6 May 4 - May 10, 2023 miaminewtimes.com | browardpalmbeach.com New Times | music | cafe | culture | Night+Day | News | letters | coNteNts | Month XX–Month XX, 2008 miaminewtimes.com MIAMI NEW TIMES | MUSIC | CAFE | FILM | ART | STAGE | NIGHT+DAY | METRO | RIPTIDE | LETTERS | CONTENTS | RX FOR TROUBLE Florida druggist refuses to fill prescription linked to abortion pill. BY TOM FINKEL M ost of the time, Dr. Jen Gunter supplies answers, not ques- tions. A Canadian-born OB/GYN who now practices in San Francisco, Gunter is the au- thor of The Vagina Bible (2019) and The Menopause Manifesto (2021), whose plain- spoken puncturing of the myths and misun- derstandings regarding the female body and reproductive system catapulted her to the upper echelons of the best-seller lists. Gunter might be even more internet-famous for skewering the sucker-born-every-min- ute sales pitches of Hollywood actress Gwyneth Paltrow, who regales women with the wonders of steaming their vaginas and stuffing jade “eggs” into them at $66 a pop. But she’s still awaiting an answer to the question she posed from her Twitter ac- count, @DrJenGunter, on the afternoon of April 25. “Hi @cvspharmacy,” reads the tweet, which Gunter also posted on her Instagram. “Can you explain why your pharmacy in Florida refused to fill this prescription for misoprostol?” The query is accompanied by a high- lighted partial screen grab of a doctor’s pre- scription indicating that the order — a single 200-microgram tablet of misoprostol to be taken “per vagina the night prior to your procedure” related to a diagnosis of “stric- ture and stenosis of cervix uteri” — had been declined. The reason: “FEDERAL JUDGE BANNED THIS MEDICATION RE- CENTLY.” Reached by New Times, Gunter clarified in a text that “[t]his isn’t my patient and I didn’t write the prescription. A doctor just asked me to make it public. I know the per- son so I know it’s valid. All I know is they tried to get this for their patient to help with a GYN procedure and a CVS employee re- fused. “I can say he is a real doctor, and this is how we would write that prescription,” she added. “One Tablet Per Vagina” The tweet is brief, the screenshot incom- plete, but there was a lot to unpack for the 4.5 million who’ve seen it. First, and most glaring: The pharmacist’s note almost certainly refers to a pending case in Texas that challenges the U.S. Food and Drug Administration’s (FDA) approval in 2000 of mifepristone, half of a two-drug regimen doctors prescribe to induce so- called medication abortions. A Donald Trump-appointed federal judge revoked ap- proval of mifepristone on April 7, but his or- der was put on hold and two weeks later the U.S. Supreme Court suspended the ruling until the Texas case is resolved. In other words, the pharmacist may have been twice mistaken: Mifepristone is legal, and the rejected prescription isn’t for mife- pristone; it’s for misoprostol — the other half of the two-drug regimen. Other commenters were thrown off by the instructions to be passed along to the pa- tient: “TAKE ONE TABLET PER VAGINA THE NIGHT PRIOR TO YOUR PROCE- DURE.” The confusion prompted the OB/ GYN to add her own comment, in which she clarified that “one tablet per vagina” is the technical way of instructing the patient to insert the tablet into their vagina as opposed to, say, consuming it by mouth. Then there was the diagnosis: “Stricture and stenosis of cervix uteri,” a narrowing of the opening that connects the uterus with the vagina (the cervix), which can cause pain and other complications. “I write this [prescription] weekly for preop on my hysteroscopies for cervical ste- nosis patients,” a fellow OB/GYN com- mented beneath Gunter’s tweet. “I have caught hell of late. I have to call every phar- macy and swear in blood that my post meno- pausal patient with thickened endometrium isn’t trying to abort. I am so tired of this.” Some patients shared that they too en- countered resistance after being prescribed misopros- tol for medical purposes other than abortion. “I’m in Florida & was pre- scribed Misopros- tol last week. I was grilled at Walgreens about it. I was able to get it, but everybody w/i earshot of the drive thru knows more abt my vagina than they probably wanted to,” one confided. Wrote another: “I live in Tampa and they gave me a major hard time about this (for my endometrial biopsy!), it was infuriating.” And a third: “Texas here. Had misopros- tol for IUD insertion last December. Was grilled by a tech at Walgreens about why I was filling it despite it being on the label and my doctor’s office calling to clarify verbally what the two tabs were being used for. Ugh.” “Getting There Together” As of 2016, according to the National Women’s Law Center, 13 U.S. states had en- acted laws or rules allowing phmacists to decline to fill prescriptions on moral or reli- gious grounds. Seven of those states permit- ted refusals but required that the patient be passed along to another pharmacist or their prescription transferred to another phar- macy. Six states specifically allowed refusals for religious or moral reasons with no strings attached. Eight states explicitly barred pharmacists from interfering with a patient’s access to prescribed medication. Under certain circumstances, pharma- cists in Florida may — and may be required by law to — refuse to fill a prescription. Those regulations specify “controlled sub- stances” and, in the case of Florida Statute 893, “drug abuse prevention and control.” Though misoprostol has many other uses, administering it alone, or in combination with drugs other, is effective in inducing abortion. Photoillustration by Anna Moneymaker/Getty Images | METRO | PENDING LEGISLATION WOULD ALLOW FLORIDA PHARMACISTS TO DENY PRESCRIPTIONS ON THE BASIS OF MORAL, RELIGIOUS, AND ETHICAL BELIEFS.
