"Beyond birth control:" the Yaz/Yasmin controversy and the risk evaluation of hormonal contraceptives
Bibliographic record
Abstract
Concerns about the safety of the pill have come to the fore recently, due in large part to the public outcry over deaths allegedly caused by popular contraceptives Yaz and Yasmin. Media reports link the drugs to at least 23 deaths in Canada and over 100 in the U.S. as well as thousands of injuries worldwide, as a result of a purported increased incidence of blood clots. The question of what should be considered an acceptable risk threshold for approved contraceptive pills has been contested by many groups, including regulatory bodies, medical professionals, epidemiologists, and consumers. This thesis provides an in-depth sociological examination of the Yaz/Yasmin controversy through qualitative analysis of stakeholder interviews and content analysis of key medical, regulatory, and legal documents. I examine the most recent safety debates in order to analyze the central phenomena that play a role in the regulation and risk/benefit assessment of oral contraceptives: managing data uncertainty, calculating reproductive risks against ancillary benefits, and the precariousness of informed consent. After an introductory chapter in which I situate the thesis within the larger scholarly conversations on contraceptive assessment specifically and technological risk more generally, the findings are presented in three article-length manuscripts. In the first article, I investigate strategies that regulatory bodies and professional associations use to assure the public of the safety of Yaz and Yasmin. I found that a discourse of pregnancy risks is employed in official risk communication. I argue that this has gendered implications for the development of contraceptives and their risk assessment. In the second article, I explore how pill users who have experienced side effects understand the risks of hormonal contraception and advocate for changes in risk communication and drug regulation. I found that women highlighted the inadequacy of risk information received from both doctors and pharmaceutical companies. In addition, affected users rejected the use of reproductive risk as the primary comparative risk when assessing pill safety. In the third paper, I look at processes through which individual stakeholders measure and debate contraceptive risk. Here, I highlight how contraceptive risk assessment is characterized by systemic uncertainty and doubt. Furthermore, the paper stresses the tough choices that users have to make in a climate of indecision coupled with pharmaceutical companies' involvement in research and marketing. While we know that the history of the pill has been fraught with many debates about its safety, less attention has been paid to the current changing context and how different social actors still contest the measurement and meaning of contraceptive risk. I found that many questions about risks are unresolved or dealt with in ways that create divergence between professionals and affected users. In the concluding chapter, I discuss the sociological implications of my findings, the limitations of this study and potential directions for future research on the evaluation of contraceptive risk. The Yaz/Yasmin controversy has amplified contemporary critiques of the pill. In documenting and analyzing the dynamics of this risk debate, this thesis contributes to a deeper understanding of how the risks and benefits of contraception are currently assessed in the North American context.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".