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Troubles with Twitter: I’m glad I couldn’t tweet when I was an idiot

Twitter might be here to stay. Those block lists, those grudges, those bridges we burn – we could be stuck with them. And that is a sobering thought.

Back when I was a young idiot the internet felt slower and more insular, like sites were the bubbles in a cold glass of beer, each a universe unto themselves. As a young idiot I’d visit websites, political forums, forums pertaining to various video games I played, and sometimes I’d read, and sometimes I’d post stuff, and sometimes I was an idiot. I was lucky, in many ways, that wiser people who I spoke to back then – people with a range of experiences from a variety of backgrounds – actually took the time with me. They answered my daft questions, they suffered my thoughtlessness and helped me begin to unpick the many layers of wrong that had built up on my world view like that scaly stuff in a kettle. It’s still a work in progress, and there is always more to learn.

I look back on the start of that process with some gratitude, because if my 20-year-old self was let loose on the internet in its current state (marauding around its vast networks like a gobshite Genghis Khan) it doesn’t bear thinking about. He’d be hoarding Bitcoins, defending rape jokes, sending emails to companies about the dark plans of “females” to take over video games, and getting incredibly upset about sexism against men and racism against white people. My young self would have sworn blind that as an atheist and egalitarian he wasn’t a racist, sexist douchebro, despite the fact that every manifestation of his personality online would imply such. I wonder how such a man might have ended up.

Twitter is a vast gathering of people way too big to be understood as a single community. There is no incentive to take the time to try to school ignorant people on why they are wrong and how, although some people still do (and they have the patience of saints). Instead, if you go on to Twitter acting like an idiot, the most likely thing to happen is you’ll find yourself adopted by idiots. Your idiocy will be embraced and your half-baked reactionary gibberish lionised.

In spite of this, it seems that Twitter is still of considerable benefit to humanity. Here is a service that almost anybody with Internet access can freely use to communicate their thoughts and feelings with anybody in the else in the world with similar access. Given how the hardware to connect to such systems is cropping up everywhere, and is only getting cheaper, it feels like the exchange of news and ideas has never been freer or more democratised than it is today.

But beyond the exchange of information and moving into how Twitter handles debate and discussion, I think that Twitter has yet to really find a proper voice. There is a sense that it is caught between two conflicting communicative styles.

On one hand, Twitter offers something comparable to the forums and bulletin boards people used mostly back when the Internet was made of wood and powered by a giant yoke. In these conversations people are not necessarily anonymous, and even those who use pseudonyms may become familiar over time through repeated communication. You might gain a sense of community from a shared interest or worldview, and this can be great, but the drawback of course is this is also how you can end up with big clusters of idiots reaffirming their idiocy. The size of Twitter and the ease with which people can be drawn together means that it’s very easy to make even groups with bizarre beliefs feel large enough that they can’t all be wrong. Twitter mitigates this by encouraging users to follow multiple interests, providing a more diverse perspective, but it’s an imperfect system.

On the other hand, however, Twitter has inherited some of the Chan culture from image boards. Born out of places like 4chan, it encourages shock value to get attention and provoke reaction. This isn’t necessarily a bad thing - communication boiled down to distilled expressions of exaggerated meaning works fine where this is the only means to talk. In such places there is little value attached to longer communication because everything is ephemeral. The problem is that the idea that tweets must be attention-grabbing, rather than sincere expressions of ideas or feelings, is somewhat at odds with the more lasting, community-driven side of the system.

This conflict of styles manifests itself most often during Twitterstorms, when somebody has said or done a thing and people pile onto them about it, and maybe their defenders pile back onto the accuser and everybody hates everybody that little bit more in the world. In order to be noticed people make more noise, and noise in the context of an electronic message tends to mean exaggeration. Suddenly a politician isn’t just an incompetent, he’s a monster; mild dislikes are expressed as violent hatred, and a person who offers criticism is labelled "troll" or a "harasser". The format and its inherent leaning towards an escalation in aggressive language brings through these assumptions of bad faith - indeed, it encourages hostility.

On a fast-paced and anonymous image board this is OK – a discussion can be earnest and considered, or it can be dishonest and vicious, but either way when it's over the words are lost. Nobody knows who they were talking to and everything is fresh for when the next thread starts.

The cleaning of the slate between threads, coupled with anonymity, is the strength of the image board style. Argument becomes a game, with changing teams and points of view just to keep it interesting. But on a more permanent medium like Twitter hostility can fester and factions can become entrenched, because there’s no magic reset button after each storm.

In some ways Twitter can trap the unwary with this combination. People can say a thing on Twitter thinking they are being clever or funny, seeking attention and recognition for their clever funniness. But sometimes when seen from another perspective, the thing they have said makes them come across in a less than positive way - and on Twitter the leap from doing something mildly objectionable to being considered by many to be a colossal scumbag is very short. This in itself can create problems, as the rejection of one faction can shove people towards others. A person might feel like a bridge has been burned before they even got to cross it, so maybe they’ll just saunter off to hang out with some actual colossal scumbags. The process of groups aggressively rebuffing people who do not immediately measure up to their standards can be damaging in the longer term.

There is a Malcolm X quote that springs to mind when I look at Twitter in the midst of one of its many storms: “Don't be in a hurry to condemn a person because he doesn't do what you do or think as you think or as fast. There was a time when you didn't know what you know today.” This is worth remembering before replying to a clumsy comment with vitriol, or when presuming a question that seems asinine is intended in bad faith. 

But there is a flipside to this, which is that there really is very little excuse in this day and age for bothering people - especially vulnerable people, or people who often find themselves subject of harassment or abuse - with facile questions. Equally there is no excuse for taking offence when you go into somebody else’s mentions, however polite you think you are being, and are rebuffed. Twitter can be a stressful place, and it can seem like a hostile place at times too. There is no way to know how stressful or hostile a given person is finding Twitter when you speak to them. Instigating a conversation on Twitter is to enter a person’s space and it should be done with the appropriate amount of respect (which is not to say that this amount is necessarily very high).

The most important lesson I have learned from Twitter mostly comes down to reading first and hitting the send key later. If there is a person involved with an issue and you want to know more about the issue, or them, don’t ask, look. Go back through their timeline, read what they link to, read their website if they have one on their profile. Maybe, if you’re not in a hurry, just follow them for a while. If you still want to know more, then ask with the benefit of being hopefully a little more informed before you do. Does this sound stalkery? Maybe, but if the alternative is lumbering into a person’s mentions to pick their brains about a subject like they’re some sort of social justice tech support department, I’d rather do my homework.

The final concern with Twitter is that it might be here to stay. Those block lists, those grudges, those bridges we burn - we could be stuck with them. And that is a sobering thought.

Phil Hartup is a freelance journalist with an interest in video gaming and culture

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The Pill pushback

The contraceptive pill helped liberate women when it arrived in the UK in the 1960s. Now, spurred by experiences shared online and a spate of new fertility apps, many are turning their backs on it.  

Six weeks before her final exams, Claire* was looking forward to the end of university and a summer of travelling. By the time the first exam arrived, something had drastically changed. “I called my mum sobbing and told her there was no way I could take the exams,” she tells me now, several years later. “I hadn’t done even an hour's worth of revision. I just ate and slept and cried without understanding why.”

Claire’s GP at university diagnosed stress, yet on her planned trips abroad, nothing improved. “I was plagued by panic attacks. I felt like the world was crashing down on me.” On her return home, she visitedher local GP, who, unlike the previous doctor, immediately asked if she was on contraception. It was then that Claire made the link: a month and a half before her exams, she was first prescribed Cerazette, a common progesterone-only contraceptive pill.

The GP explained that depression is a known side effect of Cerazette, and she had seen it in other patients before. “She told me to stop taking it immediately. Within a week, the numbness began to lift and I felt my personality coming back. I felt hope for the first time in months.”

Claire is off the pill now, and in the past, this would have been the end of the story – especially since her GP “refused” to report her side effects to the yellow card scheme, which is used to collect information on medication’s unwelcome side effects.

But over the past decade or so, those who have experienced side effects – I’ll refer to “women” from here for clarity, but these issues can affect anyone with a uterus – like Claire have begun sharing their tales of contraceptive woe across forums, blogs, and social media.

#MyPillStory, a hashtag begun earlier this month, aggregated Twitter users’ tales of pill disaster, from blood clots to personality changes. It makes for spine-tingling reading – especially for anyone who pops their own pill daily. Depression, anxiety, and an affected sex drive crop up in scores of the posts, while handfuls of woman say they experienced blood clots, strokes, acne, swollen legs, chest pains, nausea… the list goes on.

Of course, the problem with this type of “data” is that, well, it isn’t. The medical profession’s denial of women’s experiences is usually badly handled, is often unjust and unfounded, but can also be correct. A medication you take for years of your life will, necessarily, coincide with other health problems. It’s incredibly difficult to establish causation in many of these cases.

I fantasise about stopping the Pill and having normal periods

Meanwhile, anecdotal stories can cause panics, and more problems than they solve. A scare around blood clots and pills containing Gestodene and Desogestrel in 1995 led to an estimated £21m cost in maternity care and £46m in abortion provision, as many frightened women went off contraception altogether. As a result, women’s use of oral contraception fell from 40 per cent to 27 per cent between 1995 and 1997.

Sarah Kipps, a nurse and contraception specialist with the National Union of Students, tells me there’s a danger that some women assume that generic “symptoms of life” are pill-related: “If you ask people on no medication what their symptoms are, they’ll have tiredness and headaches. This mirrors what some people say about the pill.” This is backed up by studies which show that around a quarter of study participants who have taken a placebo report side effects.

And yet women who do experience side effects are simply told to change their medication – which may explain why social media as a platform to share their stories has proved so attractive. These side effects scare women off hormonal contraception altogether, which, whether wise or unwise, is as much a product of an under-resourced sexual health system that tends to dismiss female pain as the health problems themselves.

I spoke to 20 women in depth about coming off the pill, and the choices they made afterwards. They added to the mix of stories about contraception clashing badly with anti-depressants, poor advice from doctors, unwanted pregnancies after coming off the pill, and an endless quest to find a method of contraception that actually works. The idea of choice was a key element: in a society increasingly concerned with wellness and what we put in our bodies, a daily dose of hormones begins to look less and less attractive.

As one woman told me, “As silly as I know this would be, I fantasise about stopping the pill and having normal periods, like a character in a Philippa Gregory nove.” Now, women can opt for different types of pills with different doses of hormones (WebMD has a good rundown), hormonal and non-hormonal coils which are inserted into the cervix, or injections. You can also, of course, opt for nothing at all.

***

Data shows that the use of oral contraceptives as a percentage of contraceptive methods has remained largely stable over the past decade. Tellingly, though, figures from sexual and reproductive health services also show a sharp upturn in Long Action Reversible Contraception, such as coils and implants, since 2010. Arm implants contain the lowest doses of hormones available, while non-hormonal coils are also available. The data shows the contraceptive choices of women who have visited sexual and reproductive health services (not including GP surgeries or pharmacies) during a certain year, so while they show trends, they don't represent the whole UK population of women. 

Lois is one of those datapoints. While at university she experience “horrific migraines”, a common side effect of high-oestrogen birth controls she was taking. As a result, she opted for the non-hormonal coil, a T-shaped device inserted into the uterus: “It’s good for ten years, and the lack of hormones meant that I no longer got migraines from my birth control. I don’t ever have to think about it, unless I’m telling someone about how great it is.”

Perhaps the most interesting figure of all in this data comes under the heading “natural family planning” – or, in common parlance, unsafe sex. It hasnt topped 1 per cent over the past decade, but the numbers have increased over tenfold, from 500 women who visited sexual and reproductive health services in 2004/5 to 7,700 in 2014/15. (It’s worth noting that data collection methods have changed slightly over this period, which could partially account for the change.)

In the past, this decision may have been borne of religious convictions, but my interviewees suggest that secular women are using this method too. They are helped by fertility apps, which allow women to estimate the most fertile days of their cycle and take precautions accordingly.

Sarah, a sex blogger, quit the pill after reading a blogpost by a woman who, like Claire, escaped a cycle of depression and anxiety only when she went pill-free. She had noticed a decreased sex drive, and wanted to know what life without contraceptive medication would be like.

“I honestly didn’t realise how bad I felt until I started feeling better,” Sarah tells me now. “I was feeling depressed, but I never thought it had to do with the pill. Neither my therapist nor my psychiatrist ever brought it up.” Now, Claire uses condoms, but also a period monitoring app, Clue, so she knows to avoid penetrative sex on her most fertile days.

Natural Cycles is another such app that uses temperature measurements to predict fertility and marks days red, yellow or green depending on how safe it is to have sex. It recently hit headlines when a study claimed it is as effective as the pill when used correctly, based on a study of 4,023 Swedish women. Professor Kristina Gemzell, one of the authors of the study, said: “More and more women, especially in the age group of 20-30, tend to abstain from hormonal contraception and desire a hormone-free alternative. It is important to increase choice among contraceptives for women and inform them about their pros and cons.”

There's a complacency around contraception

Unsurprisingly, these claims, and the publicity around them, are worrying for those working in sexual health and family planning. Dawn Stacey, a contraceptive expert and professor, tells me that she would guess the app is “not as effective as the pill”. This is based on the fact that the app suggests users log their temperature to monitor fertility, while nurses use a minimum of three indicators to predict fertility, including the consistancy of the cervical mucus and position of the cervix. Fertility planning was once taught in clinics, but is now thought of as too complex and risky - nurses would monitor a woman's fertility for two or three months before hazarding a guess at a pattern.

“Plus, there are other factors that could impact determining your fertility,” Stacey adds. “Many women don't have regular cycles until their mid-20s and ovulation can be impacted by stress, lack of sleep, or being sick. it doesn't look like the app takes any of that into consideration.”

Sarah Kipps, a contraceptive nurse, adds that this type of natural planning “involves a lot of abstinence – you could be fertile for five days in a month”. In her eyes, "there's a kind of complacency around contraception” as the pill’s introduction in the 1960s becomes a distant memory. 

“People come in and see us, and they want to be natural. But natural means pregnancy. If you don’t get on with the pill, come and have a chat in the clinic – there are lots of other alternatives. If you don’t want to have children, you have to defeat biology. The pill defeated biology, but now there’s a backlash against it.” 

Dr Raoul Scherwitzl, co-founder of the Natural Cycles app, says that temperature is “enough…to confirm that ovulation has happened” and that the app responds to irregular cycles, adding extra "red days" to "cover the uncertainty around the irregularities". 

Despite the risk, some women see this “natural” contraception as a way of reclaiming control. This seems especially common among women who went on the pill early and are now questioning its effects on their bodies.

Yara went on the pill aged 15, “because I went to the doctor with an irregular period. Looking back I'm pretty sure it's because I was underweight, but the doctor didn't spot that and put me on the pill. After that I felt pressured by boyfriends.” Within the past few years she went off the pill, then got an implant, and now uses a combination of the Clue app and condoms. “Clue is awesome,” she says. “It makes me feel in control of my body and tells me when I’m fertile. I’d be open to using it alone, except for my concerns about STIs.” Since coming off the pill, she has had a “massive mood boost”.

***

One woman told me she saw the pill as “the lesser of several evils”, which is probably a good expression of most women’s view of their choice of contraception.

There’s an ingrained, insurmountable biological unfairness throughout the contraception debate, since women, even as we near an age of male pills and longer-term contraceptive options for men, bear the brunt of the decisions, health effects and stress around contraception.

Marie* went off the pill following dramatic mood swings, but now, her new boyfriend is “a bit less forgiving” when it comes to using condoms. “He’s really keen that I use something else, so I’m currently looking.”

Zoe* started out using Cerazette in 2012, which she says sent her “a bit loopy”, tried the coil, which was “incredibly painful”, then returned to the pill. Her boyfriend was unwilling to use condoms, and throughout, “I certainly felt that finding the right method of contraception was in my hands only, not a shared endeavour.”

These long, winding medical histories, reeled off at a moment’s notice, are common among women who use contraception. In this sense, to be fertile is a health condition which many women struggle with for much of their lives.

Meanwhile, society contains a frustrating contradiction. Women’s bodies are mythologised and sexualised, and yet discussion of their intimate workings are taboo in many forums. In 2010, a student at Dartmouth College in the US handed out nearly 2,000 hand mirrors to women so they could see their own genitalia, perhaps for the first time. A student paper called her campaign “disrespectful” to women of faith – and yet one has to wonder what motivates a religion to hide a woman's genitalia from its owner. Other students, meanwhile, saw the mirrors as an “in-your-face show of sexual profligacy”. 

Meanwhile, we ask women to make decisions about their uteruses which could affect their mental and physical health for years to come, based on a dearth of support and information which begins in the schoolroom and continues in the doctor’s office. “I was just shown some leaflets” was a common refrain among the women I spoke to. The online movement around contraception is a sign that advice and guidance serves aren’t working offline. 

So what’s the solution? Perhaps the most positive story I heard throughout this research came at the conclusion of one of the most distressing. Lisa*, whose pill interfered with her anti-depressants, eventually decided to get a coil. “My GP, who I don’t think had ever put in a coil before, tried to install a coil and did it wrong. It was one of the most traumatic medical experiences I have had – even as someone who lived in and out of hospital for two years for other reasons.”

She then found the Margaret Pyke Centre, a contraceptive and reproductive clinic in King’s Cross. The centre offers one-on-one appointments where women can discuss their decision, and Lisa says they “took me through all my options, with models [of the coil] which i could play with and loads of proper information”.

She opted for the coil again, which surprised me given her previous experiences – even a standard coil insertion procedure can range from uncomfortable to painful. So what changed her mind? “If you go to Margaret Pyke on your own for the operation, there is quite literally someone there to hold your hand.”

In an age of shrinking health budgets and ever-more confused messaging around women’s bodies, safe contraception chosen by women with access to all the information should be a right, not a privilege. Meanwhile, continued research into the pill's side effects should be a much higher priority, as the hormonal dosages may be lower, but the drugs have developed little since the 1960s. The male contraceptive pill has been hampered in its development by the fact that 63 per cent of men say they wouldn't take it if it caused side effects like weight gain and acne; side effects which most women would consider par for the course, compared to the far worse effects some experience.

The pill and the general normalisation of contraception in the UK helped shrink families, ratchet up gender equality, and increase prosperity across the second half of the twentieth century. Yet since then, progress seems to have slowed to a crawl.

“The lack of research into contraception’s side effects is unreal,” Yara says. “But it’s such a fundamental part of being a human with a uterus. To be able to not be pregnant.”

*Most names have been changed.

For advice on contraception, try your local GP surgery, the Family Planning Association, or specialist sexual health and contraceptive services, a list of which can be found here

You can join the fight to save the Margaret Pyke Centre here

Barbara Speed is a technology and digital culture writer at the New Statesman and a staff writer at CityMetric.