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Rural adolescent pregnancy is a serious public health issue, largely due to low contraceptive use. Existing data focuses on urban populations. Using a positive youth development framework, we examine associations between modifiable protective factors and birth control use in a rural population. Prior to an evidence-based health education program, students in 10th grade health class in two low-to-middle income rural schools completed surveys. For contraceptive use at last sex, students could check all methods that applied which were collapsed into three rank-ordered categories: none, condoms only, and hormonal contraception. Predictor variables included sexual self-efficacy (six items, α = 0.66, "able to say no"), parent connectedness (five items, α = 0.94, "satisfaction with your parent/guardian?"), language acculturation (one item, "in your home do you speak..."), school connectedness (five items, α = 0.85, "I feel close to people at my school") and adverse childhood experiences (eight item score). These variables were entered into a multivariable logistic ordinal regression. The sample (N = 287) was 52% female, 48% LatinX and 49% white. Higher sexual self-efficacy and parent connectedness scores significantly increased the odds of using more effective birth control. Higher language acculturation (more likely to speak another language at home) suggested less likely to use more effective birth control. School connection and adverse childhood experiences were not significant in the final model. Contraception focused interventions in rural communities should address modifiable protective factors, such as self-efficacy and parent connection. Interventions need to be trauma-informed and language accessible. [ABSTRACT FROM AUTHOR]

Direct democracy has come to the forefront of the abortion debate. Since Dobbs v. Jackson Women's Health Organization, the seismic Supreme Court decision overruling Roe v. Wade and Casey v. Planned Parenthood, a number of high-profile ballot measures about abortion have drawn both public attention and substantial turnout. The result in every such election since Dobbs has favored the pro-choice side, even in some culturally conservative states. Surveys of public opinion in the wake of Dobbs suggest that there is significant support for abortion rights and opposition to highly restrictive laws in most states. This misalignment between public opinion and abortion law is precisely the circumstance that direct democracy, and especially the initiative, is well situated to mitigate. Yet, paradoxically, precisely where direct democracy seems most needed, it is being most aggressively resisted by legislative opponents of abortion rights. In this Article, I examine this paradox, along with the reconfigured countermajoritarian difficulty that has emerged since Dobbs. It is now state legislatures in many states, and not courts, that are frustrating democratic resolution of abortion policy. All of this suggests the need to recalibrate institutional debates about abortion. [ABSTRACT FROM AUTHOR]

Many female military service members choose to use hormonal contraception to prevent pregnancy and/or to control or suppress menses. Hormonal contraception, which comes in many different forms based on dose, estrogen/progestin type, and route of administration (oral, vaginal, transdermal, implant, intrauterine device, injectable), may cause side effects, some of which can influence military medical readiness, or the health status necessary to perform assigned missions. This expert review summarizes the evidence around common military-relevant side effects of hormonal contraception that could impact readiness, including effects on weight and body composition, bone health, psychological health, and physical performance, and serves as a tool for uniformed and civilian clinicians counseling female service members about hormonal contraception. Current evidence suggests some hormonal contraception can lead to weight and fat gain, may modulate susceptibility to mood or mental health disorders, and could impact bone mineral density and stress fracture risk; more research is needed on physical performance effects. Clinicians must be familiar with readiness considerations of each type of hormonal contraception to provide comprehensive patient education and allow for optimal shared decision-making about hormonal contraception use among female Service members. Considering the relative lack of data on the effects of nonoral hormonal contraception routes on readiness outcomes and the growing interest in long-acting reversible contraceptives among female service members, future research should continue to investigate effects of all hormonal contraception methods available to service members. [ABSTRACT FROM AUTHOR]

Human rights are almost inseparable from the contemporary commonsense notion of civilization as a morally superior state of human society. In this article I argue that they are equally central to the concept of civilization as a reversible process of increasing social interdependence and cohesion as theorized by Norbert Elias. However, according to the theoretical statement included in the introduction to this special issue, the civilizing effect of human rights is accompanied by their inseparable decivilizing potential. Which of the two will be the stronger in any state of global human figuration depends on two principal factors: the resilience of human interdependencies (especially the prospects of widening the circles of intergroup identification) and the strength of centrifugal forces in the figuration, constituting a reduction of integrative effects of human rights and increasing their disintegrative influence. By tracing the emergence of global legal governance of abortion within the framework of human rights, I focus specifically on one aspect of it that is crucial for the interconnection of civilizing and decivilizing effects in this case: the status of the right to abortion law between women's rights and human rights, and, by extension, the relationship between women's rights and human rights in general. Drawing on the much-cited work of Norbert Elias and John L. Scotson, I the established-outsiders dynamics behind the old debate on whether women's rights are human rights or not, the consequences of which keep reverberating until today. [ABSTRACT FROM AUTHOR]

BACKGROUND: Several countries nowadays and in the past face a birth rates below replacement level. To what extent should the fertility of this shrinking population be increased during a given planning period such that it approaches stationarity at the end as close as possible? Both immediate adaptation to the replacement level as well as delaying it to the end of the planning period are suboptimal. METHODS: Distributed parameter optimal control theory provides an appropriate tool to ascertain the efficient intertemporal trade-off between costly birth control and zero population growth. RESULTS: It turns out that the optimal adaptation rate of the net reproduction rate (NRR) balances between unacceptable adjustment costs for fertility and huge deviations of the terminal age composition from the desired stationary one. The optimal adaptation rate is monotonically increasing with a curvature that depends on the growth rates of the NRR, the fertile population, and the value of newborns. CONTRIBUTION: The paper analytically characterizes the shape of the transition to a stationary population in an optimal way. [ABSTRACT FROM AUTHOR]

Fuelled by nationalism and Catholicism, the wartime Slovak state, a client state of Nazi Germany, aimed to promote population growth by forcing the return of women from public to private life and supporting Slovak Christian families, but also by stigmatizing and restricting any sexuality that was not reproductive. Under these circumstances, where women were shamed for not having enough children, all previously per- mitted methods of birth control were banned, and abortion was criminalized. One of the few remaining options for controlling one's fertility was a clandestine abortion. By examining files that document the criminal persecution of women who underwent abortions, this work aims to track alternative family planning practices, and thus the development of a loosely organized clandestine abortion network. It then examines the possibility of understanding abortion as a form of women's opposition to political and ideological aims to hinder their freedom of choice. At the same time, the article suggests that women's agency of this kind challenged the patriotic imperative to become a mother as well as the hegemonic narrative and idyllic picture of Slovak motherhood. [ABSTRACT FROM AUTHOR]

In 2022, HRA Pharma announced that it had submitted a long-awaited application with the Food and Drug Administration (FDA) to switch Opill to over-thecounter (OTC) status. This was the first time that a drug company had filed such an application. Efforts to "f~ee the pill" from the prescription began almost thirty years earlier. In 1993, the FDAproposed holding an open public meeting to discuss making the pill available over-the-counter. But pharmaceutical companies were reluctant to take on the challenge to make an oral contraceptive available OTC. The challenge was assumed by the Oral Contraceptives Over-the-Counter Working Group, founded in 2004, now called the Free the Pill coalition. Their goal was to make an OTC oral contraceptive that was affordable and accessible. This article explores their nineteen-year-long effort that has grown into a movement. The recent overturning of Roe v. Wiide has added a sense of increasing urgency to their effort to bring an OTC oral contraceptive to market. [ABSTRACT FROM AUTHOR]

This article traces the history of Straight Talk, a sex education curriculum introduced into US. high schools in the mid-1980s. Straight Talk was sponsored by Ortho Pharmaceutical, who offered the program as a "public service" to combat the socalled epidemic of teenage pregnancy that had inspired panic on both sides of the political spectrum. In fact, Straight Talk was part of a campaign to promote Ortho's newest product: the low-dose, multiphasic pill Ortho - Novum 7 /7 /7. Drawing on media reports, curricular materials and public relations (PR) documents, I argue that Straight Talk is a prime example of shadow marketing" in the pharmaceutical industry, in which companies use PR strategies to skirt regulations on direct-to-consumer advertising. While on the surface Straight Talk looked like a typical comprehensive sex education curriculum, its bias toward the Pill-in particular, the low-dose multiphasic pill-belied Ortho's claims of neutrality. The curriculum's promotion of the Pill also came at the expense of other contraceptive methods, such as the condom, a troubling omission in the age of HIV/AIDS. [ABSTRACT FROM AUTHOR]

In 2022, HRA Pharma announced that it had submitted a long-awaited application with the Food and Drug Administration (FDA) to switch Opill to over-thecounter (OTC) status. This was the first time that a drug company had filed such an application. Efforts to "free the pill" from the prescription began almost thirty years earlier. In 1993, the FDAproposed holding an open public meeting to discuss making the pill available over-the-counter. But pharmaceutical companies were reluctant to take on the challenge to make an oral contraceptive available OTC. The challenge was assumed by the Oral Contraceptives Over-the-Counter Working Group, founded in 2004, now called the Free the Pill coalition. Their goal was to make an OTC oral contraceptive that was affordable and accessible. This article explores their nineteen-year-long effort that has grown into a movement. The recent overturning of Roe v. Wade has added a sense of increasing urgency to their effort to bring an OTC oral contraceptive to market. [ABSTRACT FROM AUTHOR]

This article traces the history of Straight Talk, a sex education curriculum introduced into U.S. high schools in the mid-1980s. Straight Talk was sponsored by Ortho Pharmaceutical, who offered the program as a "public service" to combat the socalled epidemic of teenage pregnancy that had inspired panic on both sides of the political spectrum. In fact, Straight Talk was part of a campaign to promote Ortho's newest product: the low- dose, multiphasic pill Ortho-Novum -1 /-lj7. Drawing on media reports, curricular materials and public relations (PR) documents, I argue that Straight Talk is a prime example of"shadow marketing" in the pharmaceutical industry, in which companies use PR strategies to skirt regulations on direct-to-consumer advertising. While on the surface Straight Talk looked like a typical comprehensive sex education curriculum, its bias toward the Pill-in particular, the low-dose multiphasic pill-belied Ortho's claims of neutrality. The curriculum's promotion of the Pill also came at the expense ofother contraceptive methods, such as the condom, a troubling omission in the age of HIV/AIDS. [ABSTRACT FROM AUTHOR]

Copyright of Antíteses is the property of Universidade Estadual de Londrina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: People in Western countries are increasingly rejecting hormone-based birth control and expressing a preference for hormone-free methods. Digital contraceptives have emerged as nonhormonal medical devices that make use of self-tracked data and algorithms to find a user's fertile window. However, there is little knowledge about how people experience this seemingly new form of contraception, whose failure may result in unwanted pregnancies, high health risks, and life-changing consequences. As digital contraception becomes more widely adopted, examining its user experience is crucial to inform the design of technologies that not only are medically effective but also meet users' preferences and needs. Objective: We examined the user experience offered by Natural Cycles—the first digital contraceptive—through an analysis of app reviews written by its users worldwide. Methods: We conducted a mixed methods analysis of 3265 publicly available reviews written in English by users of Natural Cycles on the Google Play Store. We combined computational and human techniques, namely, topic modeling and reflexive thematic analysis. Results: For some users of digital contraception, the hormone-free aspect of the experience can be more salient than its digital aspect. Cultivating self-knowledge through the use of the technology can, in turn, feel empowering. Users also pointed to an algorithmic component that allows for increased accuracy over time as long as user diligence is applied. The interactivity of the digital contraceptive supports mutual learning and is experienced as agential and rewarding. Finally, a digital contraceptive can facilitate sharing the burden of contraceptive practices or highlight single-sided responsibilities while creating points of friction in the required daily routines. Conclusions: Digital contraception is experienced by users as a tamed natural approach—a natural method contained and regulated by science and technology. This means that users can experience a method based on a digital product as "natural," which positions digital contraceptives as a suitable option for people looking for evidence-based nonhormonal contraceptive methods. We point to interactivity as core to the user experience and highlight that a digital contraceptive might allow for collaboration between partners around contraceptive practices and responsibilities. We note that the user diligence required for the digital contraceptive to provide accurate and frequent data is sometimes not enough. Future research could look at designing (and redesigning) digital contraceptives with primary users and intimate partners, enhancing the experience of tamed naturalness; exploring how trust fluctuates among involved actors and in interactions with the technology; and, ultimately, designing more inclusive approaches to digital contraception. [ABSTRACT FROM AUTHOR]

This study examined the role of women's education in birth control in Rwanda from 1995 to 2000. It was conducted in four provinces, including Kigali City, using a survey questionnaire to collect data using a descriptive methodological approach. The population size is estimated to be 1067 n, comprised of women aged 15 to 49. Results indicated that younger women with fertility desire between 2-3 children are 75.07%; the rural area cohabitation rate among college students is 37.82%, while the Western model cohabitation in urban areas and universities is 19.23%; and contraceptive use is 46.3% among young women and 72.34%; among married women. Therefore, there was a significantly higher correlation between women with a high level of education and a lower fertility desire, which resulted in an increase in the age of first marriage. [ABSTRACT FROM AUTHOR]

In this paper, I argue that living with no or few children and low fertility was widespread in pre-industrial societies. After a critical discussion of demographic transition theory and the concept of "natural fertility", I investigate fertility in early modern Europe. In doing so, I follow the suggestion of "cultural demography" and combine quantitative and qualitative research. I show a great extent and many variations of deliberate birth control before the "fertility decline" took place. This finding should help to see the actual level of fertility as less exceptional and dramatic than it is often claimed. [ABSTRACT FROM AUTHOR]

The Supreme Court decided Box v. Planned Parenthood of Indiana and Kentucky in 2019. Justice Clarence Thomas’s opinion in the case claimed there was a direct connection between the legalization of abortion, in the late 20th Century, and the beginnings of the birth control movement a full three quarters of a century earlier. “Many eugenicists,” Thomas argued, “supported legalizing abortion.” Justice Samuel Alito highlighted similar claims in Dobbs v. Jackson Women’s Health, citing a brief entitled “The Eugenic Era Lives on through the Abortion Movement.” That brief was an echo of Justice Thomas’ misguided attempt at history in the Box opinion. Similar claims reoccur in Judge Matthew Kacsmaryk’s opinion in the Texas mife pristone case, Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration. These false claims are the focus of this article. There is no evidence that early leaders of the eugenics movement supported abortion as part of the movement for birth control. It is accurate to describe those leaders as anti-abortion, and their followers as people who condemned abortion for moral, legal, and medical reasons. [ABSTRACT FROM AUTHOR]

Copyright of Revue d'Histoire Moderne & Contemporaine is the property of Societe d'Histoire Moderne et Contemporaine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The prevention of unintended pregnancy was identified as a primary prevention strategy to reduce Zika-related adverse birth outcomes during the 2016-2017 Zika virus outbreak. The Centers for Disease Control and Prevention in partnership with local health agencies conducted formative research to guide the development of culturally appropriate messages and materials to increase awareness of the prevention of unintended pregnancy as a strategy to decrease Zika-related adverse outcomes in American Samoa and the Commonwealth of the Northern Mariana Islands (CNMI). Nine focus groups (N=71) were conducted with women and men aged 18-44 years living in American Samoa and CNMI. Semi-structured interview guides were used to explore participants' knowledge and perceptions of Zika, family planning, and contraception; barriers and facilitators to access contraception and use; and information sources and contraception decision-making. Trained staff from local organizations co-moderated each focus group. Thematic analysis was conducted with NVivo 10. Participants had mixed knowledge about Zika virus and its relation to pregnancy and birth defects. Women and men had varied knowledge of the full range of contraceptive methods available in their jurisdiction and identified barriers to contraceptive access. Social factors including stigma, gender roles, and religion often deterred participants from accessing contraceptive services. Participants highlighted the need for culturally appropriate and clear messaging about contraceptive methods. Results demonstrate the feasibility of conducting formative research as an effective strategy for understanding community perspectives on unintended pregnancy prevention in the context of the Zika virus outbreak to develop health communication materials. [ABSTRACT FROM AUTHOR]

Background: Over-the-counter levonorgestrel emergency contraception (OTC EC) is safe and effective but underutilized for postcoital pregnancy prevention. Unnecessary restrictions imposed by pharmacies and pharmacy workers may impede EC uptake.Objective: To assess the persistence of age- and gender-based barriers to OTC EC access among pharmacists and pharmacy staff across Los Angeles, CA.Methods: We conducted a cross-sectional survey of registered community pharmacies randomly chosen from regions with the highest unintended pregnancy rates in Los Angeles County. Using an adaptation of the 2017 American Society for Emergency Contraception EC Access and Price Survey, we interviewed pharmacy staff about their attitudes and practices related to OTC EC, with attention to age- and gender-based barriers.Results: We surveyed 139 staff members (45% pharmacists, 20% technicians, 26% retail) from 93 publicly accessible pharmacies. Thirteen pharmacies did not stock EC. Half of respondents cited age-based restrictions; only 4% noted gender-based restrictions. More than 75% reported being asked for EC by a man; 7% reported refusing to sell to a man. Nearly 40% reported that men never or rarely purchased EC. Pharmacists were more likely than technicians or retail staff to believe men rarely purchased EC (P = 0.01). The most frequently cited concern about selling to men was inability to confirm the female partner's age.Conclusion: Although gender-based restrictions to EC are rare, more than half of pharmacy staff continue to report age-based restrictions. Inability to verify the female partner's age may underlie cases where men are unable to purchase OTC EC. [ABSTRACT FROM AUTHOR]

Objective: To report on long-acting reversible contraception (LARC) experience and continuation rates in the Adolescent Medicine LARC Collaborative.Study Design: LARC insertion data (682 implants and 681 intrauterine devices [IUDs]) were prospectively collected from January 1, 2017, through December 31, 2019, across 3 Adolescent Medicine practices. Follow-up data through December 31, 2020, were included to ensure at least 1 year of follow-up of this cohort. Continuation rates were calculated at 1, 2, and 3 years, overall and by Adolescent Medicine site, as were descriptive statistics for LARC procedural complications and patient experience.Results: Implant and IUD insertion complications were uncommon and largely self-limited, with no IUD-related uterine perforations. Uterine bleeding was the most frequently reported concern at follow-up (35% implant, 25% IUD), and a common reason for early device removal (45% of implant removals, 32% of IUD removals). IUD malposition or expulsion occurred following 6% of all insertions. The pooled implant continuation rate at 1 year was 87% (range, 86%-91% across sites; P = .63), 66% at 2 years (range, 62%-84%; P = .01), and 42% at 3 years (range, 36%-60%; P = .004). The pooled IUD continuation rate at 1 year was 88% (range, 87%-90% across sites; P = .82), 77% at 2 years (range, 76%-78%; P = .94), and 60% at 3 years (range, 57%-62%; P = .88).Conclusions: LARC is successfully provided in Adolescent Medicine clinical settings, with continuation rates analogous to those of well-resourced clinical trials. Uterine bleeding after LARC insertion is common, making counselling imperative. Future analyses will assess whether the medical management of LARC-related nuisance bleeding improves continuation rates in our Adolescent Medicine patient population. [ABSTRACT FROM AUTHOR]

Several recent studies revealed that women with disabilities often receive inadequate or no reproductive and sexual health counseling and care, partly because healthcare professionals do not ask. [ABSTRACT FROM AUTHOR]

Independent community pharmacies are in a unique and powerful position to promote public and individual health in their communities. Independent pharmacies are particularly important in rural communities where there are few chain pharmacies and accessible health clinics. West Virginia received national attention recently when they opted out of the Federal Pharmacy Program collaborating with CVS and Walgreens and developed their own plan for COVID-19 vaccine distribution and administration, heavily relying on independent pharmacies and the infrastructure they already have in local communities. However, in other areas of public health with urgent, unmet need, such as pregnancy prevention, there is considerable room for independent pharmacies to improve. The pandemic has allowed independent pharmacies to shine during the vaccination effort and has demonstrated what can be accomplished when policymakers, providers, and pharmacists work together for the benefit of community health. Expanding such collaboration to include contraceptive provision and counseling in a timely, nonjudgmental manner could play a pivotal role in preventing unintended and unwanted pregnancies. [ABSTRACT FROM AUTHOR]

Objective: A study on the sexography of Mahatma Gandhi (1869-1948) that remain scattered in his books, brochures and voluminous letters was attempted. The focus of this appraisal is not on what Gandhi did, but on what he wrote and spoke about human sexual behavior. Methods: Gandhi's oeuvre (books, brochures, and pamphlets) available in print as well as correspondence and speeches available in digital version of Collected Works of Mahatma Gandhi were searched. Those items which indicated an appropriate sexuality theme were studied. Results: Gandhi had acknowledged that he was familiar with the writings on sexuality by Havelock Ellis ad Bertrand Russell; but, he had not read any of Freud's works. His primary focus of activism in sexography was that coitus other than for the purpose of procreation is sin. He was also against the promotion of 'artificial' birth control methods and promoted self-control as the alternative. Despite criticism from his concerned followers, in mid 1930s and 1940s, Gandhi practiced shunamatism and considered it as a reliable experiment for his concept of brahmacharya. Conclusion: Whereas in 1927, Gandhi defined 'brahmacharya' simply in 12 words as 'control of the senses in thought, word and deed', after 20 years in 1947, his meaning of 'brahmacharya' expanded to 115 words that included 'emissions', 'lying naked with naked women' and 'making progress towards God'. [ABSTRACT FROM AUTHOR]

Half of people capable of becoming pregnant reported difficulty accessing contraception in June and July 2020. Most attributed their delays to the COVID-19 pandemic, a new study of 1,525 New York state residents revealed. [ABSTRACT FROM AUTHOR]

Copyright of Collegium Antropologicum is the property of Croatian Anthropological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Clinicians can do more to improve contraceptive and sexual education for patients with disabilities, including youth. A big first step is acknowledging patients are interested in healthy intimate relationships, and sometimes also in preventing pregnancy. [ABSTRACT FROM AUTHOR]

Village orphans’ family fate and financial situation is a largely unexplored topic in Central European literature. In my study, I aim to reconstruct the history of the orphans in Ormánság, a South Transdanubian microregion known for its early deliberate birth control. In addition to registry data, the marriage contracts of widowed and remarrying parents, as well as the orphan documents of the estate provide an insight into the development of 19th-century orphans’ situation. Through the sources, we learn about the proportion of orphans, the operation of family systems and forms of community assistance. By focusing on the histories of certain families, we learn about the typical variants of provisions and the order between the options, from the mostly favourable solutions to the rarer less favourable ones. Taking into account the birth control practices prevailing in the region, we can see that, unlike in Western Europe, there is less of a tendency for children to be circulated as farm hands in this region, and instead, their early integration into the family estate is much more common. In addition, mosaic families created through remarriage retained a strong sense of being a “farming unit”, which is also reflected in the fact that the contracts were mostly favourable, and also restrictive, to both the stepparents and the children. Unlike western examples, the prospect of cohabitingwith the stepparent was held out even after the biological parent’s death, as long-term planning could mean the most sensible economical investment for family members. In the interpretation of the phenomena observed in the region, it is important to note that it is situated in the eastern band of the Hajnal line, thus it possesses both western and eastern characteristics. [ABSTRACT FROM AUTHOR]

Millions of Americans carry the pro-life torch into the next generation, yet most are unaware of the pioneers who founded the movement fifty years earlier. This paper looks at three pro-life scholars from the pre-Roe v. Wade era: law professors Robert Byrn, John Noonan, and Charles Rice. All three were life-long Catholics and arrived at their pro-life convictions through the prism of their faith. Each constructed legal arguments by which abortion could be rejected. Citing court cases, the history of English common law, the historical underpinnings of the Fourteenth Amendment, and evidence from science and medicine, all three carved out solid positions opposing abortion. There were differences among them though, primarily over the link between artificial birth control and abortion. Yet, all three made succinct critiques of the Roe decision. Regrettably, while they endorsed a constitutional human life amendment as the only means to protect the unborn, they mistakenly believed that appealing to science and American law would sway members of Congress. [ABSTRACT FROM AUTHOR]

The Affordable Care Act mandated that employers provide contraceptive coverage to workers at no cost. In July, the U.S. Supreme Court allowed a Trump administration regulation to let employers with religious or moral objections opt out of the mandate. [ABSTRACT FROM AUTHOR]

Copyright of Clio. Femmes, Genre, Histoire is the property of Belin Editeur and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Bulletin of Medical History is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The field of transgender health continues to expand rapidly, including research in the area of family planning. While much attention has been given to fertility preservation and the parenting intentions of transgender individuals, far less has been paid to pregnancy prevention and contraceptive needs of people along the transmasculine gender spectrum (transgender men and gender-nonbinary persons who were assigned female at birth). Existing research illustrates that many clinicians and transmasculine individuals falsely believe that there is no risk of pregnancy while amenorrheic. These studies also show inconsistent counseling practices provided to transmasculine persons surrounding contraception and pregnancy while falling short of providing robust clinical guidance for improvement. Clinicians report a lack of adequate training in transgender reproductive health, and consequently, many do not feel comfortable treating transgender patients. The aim of this publication is to consolidate the findings of these prior studies and build upon them to offer comprehensive clinical guidance for managing contraception in transmasculine patients. To do so, it reviews the physiologic effects of testosterone on the sex steroid axis and current understanding of why ovulation and pregnancy may still occur while amenorrheic. Gender-inclusive terminology and a suggested script for eliciting a gender-affirming sexual history are offered. Common concerns (such as the effects on gender dysphoria and gender affirmation) and side effects of available contraceptive methods are subsequently addressed and how these may have a unique impact on transmasculine persons as compared with cisgender women. Lastly, a model is provided for approaching contraceptive counseling in the transmasculine population to assist clinicians and patients in determining the need for and selection of the type of contraception. To center transmasculine voices, the development of this publication's guidelines have been led by reproductive care clinicians of transgender experience. [ABSTRACT FROM AUTHOR]