Later that day, I searched “Crohn’s disease” on the X app and found someone talking about Dr. Ray Peat. I connected with several sick people who were following a Peat diet, and they helped me one-on-one to build a recovery plan. Their instructions — avoid pork and seed oils (polyunsaturated fats), eat raw carrots, take desiccated cow thyroid — saved me. After I ovulate each month, I take progesterone dissolved in Vitamin E oil. The product, Progest-E by Kenogen, is crafted by Dr. Peat’s widow. The first time I took it, my body was so affected by its immediate tempering of estrogen — a key Peat idea is that estrogen is a driver of disease — that I had to lie down.

My muscles, taxed by estrogen dominance, became so relaxed from the progesterone that I could no longer stand. I still take it. The regimen runs for 14 days post-ovulation until I begin bleeding. I pop aspirin, another Peat hallmark, like candy every day. A few times a week, I take a custom blend of Vitamin D and Vitamin K called Estroban from a Washington, DC, cosmetics lab to offset aspirin’s blood-thinning properties. I eat as much red meat as I want, and my gut inflammation is at an all-time low. Three years later, my Crohn’s disease is no more. I will never try a new medication, I will never get surgery, and I will never stop Peating.

My devotion to Dr. Peat is what’s now being called healthmaxxing. It’s an online trend that, along with the intertwined practice of looksmaxxing, is drawing ire from the online Left, Millennials and Gen X specifically. “Why should so many perfectly healthy young women spend their youth tending to their imagined poor health?” The Cut asks. It’s “warped and wrongheaded” to looksmaxx, according to The New Yorker. In these precincts, taking pride in cultivating your health and personal appearance is coded as selfish and indifferent to Palestine, and women interested in healthmaxxing are targets for ridicule. 

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Women are subjected to shame online and offline. A popular Peat poster, Veronica Hoffman, known online as the mononymous Veronica, is the founder of anti-aging and hormone-safe skincare line Aurabiōm. Veronica is dragged across X as a crackpot anti-vaxx lolcow for her insistence that a cortisol-free lifestyle is required to stay beautiful. Others celebrate her and credit her with changing their lives. 

Many “Trust the Science” Millennial and Gen X women have accepted chronic illness as just part of living in an America under siege by people they disagree with. They brand themselves the permanent victims of obesity and mental-health disorders. Lena Dunham, the self-appointed voice of Millennial women, has recently completed press for her new memoir, Famesick. Like Veronica, she publicly diarizes — but instead of discussing health, she discusses her relationship with her fatness and mental illness. Dunham presents obesity as a feminist victory, a rejection of patriarchal ideals of beauty. Non-famous Millennial women watch Girls and read Famesick and see a stunning and brave heroine theatrically parading the medical interventions necessary to correct health issues that shouldn’t have arisen in the first place. Motivated by these negative examples, my generation, Gen Z, has taken health into our own hands.

Americans are sicker than they have ever been. A 2023 article in the journal Current Opinion in Immunology puts the global figure for autoimmune-disease prevalence at 19.1%, up from the approximately 8% estimated by the Centers for Disease Control and Prevention’s Emerging Infectious Diseases journal in 2004. At that time, 78% of those affected were women. Nobody with a medical degree treats this as an emergency, and the Millennial American treats psychiatric conditions as just another personality quirk.

In an inversion of the days of pro-anorexia Tumblr, the internet has become a solution for sick women. If I had not connected with the Peat community on X, I would be dead — because I refuse lifelong, humiliating interventions for my health condition. Substack and X have become places where hyper-online sick women discuss experiences in and out of the medical-pharmaceutical complex. Many of these women conclude that contemporary illness is tied to hormonal disruptions, such as estrogen dominance, thyroid dysregulation, and progesterone deficiency. They believe that nutrition and environmental conditions contribute to these disruptions, and that seed oils, synthetic additives, urban living, artificial light, lack of sunlight, and the psychic stress of New York City or Los Angeles have negative impacts on our bodies. Contemporary life is incompatible with health, and has created a public-health crisis to which women seem to be the most vulnerable.

Lily Sperry, a brand consultant who runs the popular alternative-health Substack Health Gossip, articulates the environmental side of the issue. Sperry has posted on X about living in Chicago and feeling drawn to more rural environments. “Your approach [must] consider the context that you’re operating in — like, are you living in a city, alone in a studio apartment, not getting sunlight? I think those factors should be addressed,” she wrote me in an email. Sperry’s paid-subscriber chat room functions as a nouveau, female-oriented forum for this philosophy: acupuncturists, energy healers, and the alternative-health-curious post threads asking for infrared sauna recommendations, healthy restaurant lists, and product reviews. Women share what has actually moved the needle for them, not what their doctors suggested.

Balancing hormones is the pillar of this movement, which distances itself from looksmaxxing, though both exist in overlapping internet circles. Veronica and others explicitly identify hormonal balancing as the holy grail, first for female health and second for beauty. Hoffman diarizes her wellness routines publicly on Instagram: European travels under red-light chicken lamps, nibbles of the Mexican thyroid medication Cytomel, and aspirin in between. My own Crohn’s is a case study in what hormonal intervention can accomplish. When I began progesterone supplementation post-ovulation, it deleted my symptoms. My inflammation markers sank quickly. I still see regular doctors, and haven’t given up conventional medicine entirely, but I credit my deep remission to my desire to balance my hormones, and not to my yearly $8,560.32 box of Humira.  

Health is a nobler goal than beauty, especially for women, who are labeled vain if they prioritize the latter. But healthmaxxing and looksmaxxing are intertwined, though they’re also polarized thanks to unhealthy (and fertility-destroying) pharmaceutical looksmaxxing approaches practiced by influencers like Clavicular, who takes meth to stay skinny and uses a hammer to reshape his cheeks. Hoffman coined a phrase now printed on hats: “You’re spiking my cortisol and making me less beautiful.” Chronic stress elevates cortisol, which destroys skin, hair, and body composition. Modern female life is a cortisol machine. Taking action against it is both a health intervention and an aesthetic one. 

The Millennial author Tao Lin, one of the earlier adopters of the health-first philosophy, reached similar conclusions via a different route. Like the healthmaxxing women of today’s timeline, Lin took to the internet to determine what was wrong with him, and self-diagnosed with autism and other disorders. His approach is centered on detoxification — first of the body through garlic and bentonite clay (a detoxifying skin mask), and then of the mind by opting for psilocybin over benzodiazepines for anxiety. In Lin’s 2021 autofictional book, Leave Society, he portrays the protagonist’s healing as a meaningful, spiritual event. 

Still, he says, looks can’t be separated from the overall holistic health approach. “I healed myself to reduce the amount of pain and itchiness and anxiety and depression and autism and other undesirable symptoms,” he told me. However, “most forms of healing make people look better, which can help people motivate themselves to heal themselves, which seems good.” 

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New Mexico podcaster, author, and wellness influencer Chloé Happe frames the movement with characteristic clarity: “The entire basis of alternative health is us calling out into the void, ‘Hey, we’ve really lost ourselves here. How do we find our way back?’” she told me. Happe was raised as a Seventh Day Adventist, a tradition in which health is a religious obligation. The first time she understood that this wasn’t a universal principle, she told me, she was at the state fair with an aunt who hadn’t been raised in the church. Happe, waiting in line for her first hot dog, pointed at an obese man and asked, loudly, why he was so fat. Her aunt was horrified and made her apologize. She felt guilty, initially about the comment, and then about eating the hot dog. “I knew that being fat and eating hot dogs were things to feel guilty about,” Happe says. It’s not allowed in Leftist circles to say so, but she was right.

Ultimately, this has become a political problem. In a scene from Desolation E-Girl, Happe’s debut novel, her protagonist deletes photos of herself wearing a MAGA hat from her X profile because she assumes that it may cost her suitors. For the Left, MAHA-type alternative health-consciousness and Right-wing politics have become almost the same thing, and people are afraid that embracing one means embracing the other. When RFK Jr. joined the Trump campaign, he effectively poisoned the concept of health for most Left-leaning people. Rational engagement with the health question now requires social courage. This, even though many of these impulses — a view of industrial modernity itself as the cause of illness — used to be Left-coded.

What actually drives the healthmaxxing wave is something older than MAHA and even older than the crunchy California Left that RFK channels: a concept as old as the Greeks that beauty is synonymous with health, and that both are good. What’s truly sick is that we can no longer state this without controversy. 

Once seen as a tool of sexual liberation, the Pill is now often spoken of as a pharmaceutical menace, wreaking havoc with female moods and increasing the risk of cancer. It was first rolled out on the NHS in 1961 — for married women, of course. And though still the most popular method of birth-control, its use is plummeting — data published in June last year showed that community pharmacies dispensed 7.2 million items of progestogen and combined contraceptives in 2022-3. In 2014/15, the number was 8.5 million.

A world away from the groans associated with the Pill, there is an enticing optimism to the chatter around the contraception app of the moment, Natural Cycles. To look at testimonies online is to find yourself in the lexical world of the farmers market — words like “harmony” and “rhythms” crop up just as a wrinkling of the nose, an eye roll, follow any mention of the Pill. How good might it be, I think between big rips of a vape, to be free of chemicals?

There are currently three million users, or “Cyclers”. And the Swedish developers claim a 93% effectiveness rate — similar to the Pill — when used correctly. But the app’s effectiveness is in fact disputed, with many women reporting unwanted pregnancies. The NHS says of fertility awareness methods: “If you do not follow the instructions exactly, it is only 76% effective. This means 24 in 100 women will get pregnant when tracking their fertility for a year.” Aside from this, you have to pay for it. I was quoted £69.99/year to use Natural Cycles, or £9.99/month; the Pill is free for us and costs the NHS £11-18 per year. “It takes a bit of privilege to be able to afford to do all this lifestyle stuff,” remarked one friend. “It’s kind of like being vegan.” 

One Cycler friend talks me through the appeal. “The reason I did it was because the alternatives were just shite. I had used condoms for a while and then I was seeing someone who was an absolute arsehole, who refused to use a condom.” The app requires you to take your temperature every day; some looking for more data insights also take a luteinising hormone test — a strip dipped in urine — which indicates when you are about to ovulate.

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The theory goes that your temperature rises in line with ovulation — but it’s far from an exact science. “I’ve been using it for two months and my temperature has not gone up when I’ve ovulated,” says my friend. “Another problem is the temperature is declared void if you’re hungover or if you’ve slept differently (three hours more or less than usual) which for me is quite often.” But, she adds, there is a “huge positive”: “This girl I know has the sweetest boyfriend, and they have both downloaded the app, so he can see her cycle days. I think that’s a really sweet aspect of it.”

The app’s effectiveness seems secondary to the lifestyle it implies: one of responsible, communicative relationships, control and modernity. Thinking about my past relationships, I’m not sure I’d want someone to be able to cross-reference my bouts of irritation or friskiness with charts on their phone. But might the dividend, a feeling of purity, be worth it? One hormone-free friend tells me: “I love being in touch with my body and knowing when my period is coming. Obviously if I get pregnant, I’ll probably feel differently but so far it’s been working really well for me, and I love how it feels more natural.”

I can understand this desire. Like most women I know, I’ve been through the ringer. The day after I lost my virginity, a woman in Boots told me with full confidence that I was almost definitely pregnant and had to take the morning-after pill. I fainted from the shock and found myself lying in a side room with my legs in the air, with my best friend trying not to laugh. Then I was put on the combined pill Rigevidon, the architect of so many teen crises. I would cry hysterically, rage at my poor boyfriend, break out in a rash of chin spots. A year on, I got the progesterone-only arm implant. But when I wanted it removed, three years later, muscle had grown so tightly around it that the lady in the UCL sexual health clinic had to spend a good five minutes trying to jimmy it out with a scalpel, blood streaming down the left side of my body. When my hormones went back to normal, I couldn’t cope. I was so used to synthetic interventions that I couldn’t hack being without them. So I came full circle, returning to the chemical embrace of the good old combined Pill.

And the funny thing is, my experiences are very much at the less dramatic end. Almost every straight woman my age is walking around with about 10 years of contraceptive crises behind them — pregnancy scares, alien discharge, battered sex drives, fizzing rage. 

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One explanation for Gen Z’s particular aversion to the Pill might be its much-touted sexlessness. Much has been made of “puriteens” — who are now entering their monastic mid-twenties. Over the weekend, I asked one pal why on earth she wasn’t using any contraception. “Because I don’t have sex,” she said. “It’s like a solstice,” she conceded. “Bi-annual.” She has high standards, she added. “And men are disgusting” — an afterthought.

The poisonous dating scene may be all the contraceptive we need. It also dampens hopes of a male Pill — if there even was one, would women trust them to take it? Probing further, the common refrains emerge. “I’ve never met a penis that’s worth the risk.”

Most women I speak to also cite cancer concerns. I can pinpoint the exact moment my circles started fretting about this — the publication of an Oxford study in March last year, which showed progestogen-only contraception raised the risk of breast cancer by up to 30%, an effect which disappears a year or so after you stop taking it. The extra cases of breast cancer amounted to eight in 100,000 for those in their late teens, and 265 in their late 30s. In other words, there will be just 0.008-0.265% more cases of breast cancer because of the Pill. The only new information in the study was that the risks of progestogen-only contraception were similar to those of the combined Pill — stats which had been known about for decades. But the ripples of panic among women I knew (and myself, before I looked into it more) were completely out of proportion. 

It cannot escape us that a generation so accepting of the considerably greater risks of gender-affirming hormones is so worried about those of the Pill. This tells you, I believe, how ideological the use of oral contraceptives actually is: in a cishet context, synthetic hormones are symbolic of the lack of parity between the sexes (“I feel slightly hard done-by as a woman that we’re expected to take drugs that could potentially harm us when men get off scot-free,” says one friend); for a gender-dysphoric teenager, they are framed as a revolutionary tool.

The final nail in the coffin may, I believe, be the mood changes associated with the Pill. “Instantly when I took it my libido was just zero,” said a friend. “I came off the patch by accident when I was travelling and once I got back I noticed I was a lot less anxious — despite being at quite a stressful point in life,” said another. Another tells me: “I was on all sorts of hormonal contraception for over 10 years and I’ve been doing the pull-out method for a year now. When I first came off the patch this weird dark cloud lifted off me that I didn’t realise was there and had been for years. Like I was basically a little bit depressed all the time without knowing.” I am well aware of the rollercoaster of synthetic hormones — by turns euphoric, terrifying, nauseating, lurching. I have three sisters, and suspect that the stratospheric teenaged dramas in our house at least partly originated in some pharmaceutical lab.

Politically, the Pill has always been grist to any mill going — a cypher for social malaise. Its liberating potential is a big topic in the manosphere — it variously frees men from the apparently oppressive strictures of monogamy or allows women, formerly wiping baby-sick from chins at home as they should, to sail through workplace hierarchies and tread on men’s prospects. In feminist circles, its emancipating qualities have been linked to a casual sex culture which ultimately disadvantages women. While I know this to be true, I think what gives men the desire and ability to pick up and cast aside partners has to do with more than just pharmaceuticals. 

What will really sink the Pill, though, is not its cancer risk, mental health impacts or effectiveness — but its susceptibility to the swirl of ideologies that swamps modern women. It has become synonymous with self-fashioning; do you identify as a feminist, are you sex-positive, are you a health nut? Are you a Catholic, are you a witch, are you a femcel? Any one of these labels has a corresponding stance on the Pill. What was once a question of being liberated or not has been swept up in the thousand atomised tribes of modern identity politics. We have forgotten how hard-won reproductive rights are, and look with disdain on many of the women who fought for and secured us those rights in the Fifties and Sixties, and whose views we now deem outmoded. Fragmentary feminism is at risk of forgetting where it came from.  

It matters greatly if the Pill falls out of fashion, because in a world where abortion rights are ever more precarious, we need to be on our guard about contraceptive trends — fuelled by exaggeration, misinformation and purity fantasies, they may in fact land any one of us with an unwanted pregnancy. In the sweep of history, having sex without having a baby has only recently become an option — and it may not be forever.

I don’t regret a thing. We millennials would risk pretty much anything to have carefree sex — even our waistlines. A new generation of women, however, is not so keen. They aren’t wild about the acne, mood swings, weight gain, heavy bleeding and migraines that are associated with hormonal contraceptives. According to Tik Tokers, those side-effects are now thought to extend to anxiety, depression and even suicidal thoughts. So while taking the pill used to be something of a rite of passage, now women are coming off it in droves.

Part of the problem is there just isn’t much reliable scientific research into why different contraceptives cause different reactions. For most women, finding your contraceptive is like embarking on a blind taste test of various pills, injections and contraptions. Information about how contraceptives work is hard to find and often mystifying. We’ve long known the pill wasn’t perfect.  It was described by Elizabeth Siegel Watkins in 2001 as the “least unsatisfactory choice in contraception for American women”. And the “father of the pill”, Carl Djerassi, predicted back in 1989 that “new approaches to birth control – for example a male pill, a once-a-month menses inducer, and an antifertility vaccine – cannot be realized before the next century”. In fact, he said, choice is likely to become more limited, pointing to “an informed and highly motivated group of women [who] strongly criticised the pill while emphasising their abhorrence at male domination.” This middle-class feminist politics resented the idea that women would have to endure side effects to prevent pregnancies and questioned the idea that science might enable women’s sexual freedom.

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Yet over 70 years since the pill was first synthesised, he has been proved right. In an article echoing Djerassi, Nicola Thorp wrote in 2018 that the “contraceptive industry is institutionally sexist“. She asked why it was that women were expected to “try different methods until they simply give up and are forced to accept the least painful side effects”? And she also makes the case that if women don’t take action, nothing will change. And today, women aren’t pushing for  an improved formulation, with fewer side effects or greater efficiency. Quite the opposite, in fact, the idea of scientific “meddling” with our bodies and medicalising health is increasingly eschewed by younger generations and nowhere more so than in the already fraught world of women’s reproductive health. 

The change has been drastic. NHS data for women accessing sexual-health services in 2022-2023 shows the number of women using “natural family planning” to prevent pregnancies has doubled in ten years and the number choosing oral contraceptives has plummeted (down from 429,600 to 126,400 in a decade). It’s only a snapshot but the data does align with trends we’re seeing elsewhere. Natural Cycles, the non-hormonal contraceptive method of choice for celebrities and influencers, is now so popular it boasts over two million users and has been cleared by the FDA in America.

“I’m not convinced dressing up age-old methods, like the rhythm method, in snazzy new apps is the reproductive utopia fem-tech companies want us to believe it is,” says Dr Rebecca Steinfeld, an expert in the politics of reproductive justice. “They all romanticise a past when people lacked access to revolutionary, literally life-saving innovations like modern contraception, effective pain relief in labour, safe surgery in birth, and life-sustaining formula milk,” she says. And what many pill-critics don’t like to admit is that “natural” techniques are much less trustworthy. “I felt colossally naïve,” said one user who got accidentally pregnant while on Natural Cycles, “I’d used the app in the way I do most of the technology in my life: not quite knowing how it works, but taking for granted that it does.”

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This return to “natural” or non-medical methods of contraceptives and the boom in digital period tracking does point to an interesting shift in discussions about women’s bodies. Much of what informs the criticism of the pill today is the idea that hormonal contraceptives prevent women from feeling “in touch” with themselves. No longer simply a practical issue of how to overcome a biological hurdle, methods of contraception feed into the idea of a woman’s sense of self. 

For a new small-c conservative wave of feminists, it’s also a political tool they wish to dispense of. The pill, they claim, messes with our bodies and with our agency: the pill isn’t a means to allow women sexual freedom, but a political green flag to allow men to behave like animals. This form of reactionary feminism might find most of its fans in young conservative men hoping for a more straight-laced style of womanhood, but it does suggest that for many on the right, the pill remains a symbol of degeneration in women’s virtue, honour and virginity.

“Conflating scientific innovation and patriarchal control is a problem,” Steinfeld tells me, “the two are not synonymous. Even if pharmaceutical companies are still predominantly owned by men or obstetrics originated as a male-dominated profession, why does that make the pill a tool of the patriarchy? Throwing the baby out with the bath water springs to mind.”

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Obviously, not all women take such a deterministic view. And many don’t have the luxury of experimenting with natural family planning. As a consultant in sexual and reproductive healthcare in deprived areas of the country, Jane Dickson tells me that there are plenty of women still “actively seeking effective contraception”. Obviously, she says, “women looking for the more natural methods tend to be from more affluent sectors of society who have done a lot of research themselves”. Working-class women tend to be more interested in preventing a catastrophic unwanted pregnancy than feeling their “real self”. 

This new brand of introspective, nature-knows-best feminism is failing women. Instead of demanding that the medical establishment comes up with quicker, cheaper and better ways for women to manage their bodily functions — and allowing us to enjoy our lives as unencumbered as men — we seem to be fetishising the very things that might hold us back. While those who wished to hold women back in the past claimed that we were ruled by our bodies, ironically it is now feminist campaigners calling for period leave, denouncing the pill and claiming that women are more anxious than men. This trajectory could have grave consequences for women’s freedom, reintroducing the idea that our bodies should change the way we operate in the world.  Regardless of how you fell about the pill, this should worry women everywhere.

It’s not exactly subtle. And it’s not exactly misguided, either: in the Fifties, when Dr Gregory Pincus began testing an early prototype for the pill, his test cases were incarcerated, institutionalised, and impoverished women. In other words, women whose incapacitation and economic despair made them easy to take advantage of. It was a deplorable measure, in a desperate time: funding for birth-control research was banned by the US government until 1959, so Pincus’s work was supported by private donors, whose advocacy was directly downstream from an unsavoury enthusiasm for eugenics. For those funding the research, the pill represented a way to keep the wrong people from procreating. For the doctors who created it, the pill was an exciting scientific challenge.

That it would eventually emerge as a vehicle of female sexual liberation, one of the most socially important breakthroughs in medical history, was something neither party anticipated. While women’s bodies and biology were central to the science of the birth control pill, women themselves — not only the ones who served as guinea pigs, but also the ones who would eventually choose to take the pill — were treated as something of an afterthought. Pincus rather infamously wrote off his patients’ self-reported side effects — that same litany of problems featured on McCall’s wild spinning wheel — as the “psychogenic” products of an overactive imagination.

In short, McCall is right to suggest that the ubiquity of the birth control pill has come at the expense of women’s ability to express their concerns about it. And with Pill Revolution, she seems poised to usher in a new age of pill-related controversy: one centred on health concerns.

In this, she is unlike early critics of the pill, who were, of course, far more concerned with sexual morality than women’s wellbeing. Hormonal contraception has long been a source of consternation amongst conservatives, particularly the religious variety, who see it as a facilitator of consequence-free sexual intercourse. That loathing has little to do with the pill specifically — and more to do with a categorically antagonistic relationship toward non-procreative sex of all kinds — but it proved markedly influential in the public conversation about birth control.

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For me, that influence was most clearly visible in the form of abstinence-focused sex education programmes, which were ubiquitous in American public schools in the Nineties — including the one I attended. Among other things, these classes were an exercise in institutionalised slut-shaming. Often, a piece of lint-covered Scotch tape would be brought out as a visual representation of how premarital sex ruined a woman’s ability to bond with her eventual husband. And with the primary goal of discouraging teens from doing it, the instruction we received in reproductive science verged on intentional disinformation. Girls, it was understood, were so wildly and indiscriminately fertile that just looking at an erect penis from across the room might result in pregnancy.

Birth control, meanwhile, was described as unreliable at best. Often, these programmes would tout inflated failure rates for various contraceptive methods — without ever mentioning that these numbers included pregnancies which resulted when a couple had birth control available but hadn’t actually bothered to use it. The pill, we were warned, was less than 90% effective — and that was assuming you could get past the stigma of being the kind of trollop who needed to take it in the first place.

The point, of course, was not education, but intimidation: to scare you away from sex until you were married and ready to procreate, at which point you would not be bothering with birth control. The conservative hostility to the pill rumbled along in the form of abstinence programmes and purity culture for years before reaching its contemporary apotheosis in 2012. After the US government moved to provide birth control to all women free of charge, Rush Limbaugh infamously suggested that women who supported this measure were akin to prostitutes demanding other people’s money so they could have sex.

But Limbaugh’s outburst was a swansong for the Right-wing war on contraception. And the new backlash against the pill, as embodied by programmes such as McCall’s, is fuelled less by conservative pearl-clutching about hook-up culture, and more by renewed concerns over its side effects — a full-circle return to the issues that plagued the pill in its infancy.

Among women who believe that the birth control pill has had a deleterious effect on their physical or mental health, there’s a palpable sense that the medical establishment has behaved irresponsibly, foisting powerful pharmaceuticals on them while dismissing their doubts as nonsense. “As young women, we’re just chucked on the pill and expected to get on with it — but when we go back with concerns, you don’t feel like you’re being heard,” McCall says, echoing a sentiment that comes up repeatedly throughout Pill Revolution. A few years ago, Sarah E. Hill’s book about How the Pill Changes Everything made a splash with similar points.

Whether you agree with their broader points or not, the women making this case are responding to decades of gaslighting by the medical establishment. McCall explains during her program that the weeklong break many women have from their birth control cycle each month is not medically necessary, but rather a product of the Fifties-era desire of scientists to create a contraceptive product that would not raise the hackles of the Catholic church. What she doesn’t mention is that it was also meant to quell the doubts of women themselves: when Pincus realised that the progesterone in his prototype pill would cause the complete cessation of the body’s normal menstrual cycle, he suspected women would find this alarming. His prescribed regimen — three weeks of hormonal contraceptives followed by one week’s worth of placebos — was designed to cause a monthly drop in hormone levels, resulting in the shedding of the uterine lining. It’s not a real period, but it looks and feels like one, creating the illusion that the body’s natural processes remain unaltered. If this mollified the Catholic church, it also sold women a bill of goods about the true impact of the pill on their bodies.

Two things are true. First: hormonal contraception has been unequivocally a tool of female empowerment. It gives women an unprecedented and invaluable level of control over their fertility, and, by extension, their lives. Second: the utility of the pill for women in general does not mean that it is right for every woman individually. And in the mad rush to celebrate hormonal contraception for the world-changing invention it is, some women have been silenced, and side-lined.

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If the pill has been absurdly demonised by its detractors as the purview of “sluts” and “prostitutes”, its most avid proponents seem to view it with a reverence bordering on the deific. Pill Revolution began to raise alarms within the medical community well in advance of its airing. In the Daily Mail last week, Dr Philippa Kaye wrote that while “I welcome any initiative to promote or improve women’s wellbeing”, she “was left with concerns that women may be alarmed” by the suggestion that the pill might have mood-related side effects. Where the trad movement sees the popularity of the pill as a symbol of society in decline, the progressives among us warn that its disuse would be nothing less than catastrophic.

In an interesting example of the phenomenon the French describe as “les extrêmes se touchent“, people on both sides of this issue seem to take a rather dim view of women themselves — of our ability to manage our lives, our bodies, our reproductive health. The anti-pill contingent, represented by old-school conservatives and tradfluencers alike, suggest that women are so seduced by the illusory freedom of artificially-induced infertility that they become like hedonistic children, squandering their fertile years on meaningless hook-ups and breakneck career advancement at the expense of society at large. Even more progressive sceptics — including the growing TikTok movement of self-described hormone coaches who advocate for #naturalbirthcontrol — seem to believe that women are so hopelessly manipulated by Big Pharma, and addled by contraceptive hormones, that they’ve lost all connection with their bodies.

And yet, the pro-pill side isn’t much better when it wrings its hands over the notion that women might choose not to take the pill and, hence, get pregnant. As if pregnancy is something that happens to women out of nowhere, without their knowledge or consent. As if they couldn’t possibly be trusted to weigh the costs and benefits of hormonal birth control and decide accordingly if they wish to use it.

Much is made in these conversations of the fact that so many pregnancies are unplanned — 45% in America, up to 30% in the UK — in a way that reminds me, oddly, of the way my high school sex ed programme used statistics to persuade us that birth control was futile and untrustworthy. These numbers raise the terrifying spectre of a world in which millions of women are giving birth to children against their will, eliding the fact that unplanned and unwanted are not necessarily the same thing. It’s hard not to notice that the tone of these debates — especially when they dovetail with the bigger, hairier question of women’s reproductive rights in general — has a way of crossing the line between staunchly feminist and outright anti-natalist.

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By Victoria Smith

As a woman still of an age to be at least ostensibly concerned about birth control, I personally still find the anti-pill folks more off-putting, whether they’re purity-obsessed religious scolds who want to scare and shame women away from having non-procreative sex, or the contemporary “RETVRN TO TRADITION” ones with a fetishistic fixation on women’s fertility.

And yet, I’m not convinced that certain pro-pill types — the ones whose vision of liberated womanhood seems to begin and end with free birth control and company-subsidised egg freezing, the better to avoid the pesky workplace interruption of a ticking biological clock — are the heroes we need, either. The loudest voices in this conversation leave little room for a middle way, one that empowers women to avoid pregnancy if they want to, but also supports them if they wish to become mothers.

No doubt the people who want to keep women puttering away in cubicles during their peak childbearing years believe that they’re offering a better, more feminist vision than the ones who want to keep them barefoot and pregnant. But both groups are ultimately seeking the same end: to exert control over women’s fertility, and by extension, over their destinies. On this front, at least, Davina McCall’s Pill Revolution is a welcome entry into the debate: a call for more research, more education, and better options for women than the one-size-fits-all contraceptive regimen favoured by medicine and society alike.

The topic of birth control has never not been fraught, but it has also long been dominated by men, whether they’re scoffing at women who complain of side effects or screaming at them for being sluts. Perhaps this new controversy — one that originates with women themselves and prioritises their concerns — represents something more than another skirmish in the contraceptive wars; perhaps it’s a way forward.