Note: These stories have been lightly edited for clarity. Some names (indicated by *) have been changed to protect the story sharer’s identity. Some stories are from before the ACA went into effect.
“As a trans person, having my menstrual cycle is something that doesn’t align with my gender identity.”
Mason* | Washington, DC | Asian | They/them
Mason had been scared of being denied health insurance coverage for medication in the past. When they were transitioning (Mason identifies as non-binary), they expected to face some kind of pushback from their insurance company in covering testosterone, which would aid in their transition. But Mason was able to get their testosterone covered, no problem. The same can’t be said for Mason’s experience trying to get birth control.
Like a lot of people, Mason had more than one reason for wanting to use birth control. They wanted to stop their menstrual cycle because having a menstrual cycle didn’t align with their gender identity. They didn’t want to get pregnant. They were experiencing low energy and extreme exhaustion whenever they got their period–which happened for 10 days out of every month. It was interfering with their job. Mason took a long time making the decision to get a hormonal IUD so by the time they decided to go through with it, they were ready. Ready to stop experiencing terrible side effects from their period, ready to stop being worried about getting pregnant, and ready to stop having a monthly occurrence that violated their gender identity.
“Once I had made the decision, I accepted that the process would be I would go to my primary care provider, take whatever steps they needed, and then go in and have my IUD inserted,” Mason says. “I didn’t think at all about the option for my insurance company to give me trouble.”
But when Mason went to get their IUD, they were denied. They submitted an appeal letter, and were denied again. The insurance company told Mason that the IUD Mason wanted wasn’t covered, which confused Mason, since they were familiar with the ACA birth control benefit that should’ve allowed them to get birth control with no out-of-pocket costs. A few weeks later, Mason got an official denial letter in the mail. Buried deep in the letter there was one single mention of a requirement for a letter from Mason’s doctor explaining Mason’s medical need for birth control. Mason had never heard of this requirement before–not even during their appeals process four months of back and forth, Mason was finally able to get their IUD covered.
During those four months, Mason continued to experience debilitating symptoms that made it hard to do their job, let alone have a social life. And every month, when they got their period, they were reminded of this discord between their period and their gender identity. “As a trans person, having a menstrual cycle is something that doesn’t align with my gender identity,” Mason says.
In the end, they say: “Even though I work for a very progressive employer and have a very good insurance plan, I still had a lot of difficulty accessing birth control. Things are bound to be way harder for people who have additional obstacles put in their way.”
“It may not seem like much, but I don’t have much income, being a full-time student, and I’m trying to save money to cover the costs of my education as well.”
Rylie | Indiana
“I’m a freshman in college this year, and over the summer my family doctor prescribed birth control for me to help regulate my cycle. My period had never settled into a regular cycle, and after bringing it up to my doctor year after year, she decided birth control would be the safest and simplest way to regulate my cycle. However, since I’m still on my parents’ insurance, which is provided through my mom’s job as a teacher at a Catholic elementary school, birth control is not covered. Because of this, I have to pay out of pocket for my birth control every month, which is around $30 every month. It may not seem like much, but I don’t have much income, being a full-time student, and I’m trying to save money to cover the costs of my education as well.”
“I tried to tell myself the birth control was worth $400, but the more life continued at the time, the harder affording my other payments became.”
“I was 19… and was in a serious relationship at the time. I make pizza for a living. I don’t run a business, I’m not a CEO, I’m no one important. When it was time to consider birth control, I was scared and nervous. Walking into the clinic, I was stressing. You either pay up front, or hope you make the lower income sheet. I didn’t make that sheet, and it hurt. I tried to tell myself the birth control was worth $400, but the more life continued at the time, the harder affording my other payments became. Birth control should be covered by insurance. Period. It’s not only for the use of avoiding pregnancy, or a form of contraceptive. It is a prescription medical drug that helps women with unstable periods, less painful cramping, and helping young girls, and women at any age, to practice safe sex.”
“I absolutely have struggled to afford birth control.”
Abbie | California
“I absolutely have struggled to afford birth control. I struggled with heavy bleeding and cramps each month since I was about 16 years old. My doctor prescribed a birth control pill that was mostly covered by insurance, but my body didn’t react well to it. I had to go on a low-dose birth control pill, which was not mostly covered by insurance. When I switched pills, the cost of my prescription nearly quadrupled. For me, a young person already struggling to afford college and living expenses, that difference in cost was huge.”
“For me, birth control is a medical necessity.”
Allison P. | Washington, DC | Caucasian | She/her/hers | Lesbian
Allison had been on birth control from 2010 to 2013 to help regulate her period, but stopped when she realized she wasn’t taking it regularly enough to effectively regulate her period, and, as a lesbian, wasn’t worried about getting pregnant. “As a queer woman, I don’t need birth control to prevent pregnancy,” she says. So she stopped using birth control altogether.
Two years later, Allison found herself in the hospital. She had been home in Michigan for Thanksgiving when she suddenly started bleeding very heavily, and went to the ER to figure out what was wrong. Allison worked as a contractor at the time, so she didn’t have health insurance through her employer, but as a 23-year-old, was able to stay on her parents’ health insurance for a few more years. The hospital didn’t know what was wrong, and sent Allison home with a low-dose birth control pill to help control the bleeding.
But just a few hours after Allison went home, she passed out. At that point, she went back to the ER, all the while still bleeding heavily.
Hours passed, then days.
The ER continued to give Allison doses of birth control with low levels of estrogens. But Allison’s mom—herself an ob-gyn—knew what Allison needed: birth control with a higher-dosage of estrogen. Still in the hospital, Allison underwent surgery and during the surgery, the doctors inserted an IUD, which finally stopped the bleeding. Over the six days Allison was in the hospital, she received seven blood transfusions to help keep up with the amount of blood she was losing. And in all, her hospital bills totaled $40,000–but thanks to her insurance, she only had to pay $150 out-of-pocket.
Allison says there’s still no clear understanding of what happened, or if it could happen again. She hasn’t had any issues since getting her IUD–but is worried about what might happen if she has her IUD removed and stops using birth control to carry a child, something she hopes to do in the future.
“For me,” Allison says, “birth control is a medical necessity.”
Kelly couldn’t afford the monthly cost of birth control, but she also could not afford to raise a child.
Kelly | New York | She/her/hers | Bisexual/pansexual
“When I couldn’t afford $50 a month [for birth control], a sliding scale fee through a local clinic because I was a college student with NO income, and condoms alone failed, I was responsible for a $600 abortion which required loans from friends and time off from school to work to cover the costs. If I can’t afford birth control I cannot afford a person to support.”
“I didn’t [make a living wage], and there were multiple months that I had to go without my pill”
Kimberly Steinmetz | Indiana | She/her/hers | Straight
“I have had problems getting birth control! In college especially, even at Planned Parenthood, my monthly cost was about $30. It seems like nothing to someone who makes a living wage, which is why it’s so easy to dismiss these stories. But many people don’t make a living wage! I didn’t, and there were multiple months that I had to go without my pill. It threw wrenches in my cycle and hormone level and was unhealthy both mentally and physically, but I had no choice. Add to that the fact that I was not sexually active and only used the pills to regulate my period. If you are naturally anemic, the regulation of your period becomes a lifeline.”
Amber and her husband weren’t emotionally ready to get pregnant again after a miscarriage. But their insurance company wouldn’t cover Amber’s birth control.
Amber* | Caucasian | Midwest | She/her/hers
Amber wasn’t worried about getting pregnant. Her doctor had told her long ago she’d have an extremely difficult time getting pregnant, and, anyway, her husband used protection. So she didn’t use birth control. But then one day, Amber had a miscarriage—discovering, in the process, that she had been pregnant.
Amber and her husband were torn up. They decided they weren’t ready to get pregnant again so soon after the emotional toll they experienced as a result of the miscarriage, and so Amber decided it was time to get on birth control.
But there was a problem: Amber worked as a professor at a religious university in the midwest, and though she shared the same religion as the school, their views diverged when it came to birth control. Amber thought that she, a married woman, should be able to use birth control to prevent another pregnancy as she was grieving her miscarriage. But her university disagreed, as did her insurance company, leaving Amber paying for an insurance plan that didn’t cover the one kind of health care she desperately wanted.
Amber tried to see if there was any way she could get her birth control covered. She talked to a representative from her insurance company, who told her they would not cover birth control. She asked to speak with a supervisor, and was told the supervisor would simply say the same thing. She talked to her university’s HR department, hoping to work out a resolution. Her HR department reiterated that their health insurance plan did not cover birth control for people in Amber’s situation. And Amber talked to her husband, wondering if they should switch to his company’s insurance plan, which did cover birth control—but would have been much more expensive.
In the end, Amber decided to go through with getting birth control—paying nearly $600 for it out-of-pocket. But finding the $600 was no easy task for Amber and her husband–a young couple still paying off all kinds of things, from their mortgage to their cars. And it wasn’t made any easier while feeling like a lesser person as a woman by the way her insurance company and university treated her and her needs.
“Our usual household budget had very little wiggle room, but this was not a luxury.”
Alikina | Colorado | She/her/hers | Bisexual/Demisexual
“In the summer of 2016 it was time to have my IUD replaced. At that time I was married and had been married for several years. I had insurance through my husband’s workplace. I have a genetic condition that would make carrying a child to term and delivering that child physically dangerous for me and the child, and a minimum 50 percent chance of passing this condition, which is painful and difficult to manage, to any genetic offspring. For those reasons and others, I’ve chosen not to have children. When my IUD renewal was due, I made an appointment at my local Planned Parenthood. When I went in, they said they couldn’t serve my needs without a $700 co-pay. To put this in financial perspective, $700 is more than two-thirds of the mortgage payment on the house I lived in at that time. I decided to wait and see if another gynecologist or clinic could help. My co-pays for the required check-up, IUD insertion, and the required check-up afterward came to a bit over $100. $100 was approximately one week of food or me at that time in my life. Our usual household budget had very little wiggle room, but this was not a luxury.”