What The Hell America!

Cara Stanton didn’t get her period until she was 22. For years, doctors — including her pediatrician — recommended taking hormonal birth control to kickstart it. But Stanton was hesitant. 

“If something doesn’t make sense to me, I question it,” said Stanton, now a 32-year-old nurse practitioner based in Michigan. “It was just one of those things where I thought, ‘I don’t know that my ovaries are broken, so quit trying to put a bandaid on them.’ 

When she was 10, Stanton was diagnosed with anorexia nervosa. She grew accustomed to frequent medical treatment and was chronically underweight. She also said she wasn’t too worried about a late period because her mother, aunts and grandmothers all got their first periods in their late teens.

“There’s so much of the woman’s cycle that we just suffer through because there’s no answer,” Stanton said. “Doctors are taught to just put us on birth control to take away symptoms, like a catch-all thing that may or may not work.” 

Despite her hesitation with conventional medical care, Stanton said she wanted to become a nurse because she was inspired by those she met while getting treatment as a child. She loved learning about the human body and wanted to help people. But she remains skeptical of many of the ways mainstream medicine approaches the reproductive system, a skepticism — reinforced by her Catholic faith — that now informs her politics.  

She’s been a fan of Robert F. Kennedy, Jr. for years — long before President Donald Trump appointed him to head the Department of Health and Human Services, as he shifted his very public work as an environmental attorney to that of a self-proclaimed public health crusader and Democratic, then independent presidential candidate, then Trump supporter. It was on Kennedy’s recommendation that Trump nominated Casey Means, an opponent of hormonal birth control, to surgeon general.

In the late 1960s, a Supreme Court ruling made oral contraception widely accessible for married couples, and three years later, the Roman Catholic Church responded with a document reaffirming its position condemning artificial contraception and encouraging the scientific study of natural fertility cycles. While the use of birth control grew — about 20 percent of American women between the ages of 15 and 29 were using oral contraceptive pills as of 2017, according to CDC data — some Catholic women still avoided it. Now others are joining them, though some experts worry that rise has gone hand-in-hand with misinformation. 

Means is a wellness influencer who dropped out of her medical residency to instead practice what’s known as “functional medicine,” a growing alternative medical field that focuses on finding the root cause of chronic health conditions, often utilizing untested or disproven modes of clinical evaluation. Her nomination, which requires Senate confirmation, has drawn opposition, in part because she lacks an active medical license. The Center for Science in the Public Interest called her “unqualified,” in part because of her public comments on hormonal birth control. 

“We just shut [the female hormone system] down and say there’s no repercussions for that, which I think gets to a larger issue, which is a disrespect of life,” Means told right-wing media figure Tucker Carlson in the fall. 

Means’ opinions about birth control are reflective of a larger dynamic at play among many American women, who are finding a home in Trump’s party after feeling dismissed by doctors over questions about hormonal birth control. Hormonal birth control is generally considered safe, with similar risk levels to common over-the-counter drugs like Tylenol and Advil and with lower risks of adverse health outcomes than pregnancy itself — all factors that led to one version of the birth control pill being approved for over-the-counter use in 2023. But still, women have questions about what these medications and devices might mean for their health generally —  concerns that are often waved away by health care providers who point to the efficacy and safety rates and stop there. Which means that when these same women often take these questions and concerns elsewhere — namely, the Internet. 

There, they’re finding influencers like Means, and others without any medical training whatsoever, as they explore alternative, non-hormonal means for fertility management. While this space has long been dominated by Catholic women, it has expanded, creating a MAHA-to-MAGA pipeline.  

When Stanton was trying to figure out her period and fertility health, she felt dismissed by doctors as time and time again they offered solutions without thinking about the root of the issue. She turned to alternative solutions and read PubMed. It led her to a certification from Fertility Education and Medical Management; she now instructs women how to monitor their own health and fertility using biological signs and empowers them to make decisions about their own medical care. She says it’s helped her have a baby and manage an autoimmune disease. It also, Stanton says, helped a client get pregnant. 

Many of the techniques — monitoring cervical mucus, taking urinary tests and charting menstruation — used in these alternative methods have been used for years by Catholics practicing natural family planning (NFP), a form of pregnancy planning that forgoes the use of any kind of medication or devices like IUDs or implants. These methods are often used to both achieve and prevent pregnancies.  

Katherine Dugan, an associate professor of religion at Springfield College who is currently researching Catholics and family planning, said NFP is having a moment — and way beyond the circles of Catholic women who were early on the scene. 

“I can interview Catholics studying NFP and my hippie friends living off the land, and they are saying the exact same things about birth control and the importance of fertility health for all health,” Dugan said. “This Venn diagram is now a circle where they do the same action for different reasons.”

Dugan points to recent research that indicates that young Millennials and older Gen Z women are the first generation of women since the birth control pill became legalized who are trending away from using it. “An increasing number of women are sketch on the pill,” she said.

Many of those same women see the medical establishment as synonymous with the Democratic Party — and are finding more openness to their questions among the new right. 

Catherine Pakaluk, an associate professor of political economic thought at The Catholic University of America, explains that the current conversation around birth control is political and can often translate into voting. As skepticism about birth control expands, reaching increasingly larger, and more secular, groups of Gen Z women, “all of a sudden, this group of young Catholic women feels very vindicated.” 

This feeling of rightness about wanting, and needing, to explore alternate methods to hormonal birth control is “fueling this almost triumphalism,” she said. “They’re like, ‘We’re out to make women healthy again.’ You’re seeing that it’s fueling this sense that there’s some action to take because there are people who may be actually hurt by what is essentially hormonal replacement.” 

Dr. Marguerite Duane, a board-certified family physician, serves as the director of the Center for Fertility Awareness Education and Research at Duquesne University College of Osteopathic Medicine and is an adjunct associate professor at Georgetown University. Duane is also the co-founder and Executive Director of FACTS about Fertility, an organization dedicated to educating medical professionals and students about the scientific evidence supporting fertility awareness-based methods (FABMs), a category of non-hormonal family planning practices that is backed by a growing body of evidence-based research and traces its roots back to Catholic conventions about fertility. 

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Duane underscored that hormonal birth control methods — from birth control pills to long-acting reversible contraceptives like IUDs and implants — are effective and that clinicians are trained to prioritize effectiveness. But she said she also has seen in her own practice the way that the pursuit of efficacy has left many women with real health concerns dismissed.  

It’s why she says she is so committed to her work. Though she understands that many of these methods have connections back to faith-based practices, most notably Catholic ones, she stresses that it doesn’t matter where the method derives from when it comes to providing the best and most holistically minded care for women who too often find legitimate health problems ignored by doctors looking to only manage symptoms. “Our focus is on reaching the medical professional that all they learned was birth control, they may have heard of this but think it’s just a Catholic thing — but ovaries are not Catholic.”

Duane said she sees a real information gap when it comes to women’s lived experiences and the information they receive from medical professionals, with patients routinely telling her they have been made fun of by doctors when they’re doing things even as basic as charting their menstrual cycles. “We need to understand where people are coming from, and for women, this is a common experience. And so women find that their doctors don’t know the answers and so then they search elsewhere — and there are people on the internet and social media who offer potential solutions,” she said.  

A 2023 study that appeared in the journal Health Communication found that 74 percent of YouTube influencers who spoke about birth control encouraged discontinuation of hormonal forms. A study done the following year found the same among 50 percent of TikTok influencers who talked about hormonal contraception. Research indicates that when women between the ages of 18-29 perceive an influencer as having greater expertise, the more likely they are to use non-hormonal birth control options. And many of these influencers currently discussing hormonal contraception do not have medical training of any kind and may be passing on incorrect, incomplete or harmful information.

Duane is planning a virtual conference in October through FACTS as a mechanism for bringing more people who are in this space into contact with evidence-based research. “For the influencers out there, we encourage them to come and learn more about lifestyle factors like nutrition and sleep on fertility,” Duane said. 

Shannon Leach, a nurse practitioner based in Washington state, has more than 20,000 Instagram followers. Her posts include tips on how nutrition impacts women’s health and advice for women with irregular cycles. A self-proclaimed “infertility warrior,” Leach said she only discovered FABMs when a physician gave a talk at her clinic about cycle tracking and body literacy and mentioned the work being done by FACTS About Fertility, Duane’s organization. She said she immediately looked up the website and became a member. 

“I feel like this is an area where people are desperate for the right information,” Leach said. 

Leach knows firsthand how birth control isn’t always going to fix the problem. During her junior year of college soccer, her cycle stopped. She was prescribed hormonal birth control, but it didn’t bring her period back. She was later diagnosed with infertility and told in vitro fertilization was her only option if she wanted to have kids. She wants more people to understand how to be in touch with their bodies and their fertility. 

“When I’m telling all my friends about fertility awareness-based methods or even teaching my 37-year-old cousin about these things, they say this is crazy that we weren’t taught this,” said Leach, who is now 40. 

Leach said she can’t believe she went through her years of nursing education and the grueling in vitro fertilization process, which resulted in the birth of her five children, without hearing about FABMs from any of her teachers, classmates, colleagues or physicians. 

“I have two young girls now, and I am just so excited that I now have this knowledge and can teach them to track their cycles,” Leach said. “They can use that as a means of birth control or to achieve a pregnancy or just to know their bodies and have this awareness and empowerment to know what’s normal and when to seek help.”