Shrill talks about plus-size women and the morning-after pill when the medical community won’t

Fat women have sex. This shouldn’t come as a surprise to anyone. But the media’s portrayals of plus-size sex lives—or the decided lack thereof—might cause you to think a vow of celibacy comes with shopping in the plus-size section. “Hello, ma’am, we’ve noticed you’ve picked up a plus-sized article of clothing—please be sure to check out our row of chastity belts.” That’s not how it works. In this apparent media blackout on all storylines relating to plus-size women and their sex lives, the very first episode of Hulu’s new series, Shrill, based on the memoir by Lindy West, will surprise you. The show revolves around the life of protagonist Annie, a plus-size woman who is trying to make her voice heard, both in her journalism and in her everyday relationships. And, yes, she does have sex.

[The rest of this article contains spoilers for Shrill]

From the very first episode, the audience sees Annie hooking up with her boyfriend/fuckboi Ryan (Luka Jones) in his bedroom after a text invitation similar to an eggplant emoji. Though the sex doesn’t appear to be all that enjoyable on her end…and he asks her to hop the back fence afterward to avoid running into his friends, the scene suggests that Annie has sex on the regular.

As Annie puts her clothes back on, Ryan casually mentions the fact that they didn’t use a condom. In the next scene, Annie races towards the pharmaceutical counter at the back of a convenience store in search of the morning after pill. Then, a few months after taking said pill, Annie begins experiencing certain symptoms: irritability, a stomach bug that doesn’t seem to go away, and, you guessed it, she’s pregnant.

It turns out that a lot of emergency contraceptives like Plan B are less effective on women over 175 pounds—but we don’t hear that in conversations about EC.

Considering that the average American woman weighs 166 pounds, this statistic is more than a little frightening—especially when abortion access is shrinking by the day, making access to Plan B or similar over-the-counter brands especially important to prevent unintended pregnancies. false

Annie is stumped when the pharmacist discreetly asks her if she’s over the weight limit, and she demands to know why the pill’s weight limitation isn’t common knowledge.

And just as in the show, this fact is not common knowledge in real life either. Whenever I’ve casually mentioned it to my friends, the straight-size women are baffled and the plus-size women are appalled. What are they supposed to do if they find themselves in an emergency? Despite years of studies proving this troubling link between weight and effectiveness, there are still no emergency contraceptives available that work specifically for plus-size women. It’s as if society has been taught that weight is linked with desire, so plus-size women can’t possibly have enough sex to require such a medication.

This problem can be linked to another disturbing factor: The medical field doesn’t take plus-size women’s reproductive health seriously.

Even after research into BMI and the morning after pill’s effectiveness, the medication still doesn’t have any warning label regarding these outcomes. Medical professionals being less likely to listen to their female patients is a universal problem regardless of the patient’s size, but plus-size women must also compete with the idea that any medical problem would be fixed if they just lost a few pounds. This mindset can prevent professionals from giving a proper diagnosis to their patients, and it can prevent women from even going to see their doctors for fear of receiving nothing but that faux universal cure. This medical assumption also does very little to address gaps in health care because there is no incentive to alter medicines or create an alternative.

The media is taking steps to portray plus-size characters in control of their own narratives, including Netflix’s adaptation of Dumplin’ and the character of Kate in NBC’s This Is Us, but there is still a lot of work to be done. Annie’s navigation of sexual health opens up an inclusive dialogue about sex, contraception and, yes, abortion. As shows like Shrill successfully out the dirty little secret that plus-size women have sex and shed light on how their health is overlooked, I hope the public will start to realize that all women and all bodies deserve access to safe sex options.

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