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You are the first commenter to relate anything like even a secondhand real life experience with oral birth control. This thread (edit: at the time I am posting

You are the first commenter to relate anything like even a secondhand real life experience with oral birth control. This thread (edit: at the time I am posting this) is full of men with little real knowledge of this drug insisting on why it’s reasonable it took 50 years for this to be available OTC. I don’t think the contents of their explanations are likely to be accurate, but I think they still explain why it took 50 years to be approved.

ModernMech 3y ago
Your comment is at the top of the thread, so thank you for pointing this out before I waded further into the comment section. I'm sure you saved me some grief.
SantalBlush 3y ago
This goes for other things on HN, too. If the topic doesn't involve programming, it's mostly just uninformed people talking shit.
- cudgy 3y ago
  Because, naturally, humans can only be informed about a single topic: their career. Therefore, programmers are only capable of being knowledgeable about programming. And doctors are only capable of being knowledgable about medicine. And plumbers are only informed about plumbing topics. Really?
  - SantalBlush 3y ago
    You're misunderstanding. It's not that they can't know things outside of programming (which is your strawman), it's that they usually don't make the real effort to learn, and think reading a few blog articles makes them knowledgeable about a subject.
    - tracker1 3y ago
      At what point does one cross this arbitrary barrier to being proficiently knowledgable in a subject outside their profession? I'm a self taught developer with nearly three decades of experience, still spending 10+ hours a week expanding my craft (reading/experimenting). But in the past 5-7 years have spent twice that time on food and nutrition science study. Part of that understanding research quality, not just quantity, and the value of different types of testing vs study.
      - SantalBlush 3y ago
        So you believe all of that time you put in suggests that you know more about the subject of food and nutrition? To put it another way: if you could have acquired all of that knowledge without spending so much time and effort, then why didn't you?
        tracker1 3y ago
        Yes, I believe all that time I put into learning means I do know more than most. And no, I didn't suggest that I'd have that knowledge without the time, effort and study, never did. I'm not sure what you are asking exactly. The initial response above seems to indicate that a person shouldn't speak on something outside their primary career. So my question is, at what point is one able to pass the bar of being able to speak to a subject materially?
        SantalBlush 3y ago
        To be honest, it seems like we mostly agree, so I don't see what the issue is. >The initial response above seems to indicate that a person shouldn't speak on something outside their primary career. Already addressed this in the very comment above that you replied to. This is incorrect. Regarding where the "bar" is exactly, that is of course subjective. But I reject any idea that its subjectivity implies that all opinions are valid or whatever it is you're suggesting, because they're not. Some opinions are uninformed, and I have no problem saying so.
  - tracker1 3y ago
    Thanks for this... It's kind of funny considering I've probably done as much reading on nutrition science the past 5-7 years as I have programming (almost 30 years into this career). Mostly in that there's been so much mis/disinformation regarding food and nutrition over the past couple centuries, and I have a lot of health issues as a result. I bring the above up, because even a lot of doctors are ill informed. Not to mention nutritionists that are institutionally trained in dogma first, for licensure. Australia is over a decade ahead of the US at this point, and EU is about half that ahead. US nutrition is too entwined with industrial agriculture. On TFA, I don't have too much opinion on the specifics. Other than gatekeepers gonna keep gates. It's as likely big pharma ran the numbers that they'd make more with this medication being OTC today, where a few years ago it was better gatekept. And they just, finally, pushed for OTC from the FDA. That mostly comes from my general opinions around the incestuous relationship of the FDA and private industry (similar to USDA).
    - euler5050 3y ago
      See this is a great example, you've studied this topic extensively but don't seem to know the absolute basics of the industry. "Not to mention nutritionists that are institutionally trained in dogma first, for licensure." Nutritionist is not a protected title in the US or Australia, and actually requires no training whatsoever. It does require training and licensure to become a dietitian, because it's a clinically focused role. In many cases dietitians have prescribing privileges and are prescribing recipes for intravenous or tube fed nutrition. That's why they're so heavily regulated my dude, I promise you clinically focused dietitians are not using the kind of industry research you're talking about. They are following protocols established over decades of clinical practice. And if you're wondering why doctors are ill informed, it's because they're not typically trained in nutrition outside of the basics (outside of gastroentorology). Modern medical teams rely on a ton of support staff, one of those being clinical dietitians. Your doctor's job is to know who to consult.
      - tracker1 3y ago
        So, because I displaced the term dietician with nutritionist conversationally you side step into a diatribe. You do realize that a lot of people have learning disabilities that make it difficult to remember specific terms in their place? It's kind of like a mental block in trying to remember. I have this when it comes to proper names all the time. It doesn't mean that I don't have an understanding of the conceptual base. So, dieticians never suggested limiting cholesterol, and cutting out all saturated fat?
uncletaco 3y ago
> This thread (edit: at the time I am posting this) is full of men with little real knowledge That’s almost every reply on HN that isn’t specific enough to let someone shine through with their tech experience. It’s been like this as long as I’ve been here. EDIT: It occurs to me that I've been here for just over 10 years as of last month. Time really flies.
- libraryatnight 3y ago
  [flagged]
  - Forgeties79 3y ago
    And then when you try to point it out they pearl clutch/gasp and accuse you of having an agenda/over-interpreting their words. It’s very frustrating.
idopmstuff 3y ago
You're right that women ought to be the ones in charge of dealing with this sort of thing, but I don't think a bunch of guys presenting positions that are generally skeptical of the FDA restricting things that are generally considered safe from being sold OTC (even if not for the right reasons) are the reason that it took a long time for this to be approved to be sold OTC.
- maerF0x0 3y ago
  > You're right that women ought to be the ones in charge of dealing with this sort of thing, That's pretty contrary to the typical diversity rationale that suggests out group people have valuable inputs. I think it makes a lot of sense to have society as a whole making decisions about how society as a whole operates. It's not just an individual's choice if they take a drug which may or may not end up being like thalidomide. At the very least it affects fathers, and those born with the side effects. Of course women should have a voice in this area, but also should many other groups :)
  - mathisfun123 3y ago
    everything in this reply espouses ideas and positions that are literal antitheses of a liberal society.
    - mcpackieh 3y ago
      In liberal democracies, people have a right to get to have their say (on a soap box and at the ballot box) in matters that don't rationally concern them.
      - mathisfun123 3y ago
        have a say but not dictate. so my point isn't that the response says things but that it advocates for policy/governance.
        3y ago
Ensorceled 3y ago
There is a lot of horrid comments in this thread ("Just have lots of kids!" and "Great, now people can live their addictions without worry"). It's a mix of ignorance, intolerance, misogyny and with a topping of "total lack of empathy". I'm a bit mollified by the number of people responding to all of the horrid comments.
- spondylosaurus 3y ago
  Also, a lot of people don't realize that oral contraceptives offer benefits beyond literal contraception. I've been on the pill since I was a teen because it's the only thing that keeps wicked endometriosis symptoms at bay (and coincidentally have had the best luck on a progestin-only pill similar to the one that just got approved). And this is despite being in a monogamous relationship with a cis woman for the past five years—zero pregnancy risk there :P
  - Ensorceled 3y ago
    My first wife had to deal with "slut shaming" in her teens for being "on the pill" for exactly the same reason. > And this is despite being in a monogamous relationship with a cis woman for the past five years—zero pregnancy risk there :P Ha! I can't believe this is the first time this scenario occurred to me!
deleted 3y ago
[deleted]
spondylosaurus 3y ago
Totally agree with your take here, although I would like to offer my perspective/speculation as someone who actually takes oral birth control daily: It may be notable that the pill that got approved is a progestin-only pill that's been on the market for fifty years (so long enough to demonstrate safety/effectiveness) and, crucially, does not contain any estrogen. Because there are risks associated with estrogen-based birth control, to the point where I understand why the FDA might still recommend getting screened by a doctor first—most notably, there's an elevated risk of DVT if you're a smoker. Granted, given the current, uh, situation in the US, I do think people should be able to make informed decisions about that risk for themselves without needing a doctor's approval. But a progestin-only pill mitigates a lot of that risk anyway while still being a reasonably effective contraceptive.
Obscurity4340 3y ago
Just in general, people on the whole are idiots about drug culture and history. Most people have no idea their drug scheduling system makes no sense, that they have a bunch of dumb cops (DEA) that came up with and maintain that system rather than actual medical experts, that there were racist and economic interests at the root of all this nonsense rather than genuine concern for their well-being, etc. Also the idea that you can use control of a drug as a proxy to control and disempower various marginalized demographics.

ModernMech 3y ago

Your comment is at the top of the thread, so thank you for pointing this out before I waded further into the comment section. I'm sure you saved me some grief.

SantalBlush 3y ago

This goes for other things on HN, too. If the topic doesn't involve programming, it's mostly just uninformed people talking shit.

cudgy 3y ago
Because, naturally, humans can only be informed about a single topic: their career. Therefore, programmers are only capable of being knowledgeable about programming. And doctors are only capable of being knowledgable about medicine. And plumbers are only informed about plumbing topics. Really?
- SantalBlush 3y ago
  You're misunderstanding. It's not that they can't know things outside of programming (which is your strawman), it's that they usually don't make the real effort to learn, and think reading a few blog articles makes them knowledgeable about a subject.
  - tracker1 3y ago
    At what point does one cross this arbitrary barrier to being proficiently knowledgable in a subject outside their profession? I'm a self taught developer with nearly three decades of experience, still spending 10+ hours a week expanding my craft (reading/experimenting). But in the past 5-7 years have spent twice that time on food and nutrition science study. Part of that understanding research quality, not just quantity, and the value of different types of testing vs study.
    - SantalBlush 3y ago
      So you believe all of that time you put in suggests that you know more about the subject of food and nutrition? To put it another way: if you could have acquired all of that knowledge without spending so much time and effort, then why didn't you?
      - tracker1 3y ago
        Yes, I believe all that time I put into learning means I do know more than most. And no, I didn't suggest that I'd have that knowledge without the time, effort and study, never did. I'm not sure what you are asking exactly. The initial response above seems to indicate that a person shouldn't speak on something outside their primary career. So my question is, at what point is one able to pass the bar of being able to speak to a subject materially?
        SantalBlush 3y ago
        To be honest, it seems like we mostly agree, so I don't see what the issue is. >The initial response above seems to indicate that a person shouldn't speak on something outside their primary career. Already addressed this in the very comment above that you replied to. This is incorrect. Regarding where the "bar" is exactly, that is of course subjective. But I reject any idea that its subjectivity implies that all opinions are valid or whatever it is you're suggesting, because they're not. Some opinions are uninformed, and I have no problem saying so.
- tracker1 3y ago
  Thanks for this... It's kind of funny considering I've probably done as much reading on nutrition science the past 5-7 years as I have programming (almost 30 years into this career). Mostly in that there's been so much mis/disinformation regarding food and nutrition over the past couple centuries, and I have a lot of health issues as a result. I bring the above up, because even a lot of doctors are ill informed. Not to mention nutritionists that are institutionally trained in dogma first, for licensure. Australia is over a decade ahead of the US at this point, and EU is about half that ahead. US nutrition is too entwined with industrial agriculture. On TFA, I don't have too much opinion on the specifics. Other than gatekeepers gonna keep gates. It's as likely big pharma ran the numbers that they'd make more with this medication being OTC today, where a few years ago it was better gatekept. And they just, finally, pushed for OTC from the FDA. That mostly comes from my general opinions around the incestuous relationship of the FDA and private industry (similar to USDA).
  - euler5050 3y ago
    See this is a great example, you've studied this topic extensively but don't seem to know the absolute basics of the industry. "Not to mention nutritionists that are institutionally trained in dogma first, for licensure." Nutritionist is not a protected title in the US or Australia, and actually requires no training whatsoever. It does require training and licensure to become a dietitian, because it's a clinically focused role. In many cases dietitians have prescribing privileges and are prescribing recipes for intravenous or tube fed nutrition. That's why they're so heavily regulated my dude, I promise you clinically focused dietitians are not using the kind of industry research you're talking about. They are following protocols established over decades of clinical practice. And if you're wondering why doctors are ill informed, it's because they're not typically trained in nutrition outside of the basics (outside of gastroentorology). Modern medical teams rely on a ton of support staff, one of those being clinical dietitians. Your doctor's job is to know who to consult.
    - tracker1 3y ago
      So, because I displaced the term dietician with nutritionist conversationally you side step into a diatribe. You do realize that a lot of people have learning disabilities that make it difficult to remember specific terms in their place? It's kind of like a mental block in trying to remember. I have this when it comes to proper names all the time. It doesn't mean that I don't have an understanding of the conceptual base. So, dieticians never suggested limiting cholesterol, and cutting out all saturated fat?

uncletaco 3y ago

> This thread (edit: at the time I am posting this) is full of men with little real knowledge That’s almost every reply on HN that isn’t specific enough to let someone shine through with their tech experience. It’s been like this as long as I’ve been here. EDIT: It occurs to me that I've been here for just over 10 years as of last month. Time really flies.

libraryatnight 3y ago
[flagged]
- Forgeties79 3y ago
  And then when you try to point it out they pearl clutch/gasp and accuse you of having an agenda/over-interpreting their words. It’s very frustrating.

idopmstuff 3y ago

You're right that women ought to be the ones in charge of dealing with this sort of thing, but I don't think a bunch of guys presenting positions that are generally skeptical of the FDA restricting things that are generally considered safe from being sold OTC (even if not for the right reasons) are the reason that it took a long time for this to be approved to be sold OTC.

maerF0x0 3y ago
> You're right that women ought to be the ones in charge of dealing with this sort of thing, That's pretty contrary to the typical diversity rationale that suggests out group people have valuable inputs. I think it makes a lot of sense to have society as a whole making decisions about how society as a whole operates. It's not just an individual's choice if they take a drug which may or may not end up being like thalidomide. At the very least it affects fathers, and those born with the side effects. Of course women should have a voice in this area, but also should many other groups :)
- mathisfun123 3y ago
  everything in this reply espouses ideas and positions that are literal antitheses of a liberal society.
  - mcpackieh 3y ago
    In liberal democracies, people have a right to get to have their say (on a soap box and at the ballot box) in matters that don't rationally concern them.
    - mathisfun123 3y ago
      have a say but not dictate. so my point isn't that the response says things but that it advocates for policy/governance.
      - 3y ago

Ensorceled 3y ago

There is a lot of horrid comments in this thread ("Just have lots of kids!" and "Great, now people can live their addictions without worry"). It's a mix of ignorance, intolerance, misogyny and with a topping of "total lack of empathy". I'm a bit mollified by the number of people responding to all of the horrid comments.

spondylosaurus 3y ago
Also, a lot of people don't realize that oral contraceptives offer benefits beyond literal contraception. I've been on the pill since I was a teen because it's the only thing that keeps wicked endometriosis symptoms at bay (and coincidentally have had the best luck on a progestin-only pill similar to the one that just got approved). And this is despite being in a monogamous relationship with a cis woman for the past five years—zero pregnancy risk there :P
- Ensorceled 3y ago
  My first wife had to deal with "slut shaming" in her teens for being "on the pill" for exactly the same reason. > And this is despite being in a monogamous relationship with a cis woman for the past five years—zero pregnancy risk there :P Ha! I can't believe this is the first time this scenario occurred to me!

deleted 3y ago

[deleted]

spondylosaurus 3y ago

Totally agree with your take here, although I would like to offer my perspective/speculation as someone who actually takes oral birth control daily: It may be notable that the pill that got approved is a progestin-only pill that's been on the market for fifty years (so long enough to demonstrate safety/effectiveness) and, crucially, does not contain any estrogen. Because there are risks associated with estrogen-based birth control, to the point where I understand why the FDA might still recommend getting screened by a doctor first—most notably, there's an elevated risk of DVT if you're a smoker. Granted, given the current, uh, situation in the US, I do think people should be able to make informed decisions about that risk for themselves without needing a doctor's approval. But a progestin-only pill mitigates a lot of that risk anyway while still being a reasonably effective contraceptive.

Obscurity4340 3y ago

Just in general, people on the whole are idiots about drug culture and history. Most people have no idea their drug scheduling system makes no sense, that they have a bunch of dumb cops (DEA) that came up with and maintain that system rather than actual medical experts, that there were racist and economic interests at the root of all this nonsense rather than genuine concern for their well-being, etc. Also the idea that you can use control of a drug as a proxy to control and disempower various marginalized demographics.