Doctor recommends Mirena, insured through Christian parents

[BlueFish2]

(Disclaimer--I'm 25, so I know I'm right at the top of your age limit. I figured it would be worth asking this here, but if you need me to take my question somewhere else, let me know and I will)

I've tried about five different brands of pill and have struggled with side effects each time, so based on my body's reactions, my GYN is recommending Mirena. Since I'm sexually active, I like the efficacy and no-fuss nature of Mirena, and given that my blood pressure has fallen in the prehypertensive range ever since I started on COC's, I would like to make the switch as soon as possible.

My insurance will completely cover the cost of getting Mirena, but my parents agreed to keep me on their insurance policy to help me save money since I only recently completed grad school. My parents are very Christian, and they believe that all forms of birth control, including condoms, are sinful. They're also convinced that hormonal birth control causes cancer and is dangerous to your health. While they know I'm on birth control to treat heavy, painful periods, they're constantly telling me things like: "You need to get off the pill." and "The next time you go in for your annual GYN exam, you should talk to your doctor about other treatments for painful periods." They also--still--constantly tell me that sex should be saved for marriage. I don't share my parents' beliefs on sexuality, and my doctor has been pretty good about explaining the risks and benefits of contraception, so its VERY frustrating that my parents won't respect my decision.

Right now, I'm trying to decide whether I should tell my parents that I would like to get Mirena, just get it and not say anything, or just wait out the months until I turn 26 and am required to purchase insurance of my own. (I live in the U.S.) Do you know what actually appears on the explanation of benefits form? I have used my insurance to pay for STI screenings, and my parents have never said anything, so I'm wondering if what they see is fairly generic.

More importantly, I would like my parents to understand that, in terms of my sexuality, I'm an adult and will make my own decisions, which don't necessarily line up with their beliefs. They don't need to know the gory details of my sex life, but I would like for them to stop pressuring me about my decision to use contraception and to stop telling me things like "You shouldn't be having sex if you're not married" when we're out in public with friends. Their feelings on sex and contraception are some of their deepest, most-strongly held beliefs, and I know I won't be able to change their mind in that regard, but it's frustrating that they continue to treat me like a child when it comes to sexuality, especially since they respect my right to make my own decisions in all other aspects of my life. Do you have any advice on how to broach this topic with them or reach some sort of compromise?

[Heather]

I'm so sorry you're in this pickle.

What I'd suggest as your first step here is to ask your doctor how this all works with statements and billing for you. If they don't know, then you'll want to call into your insurance provider (and that call certainly will not show up on statements). Chances are that this won't show up on the bill since it's completely covered, but clearly, given what the fallout could be (and goodness knows, it sounds like you deal with enough with this already), you'll want to do what you can to double-check.

In terms of the larger issue with your parents, have you had any conversations with them where you have set limits with this? In other words, have you yet started by telling them that this is not something you want them involved in and are asking them to please not discuss it with you unless you ask for their help or opinions?

[BlueFish2]

Odd as this sounds, I didn't think to call my insurance company and ask them what shows up on the statement. Thanks! It's too late to call them now, but I'll do it tomorrow.

I haven't yet had a conversation with my parents where I set limits on this. To be honest, until recently, I had been fairly passive-aggressive when it comes to setting boundaries with my parents. They were fairly overprotective and had an "as long as you live in my house, you play by my rules" attitude when I was a teenager, so I became quite anxious about accidentally upsetting them. I moved pretty far away for college, so many of the boundaries naturally fell into place because of the distance, their not being to help me at a moment''s notice, my experience living with roommates, etc. Since I went to college, there have been a few times where I've directly asked them to respect a boundary, but never in regards to an issue as "emotionally charged" as sex and spirituality. I know this needs done, but I'm nervous.

The other reason I haven't set limits is because I don't know what to say. In many ways, their attitude towards birth control reminds me of the stereotypical anti-vaxxer's attitude towards vaccines. They refuse to believe the many controlled studies showing that birth control is safe and instead deliberately seek out and believe biased news sources stating that they're not, and then they'll pass this information on to me. Since my parents are otherwise rational and well-educated, I think they're subconsciously looking for logical reasons to support the church's prohibition on birth control. I don't know how to argue with that--I'm not sure I even can. After reading your reply, I started thinking, "Well, maybe I can just say 'I appreciate your concern, but these decisions should remain between me and my doctor. Please trust that I discuss the risks and benefits with her extensively before making a decision.'" Would something that simple work?

[Sam W]

Hi Bluefish,

I hope the call is productive

I do think that the simple statement you came up with is a good once to use. Really, when you're trying to set boundaries, the less room you give the other people to think that they can argue about it or debate it, the better (and simple, to the point declarations can help do that). Too, I would brace yourself for some pushback when you set this boundary, especially if that's still a relatively new thing for you to be doing, because it will be a new thing for them to encounter and they will probably not like it. So it can help to prepare yourself for what you'll do in the face of the most likely types of pushback. One thing that can help is a broken record approach. So, you set the boundary, they go "but X!" and you say "thank you for your concern/input, but this is not negotiable/ this is between me and my doctor."

[Heather]

Just wanted to follow up with you on this if you wanted to talk about it more, or if you needed further help with getting the IUD you want.

[BlueFish2]

Hi Heather,

Thanks for checking in, and I'm sorry it took some time to get back to you. My insurance company told me that my parents would see something generic on their explanation of benefits statement, something like "Medical supplies," but it wouldn't specify that the supplies were a contraceptive device.

My first thought once I heard this was that it wouldn't be wise to get the IUD until I establish with my parents that my medical decisions are private. Do you think differently, or do you see another option?

[Sam W]

Hi Bluefish,

Heather's out for the day, so hope you don't mind my stepping in. I'd say the answer depends on how urgently you want the IUD. Setting a boundary like that with parents can take time, especially if they push back, so it may help to get the boundary in place, then get the IUD. However, the truth is, you don't have to tell them anything when/if they see it listed on the statement. They may ask what it was, but you're just a broken record saying "that information is between me and my doctor." (A caveat being that if you think doing that would result in them doing something scary, like kicking you out, then you may indeed have to wait until they respect the boundary)