Feature: The Empowerment of The Pill in Korea
Citing health concerns, the Korea Food and Drug Administration might reclassify the birth control pill as a specialty medication after it being an over-the-counter item for over five decades. But what is the real motivation behind the move? The Grand Narrative's James Turnbull examines the contentious issue of The Pill.
Questions difficult to avoid answering in any situation without sounding rude, my young Korean girlfriend really felt put on the spot on this, her very first visit to a gynecologist. Understandably, she wouldn’t visit another until forced to by her first pregnancy.
Two babies later though, my now-wife and I have nothing but praise for all the Korean gynecologists and obstetricians (OBGYNs) we’ve dealt with. Combined with pharmacists no longer lecturing young (read: unmarried) women purchasing the pill from them (although unlike religious pharmacists in the US, they at least still sold them), our own experiences attest that people’s attitudes and professionalism have really improved since my wife’s ill-fated visit 12 years ago.
And perhaps, in general, they have. But as numerous women have made clear this summer, there are still all too many intrusive, insensitive, pushy and just plain creepy gynecologists out there. Patients’ complaints about them include everything from having to explain their reasons for visiting in crowded waiting rooms, to later receiving compliments on how pretty their vaginas look, and how their husbands weren’t as “reckless” with them as most other men would have been. By no means extreme cases, it’s no wonder many women never visit.
This context is crucial for understanding the real-life implications of the Korea Food and Drug Administration’s (KFDA) June 7 announcement of the possible reclassification of the birth-control pill from “ordinary” into “specialty” medication, meaning that it would require a prescription. Because in isolation, the requirement sounds quite reasonable, as OBGYNs would be able to ensure that women a) receive the most appropriate pill for them, b) are fully advised of possible side-effects, c) are made aware of other contraception options, and d) are encouraged to also receive any other needed check-ups during their visits, including pap-smear tests. Whereas in practice, many women are already hoarding pills in reaction to the news, with students and those on low incomes particularly worried about how they will be able to afford monthly consultations. Moreover, it is very questionable whether women’s health is really the main motivation here.
First, because the pill has already been available over-the-counter in Korea for more than five decades, with the third generation, low-dosage versions available today being the safest and most effective contraception available in, well, all of human history. No sudden compelling evidence has emerged to prove them now dangerous.
Second, because directions on how to use them, and warnings about possible side-effects, are readily available on the boxes they come in, not to mention on the Internet. Why women are especially in need of doctors’ guidance on taking these—but not, say, women and men on the far more dangerous amphetamines used in cold medicines—is not explained. And again, there’s no evidence that women are widely “misusing” them, unless taking advantage of them to clear up acne or schedule their periods around vacations and exams is construed as such.
Finally, because it is difficult to reconcile purported concerns about women’s health with the fact that the KDFA would actually be making the morning-after pill available over-the-counter at the same time. Yes, really. And it is common knowledge that there is no medical reason for this strange state of affairs, but rather that it is the result of the KFDA’s compromise between the demands of the Korean Medical Association (KMA) and the Korean Pharmaceutical Association (KPA), which want to have both pills made available only by prescription or over-the-counter respectively.
That is not to say that all OBGYNs and pharmacists are only motivated by money, of course, nor that all complaints about them are valid. Some naive patients report feeling perplexed and ashamed at merely being asked if they were sexually active, for instance, which may be why OBGYNs will usually ask the archaic “Are you married?” instead, and raises the possibility that patients themselves can be responsible for stigmatizing women that have sex before marriage. Also, there’s no real alternative to using stirrups, however uncomfortable and/or humiliating they may feel.
However, it is also true that falling birth rates meant that OBGYNs were already leaving the profession in droves well before the Lee Myung-bak administration (re)criminalized abortion, further depriving them of a source of income, and that the KMA has a long history of scaremongering about easy access to the pill. Consider the following alarmist statement from a July 2009 Korea Times article, for instance, in which then-president Choo Soo-ho claimed that the pill can “result in nausea, weight gain, menstruation pattern changes and depression. Other possible side effects include pimples, stroke, hypertension, cervical cancer, kidney disorder, thyroid disorder and a tumor in the ovary.”
Perhaps it’s no surprise, then, that ironically only 2.5 percent of Korean women actually use the pill, against 20-to-40 percent in most other developed countries. Nevertheless, its current over-the-counter access still represents a genuine—and all-too-rare—source of sexual empowerment for Korean women. Here’s hoping the KFDA won’t take that away when it makes its final decision at the end of August.
James Turnbull’s popular blog, The Grand Narrative, discusses Korean sociology through gender, advertising, and popular culture, and has become one of the leading Internet sources on those topics, with mentions in Time Magazine, The Washington Post and Jezebel.
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