A federal program is collecting a trove of intimate monthly birth control data on hundreds of thousands of patients, many of whom are teens, including the results of mandatory pregnancy tests.
. But the iPledge program continues to stand alone in its invasiveness and obstructiveness, and there hasn’t been any apparent justification for why a program like iPledge must exist when other drugs linked to severe birth defects don’t have a similar system.
I was on Accutane myself for most of 2019. When my dermatologist told me about iPledge, I laughed her off – I have a mechanical heart valve, so I physically can’t carry a pregnancy to term anyway. My cardiothoracic surgeon had a serious conversation with me before proceeding with surgery, ensuring I wasn’t planning on having biological children and making me aware that.
As a patient, being on Accutane and complying with iPledge felt menacingly paternalistic. It is condescending to be treated as though we can’t be trusted to understand and manage our medical treatment’s risks and side effects. It is wildly uncomfortable to submit information about our sex lives to the government every month.
It’s not as easy as not taking Accutane, either. It’s a drug of last resort for a type of acne that is particularly obstructive and painful, let alone cosmetically frustrating. The side effects, including severe dry, cracked skin, extreme sun sensitivity, and potential vitamin A toxicity, are incredibly annoying and can even be dangerous.
I’m lucky; I’m done, my skin looks great, and I don’t have to tell the FDA what backup birth control I used last month. But hundreds of thousands of patients still have to comply with the iPledge system. Young women and young AFAB people shouldn’t have to sacrifice their reproductive data privacy rights to get medical treatment. We do not ask patients to do this in any other setting; asking them to do it here is wrong and baffling.
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