10 Boomers and Birth Control

Grace Miller

10.1 Introduction

Keywords

  • Contraceptive: anything used to prevent pregnancy
  • Dysmenorrhea: this is when a person’s period is very painful. Lots of pain during menstruation is abnormal and the person should consult with their doctor if they are experiencing dysmenorrhea.
  • Ectopic pregnancy: This occurs when the fertilized egg implants itself in a place where it is not supposed to be, which is outside the uterus. Typically, ectopic pregnancies occur in the fallopian tube but they can also happen in an ovary, within the abdomen, or inside the endocervical canal.
  • Egg: This can also be called an oocyte, ovum or female gamete. The egg is the pre-fertilization sex cell for anyone with a uterus.
  • Endometrium: the inner covering of the uterus that gets shed typically once a month.
  • Estrogen: This is the primary hormone for those who have a uterus. It is mainly formed by the ovaries, but can also be released by the adrenal cortex, testes, and placenta. Oral birth control pills contain this hormone.
  • Eugenics: A movement that began in the late 1800’s which stated that certain groups of people were superior and more deserving of life than others. It is a scientifically false and inherently racist belief that genetic modifications and selective breeding could eliminate “imperfections” in the human race.
  • Gonads: the organs (testes and ovaries) that make reproductive cells, also called sex cells
  • Hormone: Hormones are thought of to be “messenger molecules.”They organize and regulate the activity of various tissues. They cause a specific effect in a localized region.
  • Implantation: This is when an egg has been fertilized by a sperm, so it adheres itself to the uterus lining six to seven days post-fertilization.
  • Injectable contraceptives: These are forms of hormonal birth control that are injected via needle into a person. Depo-Provera (DMPA) and norethindrone enanthate are two examples of injectable progestin contraceptives.
  • Intrauterine Device (IUD): A contraceptive device that is placed in the uterus. It is usually plastic and can also contain hormones or other metals that help with contraception. It causes localized inflammation in the uterus which makes it hard for successful fertilization and/or conception.
  • Menopause: This is when a person with a uterus stops having a period. This can occur naturally with age or can be induced by the surgical removal of the ovaries
  • Oral contraceptive pill (also known as “the pill”): a prescribed medication for people with uteruses. There are many different types of the pill, but all of them have either some combination of estrogen and progestin or just have progestin. It is usually in tablet or pill form and is taken orally. This pill can prevent pregnancy because it can change the thickness of cervical mucus, the  time of ovulation, and many other things. When these changes occur, the person is less likely to get pregnant.
  • Ovaries: The female reproductive organ that produces female sex cells, known as ova or eggs.
  • Ovulation: This occurs in the ovary during a person’s menstrual cycle and happens when an egg is released from the ovarian follicle.
  • Perimenopause: This is the period of time where the level of functioning for ovaries decreases. This causes hormonal changes and a variety of symptoms and can occur up to ten years before a person’s last period.
  • Progesterone: A hormone that is made by the corpus luteum, adrenal glands, and the placenta. This hormone causes changes in the endometrium of the uterus during the menstrual cycle.
  • Progestins: artificially made hormone that imitates the effects of progesterone on the uterus.
  • Sexual Revolution: A movement that began in the 1960s that declared women desired sex just as much men and should be allowed the same sexual freedom.
  • Sperm: The sex cells for those with a penis.
  • Transgender: Also called trans, it is an adjective that describes anyone who identifies with a different gender than the one they were assigned at birth.
  • Transitioning: The process a transgender person undergoes to align their internal identity of their gender with their external characteristics. This can include changes in someone’s name, pronouns, voice, hair style, clothing, and/ or other behaviors.
  • Uterus: The muscular female reproductive organ that houses the fetus while it grows throughout pregnancy.

 

Learning Objectives

 

  • By the end of this chapter, students should be able to:
    • Define the oral contraceptive pill.
      • Discuss its purpose and how it works.
    • State the hormones within the oral contraceptive pill and how the birth control pill works biologically.
    • List the positive and negative effects of the pill.
    • Describe the history of the invention and the key people involved in its creation.
    • Explain the social impacts from the invention of the oral contraceptive pill.
    • Identify the moral and ethical issues that were present in the creation of the birth control pill.
    • Define the sexual revolution and the role of the birth control pill in the movement.
    • Elaborate on what hormonal contraceptives look like today.

 

If someone were to ask you if you knew anyone on “the pill”, would you know what they were referring to? If you answered the oral birth control pill, you would be correct. The oral birth control pill is the first pharmaceutical invention in history that has had such a big social impact.  It was created in the 1950s and has had a huge legacy since its conception, especially on the baby boomer generation. It is so well known and popular that it is referred to unanimously as “the pill.” It impacts almost everyone in some way and has shaped society as we know it. However, it took a long time for it to be invented and then integrated into society. Its history is filled with obstacles, moral dilemmas, and ethical wrongdoings. It is important to educate ourselves about the history of the oral birth control pill so we do not repeat the mistakes.

In the upcoming sections, we are going to paint a picture of the impact of oral contraceptives through the lens of science and culture.  We are going to start by defining oral birth control, elaborating on the medical science behind this invention, and discussing its biological and societal impacts. The baby boomer generation was in young adulthood when the pill gained popularity. This meant that they were in the time of their lives where pregnancy, whether intended or unintended, was a possibility. During this time of life,  relationships and sex are incredibly relevant, which is why the invention of the birth control pill had such an impact on this generation. The women of this generation were the first in history to have the freedom to control their reproductive ability. This had a lasting impact on their social generation and the United States as a whole.

10.2 What is the birth control pill?

Key Takeaway(s)

The birth control pill is a medical technology that was created to help women control their reproductive cycles. It has many additional uses and comes in different varieties.

10.2.1 Introduction

The oral contraceptive pill, also known as “the pill”, is a medication for people with uteruses which causes changes within their body that makes them less likely to become pregnant. The uterus is the muscular female reproductive organ that holds the fetus throughout pregnancy. This is not to be confused with gonads, which are the organs within the body that make sex cells. For people with a uterus, their gonads are the ovaries and for people with a penis, their gonads are the testes.

Oral contraceptives are usually in tablet or pill form and are taken orally. This pill can prevent pregnancy because it can change the thickness of cervical mucus, the time of ovulation, and many other things. There are many variations of the pill, but all of them have either a combination of one or two different hormones. Hormones are “messenger molecules”, which means they organize and regulate the activity of various tissues (Institute of Medicine (US) Committee on Contraceptive Research and Development, 1996). They cause a specific effect in a localized region. There are two different types of oral contraceptives, and they are classified based on the different hormones they have in them. Combination pills contain the hormones estrogen and progestin, whereas the progestin-only pills only contain progestin. Combination pills are the most common. Estrogen is the primary sex hormone for those who have a uterus. Estrogen is mainly formed by the ovaries, but can also be released by the adrenal cortex, testes, and placenta. Ovaries are the female reproductive organ that produce female sex cells, known as ova or eggs. Oral birth control pills also contain progestin, which is artificially made progesterone. Progesterone is a natural hormone made by the body that causes changes in the endometrium of the uterus during certain times in the menstrual cycle. The endometrium is the inner covering of the uterus. Bill control pills come in a pack like the one pictured below, and the consumer would take one pill a day.

 

Figure 10.1 This is an example of modern-day oral contraceptives, which are commonly referred to as “the pill”. The rectangular package holds a month’s worth of medication, including a 7-day placebo supply to induce a regular period.

“Oral pills for female pregnancy contraception” by Hlaw0917, Wikimedia Commons is licensed under CC BY-SA 4.0

 

10.2.2 The Science Behind the Pill

The pill works by interfering with ovulation. Ovulation occurs in the ovary during a person’s menstrual cycle and happens when an egg is released from the ovarian follicle. The previous section mentioned the different hormones that the pill is made of. One purpose of these hormones is to elevate a person’s level of progesterone in their body. When there is a high level of progesterone, the body thinks it is pregnant and stops ovulating. Without ovulation, the person cannot get pregnant. There are also other mechanisms of the pill that make it less likely to get pregnant. The hormone progestin increases the amount of mucus on the cervix, which means the sperm cannot get into the uterus (Raup, 2007). Sperm are the sex cells for those with a penis. If the sperm cannot get into the uterus, pregnancy is prevented. The effects of the pill are reversible, which means someone can get pregnant immediately after they stop taking the medication. Implantation is when an egg has been joined together with a sperm, and so it adheres itself to the uterus lining six to seven days post-fertilization. Another thing the pill does is prevent already fertilized eggs from being able to implant within the uterus. If it does not implant, then the pregnancy does not progress.

10.3 History of the birth control pill

Key Takeaway(s)

There were several obstacles to the legalization of the oral birth control pill. Its journey to where it is today was filled with ethical issues and numerous challenges.

10.3.1 Origins of the Pill

Contraceptive devices and medicines have been a topic of controversy for hundreds of years. Contraceptives are defined as anything used to prevent pregnancy. There were several important people that began the movement to normalize birth control in American society. First, Margaret Sanger is credited with being the leader of this reproductive freedom movement. She was born on September 14th, 1879 and was the founder of the Birth Control League, which is now known as Planned Parenthood. She fought throughout her life for a child’s right to be wanted by their parents and a woman’s right to be able to choose if she wanted to be a mother. She fought for birth control before women had the right to vote! There were many obstacles in Sanger’s journey to make birth control normalized and accessible. The law called the Comstock law prohibited scientific research and public discourse about birth control. The law was enacted in 1873 and classified the topic of contraceptives as obscene  (Liao & Dollin, 2012). Despite this, Sanger continued to fight for contraception. She partnered with Katharine McCormick, a wealthy women’s rights advocate, and Gregory Pincus, a research scientist in 1950. They worked together to create the birth control pill. 

 

Figure 10.2 This is a picture of Margaret Sanger, who is known for championing women’s reproductive rights. She was a key player in the invention of the oral birth control pill.

“Margaret Sanger” by Harris & Ewing is in the Public Domain

10.3.2 Testing Trials

Beginning in the 1930’s, scientists were already conducting animal experiments to determine what could be an effective contraceptive. They discovered that concentrated doses of the hormone progesterone would stop an egg from being released, which is the process known as ovulation (Liao & Dollin, 2012). This began the process of creating the oral birth control pill; however, the scientists and researchers who were creating it could not solely test it on animals. They needed human subjects. The early days of testing the effectiveness of the oral birth control pill was filled with ethical concerns. It is important to learn this history so we do not repeat it. First, we are going to discuss the early pill trials. The scientists and doctors needed to test the pill on humans because they had only done so in rats thus far. However, they knew it would be hard to convince the public to try an experimental drug. In 1954 and 1955, Pincus used psychiatric patients to test the effectiveness of the pill. He tested 12 women and 16 men. He did not get consent from the patients themselves, only their relatives. They also tested the pill on 50 consenting patients at a boston gynecology practice who were under the impression that they were partaking in a fertility study. After encouraging results from these studies, the scientists needed to test the pill on a population. In 1956, they conducted a trial in the Puerto Rican low income housing project called Rio Piédras. They knew that those who were living in this area were desperate for birth control and lacked education (Liao & Dollin, 2012). The doctors and scientists took advantage of the situation of the Puerto rican people in order to get them to agree to participate in the trial. The women who participated in the trial were not informed that it was an experimental drug, and they were not told there would be unknown side effects. The side effects included vomiting, blood clots, headaches, and stomachaches. Over 1500 women participated in this trial and 22% dropped out because of the severity of the side effects. The beginning studies showed side-effects but they were kept hidden until it was marketed to the public, and then the consumers discovered how widespread those side-effects were.

10.3.3 Birth Control Pill is Approved

In 1960, the Food and Drug Administration (FDA) approved the first oral birth control pill. In 1960, the pill was originally marketed to help women regulate their periods and it was illegal to prescribe the pill for contraceptive reasons. The pill was called Enovid 10 and contained 9.85 mg progestin and 150 μg estrogen. Enovid 10 had an extremely high amount of hormones in comparison to the modern day pill, which contains 0.1 to 3.0 mg of assorted progestins and 20 to 50 μg of estrogens  (Liao & Dollin, 2012). Such a large amount of hormones increased the risk of severe side effects, but the researchers did not disclose this to consumers. Venous thromboembolism, blood clots, was the most well known side effect. It also increased the risk of getting some cancers. It was not until Barbara Seaman’s released The Doctor’s Case Against the Pill, which revealed the questionable ethicality of the trials and how the doctors have been keeping the side effects of the pill quiet. This had huge ramifications that we will discuss in the following section.

10.4 Impact of the birth control pill on the baby boomer generation

Key Takeaway(s)

The oral birth control pill had a powerful impact on American society, especially for those within the baby boomer generation. It had a variety of positive and negative consequences, which were both expected and unexpected

10.4.1 Anticipated consequences

 

After the birth control pill was introduced, more hormonal contraceptive options were created such as intrauterine devices (IUD’s), implants, rings, and more. Intrauterine devices (IUDs) are a contraceptive device that is placed in the uterus. It is usually plastic and can also contain hormones or other metals that increase contraceptive properties. It causes localized inflammation in the uterus which makes it hard for successful fertilization and/or conception. It was expected that the invention of hormonal birth control via the oral birth control pill would lead to new inventions that were variations of the same science. The invention of the hormonal birth control pill opened the door for open conversations about family planning, which caused an increased demand for different contraceptive options.

 

Figure 10.3 This is a diagram that shows the placement of an IUD. The plastic t-shaped device rests in the uterus and acts as a very effective form of contraception.

“Intrauterine Device (IUD).” by BruceBlaus is licensed under CC BY 3.0

 

However, the pill was created to do more than just prevent pregnancy. It also became a treatment for painful and/or irregular periods. Dysmenorrhea occurs when a person’s period is very painful, which is not normal.  Many doctors prescribed it to prevent symptoms of premenstrual syndrome and perimenopause. Because oral birth control pills alter hormone levels, the pill worked very well to mitigate some of the symptoms of these two conditions. Perimenopause is the period of time where the level of functioning for ovaries decreases. This causes hormonal changes and a variety of symptoms and can occur up to ten years before a person’s last period. This is not to be confused with menopause, which is when a person with a uterus stops having a period. This can occur naturally with age or can be induced by the surgical removal of the ovaries.

The invention of the oral birth control pill also had the social effects that it was predicted to have. For the first time in history, women had the freedom to choose when they wanted to have kids. Margaret Sanger foresaw that the invention of accessible birth control would give women more freedom, as they were no longer limited by their biological processes. In her 1920 text entitled Women and the New Race, Margaret Sanger wrote, “No woman can call herself free who does not own and control her body. No woman can call herself free until she can choose consciously whether she will or will not be a mother” (Sanger, 2015). Margaret Sanger was a very influential person in the invention of the birth control pill; however, it is crucial to know that she was also a eugenicist and these beliefs were part of her motivation to create an oral contraceptive. Eugenics is a scientifically false belief that genetic modifications and selective breeding could eliminate “imperfections” in the human race. This is an inherently racist belief system that aims to eliminate diversity. Eugenicists tried to get rid of “undesirable” groups of people through involuntary segregation, forced sterilization, and exclusion (“Eugenics and Scientific Racism”, 2022). The movement for birth control and reproductive freedom only applied to white women, which had lasting implications for minority groups.

10.4.2 Unintended consequences

The pill also had profound effects on society; it was unanticipated that these effects had such a widespread and long lasting impact. The oral birth control pill had such a big social impact that it was referred unanimously to as “the pill.” Before the invention of the oral birth control pill, there had not been a pharmaceutical technology that was so well known and popular that it could just go by “the pill.” One of the most notable instances was the pill’s influence on the sexual revolution. According to the PBS article “The Pill and the Sexual Revolution” (n.d.), the sexual revolution began in the 1960’s. It was a movement that declared women desired sex just as much men and should be allowed the same sexual freedom. The pill did not start the sexual revolution; however, it had a great impact on the trajectory of the movement. Many people saw the invention of oral contraceptives as an attack on morality and traditional family values. It gave women the ability to have sex for reasons other than reproduction, and this caused a lot of fear. The invention of the pill in combination with the sexual revolution changed societal values. Personal and sexual exploration were encouraged. This led to more women joining the workforce and gaining more autonomy.  More women joining the workforce meant the economy would improve. Also, gender inequities would lessen due to the fact that women were now given the opportunity to contribute to scientific advancement and progress just like men. It became common for there to be women who were voluntarily single or valued having a professional career over starting a family. These things did not provoke as much shame as they had in the past. The baby boomer generation was the first generation to begin to adopt these ideas. They grew up midst the sexual revolution, the civil rights movement, and the anti-war movement. They dismissed the old-fashioned views of their relatives and changed how society viewed women, people of color, sex, war, and so much else.

There were several unexpected positive side-effects of the oral birth control pill. Not only did it prevent pregnancy, but it also made menstrual cramps hurt less and lightened duration/ intensity of periods. It also lessened the chance of an ectopic pregnancy, which occurs when the fertilized egg implants itself in a place outside the uterus where it is not supposed to be. Typically, ectopic pregnancies occur in the fallopian tube but they can also happen in an ovary, within the abdomen, or inside the endocervical canal. Preventing ectopic pregnancies is a very good thing for both the mother and their future child. Another unforeseen benefit of oral contraceptives was the protection it gave individuals from ovarian and uterine cancer. The surgical removal of the uterus, also known as hysterectomies, due to uncontrollable bleeding also decreased significantly due to the invention of the birth control pill.

There were also unfortunate negative consequences from the pill. After Barbara Seaman published The Doctor’s Case Against the Pill, public trust in medicine was destroyed. Once Seaman revealed that the oral birth control pill’s history was filled with secrecy and lack of consent, people lost trust in doctors and scientists. This especially affected people of color and minority groups because they were the most likely to be taken advantage of by those in positions of power.

10.5 The Oral Birth Control Pill Today

Key Takeaway(s)

The oral birth control pill has changed a lot since its development.

10.5.1 What it Evolved Into

The invention of the oral birth control pill led to the creation of new forms of birth control. An example of this was the invention of long acting reversible contraception (LARC’s). They are a form of contraception that were created to try to solve some of the issues of the oral contraceptive pills. With the pill, the user has to take the pill at the exact same time every day or else it is not effective. This is a problem for many people, which is why LARCs became popular. Some examples of LARCs include copper intrauterine devices (IUDs), injectables, implantable devices, and progestogen-releasing intrauterine systems. Injectable contraceptives are forms of hormonal birth control that are injected via needle into a person. Depo-Provera (DMPA) and norethindrone enanthate are two examples of injectable progestin contraceptives. Table 1.1 shows the different varieties of contraceptive options and what percentage of women ages 15-44 use each different type. This table is a comparison between the years 1982 and 2011-2015. It shows that while the birth control pill was the most popular in both time frames, women are using a wider variety of contraception in 2011-2015. Without the invention of the hormonal birth control pill, these other contraceptive options would not be available.

 

Table 10.1 The percentage of women from ages 15 to 44 using different methods of contraception.

Created by Grace Miller based on data from: “National Center for Health Statistics. (2016). Contraceptive use in the past month among women aged 15–44, by age, race and hispanic origin, and method of contraception: United states, selected years 1982 through 2011–2015. ().Center for Disease Control and Prevention.”

Birth Control and the LGBTQIA+ Community

The invention of the oral hormonal birth control pill had a global effect; however, it specifically made a huge impact on the LGBTQIA+ community. The word transgender, also called trans, is an adjective that describes anyone who identifies with a different gender than the one they were assigned at birth. Transitioning is the process a transgender person undergoes to align their internal identity of their gender with their external characteristics. This can include changes in someone’s name, pronouns, voice, hair style, clothing, and/ or other behaviors. While this does not apply to everyone who is trans, many transgender people use hormonal contraceptives to suppress their menstrual cycles and prevent pregnancy (Kanj et al., 2019). Hormonal contraceptives have been incredibly useful for the LGBTQIA+ community.

A study was conducted at the Transgender Health Clinic at Cincinnati Children’s Hospital Medical Center (CCHMC) regarding the use of hormonal birth control with their trans patients (Kanj et al., 2019). Over 200 trans people who were assigned female at birth were a part of this study. This study found that the main reason for using hormonal birth control was menstrual suppression for 67% of the patients. The most common hormonal contraceptive method was depot medroxyprogesterone (DMPA). Tied for the second most common method was combined oral contraceptives (COC) and the progestin-only birth control pill (POP). Results from this study demonstrated the value of hormonal contraceptives for the transitioning transgender patients. Without the invention of hormonal birth control pills, people would not be able to change their hormones to make a life for themselves that aligns with their gender identity. The impact of oral contraceptives is immense.

 

Chapter Summary

Oral contraceptives have been one of the most influential inventions in modern history. It is a medication for people with uteruses which causes changes within their body that makes them less likely to become pregnant. Not only does it act as a contraceptive, but it also can be prescribed as a treatment for dysmenorrhea, premenstrual syndrome, and perimenopause. The birth control pill has a long history. There were several obstacles to the legalization of the oral birth control pill. Its journey to where it is today was filled with ethical issues and numerous challenges. When this was revealed, the American people lost trust in doctors and scientists. This was one of many societal effects that the pill had on the American people.

The oral birth control pill also had several effects on the social aspect of American society. First, for the first time in history, women got the freedom to choose when they wanted to have kids. This led to more women joining the workforce and gaining independence. This helped decrease gender inequities and improve the economy. The baby boomer generation was especially impacted by this invention because they were in early adulthood when it became popularized. They also grew up midst the sexual revolution, the civil rights movement, and the anti-war movement. The baby boomers were the first generation to begin to change old ways of thinking and adopt new ideas regarding sex, war, and social justice. The birth control pill is a very important technology to learn about and it had an incredible impact on the baby boomer generation.

 

Review Questions

    1. What is the name of the movement that began in the 1960s that declared women desired sex just as much men and should be allowed the same sexual freedom?
      1. Reproductive Rights Movement
      2. Sexual Revolution
      3. Sexual Freedom United
      4. The Industrial Revolution
    2. One of the ways the pill prevents pregnancy is by….
      1. Increasing sperm count
      2. Increasing ovulation
      3. Preventing ovulation
      4. Destroying the uterus
    3. What is a reason someone may choose to take the oral birth control pill?
      1. To prevent pregnancy
      2. To lessen the intensity of their period
      3. To help with dysmenorrhea
      4. All of the above

Answers:

    1. 2
    2. 3
    3. 4

 

Food For Thought

  1. How do you think the world would be different if the oral birth control pill was never invented?
  2. Think about your family, friends, relatives, and community. How do opinions about birth control differ? Is there a difference between generations?
  3. Do you think the birth control bill will ever become obsolete? Why or why not?

References

Birth control pill. (2022). Planned Parenthood. https://www.plannedparenthood.org/learn/birth-control/birth-control-pill#:~:text=The%20birth%20control%20pill%20works,so%20pregnancy%20can%27t%20happen

Institute of Medicine (US) Committee on Contraceptive Research and Development; Harrison PF, Rosenfield A, editors. Contraceptive Research and Development: Looking to the Future. Washington (DC): National Academies Press (US); 1996. Glossary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK232759/?report=classic

Kanj, R. V., Conard, L. A. E., Corathers, S. D., & Trotman, G. E. (2019). Hormonal contraceptive choices in a clinic-based series of transgender adolescents and young adults. The International Journal of Transgenderism, 20(4), 413-420. 10.1080/15532739.2019.1631929

Keating, A. (2020).  History of the birth control pill. Journal of Undergraduate Social Work Research, 4(2), 13-23. http://hdl.handle.net/2142/113567

Kruvand, M. (2012). The pill at fifty: How the new york times covered the birth control pill, 1960–2010. American Journalism, 29(4), 34-67. 10.1080/08821127.2012.10677847

Liao, P. V., & Dollin, J. (2012). Half a century of the oral contraceptive pill. Can Fam Physician, 58(12), e757. http://www.cfp.ca/content/58/12/e757.abstract

National Institute of Health. (2022, May 18). Eugenics and scientific racism. National Human Genome Research Institute. Retrieved November 29, 2022, from https://www.genome.gov/about-genomics/fact-sheets/Eugenics-and-Scientific-Racism

National Center for Health Statistics. (2016). Contraceptive use in the past month among women aged 15–44, by age, race and hispanic origin, and method of contraception: United states, selected years 1982 through 2011–2015. ().Center for Disease Control and Prevention.

Oral contraceptives. (2001). In J. S. Baughman, V. Bondi, R. Layman, T. McConnell & V. Tompkins (Eds.), American decades (pp. 420-421). Gale.

Raup, Christina, “The Birth Control Pill”. Embryo Project Encyclopedia (2010-07-01). ISSN: 1940-5030 http://embryo.asu.edu/handle/10776/1666.

Sanger, M. (2015). Margaret Sanger champions birth control, 1920. Gale U.S. history online collection (). Gale.

Sims, L. B., & Appenroth, M. N. (2022). Contraceptive technology research & development: A call for inclusion of trans and gender diverse individuals assigned female at birth. The European Journal of Contraception & Reproductive Health Care, 27(2), 142-147. 10.1080/13625187.2021.2000960

Transgender people (2022). (11th Edition ed.). Gay & Lesbian Alliance Against Defamation (GLAAD).

WGBH Educational Foundation. (n.d.). The pill and the sexual revolution. PBS. Retrieved November 29, 2022, from https://www.pbs.org/wgbh/americanexperience/features/pill-and-sexual-revolution/  

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From G.I. to Z: A Generational Guide to Technology Copyright © by Annsley Baxley; Anthony Surdich; Ashton Krol; Ava Tarzian; Brandon Marks; Danielle Cann; David Barnett; Dion Robinson; Emily Kneller; Evan Hashley; Grace Miller; Jacob Marasco; Johanna Krause; John Howell; Kyle Jenko; Kaitlyn Wise; Kyle McCormick; Laci Ellis; Lauren Zarrella; Madelyn Bullard; Matthew Gibson; Mitchell Esbenshade; Nikolas Watson; Peyton Rail; Sam Flagler; Shelbey Jumper; Simon Penso; Tyler Fragola; William McGlone; William Wei; and William Young is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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