somewhere different now

Genetics: Do not. Unless cheek swabs?

Chemistry: NO!!!!! DO NOT!!!!!!

Archaeology: Perhaps. But might be human bone.

Geology: Sometimes needed, sometimes dangerous 

Psychology: Best not.

Physics: ????????? How??????

Plan B is not effective for people over 176 pounds.

Plan B is not effective for people over 176 pounds.

Plan B is not effective for people over 176 pounds.

Hey friends (all 198k of you who’ve liked or reblogged this), let’s be responsible about our use of tumblr to spread health-related information. Lucky for you, this one is true. Here’s a source: Planned Parenthood says so. Statements like this that are not backed up by legitimate sources are dangerous. What if this were not true? I had never heard of the weight restriction before, so I looked it up. Please fact check your shit and include references before posting stuff that is going to worry a lot of people. They deserve to know if you are telling the truth or making things up. What did we learn from our after-school specials about not trusting strangers on the internet? 

Love, your local academic who cares about your reproductive health

::perks up:: Internet misinformation about emergency contraception? My specialty!

It’s true that Plan B becomes less effective with increasing weight, but the “176 pounds” figure is misleading. It’s much more useful to talk about EC in terms of BMI. (Planned Parenthood uses pounds in some of their resources, but BMI in others.) Plan B (and other levonorgestrel-based EC, like Next Choice) is less effective for people with a BMI over 25, and not effective for people with a BMI over 30. ella is a better choice for people with a higher BMI, but does become less effective for people with a BMI over 35. (so, ella is not effective for everyone -- but it’s better than Plan B!)

So where did 176 pounds come from? 176 pounds is the cut-off for a BMI of 30 if you are 5′4″ (the average height for FAAB people in the U.S.). It’s an oversimplification based on the fact that a lot of people don’t know off the top of their head what “BMI of 30″ means for someone of their height.

Why does this matter? I’m 5′0″. That means that for me, Plan B stops being effective when I hit 155 pounds. On the other hand, someone who is 5′9″ and weighs 180 pounds would be totally fine to take Plan B. Saying “176 pounds” instead of “BMI of 30″ overstates Plan B’s efficacy for shorter people, and understates Plan B’s efficacy for taller people.

But also: I'm a little worried that using Robert Eads Day to talk about HPV and Pap smears may mislead people about ovarian cancer, which is what actually killed Robert Eads. So, a few quick facts (ha, whenever I say this it never ends up being quick):

- Pap smears can detect cervical cancer, but they don't detect ovarian cancer (or any other kind of cancer). Ovarian cancer is not strongly linked to HPV the way that cervical cancer is, and it isn't prevented by the HPV vaccine.

- Ovarian cancer is about twice as common as cervical cancer and causes three times more deaths. Because the symptoms are often vague or nonexistent and there isn't a good screening test, it's notoriously difficult to detect early.

- Ovarian cancer generally appears at a later age than cervical cancer. However, a) we should all know how to take care of our health as we age, and b) there is virtually no research into how long-term testosterone use affects the risk of ovarian cancer for trans men and other FAAB trans folks. A few studies have found that cis women who take androgens or drugs that increase androgen levels have a higher risk of ovarian cancer. In addition, Nick Gorton's awesome book Medical Therapy and Health Maintenance for Transgender Men is a little out of date at this point, but he notes that of the few published cases of trans men with ovarian cancer, all were younger than the median age of ovarian cancer development for cis women, and none had a family history of ovarian cancer.

- The most common signs and symptoms of ovarian cancer are pelvic pain, bloating, feeling full quickly while eating, and needing to urinate more frequently. Yep, these symptoms are annoyingly vague and are linked to tons of other health conditions! If you have any of these symptoms persistently, it's a good idea to see a doctor.

- People have increased risk of ovarian cancer if they have endometriosis or PCOS, or if they have never given birth or used birth control pills. Anecdotally I'd guess that all of these factors are more common among trans men and other FAAB trans folks, although as with almost every area of trans health, it's hard to find data!

- People with close relatives who have had ovarian cancer may want to look into getting tested for BRCA1 and BRCA2 (genes associated with ovarian cancer and breast cancer) and/or HNPCC (associated with ovarian cancer and colorectal cancer). Not only are these good things to know about our health, but they can also help persuade an insurance company to cover a hysto with oophorectomy (removal of ovaries).

I don’t really know much about Next Choice, but I assume the age requirement is more to do with side effects.

Well, I heard about this one, and I couldn’t find any mention of an age requirement on the website. You need a credit card to get it, so that might make it less feasible for you. BUT one thing that it has going for it that Plan B doesn’t is that it works for heavier people. Plan B only works for those under 180 pounds. I don’t know if that’s an issue for you, but I thought I’d put it out there. If you want to go with Plan B, though, here is a link to a printable coupon for it.

Also, I have a /tagged/emergency_contraction page if you want to check that out for some general info.

First of all, keeping some EC around as a back-up just in case is smart and responsible and awesome!

Age requirements for EC in the United States are overwhelmingly related to politics, not to efficacy or side effects. Emergency contraception pills are safer than Tylenol. Check out this kick-ass article on "The Politics of Emergency Contraception" from the New England Journal of Medicine -- it's a few years out of date, but still on point.

Plan B, and generic pills like Next Choice, Take Action, and My Way are different brands of the same drug, levonorgestrel. Levonorgestrel-based EC should be taken within 3 days of a pregnancy risk, and is less effective for people with a BMI over 25-30. In the U.S. it's available over-the-counter without an age restriction (see here for more info about who can buy it [anyone!], whether they need to show ID [no!], and how much they can buy at a time [as much as they want!]).

ella is a form of EC based on ulipristal acetate. Unlike Plan B, there are no generics available. It can be taken up to 5 days of a pregnancy risk and is more effective than levonorgestrel, particularly for people with BMIs in the 25-35 range, though it still loses efficacy with increasing weight. In the U.S., ella requires a prescription, but there are no age restrictions on who it can be prescribed to. (If you see a doctor for a routine check-up, they can write a prescription for ella for you to have on hand just in case; if that's something that you want and they don't offer, feel free to ask!)

The most effective form of emergency contraception actually isn't a pill: it's Paragard, the copper IUD. When it's inserted up to 5 days after a pregnancy risk, Paragard is over 99% effective at preventing pregnancy -- that runs circles around both ella and Plan B. Not only that, but it isn't affected by BMI and continues to be >99% effective at preventing pregnancy for twelve years. Obviously getting an IUD is a bigger decision than taking a pill, and you aren't going to keep a Paragard in your bathroom cabinet just in case, but many clinics (including the one where I used to work!) offer same-day walk-in appointments to people who want a Paragard for EC.

San Francisco-based Trans Lifeline has collected an all-trans staff of volunteers who aim to make the crisis hotline experience more comfortable and accessible for trans callers.

"This line is primarily for transgender people experiencing a crisis. This includes people who may be struggling with their gender identity and are not sure that they are transgender. While our goal is to prevent self harm, we welcome the call of any transgender person in need. We will do our very best to connect them with services that can help them meet that need. If you are not sure whether you should call or not, then please call us at +18775658860."