Six Things I Learned From Being a Birth Control Counselor.

Like many sex educators I know, my very first sex ed gig was taking part in my undergrad university’s peer education program. Getting the training and the opportunity to deliver sex ed was a powerful experience for me and a real boost to my career as a sex educator (penis costume notwithstanding).
One of the key responsibilities of being a peer educator was providing one-on-one sexual health counseling for students at the University’s health center – many of them young women wanting to start using birth control. Since the doctors and nurse practitioners at the health center had little time to spend with patients, my role was to educate the “clients” about their options beforehand. I had the time to ask questions about their lifestyle, sexual activities, preferences, and what would be convenient for them. Then I’d present them with options, so that they could better lead the discussion with their doctor about their healthcare decisions.
I credit a lot of valuable lessons learned to this experience, but here are the six that seem to come up over and over again.
1. There is no one right type of birth-control for everyone. I was often asked what was the “best” birth control method, as if a one-size-fits-all approach applied to contraception. Unfortunately, that’s a bit like asking what is the “best” variety of music or food. A method that works for one person might be terrible for another, and one person’s side effect (like having your periods stop) can be another person’s benefit. And that’s totally okay. But it does highlight the value of really thinking about your needs, wants, and priorities so you can find the one that’s “best” for you.
2. Having choices is powerful. In the counseling sessions, I’d often start by asking a few preliminary questions like “Do you feel comfortable taking a pill every day?” or “Are you interested in a hormonal or non-hormonal method?” After narrowing it down to a few options, I’d bring out the demonstrator models. Clients could play with an IUD, feel a pack of birth control pills, or practice putting a condom on a wooden shaft. These usually caused giggle fits at first—but most people eventually told me that they’d not previously had the opportunity for hands-on explorations of these methods. Many also gave the specific feedback that they felt much more comfortable talking about these choices after our sessions.
3. People don’t talk about sex enough. It sounds like a funny thing to say when “SEX!” is splashed across every billboard, magazine cover, and movie screen that hits your eyeballs. Some would say (and some do) that if anything, we talk about sex “too much.” But when I say that people don’t talk about sex enough, I don’t mean in a Justin Bieber-in-a-brothel sort of way. I mean useful, accurate, and genuine conversations about people’s sexual health and sexuality. Several of my clients mentioned that they had no one in their life with whom to talk about such stuff. As we know, communicating about sex is important. It can also feel awkward, and I’ve made it my mission in the work that I do to facilitate more spaces where meaningful sex conversations can happen.
4. Healthcare literacy is crucial. Even for the educated, mostly middle- to upper-middle-class clients I served as a peer educator, navigating the process of getting contraception was seldom straightforward. Many of us are uncomfortable asking our doctors comprehensive questions. When the conversation relates to sex, this communication can be even more difficult. In the work I did, it became clear to me that there’s a skill set to build around having effective, beneficial relationships with healthcare providers. Naturally, a single consultation wasn’t going to magically dispel a client’s embarrassment and make them feel effortlessly empowered. But I do think that the spaciousness of time that the consultation format provided helped contribute to their personal education about how to advocate for their sexual health.
5. People come with sex ed baggage. More often than not, clients would express displeasure with how little sex ed they’ve received up to this point. Some even had intense anger about it. I heard plenty of stories about sex-negative “sex education” happening in their previous schools, much of which was shame-based or filled with misinformation. Occasionally, I’d spend a significant part of the session just listening to the client talk about her feelings about what a crap deal she’d been given in terms of sex ed. The instruction they received in school left many feeling invalidated, embarrassed, or patronized. Learning how to clarify myths in a way that wasn’t condescending was a key part of my role.
6. You’re never too old for sex ed! There’s a good reason why school-based sex ed gets so much attention: it’s vital, under-resourced, and faces a ridiculous amount of resistance to its implementation. But grown-ups need sex ed too. I’ve done most of my teaching with people in their 20s, and what I’ve learned is that many of them have the same questions that under-18s have—it’s just (usually) more applied, and less theoretical. But sex information messages targeted to adults often don’t address these questions; instead, they’re about mastering “techniques” and “tricks” to “drive your partner wild.” I’d argue that this focus on sex “mastery” can make adults feel unnecessarily inept when asking basic questions or expressing curiosity about their sex lives—not to mention perpetuating the myth that all people are alike in what makes sex good for them. Honest, realistic sex ed for adults can help remove this barrier to acquiring new and valuable information.
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Since people know this is something I’ve done in the past, even today I’ll get the occasional request from friends-of-friends for Skype consultations about choosing contraception (particularly IUDs). Even if you’re not a sex educator (peer or professional), being a person to whom your friends can turn when they have sex questions can be a powerful thing. You don’t have to have all the answers, but listening and giving permission that it’s OK to talk about these things is an important step toward making the world a more sexually healthy place.