If you have a private insurance plan, such as through an employer or Healthcare.gov, your plan documents should include in-network providers who can perform the surgery, and one may offer partial coverage for an out-of-network provider. If you go this route, you might be billed directly and will then need to seek reimbursement through your insurance company.If you have Medicaid, it’s possible your surgery will be covered, but it depends on where you live. (You can see if Medicaid in your state covers transition-related care here.) As of 2014, Medicare covers medical transition-related surgery.What if I don’t have health insurance?Not everyone seeking top surgery has insurance or can get their carrier to cover their surgery. According to a recent report from the Centers for Disease Control and Prevention (CDC), 31.6 million—that’s almost 10%—of people in the US were uninsured in 2020. Additionally, transgender people face higher unemployment and poverty rates compared to cisgender people which makes them more likely to be un- or underinsured. If you fall into that category, one option is to seek out community funding to cover the cost of the procedure, as well as related costs like transportation and meals while you recover. There are grants you can apply for, such as Point of Pride’s Annual Trans Surgery Fund, the Jim Collins Foundation grant, and others. Another option, though no one should have to do this, is raising money for your surgery using crowdfunding. For help with insurance, check out the legal resources compiled by T4T Caregiving, which includes services that help people get their gender-affirming treatments covered.Does my top surgery need to be “approved” in some way?Between barriers to gender-affirming care (caused by stigma, lack of provider awareness, and other systemic issues) and the administrative process of getting any medical care covered by insurance, pursuing top surgery can seem frustratingly complex. The gatekeeping around who should be allowed to receive gender-affirming care is detrimental and actively prevents people from getting the treatments they need. With that in mind, familiarizing yourself with what’s ahead and knowing how to access resources and required paperwork will demystify the process and make it more accessible. Let’s get into it. First, you should know a few things about WPATH: The World Professional Association for Transgender Health is a professional organization made up of clinicians and researchers working in medicine, psychology, law, social work, counseling, psychotherapy, nursing, and other disciplines dedicated to understanding and treating gender dysphoria. They publish a comprehensive document called the Standards of Care (SOC) that contains clinical guidance for health care professionals who treat transgender and gender-diverse people. Loren Schechter, MD, medical director of the Gender Affirmation Surgery Program at Rush University Medical Center serves on WPATH’s executive committee. He tells SELF that the SOC are intended to be used to “help provide a framework” for how health care providers should offer gender-affirming treatment. One thing the SOC do is make recommendations for what criteria a person should meet before being approved for gender-affirming care, like hormone therapy or surgery. Over the years, WPATH criteria have been criticized by trans and gender-diverse people because of the barriers it can pose to getting treatment. And even though, as Dr. Schechter explains, health care providers and insurance companies are not required to follow the SOC, many do use them for guidance. As a result, your surgeon’s office may require you to meet some (or all) of the criteria for surgery established by the SOC. Unfortunately, many surgeons will not move forward without documentation that certain criteria have been met (typically in the form of a letter from another doctor or a therapist or other mental or behavioral health provider). So what are the criteria? According to the latest update to the SOC (SOC 8, which was released in September 2022), criteria include “marked and sustained” gender incongruence, an understanding of the effects of gender-affirming surgery, identifying and ruling out other possible causes of “apparent gender incongruence,” the ability to consent to surgery, and more. You can see the full list here, but keep in mind that the most important thing to determine is what, specifically, from these guidelines your doctor and insurance company (if applicable) will require in order to have your surgery approved. How can I go about getting the approvals I need for surgery?Some folks have affirming primary care providers and/or therapists who will happily write a letter to a surgeon and/or insurance company as needed stating that a person meets all the criteria for gender-affirming surgery. Others may not have access to health care providers at all, let alone affirming ones. And other providers require you receive specific treatment (like therapy, for example), before they’ll write the letter, and that might not be something you can afford. The good news is that there are some resources that can help fill this gap. The Gender-Affirming Letter Access Project (GALAP) is a group of transgender, nonbinary, and allied mental health providers working to increase access to free letters for trans and gender-diverse people who need them. GALAP’s directory can help you find a provider who has signed GALAP’s pledge that they’ll provide free, accessible documentation and don’t believe in institutional gatekeeping for trans and gender-diverse people. How do I find a good surgeon?First, make sure that any prospective surgeons are board certified in plastic surgery and meet the rest of the criteria listed by the American Society of Plastic Surgeons. Dr. Liebman also recommends choosing a surgeon who has experience not just as a plastic surgeon but with top surgery specifically, who he says “have the best toolbox for multiple different types of procedures to accomplish top surgery.”
I think the pills are so incredibly important as an option for abortion. But I hope people know it isn’t a 1-to-1 substitution. Abortion pills can be very painful, and I feel I wasn’t properly warned about how sick I could get. I thought I could just chill out and cramp it out, but it wasn’t like that at all. I needed support and care, which was luckily available to me.”Alina, 26, she/her“When I found out I was pregnant, I was researching my options, and the medication abortion just seemed a little bit more accessible and easier for me. I liked the idea of being comfortable at home. I wanted to hear about other people’s experiences with medication abortions, but there wasn’t that much available out there (that I could find, at least); I was lucky to have a supportive partner who was able to take care of me, but truthfully, it was a difficult and painful experience in a lot of ways—until the next morning, when I was just tired.I went through Planned Parenthood, and while they do great work, they also gave me a phone number to call if I experienced any worrisome complications, and then it turned out that number wasn’t connected. Honestly, I wish there was a resource I could have called upon in order to explore my surgical options a little bit more.”Amy, 28, she/her“I guess I could have had a surgical abortion. I didn’t even think about that. I think there’s a lot of stigma about the process, but to me, the medication option seemed like what you do earlier in the pregnancy, whereas the [procedure] seemed far more invasive. I’m really vehemently pro-abortion, and my experience is part of that; when I realized I was pregnant, I didn’t tell the person who was the other half of the equation. I knew that it would be potentially a situation where our views differed, so I was like, I’m not sharing this information. I felt really ill, though, because it’s not easy to be pregnant, right? I remember feeling so tired and unable to go running, and even eight weeks along, you can feel the pregnancy progressing and growing. I had this horrible feeling of, you know, I don’t want to be pregnant.When I went to the clinic, I was so freaked out; I was like, oh my God, there are going to be picketing Christians throwing insults at me. Ultimately, though, there was nobody protesting. I remember the waiting being nerve-wracking because I had to come back to the clinic the next day. They ask you all these questions, and I remember them being like, with some trepidation, ‘Are you sure that this is what you have to do?’ I think they have to ask something like that, and I was so enthusiastic, like, maybe inappropriately enthusiastic for the level of gravity that was coming at me. The process of taking the medication was like a horrible, extremely bad period, but they do prepare you pretty well. I knew what to do, but I had no idea what my housemate would have thought was happening at the time.Afterward, I remember immediately feeling so much lighter, so much safer, and so relieved and free. I think a lot of people have a grief experience, or they feel really torn about [having an abortion] or harmed by it, and I get that, but I think I had a very different experience. It was really painful, but in a way that a bad period is painful; in comparison to being pregnant and being fatigued and the pain of an actual pregnancy growing inside you, it was a no-brainer. It was such a relief to be like, I’m not forced into this situation anymore.”These interviews have been edited and condensed for length and clarity. This article was originally published by Vogue.Related:
Jennifer Aniston tried to get pregnant for many years. “It was a challenging road for me, the baby-making road,” the actor told Allure in its December cover story. Aniston opened up about the challenges she faced while trying to have a baby, including intense media scrutiny and unsuccessful rounds of in vitro fertilization (IVF). The rest of us don’t have to face the kind of painful speculation Aniston was up against, but the latter is a reality too many can relate to; the success rates for IVF are about 25% for people between the ages 38 and 40, and just under 13% for ages 41 and 42.“My late 30s, 40s, I’d gone through really hard shit, and if it wasn’t for going through that, I would’ve never become who I was meant to be,” Aniston said, adding, “I was trying to get pregnant.”Remember the many (many) years that Aniston was the subject of a tabloid “bump watch”? “I was going through IVF, drinking Chinese teas, you name it. I was throwing everything at it,” she said. “I would’ve given anything if someone had said to me, ‘Freeze your eggs. Do yourself a favor.’ You just don’t think it. So here I am today. The ship has sailed.”“I have zero regrets,” Aniston, now 53, said. “I actually feel a little relief now because there is no more, ‘Can I? Maybe. Maybe. Maybe.’ I don’t have to think about that anymore.”But there was certainly pain in the past. The hurt of the “Does Jen Have a Baby Bump?” headlines was compounded by “the narrative that I was just selfish,” Aniston said. “I just cared about my career. And God forbid a woman is successful and doesn’t have a child. And the reason my husband left me, why we broke up and ended our marriage, was because I wouldn’t give him a kid. It was absolute lies. I don’t have anything to hide at this point.” Aniston’s five-year marriage to actor Brad Pitt ended in 2005; she was with Justin Theroux from 2011 to 2018 (they married in 2015).As writer Danielle Pergament wrote in the cover story, “We all felt entitled to the cellular happenings inside her uterus. We consumed those headlines, then dropped them in the trash and got back to our lives. But she couldn’t.”Aniston’s frustration led her to write an op-ed for The Huffington Post in 2016, criticizing the media for its fixation on her reproductive status and its treatment of women, generally: “I was like, ‘I’ve just got to write this because it’s so maddening and I’m not superhuman to the point where I can’t let it penetrate and hurt.’”Read the rest of the interview with Jennifer Aniston here.Related:
If you’ve heard it once, you’ve heard it a thousand times, right? Abortion is on the ballot this midterm election season. If you’re feeling a little cynical about this, it’s hard to blame you. I, too, get a panicked fundraising email from Nancy Pelosi at least once a day. But the truth is that the 2022 midterms really are make-or-break for abortion rights in states all over the country.So let’s put Pelosi and the rest of the Congressional Democrats on mute for a second and break it down.In CongressAs long as the Supreme Court remains as stacked in the anti-choice column as it is now, the only way to reinstate the right to an abortion in all 50 states is through Congress; and to do that, we need the Senate. You may remember that the Democrats actually passed a bill in the House of Representatives—The Women’s Health Protection Act—that would guarantee the right to an abortion, but it failed in the Senate because Democrats didn’t have the 60 votes to pass the filibuster and didn’t have the majority needed to overrule the filibuster to pass this bill.Passing legislation would be a big deal, but it’s not the only thing Congress can do to protect abortion rights. A pro-choice majority in the House and Senate might also be able to finally pass the Equal Rights Amendment, which would guarantee equal protection under the Constitution regardless of sex. Technically, the deadline for ratification of the ERA has passed, but what if the Senate just voted to extend the deadline? With equal protection under the Constitution, it becomes that much harder to argue against the right to an abortion for everyone who chooses one.The good news is that, according to FiveThirtyEight and the Cook Political Report, among other polling aggregators and analysts, Democrats have a better-than-fighting chance to not just maintain control of the Senate, but to actually increase their majority. And a big part of that is very likely the Dobbs decision. It turns out, losing the right to an abortion is actually is a very energizing issue for voters everywhere.Governors’ racesBut that’s just national politics. Since the fall of Roe, there are some states where the legal right to an abortion literally hinges on a single election. Per Vox, Democratic governors Laura Kelly in Kansas and Tom Wolf in Pennsylvania have been those states’ last remaining defense protecting abortion rights—and both face tough challenges from Republican candidates. Kelly is up for reelection this year, and Wolf will be replaced either by Democrat Josh Shapiro or hardline, extremist anti-abortion Republican Doug Mastriano.Governors’ races are also vitally important—and terrifyingly close—in Michigan and Arizona. Michigan’s Democratic governor Gretchen Whitmer has repeatedly vetoed the Republican legislature’s efforts to enforce the state’s trigger ban and other abortion restrictions. If Republican challenger Tudor Dixon wins the race for governor, abortion rights might be in danger. In Arizona, Democrat Katie Hobbs is challenging incumbent Doug Ducey for governor. Hobbs has vowed to block further restrictions on abortion, but if Ducey and downballot Republicans win in the upcoming midterms, the right to abortion could all but disappear in the state.State legislaturesState legislatures often get short shrift in national news because they’re small and local, and there are just too many of them for national outlets to name each important one by name. But which party controls the state legislature is vitally important to which laws get passed in each state. Even if you have a Democratic governor, there’s only so much they can do to advance their agenda if the state legislature is controlled by Republicans. In particular, state attorney general races are vitally important when it comes to protecting abortion rights in individual states.Ballot measuresIn many states this midterm election cycle, abortion is on the ballot in a literal sense. According to Kaiser Family Foundation (KFF), a nonprofit organization focusing on national health issues, Kentucky will vote on an amendment to the state constitution to declare that there is no constitutional right to abortion in that state. Meanwhile, Michigan, California, and Vermont are all voting on state constitutional amendments that would expand or solidify abortion rights.This article first appeared on Glamour. To find out if you’re registered to vote, click here.Related:
Regardless of whether you get care through your college, a local Planned Parenthood clinic, or another provider who isn’t associated with your campus, you’ll also probably want to know how your provider handles information you might like kept confidential, like prescriptions for birth control, says Dr. Lincoln. For example, even though you have a legal right to medical privacy, your parents might get statements that show you visited an ob-gyn if you go through their insurance for the visit. Dr. Lincoln says you can ask your provider what types of information the insured party might get in the mail and notes that a Planned Parenthood or campus-based clinic is more likely to be discreet.If you live in a dorm, your resident assistant may also have some answers to your questions about your school’s sexual-health services, including those that are specific to the LGBTQ+ community. For example, at least 149 colleges and universities offer insurance plans that cover hormones and gender-affirming surgeries for transitioning students, according to data collected by the non-profit Campus Pride.And even if you aren’t sexually active at the moment, it’s a good idea to get familiar with the health care services you have available so that you feel comfortable using them if and when you need them. If you have a vagina, it’s particularly important to have a provider to speak to when you suspect that you have an infection, such as bacterial vaginosis, a yeast infection, or a UTI, because you’ll want to get speedy treatment.3. If you want to avoid pregnancy, decide on a contraception plan.Using a condom during sex can significantly reduce your odds of getting an STI or becoming pregnant—with perfect use, they’re effective at pregnancy prevention 98% of the time. But user error is common: In a 2017 analysis of contraceptive failure published in Perspectives on Sexual and Reproductive Health, condoms had, on average, a 13% failure rate over the span of one year. In other words, if you’re having the kind of sex that can lead to pregnancy, ideally, you’ll have a backup method of birth control.Choosing a birth control method can be daunting, though, since there are so many options available, says Dr. Lincoln. Your best bet is to do a little research beforehand so that you have an idea of what method would work best for you. “It’s important to go to legitimate sources, and not TikTok, which can scare you off just about every birth control option,” Dr. Lincoln says. She points out that experiences with birth control that you might see on social media are pretty much like online business reviews, where people only share “if it’s really awesome or really horrible.”Dr. Lincoln recommends FindMyMethod and Bedsider.org as sites to consult as you start your research. Once you’ve compiled a list of pros, cons, and potential side effects for a few birth control options, you’ll be more empowered for a conversation with your provider.4. Understand when to get tested for STIs.STIs can be an unfortunate part of being sexually active. That’s true even if you aren’t engaging in penetrative sex of any kind. If body fluids like saliva, semen, or vaginal secretions are getting swapped, your risk of infection will never be zero, Kristen Mark, PhD, a professor of family medicine and community health at the University of Minnesota Medical School’s Institute for Sexual and Gender Health, tells SELF.
South Carolina Senator Lindsey Graham proposed a federal ban on all abortions after 15 weeks of pregnancy on Tuesday. The move comes just weeks after Senator Mitch McConnell said Republicans were unlikely to propose a nationwide ban like the one Senator Graham just introduced, The New York Times reports, and months after the Supreme Court voted 6-to-3 to take away the constitutional right to abortion.Senator Graham’s proposed bill, the “Protecting Pain-Capable Unborn Children from Late-Term Abortions Act” (a name that is both gross and misleading) would aim to stop so-called late-term abortion—which isn’t a thing. The term “has no medical or clinical significance,” per the American College of Obstetricians and Gynecologists (ACOG); instead, it’s a phrase bandied about by politicians and other bad actors looking to limit access to essential health care and bodily autonomy.Twitter contentThis content can also be viewed on the site it originates from.In January 2021, Senator Graham tried to pass an abortion ban after 20 weeks—despite the fact that about six in 10 Americans believe abortion should be legal in most or all cases—but 15 weeks is even more extreme. The overwhelming majority of abortions, including those performed after the 15-week mark, are safe, the ACOG notes. In fact, people who get an abortion procedure 15 to 23 weeks into their pregnancies usually don’t even have to stay in the hospital overnight. When a person is 15 weeks pregnant, the fetus isn’t fully developed. Ultimately, the health of the pregnant person matters, and they should have a say over what happens to their own body. As the ACOG notes, banning abortion can force some people to carry a pregnancy to term even if it poses a significant risk to their well-being. In addition to putting pregnant people’s health at risk, abortion bans may also criminalize doctors and other health care workers who provide essential, potentially life-saving services.Senator Graham’s bill is in part intended to rally his party around the issue ahead of midterm elections in November—even though anti-abortion legislation is wildly unpopular and led to record voter registration and turnout in Kansas in August, where people made it clear they wanted to keep abortion legal and accessible.
Moore suspects that some anti-abortion lawmakers will eventually try to enact laws that prohibit sending abortion pills through the mail. First-class packages mailed through the US Postal Service are protected by the Fourth Amendment and can only be opened with a search warrant if a postal inspector suspects the contents violate federal law—and abortion pills remain legal under federal law, at least for now.People are accessing telehealth abortion services regardless of where they live.Ultimately, accessing any type of abortion will come down to weighing individual risk as the legal landscape fluctuates state by state. “The biggest issue is going to be the fear these laws instill in people,” Elisa Wells, MPH, cofounder and codirector of Plan C, an advocacy group that researches how people are accessing abortion pills in the US, tells SELF.If you live in a state without restrictions on medication abortion, you can get abortion pills in person from a health care provider who prescribes them. (You can find a list of providers near you at Plan C.) In those states, you can also get abortion pills mailed to you following a consultation with a health care provider through one of many US-based telehealth services, including Carafem, Hey Jane, Choix, and Just the Pill. These providers are almost entirely asynchronous. For instance, with Hey Jane, you don’t have to schedule a phone call but, instead, fill out a medical form and consult with a practitioner using encrypted messaging. The medication usually arrives within three to four days in an unmarked envelope, but you should always confirm these details with your provider as timing may vary slightly with each service.In states where abortion is banned or restricted, some have found possible work-arounds when it comes to telehealth. For example, certain people rent a “virtual mailbox” from a mail forwarding service (such as PostScan Mail) in a state where telehealth abortions are allowed. They then use this address on forms to get pills shipped to their homes without costly travel, Wells says. This way, you’re, at the very least still in touch with a health care provider. (Plan C offers a clear guide for this process.) “When we talk to lawyers, they say everyone appears to be complying with the regulations that pertain to them,” Wells says, adding that authorities may still find other ways to penalize people who use this strategy.AidAccess is another telemedicine option that’s becoming popular, The New York Times reports. The Austria-based nonprofit, run by Dutch physician Rebecca Gomperts, ships abortion pills to you no matter where you live in the US (In fact, research shows the organization received more than 57,000 requests from people in all 50 states between March 2018 and March 2020.) Depending on the state you live in, consultations are done with either a doctor based in the US or a doctor based in Europe. For people who live in states that require a European doctor, the medications are shipped from a pharmacy in India. These pills typically take two to three weeks to arrive, which may be a drawback, depending on how far along you are. Under the Trump Administration, the FDA sent Aid Access a warning letter to cease operations, but the organization refused and sued the federal agency to halt further legal action; it’s unclear whether state or federal prosecutors have plans to place another cease-operations request in the future. (Again, it’s important to research your state’s abortion laws before making any decision.)Will telehealth abortion access be enough in a post-Roe world?While preserving access to abortion pills via telehealth is incredibly important, these pills aren’t a panacea for abortion care in a post-Roe world. Some people prefer to come into a health center or prefer an abortion procedure, which is colloquially known as a surgical abortion, Melissa Grant, the chief operating officer at the telehealth abortion provider Carafem, tells SELF. “Those options should be available,” she says.
Spenser Cattin, 30, has never wanted children and said he first thought about getting a vasectomy eight years ago. He talked about the procedure with his partner, who also doesn’t want children, numerous times over the years, but didn’t take action until October 2021. At that time, Cattin talked to his primary care doctor for referrals to a urologist and had a consultation within the month.In mid-May, Cattin finally scheduled his vasectomy appointment, which coincided with the leaked draft of the decision that overturned Roe v. Wade. Although Cattin had wanted a vasectomy for years, he says the news about Roe solidified his decision. Cattin had the procedure on June 30 (just days after Roe was officially overturned) and publicly shared his experience on Facebook.Below, read Cattin’s story as told to SELF’s associate health director Melissa Matthews. This interview has been edited and condensed for clarity.When the Supreme Court’s draft opinion first came out, there was a thought nagging in the back of my head that said, They came for everyone else, and when they came for me there was no one left to speak out. I felt like I was watching time go backward. Being a cisgender white male, there has never been much of a threat to my bodily autonomy. That was a big part of me wanting to get the vasectomy done sooner rather than later. After the ruling, I was chomping at the bit waiting for my already scheduled appointment to get it done.For me, accountability was a big reason I chose to get a vasectomy. I’ve had conversations with new partners in the past about birth control, but no one has ever asked me if I have had a vasectomy. It takes two people to conceive a child, and all of that responsibility shouldn’t be put on one of those two people. I was also reading that it could become harder for someone with a uterus to acquire certain types of birth control like IUDs. It would almost feel irresponsible not to do something when I felt like having a vasectomy was a simple option.Having the procedure has been eye-opening in ways that I didn’t really expect. My consultation lasted about five minutes, and I only remember being asked if I had kids. In comparison, I know women in their 40s whose doctors told them to hold off on getting their tubes tied in case they want kids. You don’t realize how easy you have it until you get something done really simply and it isn’t available to other people. I wondered why it couldn’t be easy for everyone.On the day of the procedure, I was told that someone needed to drive me to and from my appointment, but no other preparation was involved. I didn’t feel nervous at all. I had more trepidation about taking vacation time off work than I did about having a vasectomy.The whole procedure, from local anesthesia to walking out the door, took about 30 minutes. I went in, was given local anesthesia, and the doctor asked if I wanted a play-by-play of the entire procedure. He was very calm and explained that some people prefer to know every step while others find that worrisome. I’m the type of person who wants to know what’s happening, so the urologist explained the process in detail. He made a small incision on one side, cauterized my vas deferens (the tubes that carry sperm), and did the same on the other side. Then, I put on a jockstrap that contained gauze and was told to wear that for 48 hours, meaning I couldn’t shower for two days. As I was leaving, I felt like a weight was lifted off my shoulders because I no longer had to worry about having kids.
It’s also important to remember that when people aren’t able to access abortion when they need it, they are often pushed much further into pregnancy. “This increase costs exponentially,” says Ghosh. “For many, the increased financial burden will push abortion care completely out of reach.”Nicole, whose insurance plan wouldn’t cover her abortion at the time she spoke to SELF, was just barely able to scrape together enough money by splitting the cost with her boyfriend. Her best advice when it comes to paying for your abortion? “Don’t wait to make your appointment until you have the money,” Nicole says. “Make the appointment, ask how much it is, and you can figure it out from there.” Dr. Minkin agrees. “Once you have decided on an abortion, do start working on scheduling things as soon as you can,” she says. If you wait until you have the funds, you may not be able to get an appointment until you’re already past the window of time when you can legally get an abortion in your state or neighboring states.10. Make a plan to take care of yourself afterward.Plan to take it as easy as possible for a few days following your abortion if you can. Many people will potentially experience side effects like cramping, bleeding, and fatigue after either kind of abortion, Dr. Streicher says, and a medication abortion may also cause potential side effects like chills, fever, nausea, and vomiting, per ACOG. “We tell people to expect that, for 24 hours, you might have some cramping, like severe menstrual cramping,” Dr. Streicher says. “Sometimes bleeding will continue for a week or so.”Stocking up on items like pads, heating pads, and over-the-counter pain relievers can help, Dr. Minkin says. “Alter your exercise regimen a bit,” she adds. “Although you certainly can walk around, don’t plan on a workout at the gym. Do ask your provider when they would suggest you get back to regular exercising. Most will say about a week.”Here’s more information about exactly what might be helpful when you’re recovering from an abortion, including any red flags, like excess bleeding, that signal you should call a doctor. Talk to your medical providers about all of this, too.“I received a concierge level of information from the doctors and nurses about what was going to happen, what to expect, and what to know about something going wrong,” Nicole says. “The doctor, nurses, and staff really handheld me.”It’s a national disgrace that what is at its core a safe and effective routine health care service became an unnecessarily complicated ordeal due to the logistical barriers that stood in Nicole’s way. “It took so much planning and making appointments and confirming them. All that money and time,” she says. “And it was around the holidays … That stuff piles up.”Even with the advantages she had—background knowledge of how things worked in her state thanks to her volunteer work, a supportive partner and friends, a car, financial means, and a flexible work schedule—Nicole, like so many did even pre-Roe, had to jump through far too many hoops to make the right decision for herself and her future.Related:
If you’re currently dealing with a swollen vagina or vulva, it’s understandable to have questions—like, a lot of them. One biggie: How long does it usually take for that swelling to calm down?Unfortunately, there’s no one-size-fits-all answer here. “It really depends on what’s causing it,” Christine Greves, MD, an ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando, tells SELF. “It could be a day or a couple of weeks.” (For your sake, we’ll hope it’s the former.)Unfortunately, the answer might not always be obvious, as there are several issues that can cause a swollen vagina or vulva (including your labia and clitoris). Here’s a breakdown of what might be triggering the puffiness, plus when you need to see a doctor already.Let’s talk about vaginitis, the most likely reason you could have a swollen vagina or vulva.If you have swollen labia and it’s not going away, you probably want to check in with your doctor. While you wait to be seen, here’s what you should know: It’s not uncommon to deal with vaginal and vulvar inflammation in general for a whole bevy of reasons. This is known broadly as vaginitis, an umbrella term for various causes of inflammation or infection of the vagina and/or vulva, according to The American College of Obstetricians and Gynecologists (ACOG).First, there’s noninfectious vaginitis, which is caused by dermatitis, the medical term for skin inflammation, per the Mayo Clinic.Dermatitis—specifically contact dermatitis—typically happens around your vulva or vaginal area when something irritates your skin or causes an allergic reaction.1 The specific irritant in question can vary based on your skin’s sensitivities. When it comes to the vulva and vagina, however, some of the main culprits include soaps, douches, and bubble bath products, Mary Rosser, MD, PhD, assistant professor of obstetrics and gynecology at Columbia University Medical Center, tells SELF. In addition to the swelling, you might notice itching, stinging or burning, or blisters.Here’s some general advice: It’s best to keep anything with fragrance away from your vulva and vagina, period. Yes, even soap, because it might bother the truly delicate skin of your genitals. You actually don’t need to clean your vulva with anything but water, but if you truly feel compelled, use the gentlest soap you can find and try to make sure none gets inside of you, where it can cause more irritation.That said, we’ll walk through some of the most common reasons your vagina and/or vulva might be swollen and irritated, including products you might not even be aware are a problem.Back to top1. Scented tampons or padsScented tampons and pads have mostly fallen out of favor over concerns that they introduce unnecessary fragrances to your vaginal area. But there are still plenty floating around out there disguised under the promise of being “odor blocking.”But Dr. Greves says you shouldn’t fall for this misleading (and stigmatizing) marketing. “You can swell up easily from a scented tampon or pad,” she notes.According to the American Academy of Dermatology (AAD), you might experience irritant or contact dermatitis due to the fragrance in these products, which can lead to a rash, excessively dry skin that peels or cracks, tender skin, burning or stinging, hives, or even blisters in addition to swelling.What to know about treatment: This really depends on how bad your swelling is. For starters, Dr. Greves recommends that you stop using scented tampons and pads ASAP and see where that gets you. “Sometimes the swelling will go away quickly,” Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF.When to see a doctor: If you’ve stopped using scented tampons or pads and your swelling is sticking around for more than a day, Dr. Greves says it’s time to see a doctor, who may prescribe a steroid cream to help resolve the situation. Ditto if you feel like your symptoms are getting worse.Back to top2. Scented laundry detergentLaundry detergent seems innocent enough, but it can definitely wreak havoc on the delicate skin of your vulva, including your labia and clitoris. It’s a similar situation to using a scented pad or harsh soap, some laundry detergents contain fragrances that can irritate your vulva, causing contact dermatitis, Dr. Streicher says.