Paper short abstract:

Side effects are a key reason why hormonal contraception is discontinued by a user. However, they continue to be dismissed. How can moving from focusing on contraceptive access and choice to bodily autonomy help to reorientate user-reported data as reliable rather than anecdotal?

Paper long abstract:

When first developed, side effects from hormonal contraceptives (HCs) were overlooked as ‘noncompliance’. After 60 years of use, understanding has not significantly increased, despite side effects being the main reason why an individual may discontinue use. The stratified evaluation of HC side effects became plainly obvious in the midst of the COVID-19 pandemic when the AstraZeneca vaccine was scrutinised for its possible side effect of thrombosis, when the same risk from combined HCs is at least 50 times higher. While studies have rarely considered how social, economic and racial identities impact HC side effect experience, their reference carries assumptions about the uneducated, unreliable and marginalised female user who is more likely to discontinue use. Based on ongoing ethnographic research in the UK, I suggest alternative reproductive futures. My research displays how side effects are unacknowledged by clinicians and society, considered necessary collateral damage to save them from the risks of ‘hormonal’ and ‘reproductive’ bodies, and nullified as side effects are considered to be the result of not having found the right HC. There are a number of barriers to contraceptive access in the UK; however, this research highlights that presumed access does not necessarily improve recognition of side effects. This suggests how our priority on choice and access needs to include bodily autonomy, as exemplified by reproductive justice framework. This framework offers a starting point to consider how anthropologists can provide and present user-reported data in ways that encourage investigation rather than its current categorisation as ‘anecdotal’.