This book assesses the impact of gender in shaping debates over birth control in the United States. While situating itself in the appropriate historical context, this book’s primary focus is on the controversies surrounding insurance coverage of contraception between Congress’s 2009 deliberations over the Affordable Care Act and the Supreme Court’s 2016 ruling in Zubik v. Burwell. Specifically, the book addresses three interrelated questions about the politics of the pill during this often contentious seven-year period: Who spoke? What did they say? Did it matter? In answering these questions, the book casts a wide net, examining legislative floor debates, committee hearings, statutory wording, amicus briefs, media coverage, Supreme Court rulings, and public opinion polls. Throughout this examination, the book emphasizes the ways in which contraception fit into broader conversations about morality, women’s agency, and reproductive health, and it considers how gender intersected with other identities (e.g., religion and partisanship), in driving media frames, policy narratives, and political attitudes. The book’s central argument is that who has a voice significantly impacts policy deliberation and outcomes. While women’s participation in contraception debates was limited by a lack of gender parity in the media, the legislatures, and the courts, women nevertheless shaped policy making on birth control in myriad and interconnected ways. Put simply, the inclusion and exclusion of women is essential to understanding the tenor, quantity, and quality of contraception debates across time, place, and venue.