions for WOMEN in America,” the singer wrote. It garnered nearly half a million likes.
But when Arkansas and Oklahoma passed near-identical laws this year, pop stars, like the rest of the public, were mostly silent. As a longtime reproductive rights reporter, I’m used to people shrugging away abortion restrictions, but I was still struck by the slide from outrage in 2019 to indifference in 2021. Although the Texas ban has now drawn far more attention, it was only after the Supreme Court failed to stop it, after it was too late to stop mob justice from becoming the law of the land, that more people realized what had happened.
The earlier bans have been halted by court challenges, which may explain why the new ones didn’t feel pressing; people may also just be numb to seeing the same regulation over and over again. Or they may lack the ability to even realize what’s happening in the first place. Politics limits students’ sex ed in schools, cutting them off from information about abortion, birth control, and STIs.
Twenty-eight states mandate that, when kids receive sex ed, abstinence must be “stressed,” according to the Guttmacher Institute. In 19 states, educators must teach students that it’s best to only have sex once you’re married.
Milstein’s Texan students are frequently flabbergasted by how little they know about their own bodies. Last year, a student approached Milstein after class and told her that the class had left her enraged.
“‘What happened? Why did I have to take an elective in my junior year to find out how my body worked?’” Milstein recalled the student telling her. “For some of them, there is a lot of anger that they’re learning things they feel like they should have known about themselves before, and now they’re also finding out these laws that exist, that they didn’t even know they could be impacted by.”
“The only advice we ever got was to not have sex, and if you have sex, you’re gross and tainted and you’re gonna carry that with you for the rest of your life,” recalled Paxton Smith, an 18-year-old incoming University of Texas at Austin freshman, who recently went viral when she gave an unsanctioned speech about abortion as her high school’s valedictorian.
A native of the Dallas suburbs, she recalled how, in middle school, she got sex ed by way of something she called a “tape game.” “You take a piece of tape, and you have the tape passed around the room from one person to another. And then at the end, the piece of tape is disgusting. It’s covered in hair and lint and fingerprints. It’s not sticky anymore. And basically, it’s like, ‘See, once you have sex, you’re like this piece of tape.’”
When she spoke at her Dallas-area high school graduation, Smith wanted to make sure that people—including her peers sitting in the audience—knew that Texas was gearing up to cut off access to abortion. “I have dreams, and hopes, and ambitions. Every girl graduating today does,” she told her classmates. “We have spent our whole lives working towards our futures, and without our input and without our consent, our control over our futures has been stripped away from us. I am terrified that if my contraceptives fail me, I am terrified that if I’m raped, then my hopes and aspirations and dreams and efforts for my future will no longer matter.”
“It’s really none of anyone’s business.”
Smith doesn’t plan to rewrite her approach to sex and relationships; she always uses two forms of contraception anyway. But that’s a privilege that not everyone possesses, she told VICE. And whether someone changes their sexual habits to adapt to the end of Roe shouldn’t affect whether they deserve an abortion.
“However a person decides to go about their sex life really should not play into any argument when it comes to legislation,” Smith said. “I think a lot of people think of pregnancy as a direct consequence of sex. If you have sex and you get pregnant, then you shouldn’t have access to an abortion because that’s your fault. And they take people less seriously, or they judge people more seriously, for the contraceptives that they use and the sex that they have, which I don’t think is warranted. It’s really none of anyone’s business.”