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In response to a recent Department of Health & Human Services mandate, Christopher Tollefson offers a fine starting point for understanding the difference between genuine healthcare and the use of contraceptives: i.e., healthcare has to do with treatments and “preventive services” that guard against illness; and that the inability to engage in sexual intercourse without fear of conceiving a child does not count as such.

A popular response to this position—and one that causes no small amount of confusion for even the most clear-thinking individuals—is that the ability to act freely with regard to one’s natural sexual desires is in fact a matter of health, since proper sexual expression is one vital aspect of a person’s overall well-being. Moreover, this case contains both psychological as well as physical components, making it all the more appealing. Access to contraceptives enables women (and men) to maintain psychological and physical balance, many would say, since it removes the possibility of potentially devastating consequences (i.e., pregnancy) from an otherwise beneficial and natural type of human interaction. In short, sex is unavoidable, and necessary for our health; and the possible physical and psychological side effects of sex resulting in pregnancy require that we have subsidized access to contraceptives and sterilization procedures.

This way of thinking, popular as it is, assumes a number of things—not the least of which is the idea that proper sexual expression necessarily entails genital sexual expression with another person (or even at all). But for the purpose of our conversation, here, this perspective also assumes that the preclusion of activities, for whatever reason, that could be healthy is tantamount to an illness, in itself. In other words, per the case at hand, something precluding full sexual expression vis-à-vis genital intercourse with another is seen as an inhibition to health; and it is therefore classed and treated as an illness.

Tollefsen is right when he notes that the recent HHS decision points us in a direction of responding almost exclusively to “patient desires.” And desires, when it comes to grounding sweeping policy decision, are an uncertain thing.

Andrew Haines is a PhD student in philosophy at The Catholic University of America, and president of the  Center for Morality in Public Life .

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