Pain and Shame: What Real Life Looks Like in a Religiously-Affiliated Non-Profit Without the Birth Control Mandate

By “Dara:”  Due to concerns about job security the author of this post has chosen to write under a pseudonym.

See all our coverage of the 2012 Contraceptive Mandate here.

Lately the water cooler conversations at my religiously-affiliated nonprofit social service agency have been focused on trying to understand the new HHS contraceptive mandate. My younger, female coworkers and enlightened male coworkers are giddy with anticipation. For as long as any of us have been working here, we haven’t been able to get coverage for our birth control and have even had to struggle to get our employer to cover contraception prescribed for conditions like polycystic fibrosis and dysmenorrhea.

When a coworker with a cancer-causing condition needed contraception, she didn’t know what to do. She couldn’t afford the medication out-of-pocket with her meager nonprofit salary. I called our HR Director on her behalf. It took weeks to get an answer. Meanwhile my coworker couldn’t fill her prescription and her condition got worse. Recently I found out that another coworker has been paying $90 a month out-of-pocket for the contraception she needs to treat her polycystic fibrosis.

HR then told us that we would have to ask permission of the agency’s CEO on a case-by-case basis. It reminded me of when I first got my period at age 12. My cramps were so bad that my pediatrician recommended low-dose contraception. My non-Catholic mother said that my very Catholic father might not allow it and that I would need to ask him for permission. The only difference here is that we are not young girls and the CEO is not our father.

I pursued my coworker’s issue with our agency’s lawyer. She acknowledged that the agency had to cover the contraception in this situation, and she finally intervened and informed HR that they needed to cover it. A year later, I too needed to get contraception for dysmenorrhea, so when I asked for coverage I ended up in battle with a male HR employee that knew nothing about the earlier situation. It was embarrassing to have to reveal my medical condition to him. The ground I thought I covered last year had been lost it seemed, making it a continuously frustrating battle.

When I finally got a clear answer, I requested that the agency develop a protocol and send it out to our thousands of staff throughout the city. They refused.

We’re relieved that with today’s announcement from President Obama, by this time next year, the HHS mandate will allow us to make our own decisions about whether or not to take birth control. We will consult our own consciences, informed by our own health needs, and our own religious and moral convictions, not the religious beliefs of a distant religious figure. As U.S. Sen. Kirsten Gillibrand recently said, “whether or not to take birth control is the woman’s choice, not her boss’s.”


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  • crash2parties

    The Republicans and Catholic Bishops are now talking of pushing for the exclusion to apply to any employer being able to refuse coverage for anything based on the so-called conscience clause.  To anyone who thinks this could never come to pass, or that it can be repealed or its advance fought once enacted, there is a bad precedent.

    Over twenty ago, right wing conservati­ve Jesse Helms added an after-the-­fact amendment to the ADA that prohibited covering transsexua­ls based on his religious conviction that their condition was somehow immoral. That clause was then copied downstream into the Rehabilitation Act and countless other legal documents.  Meanwhile, neurologis­ts (Zhou et all) found the first of many sites in the brain that develop ‘male’ or ‘female’ and showed that trans people’s brains develop opposite expectations. Over the next 15 years hundreds of other studies found a few dozen other brain sites and endocrinol­ogical features confirming Zhou’s original findings. The American Medical Associatio­n passed resolution­s 114, 115, and 122 calling for insurance policies to cover treatment for transsexua­ls. The IRS ruled that the procedures are effective and the expenses are deductible­. And the APA is declassify­ing GID to no longer be a ‘disorder’ but is keeping it in the DSM so that it can be coded for insurance.   In other words, the correct decision based on medicine is clear.

    But because of Helms’ religious values-b­ased amendment, almost every health insurance policy in America to this day has a specific exclusion for the treatment of transsexua­ls (even post transition) based on right wing, fundamenta­list religious values, not medicine or even profit. Many are denied any coverage at all, even for issues that have nothing to do with being trans.  Chances are your policy has the exclusion, if you look.  The HR and coverage situation for most trans people is very like that of the author who works for a religious non profit, except that it applies to most every employer, anywhere.   There are very few exceptions.
    If religious values, no matter how extreme, can be exploited for political gain and our Legislator­s go along with it or worse still, create it, exclusions such as the one for contraception will become commonplac­e for all health insurance.  And like the exclusion for medical coverage of trans people, it will prove amazingly difficult to roll back or work around.