Columns Feb 27, 2013 at 4:00 am

Queer Goggles


First comment!
The "savage_response" tag didn't get properly set at the start of the response to the second question
IUDs are awesome when they work for you, but it can be painful to have one inserted, especially for someone who hasn't previously given birth (whether you've had sex doesn't matter). I've had one pain-free insertion, a number of months after vaginal childbirth, and one fairly painful insertion many years later. I would look for someone who routinely numbs the cervix before insertion.
TIMELY=Amy from Big Bang Theory
There are certain risks to going on progesterone. It's not extremely common, but they can have mood-altering effects. Occasionally these might actually be good, and decrease natural moodiness, but frequently they're not.
Before going on a 10-year dose of the stuff, I'd suggest a 1-month trial period. (Or a copper IUD, if you prefer.)
I used the Mirena low-dose progesterone IUD and never had trouble with it, even though I DID have terrible mood problems with progesterone pills and with Depo. The Mirena was far and away my favorite method of birth control ever, at least until my husband got a vasectomy (thanks, babe!). It can cause your periods to disappear or to be very light (not a problem for most ladies) and it can cause ovarian cysts, especially in the first year. I had mine placed after giving birth, so I imagine having it placed a virgin would be more painful. But it only takes a minute, and gives five years of fear-free fucking.
When I first got on the pill, I was miserable for months afterwards. It messed with my moods fiercely, water retention. Over time it was also bad for my circulation & natural hormone levels. They tried a buncha different formulations & percentages. If I'd educated myself better or gotten on B.C. *before* starting having sex, so its need wasn't immediate, I likely would have chosen a different form of B.C.

Want to repeat Dan's point about how TIMELY will still need condoms. Seen people act like anti-pregnancy B.C. have 'em a pass. All of my college era & immediately after homes had a candy dish w/ condoms in 'em.
Several of my friends experienced some serious cramping while adapting to their IUDs. I agree with commenter #6 that it would be helpful to try a birth control with hormones for a trial period before you decide which IUD to get. I don't like hormonal birth control because it decreases my sex drive (which, I guess, make it more effective, right?). Also, tell your doctor if you smoke cigarettes because of problems with some forms of birth control.

When I was in college, I got the birth control shot, which I liked at the time because I only had to get it four times a year. It turns out that it causes bone loss, though, if you are on it for too long. My doctor let me get the shot for two years and then take two years off and then get on it again.

The Planned Parenthood website has a lot of good information about the various forms of birth control:…

Some other bits of advice about virginity, sex and college:

1. If you haven't already, spend time finding out how to give yourself an orgasm.
2. Many young men in college have misconceptions about sex, and especially about sex with an actual living, breathing young woman with a brain and feelings and sexual preferences.
3. The better you know yourself sexually, the more you can help your sexual partner to please you.
4. Don't have sex with anyone who doesn't care about your pleasure, or who makes you feel inferior. Only have sex with people who make you feel good. Trust yourself, have fun and be safe.
Condoms, homegirl.

Cheap, (probably free somewhere on your campus), ubiquitous, simple-to-use, hormone-free, and protect you from STIs such as HIV.

College-aged kids are notorious for serially monogamous, unprotected (STI-wise) sex. They date for a few months, never bother to get tested, and give up condom use wayyy before it's appropriate too, since they consider themselves "in a relationship".

Which is why walk-in clinics near college campuses get antibiotics shipped to them in bulk by public health departments.

IUDs are painful to insert and sometimes can be felt by the male. And they do nothing to stop STDs.

Demand condoms, every time.
I have a copper IUD and have become a complete evangelist for them. No hormones (after more than a decade of unpleasant side effects, I had dumped the pill and stuck to condoms before persuading my GYN to give me an IUD). Some GYNs are leery of giving IUDs to women without children for two reasons--the cervix of a nulliparous woman is smaller and makes insertion more painful, and also some doctors still have hangovers from the first generation IUDs (Google Dalkon shield, but only if you're brave) and the complications that they caused, often resulting in permanent infertility.

There's not much to be done about the cervix--yes, it'll hurt, you'll bleed like a mofo for a few days and spot for a few days after that, and your first six months of periods will be pretty ghastly as your body adapts. BUT! Hang in there, and they will normalize. I never feel mine; I never think about it except once a month when I check the string to make sure it's still in place; and it's good for 10 years. Set it and forget it!

And the problems with the Dalkon shield and its ilk have been resolved with technology--what happened was that the string attached to the old IUDs was made of cotton, which had a nasty habit of wicking vaginal bacteria up into the uterus. The new IUDs use strings made of nylon, which are not absorbent and do not do this. There are always risks to implanting anything in your body long term, but those risks are much, much smaller than they used to be.

TL;DR I wish I'd had an IUD in college and highly recommend it.
Condoms are great, but as a woman, I'd get an IUD or long-term shot as a backup prevention for the most commonly sexually transmitted complication there is: pregnancy.
@12 I too adored my copper IUD. I had it removed after a couple of years because the heavy, long periods and bad cramping never did improve. After I pop out a kid, I would definitely get another.

She should avoid depo provera (the shot) like the plague. Weight gain and depression are fairly common and really miserable. Also no sex drive, even relative to other hormonals.

The Nuva Ring is a good pick for not having to remember it every day.

Most women have to go through several types before they find one they can tolerate. She may as well start that process now.
For TIMELY: I suggest condoms!

I have the Mirena IUD, and have no kids - insertion was very painful even with a prescribed Vicodin beforehand. Rough sex was a favorite pre-Mirena, and now it just hurts too bad to continue (the Mirena causes cramping, at least for me, from rough sex). Even soft sex can trigger the cramping.
To top it off the strings have also fallen out, and the IUD has risen up in my cervix out of sight, so they had to do an ultrasound to find it. My gyno explained that she uses a tool in these circumstances to fish it out, I have no idea what kind of painkillers they use for this, or if they will need to do surgery, but it's something I'm not looking forward to!
The plus sides: Your period disappears, or will almost disappear, which is really nice, and for me the mood swings are gone with it. It's also great not having to worry about taking a pill everyday, but the discomfort it has caused me is NOT worth it.
It sounds like others have better experiences with the IUD, but you're new to sex! Complications like these could make life complicated, especially since you wouldn't be able to gauge from experience if the sex is uncomfortable or if its the IUD. Use condoms, and when you get into a legit committed relationship check out the Nuva Ring, it's been my favorite so far.
Waiting for those pictures, Dan!
@15 -
sorry you've had issues with the Mirena. Before I got mine, I asked specifically about rough sex. Well, I asked "does having an IUD place any restrictions on your sex life?" and when the midwife said no (always use a midwife, ladies) I said "are you sure? I mean like ANY restrictions?" and she repeated NO. I can't say I ever noticed any difference, and our sex gets pretty rough sometimes.

However, I also had the "lost string" experience and an ultrasound to make sure it was still in the right place. Don't freak out about the "instrument." When it was time to get mine removed (thanks again for that vasectomy, babe!), it turned out she was able to locate the string within the cervical canal and remove it the same way she would have normally.

I know all this female anatomy is probably giving Dan the vapors, but the truth is that our junk is seriously tough. It's made to be; the survival of the human race depends on it. If you have basically healthy parts, and can "man up" (ha!) and endure five minutes of pretty bad pain, your girly bits will suffer zero lasting effects. Babies come out of there, IUDs are like an inch long.
Helvetica Bold! So adorable!
Everyone on here seems to be posting about IUDs. I don't know how much of an option that actually is for this girl. I know when I went in to the doctor and asked for an IUD, they told me they were not physically capable of inserting one because I'm naturally small and had never given birth. I used Depo-Provera for two years (had to stop because it decreases bone density) and LOVED it. I was a little moody for a couple days after each injection, but eight days a year vs. a week per month of moodiness was nothing to me. When I stopped the Depo, I got an Implanon implant inserted into my arm. I am about a year in and have no negative side effects other than increased sex drive (darn) and occasional spotting. Try one, if it doesn't work for you, don't be afraid to change it. Honestly, the Implanon has so far been the least painful, least side effects, and most effective for me. But everyone is different.
queralinda - I'm glad you had such a positive IUD experience. I'm a health care provider and see TONS of people with serious side effects from both the copper and Mirena varieties; myself included. I cramp (severe, blacking out and screaming type cramps) 14 days out of my now-21-day cycle (thanks, IUD!) and after certain sexual positions... so now it's non-deep-penetrating positions only.

Still, I've kept it for 4 years and will probably keep it for the next 6 because it's hormone free and I won't get pregnant. And, it was so bloody painful to put it, I can't imagine taking it out until I have to. Hopefully by then I will be trying to get pregnant and won't need to worry about birth control.

It's a rough world for us ladies, the sole bearers of the birth control burden. Can't wait until VasoGel or something like it gets approved!!!
I'm with @18: Helvetica Bold---I love it, Dan!!
I'd love to see the pics.

Great acronym, TIMELY, and all the best in your studies!
Definitely go with spermicidal condoms, but watch the BCPs--
the Pill, especially Ortho-Novum 777, can have nasty side effects!

Thanks again for spot on advice, Dan!
Any doctor who would implant an IUD in a virgin is a sadist.
Important to note that Planned Parenthood WON'T give you an IUD if you're not in a long term relationship. If you are planning on having multiple partners, or don't know yet, they don't give it to you because of the lack of STD protection.

Maybe ask your doctor also for resources you can consult once you've moved. I guarantee that sometime in the 6 years that you're in another state, you're going to need advice on birth control and you're original doctor won't be available. Planned Parenthood is usually amazing. Find out how the helpers at your college health center are. Make sure you know what your options are and find what you're comfortable with. Part of leaving for college is leaving your comfort zone and finding a new one somewhere else.

And as for the first letter, while I suppose it is generally wise to not hook up with strangers when you're super drunk, I got the distinct impression that had the people this guy's friend had been wanting to hook up with been bio women, there would've been significantly less cock-blocking. It's as if the friends were saying, "Omg he's drunk, he doesn't know what he's doing, get him away from the transvestite," rather than, "wow, they are really hitting it off. Let's make sure they are safe before we high five both of them." Not cool guys.
You trust your doctor. Your doctor has offered you information on birth control years ago.
Why do you write to a sex advice columnist instead of discussing this with your doctor?
Your doctor is the one who will be able to tell you if you are in any risk group regarding the suitability of hormonal BC, or if your cervix is too small/ strangely formed/ whatever for an IUD.

But why is no-one commenting on that stupid LW who sounds slightly homophobic and does everything he can to keep his friend in whatever closet that friend is?
my 2 cents on IUDs: I have a Mirena IUD, and no problems whatsoever. Some very light cramps when setting it (without having given birth), and no issues after. Any and all kinds of sex still great.
Sure, with IUD you'll still need condoms, but last time I slept with an asshole, and turned out the condom broke, I didn't have to freak out all that much. I'm just saying: make sure you have extra precautions for the really important stuff like pregnancy-prevention!

@18&21: me too! Immediately checked my twitter and disappointed Dan didn't come through. We'd love to see those pics Dan!

Good point.

Probably because she wanted to write to Dan and as a virgin this was her only option for material?

Still though... good idea to go to health professionals for health advice.
Speaking as someone who was a virgin when i got my mirena, i still thought it was a reasonable choice. Insertion was a wee bit uncomfortable but i saw a gyne who inserted iuds like 30x/day. Which i think is key. Also i took like 800mg of advil an hour prior to insertion (actually probably better than vicodan since it decreases cramping).

I found that i had random spotting for a few months - nothing i actually needed a pad for and since then only minimal periods.

Actually, perhaps half the female population of my medical class have mirena iuds. Its the cool thing to do. And here in canada, our mirenas last 7 years (american regulations say 5 for reasons i dont fully understand).

Obvious caveats: some things dont work for everybody and you have to be responsible about protecting yourself against STIs especially with a foreign body in your uterus.
"make sure you have extra precautions for the really important stuff like pregnancy-prevention!"

Okay, why am I repeatedly hearing the sentiment that pregnancy prevention is more important than STI prevention?
Here's a Twitter pic Helvetica Bold posted in 2010:…

Also, I have a slightly unbelievable IUD story -- I had the Mirena inserted when I was in a prolonged period of single-dom (to decrease bleeding). Shortly after I started dating my fiance, 18 months later, the Mirena started coming out. My doctor said she had never seen such a thing (it had moved from being high up in the uterus to near the cervix, and the string was *long* outside the cervix), and I had to get it removed. My theory is that my orgasms were so incredible (seriously amazing, lifetime best, and I've had a few) that I was experiencing unusually strong uterine contractions, leading to expulsion. Just a theory, and one that I didn't share with my doctor ;-)

I second the caveat about hormonal BC affecting women with mood disorders, but from my experience, a 1-month trial of a BCP would have no bearing on what effects the 5-year Mirena would have on your mood -- I've had different impacts on my mood from various hormonal methods, at various times. I'm leery enough that I've stopped using hormonal BC, but TIMELY should experiment now to find out how her body interacts with these.

Also, @24, what else is there to say to CLOD beyond what Dan already said? Wouldn't any clear-thinking person have come to the interpretation that Dan offers without having to write to a sex columnist? CLOD, offer to go with your friend to a drag show -- that can be the first step to letting him know that you're done cock-blocking him.
LOL at Helvetica Bold. That is all.

I am going to need pictures though.
I LOVE my Paragard copper IUD. I'm on my 2nd one - got my first at 23 and had it in for 15 years (not recommended). Second one in for 8 years so far and since I'm approaching menopause that should be the last one. Yes, it made my menstrual cramps worse for the first year or 2 but it is soooooooo much better than hormonal birth control (makes me depressed, moody, and go from an A cup to a very painful C cup) or some other kind of barrier method (anyone remember diaphragms?) I love it. Recommend it to anyone who can find a doctor who will insert one.
What #10 said. Convenient, functional contraception.

and, it has a useful side-effect: whilst the 18 yo virgin might just want a guy for a night, she gets to pretend that she does not have them,(at first) to see if he is the type who travels prepared.
TIMELY-- I recommend condoms. If your first experience with PIV sex is with someone you've known only briefly, you'll want them for the STD prevention. If your first experience is, as the "love yearning" in your sig suggests, with someone you know well enough to talk about love, pregnancy, and STDs with, then you'll have plenty of time to get a long term method of birth control when that happens.

It's great that you have a doctor you're comfortable with at home, but the experience of going to a doctor you don't know as well won't harm you. You have the information you need so you assertively walk into a recommended doctor's office or the campus health clinic, say what you want, and take it from there. Any problem is more likely to be with insurance and payment. Alternately, if I'm wrong about the out-of-town doctor, use condoms until you're home for a break, then see your regular doctor. A few months is a long time to wait for sex if that's what you want. It's not too long to wait for the perfect birth control method if you have condoms in the mean time.
Just be aware that there are risks with having an IUD inserted. When my doctor put mine in, it perforated my uterus and ended up in my abdomen. I needed surgery to remove it. This is a rare complication (happens about once in every 1000 insertions), but it does happen. I desperately wanted the IUD to work out for me, since it seems like a fantastic method of birth control, but, alas, no such luck.
TIMELY: ignore the comments who say no to IUDs because they had problems and go with what Dan said: implant or IUD + condoms against STIs.

Listen to them when they say that things can go wrong, yes that's true. As you're going to college, great time to learn about statistics and that nothing in life is a sure bet.

While IUDs may have a 1 in 1000 complication rate + failure rate, condoms have a 150 in 1000 failure rate in typical usage (yes, 15%).

So that means many many more unwanted pregnancies across thousands of women who use condoms ONLY compared to condoms + another method.

And if some of those carry a pregnancy to term, there is *far* more than a 1 in 1000 chance of a life-threatening complication from the pregnancy itself. Even abortions, while almost always safe, can have complications. So the net IUD complication rate is far lower than any alternative.

Very sorry for those commenters who had problems with IUDs, and people should be aware anything can happen -- indeed, every day hundreds of people on the planet just drop for no apparent reason right in the middle of typing a sente
I don't have anything to add to everyone's excellent advice re: bc methods, but I am still stuck on the portion of CLOD's letter where he notes that his friend "reached into her pants and felt for a pussy only after she started giving him head." I regrettably never have given head to a stranger in a club, but is that a normal part of the ritual in any event? "Here comes some free cocksucking!" "HANG ON, MUST DO A QUICK VAGINA-CHECK."
Of course he doesn't grab a presumably-a-girl's genitalia until something else is already going on! Pulling a Crocodile Dundee could get him an elbow to the face, arrested or preferably BOTH!

"Coercively assigned male at birth?" I call bull. We do not assign gender; we only recognize it. If a baby has a penis, it's okay to assume that that baby also has male brain anatomy or whatever else it is that makes a boy male on the inside. It's not coercion; it's not wickedness; it's just a mistake, and considering that most boys with penises and XY chromosomes actually are boys, it's not a remotely unreasonable one. A trans woman is someone who was raised male but discovered that she was really female, not someone who was coerced into being male by mean doctors.
Of course he doesn't grab a presumably-a-girl's genitalia until something else is already going on! Pulling a Crocodile Dundee could get him an elbow to the face, arrested or preferably BOTH!

"Coercively assigned male at birth"? I call bull. We do not assign gender; we only recognize it. If a baby has a penis, it's okay to assume that that baby also has male brain anatomy or whatever else it is that makes a boy male on the inside. It's not coercion; it's not wickedness; it's just a mistake, and considering that most boys with penises and XY chromosomes actually are boys, it's not a remotely unreasonable one. A trans woman is someone who was raised male but discovered that she was really female, not someone who was coerced into being male by mean doctors.
I'm glad Dan told the first letter writer to "stop cock & frock blocking" the guy because as I was reading the letter, I couldn't understand why so-called "friends" kept preventing the guy from moving forward w/his actions, as if he were going to "regret" it later. It wasn't their place to interfere w/his desires & decide for him what those desires should be!
So how much of Dan's salary for this week's column goes to Unjali Malhotra for writing half of it?
Aren't "beer goggles" generally just an excuse to go after the people you really like instead of the ones that you are supposed to like? "Oh, I got drunk and slept with a fattie," for example means, "I really like heavier women, but I am ashamed to admit it."
How about the Implanon? It's less invasive (and painful) than an IUD and lasts three years.
@41: Not always, and not necessarily. People often look better as the night wears down and the level of alcohol in the bloodstream rises.
In the case of this letter, though, it seems like this poor guy has a lot of freaked-out and perhaps homophobic friends all trying to save him from himself. I'm wondering what kind of bars they are frequenting, and getting ready to comment that CLOD's attitude suggests that he (CLOD) has a drinking problem.
@29: thanks for posting the link. Dan, you make a hell of a foxy lady . . . or look somewhat like my aunt did as a young woman--yikes!
There are a few pics of Dan in drag in the SLOG archives:…
My mom took me to get the pill before I started college for this precise reason. (God bless her.) Orthotricyclen, used in tandem with condoms (EVERY TIME) is a good option for college women.
@28: Because pregnancy is more common than STIs as a result of unprotected sex. Especially for people in their late teens/ early twenties. And because while many, many STIs respond to simple medical treatment if you pay enough attention to know you have them, pregnancy ends in miscarriage, abortion, or the birth of a child. Even among the strongly pro-choice, all of these are usually considered more emotionally weighty than a round of antibiotics for chlamydia. For a lot of people, the emotional weight would be greater than for even the untreatable or bad complications STIs. (And of course pregnancy can have its own serious complications.)

For the LW, I would incline to:
a) Talk to your own trusted doctor, since you're lucky enough to have one.
b) Use condoms for STIs and as one method of birth control.
c) Condoms plus something-different (i.e. not just spermicide applied with the condom, but a different method entirely), both used correctly, will get your risk of pregnancy very low. If you use two 90% effective methods the combined effect is about 99%. (10% of 10% for failure rate.) I would incline toward something easier to go on and off than an IUD as you see how you do with various types: as someone noted, you want to be able to tell what's the sex and what's the birth control method.
I have a Mirena IUD and yes it hurt getting it inserted (I've never had children), and the first three months were a constant cramp-fest. BUT two years later, I am thrilled with it. Almost no periods, no pregnancy worries and while condoms are a must, there's no additional concern about accidental breakage.

Why anyone would think that inserting one into a virgin is wrong or cruel is beyond me.

As for rough sex being a problem, it's not the sex, it's whether the penis is hitting the cervix that could be an issue. Frankly, that's pretty damn painful with or without an IUD and I can see it being more of an issue with one, but thankfully most men are not that big. Though if you find yourself enjoying cervix hitting sex, it is something to consider.
As a non-vagina owner, no opinion on the IUD, except to say; contraception and STI prevention are a good idea - ie, condoms in addition.

And yeah, like @16: still waiting on the pics!!!
Jeebus, I am amazed at the number of people being pro-IUDs, despite experiencing what sounds like horrendous insertion processes and side effects. Why would anyone put up with that unless they are in a long term relationship where condoms are not also needed?

Condoms (male and female) are great if you're not in a settled relationship, and how about not defaulting to PIV? Any kind of hormonal or inserted birth control has problems, and they need trying out to find which suits an individual. Committing to one which will last years before becoming sexually active sounds like taking on an extraordinary burden.

The morning after pill is available very easily where I am, and although it's not to be abused, on the rare occasions where condoms have come off it has been a simple and easy solution.

Slate did an article in their "medical examiner" section on this topic. Their conclusion was that IUDs are generally a good birth control option even for young woman without children. The article is called "Why Have Teen Pregnancy Rates Dropped?"…
I think Helvetica Bold is a fantastic drag name. So much better than Comic Sans. I definitely want to see those pics.

Also, my drag queen friends call those guys "clown fuckers."
I'm on my second Implanon (upper arm implant). I've had them for a total of almost 5 years. It's fantastic - no side effects in my case and nothing to worry about for 3 years. Both insertion and removal are pretty easy with a local anesthetic.

I would have gotten an IUD after childbirth, but it wasn't an option due to a retroverted uterus. From what I've read, IUDs are now considered an option for most women even if they haven't given birth. Some discomfort on insertion seems like a small price to pay for 10 years of protection with a copper IUD.

And, yes, condoms, obviously. But not condoms alone if you're serious about preventing pregnancy.
Why didn't this doctor mention NUVARING? It solves a problem with 'typical-use' failure. That's why I never took pills, just seems too annoying.
But you insert it yourself, take it out for a week, then keep one in place for 2 weeks, and you dont have to go through painful installation of IUD.

to #49
"and how about not defaulting to PIV?"

PIV is great and avoiding it entirely so you don't have to bother about birth control is just sad
I just wanted to say that how much the IUD hurts to be inserted, in my experience, has less to do with being parous/nulliparous and more to do with the experience and skill of the practitioner. My first one, which I got before getting pregnant and which was inserted by an experienced OB/GYN, hurt hardly at all (although I did feel what pain there was for longer), whereas the one I got after having my kid hurt like a bitch because the NP who put it in had no idea what she was doing.

Also, Helvetica Bold is a *fantastic* drag name.
And one more thought: I freaking LOVE my Mirena. Pills made me fat and moody, the Mirena does nothing to my mood but stop PMS in its tracks.
Here's the way I interpret TIMELY's letter:

I am an 18 year old straight female woman who has never had PIV sex before going off to college. I have never had a long term boyfriend or even short term boyfriend at this point, and while I look forward to having sex some time in the future, I'm okay with the amount of sexual experience I've had at the moment. Should I be on some sort of long-term birth control in advance of a relationship in which I might need it, or should I wait for the relationship first and get the birth control second?

My answer is to wait. What if this young woman doesn't end up needing birth control for another few years? It's perfectly fine for her to wait. If she does find someone she wants to have sex with, they can use condoms until she gets a prescription. Given the (possible) side effects of hormonal birth control and IUDs, it doesn't make sense to me to be on them when they're not needed. Sure the benefits outweigh the risks when there's the possibility of pregnancy, but I'm not sure we can say the same thing when there's only a possible preliminary risk of pregnancy because the man involved is, at present, imaginary.

Of course, there is the 3000 miles away business, and for that, I think several packets of conventional birth control pills make a good answer. She goes off to college with them, but she doesn't take them. When she meets the right guy, they use condoms until her next period. Then she starts taking the Pill according to package instructions.

Implant + Condoms

Do NOT get Mirena. IUDs carry a small risk of perforation of the uterus or the cervix. There is a pending class action lawsuit against Mirena because of this problem. If you're opting for hormone based contraception, Implanon is the safer option.

If you prefer a non-hormonal long term method, you're pretty much stuck with ParaGard. It can cause perforation, too, but there isn't an alternative long term hormone free method. (Make sure you're not allergic to copper, first, though!)
#36 LOL thanks for that comment!
Progesterone releasing iuds last 5 years, copper last 10 years @6. And I can say having experienced both, the copper one caused exessive bleeding and debilitating cramping while the progesterone releasing plastic one I have now caused my mothly period and accompanying pain to cease without putting me at risk for bloood clots or stroke like the other hormone birth control methods would have. I was happy with the Nuvaring for 6 years until I had a stroke at age 31 which may have been in part caused by the estrogen in that birth control option.
@39: I couldn't understand why so-called "friends" kept preventing the guy from moving forward w/his actions, as if he were going to "regret" it later.

True. 12 years ago I got plastered in a Greenwich Village bar and ended up making out with a drag queen. My friend (who's gay) didn't try to stop me - in fact, he egged me on. I'm as straight as they come, but whatever, the whole night was just crazy and fun.

If I have any regrets, it's that I didn't get a BJ out of the deal - would have been interesting to find out whether that would have worked for me.
@57: I think several packets of conventional birth control pills make a good answer.

Birth control pills are fabulous if you're the sort that can remember to take them EVERY day (or have the discipline to stick with oral for the remainder of the month if you forget a day).

Otherwise, they are an unwanted pregnancy waiting to happen.
"coercively assigned male at birth,"

This phrasing pisses me off so, so much (probably only because I'm a geneticist). Fuck you, you were not "assigned" shit and there's nothing "coercive" about it, an X or Y sperm happened to be the one to fertilize the egg and thence genetic gender was formed.

Certainly that can be different from the gender you truly feel you are, which is how trans* folk end up existing. But come on people. Coercively assigned? That only makes sense if you believe in god or some equally juvenile horseshit.

Although, Tumblr.
The WHO no longer promotes the use of spermicidal condoms, and for good reason. They have a shorter shelf life than normal condoms, they've been linked to UTIs, and if you're already using a condom, they really don't reduce your pregnancy risk much. In addition, if you're allergic to them like I am, they can cause some serious burning and/or itching after use.

If you want to use condoms, I would recommend getting lubricated ones without spermicide. Of course, if it's a condom with spermicide or no condom at all, it's still better to go with a spermicidal condom.
Everyone's so anti the pill these days! There are plenty of good reasons to be on birth control even if you're not planning on having sex - it can help with heavy or painful periods, unplanned sex can happen in many ways, and starting off on the right foot by taking responsibility for your body is a good thing.

If she's an 18 year old virgin thinking about birth control, she's probably responsible and would remember to take her pills. Not everyone has side effects from hormonal oral contraceptives. I've got a 28 day mini-pill - I don't get periods ever and I experience no side effects. It's all about finding the one that works for you, and sometimes that's the pill.
"Helvetica Bold" looks pretty cute. I suppose I have gynandromorphophilic tendencies.
LOVE your drag name, Dan. :-)

Sorry if this is already mentioned but how is she supposed to remain a virgin and get an IUD inserted? Wouldn't that procedure rip the hymen?
Crinoline at 57 makes a good point: All of these have possible side effects and if she doesn't wind up needing birth control for a couple of years, why not be conservative on the stuff introduced into her body? (Plus it could help on the no, really, use a condom, even if you're in a relationship, even if you're both virgins front.)

I think waiting for a relationship is a really good idea for virgins, because guessing blind how sex is going to affect you emotionally isn't terribly smart--if you might be feeling wildly bonded the next day it's nice if it's with a person who likes you and wants to talk to you still.
Re 49 defaulting to PIV: Because straight people have a pretty strong urge for PIV sex and saying "We'll do everything but that! And we totally won't get carried away in the heat of the moment!" isn't terribly smart.
I have knocked an IUD out of alignment during rough sex. My friend bled significantly afterward and had to have the IUD realigned by her doctor. She said the doctor seemed to have seen the situation before.

That said, that friend has been very happy with her IUD overall, it never caused a problem during any of our other meetings over a few years, and it was nice knowing it was there in addition to the condoms we were using.
@70: Special magical birth control with no side effects and a 100% effectiveness rate? I hope you share with the medical community this great discovery of yours.

And I'm mystified as to why you aren't promoting it for those who favor abortion, too: abortion has risks and complications, even if fewer than pregnancy, and is not viewed by most women as carrying the emotional weight and physical consequences of, say, sneezing. I feel pretty confident that the vast majority of women who have had abortions would much rather have had that magical perfect birth control instead.
I went on a 5 year implant when I was 19. Like TIMELY, I was nervous about forgetting to take my pill daily, so I went with Norplant. Mind you, this was in 1992, and I'm aware that medical advances have a tendency to occur over 20 years. However, after an armload of surgical scars, and an extra fifty pounds I couldn't shift until the removal of the implants (after which the weight practically fell off with no change in diet or lifestyle), I would caution TIMELY not to be too eager to use something that requires that much commitment and a surgical procedure to insert or remove. One of the benefits to oral contraceptive is that you can stop immediately if dire, or simply inconvenient, side effects present themselves. If TIMELY is concerned about starting a daily routine, I recommend she start practicing with the use of a daily multivitamin. If she can remember her vitamins, which she probably ought to be taking anyway, she can be confident that she won't forget the pill. And yes, absolutely, insisting on condoms every time and regular testing is still a must regardless of contraception.
Dear TIMELY virgin. I think the main thing that you need to worry about is not necessarily so much about getting pregnant but about avoiding STDs. Clearly neither an IUD nor a birth control pill will protect you from an STD. I thought that I needed to spell it out again, just in case. That being said, condoms are what you will need. And common sense in choosing a partner. But whether you are planning on having a monogamous relationship or recreational sex with multiple partners, you must stock up on condoms, condoms, and more condoms. Once you and your monogamous partner reach that level of trust where you definitely know that he does not have sex with other people and that he is free of STDs, then by all means consider other contraceptive devices, UIDs, pills, etc. From the health standpoint though, I'd stick with condoms. Why anyone wants to screw with their hormones is beyond me. I would like to avoid extra pounds and facial hair growth (which could happen when you are on birth control pills - I have known girls that experienced those unsightly side effects). Good luck with your studies!

Dan -- love the twitter pic!!
UNDER NO CIRCUMSTANCES should she begin with the depo shot, whatever choice she ends up making- I say this not because it's necessarily a poor choice- there's a few ladies already who've commented that they love it, but it's the single option mentioned that is entirely irrevocable and should our sensible young lady find that the hormones cause problems, the only answer is to be horribly miserable for months until it wears off.

Personally, I take a pill so I can skip periods. I have an alarm that goes off every single morning at the same time so I don't -forget- the pill, in fact, because otherwise it doesn't work very well. Nuvaring was lovely [though it can... come out at inopportune moments], but it's prohibitively expensive for a lot of people because of the tier drug it is and I had to switch off it.
I went on a 5 year implant when I was 19. Like TIMELY, I was nervous about forgetting to take my pill daily, so I went with Norplant. Mind you, this was in 1992, and I'm aware that medical advances have a tendency to occur over 20 years. However, after an armload of surgical scars, and an extra fifty pounds I couldn't shift until the removal of the implants (after which the weight practically fell off with no change in diet or lifestyle), I would caution TIMELY not to be too eager to use something that requires that much commitment and a surgical procedure to insert or remove. One of the benefits to oral contraceptive is that you can stop immediately if dire, or simply inconvenient, side effects present themselves. If TIMELY is concerned about starting a daily routine, I recommend she start practicing with the use of a daily multivitamin. If she can remember her vitamins, which she probably ought to be taking anyway, she can be confident that she won't forget the pill. And yes, absolutely, insisting on condoms every time and regular testing is still a must regardless of contraception.
HELVETICA BOLD! I haven't laughed this hard in weeks. Good one, Dan!
A lot of doctors won't insert a Mirena IUD in women who haven't had kids- just keep asking around until you find one who *does*. I had one put in at 21 (no kids) and it's fabulous! I had less cramping than before and I don't get a period at all.
Also, please only listen to your doctor about the objective statistics on all BC failure and risk rates. The internets are full of horror stories for every method, mainly because the many people who are quite happy with whatever they have don't feel the need to post rants about it on their blogs :)
And yes, always use condoms.
Oh, and if you do get an IUD- it will hurt, like really really bad cramps. Take two Robaxacets (muscle relaxants plus advil) and it'll be waaaaay better :) It stops the uterine muscles from clenching as much.
I was told by my GYN that IUDs carry an increased risk of STI transmission (due to pelvic inflammation?) so they weren't recommended outside of a committed monogamous relationship (though they would still give one to me if I wanted). Can't find any conclusions on that one way or the other online--thoughts?
Nice shout-out to the silly, silly culture of Tumblr.
Helvetica Bold

Loved it!
@37 @63 I think you might find the following helpful re: the word assignment, and its usage here…
I happily had my copper IUD for 8 years, six of which were spent in a very sexually healthy relationship, until I got pregnant this past December. It was a terrible situation to be in considering where I am in my life. If that news wasn't bad enough, the pregnancy was ectopic. The ER removed my IUD and left me seriously wondering what a responsible girl, who absolutely doesn't want more children, should do to protect herself. After lengthy discussions with my ob, I have a brand new copper IUD.

Truth is, as long as you are fertile, nothing can completely protect you from an accidental pregnancy. You just have to evaluate your life, get to know your body, and make a decision with a doctor you trust.
@11: Demand condoms, every time.

If your sex life consists of short term hookups, condoms make sense.

However, if LW expects to find herself in a long term monogamous relationship with no clear expiration date, then it might make sense to consider other methods.

Also, relationships generally work better when both parties treat birth control and other mutual issues as shared problems rather than decisions to be made unilaterally.
Why hasn't anyone asked the most pressing question here: where in tarnation is this guy hanging out to meet drag queens seemingly anytime he goes anywhere?? I mean, Halloween, Mardi Gras, Gay Pride, certainly, but I don't find that many big girls just making the rounds on weekends. Kind of odd, no?
Are you completely sure that Eddie Izzard doesn't refer to himself as a transvestite? Is he not allowed?
Are you completely sure that Eddie Izzard doesn't still refer to himself as a transvestite? Is he not allowed?
Get your BC in place beforehand!! I'm 32 and had PIV for the first time only last year. Completely unexpected, unprotected, and had to get emergency contraception in the form of a copper IUD because it was really close to ovulation day. The 'morning after' pill just delays ovulation, so if you've already ovulated it won't work, but a copper IUD will prevent implantation. (This is what they told me at the clinic; I am not a doctor). Thankfully I live in the UK where it was easy, no-fuss, and free. And no judgment either, even though it was probably the riskiest thing I'd ever done. And it didn't hurt that much - I was told to take a painkiller beforehand (I didn't) and it wasn't anything I couldn't breathe through ok.
@90, I hope your unexpected/unprotected PIV wasn't also unwanted :-(

Re emergency contraception, some of the pills also work to prevent a fertilized egg from attaching to the wall of the uterus. Not sure about the products available in the UK, though.
I have a Paraguard IUD and it's great. I have a long term partner who I have unprotected sex with; but for the times I sleep with other penis-having folks, I always use a condom. I suggest you do the same. Good luck!
Up until last week I would have been raving about my ParaGard, which I've had for 3 years (I'm 27 and nulliparous, very little pain with insertion). Before that I tried 3 types of BCP and NuvaRing, and the variety of not-great side effects convinced me to go hormone-free.

And then last week I had a miscarriage, and now I'm having to re-think the very lengthy thought process that led me to the ParaGard in the first place.

Some thoughts for the writer:
--I would try BCP, possibly multiple types, for at least 6 months to see how you tolerate them
--If they work for you, stick with them or another hormonal method
--If not, consider ParaGard, but keep in mind that (a) if you do get pregnant (let's say 1 in 300) you've got a higher chance of ectopic pregnancy (very bad) and miscarriage; (b) if you contract an STD, your risk of PID/infertility/etc. is increased (so use condoms!); (c) your periods will likely be more crampy/heavy, so if they're already the least bit bad you might want to rethink ParaGard
90-ISIHAC-- Are you saying you wish you'd been on some kind of birth control from the time you started ovulating in your teens until the time you had PIV sex for the first time when you were 31 all in the name of precaution? That would have been worth it to you in order to avoid needing emergency contraception, emergency contraception that you say was readily available? I'm trying to avoid judgment and second guessing, but if that really is your conclusion, I'll admit that it's hard. Being so turned on that you have consensual sex at the spur of the moment, now for that, I'm judgment free (go girl!). As far as I'm concerned, no problem with having fresh condoms in your purse all the time just in case. But having an IUD implanted when you're not sexually active and have no actual plan to become sexually active in the near future? I can't understand that-- if that is, indeed, what you're recommending.
The main message from this comment thread is that no birth control method works for everybody, you have to weigh up the risks and benefits of each for yourself, often after trying many.

Me, I'm childless and on my second Mirena, after wearing the first out with my now-husband. Some serious pain and spotty bleeding the first few months of the first one, but the second was inserted with no more pain than a pap smear. I was told by the doctor in the UK that a lot of US doctors cut the strings waaaay too short out of a feeling that American males could become distressed by palpable evidence that women have to take precautions against pregnancy and aren't instant porn fuckdolls.
TIMELY, use condoms.

Unwanted pregnancy can be dealt with, but STIs are for life. HPV, HIV, chlamydia can have life-altering consequences. Take the pill if you need it for non-contraceptive reasons, but otherwise you really do not want an excuse not to use condoms. If a condom breaks, then the morning-after pill is there for you. Ask your nice home doctor to give you a couple to keep in your bathroom cabinet.

If in the future you find yourself in a LTR in which STIs are no longer an issue, then you can reassess.

(Yada, yada, yada, on emotional issues around abortion, the sop to the anti-choice brigade. Fuck that! I’ve never been pregnant, but I'm pretty sure that while a minor medical procedure is never fun, it is much better than being told you have contracted a terminal disease/cancer/been rendered infertile..)
@73, that magical stuff can be gotten from any of the "shops" you find in the larger new style mega churches. You can buy K-cups with jesus on them and lunch boxes, and hot romance books with no sex, and 100% birth control.

Dan, they may not use "transvestite" in Seattle, but it is preferred over "drag queen" in other places. Or do you prefer "cross-dresser?" Jeebus, how strange it is to hear declarative statements of that ilk from YOU!

PS why share photos only on twitter? Got something against The stranger?
One more shout out for the copper IUD, after a decade on the pill, a significant increase in libido and 15 lbs that disappeared with out much effort on my part. Could be a coincidence, but it feels like going off the pill had something to do with it
I don't know that I can add much that other women haven't said, but I wanted to point out (in case it's not obvious from other comments) that birth control methods (and girl parts) have a lot of variables and different women can have wildly different experiences with the same method. The only way you are going to know is by trial-and-error, unfortunately. So I would recommend steering clear of anything really long-term (and probably expensive) like an IUD and go for the old stand-by of The Pill. You can experiment with different pills and see which hormones work best for you, and get in the habit of taking them at the same time every day (*very important*) before you are sexually active. They are also available free or cheap, unlike other methods, especially to college students. Do use condoms with new partners, and explore other BC options as you feel moved to, but I would start with the pill.
I had severe menstrual symptoms as a teenager that prevented me from playing sports, swimming, and made me leave school early in tears several times, and I was 18 before someone finally took me seriously and I got on BCP. I take them pretty much continuously and don't bother with their "fake period" phase and have never had PIV, so no, it's not silly to figure out your birth control/reproductive health options extremely early.

I set several alarms to ensure that I always take my BCP before I go to bed since I'll get bleeding if I miss a day.
This doesn't have to do with birth control, but get the set of three Gardasil shots if you haven't already. Because FUCK getting cervical cancer.
The "Panty chaser" may actually be transgender himself.

While it's not common, but I do know of a few transsexuals who engaged in similar behavior before finally coming to terms with themselves. For some it was a coping mechanism for them and for others it was a way to explore.

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