Are we closer to a pill for men?

Word on the street, okay in the New York Times, is that we are getting closer and closer to getting long-awaited male contraception:

Prompted by women’s organizations, global health groups and surveys indicating that men are receptive, federal agencies are financing research. Some methods will be presented at an October conference sponsored by the Bill and Melinda Gates Foundation.

“Male contraception is a critical area,” said Jenny Sorensen, a foundation spokeswoman. “It doesn’t make sense to not include everyone in the discussion.”

Srsly. What the heck has taken so long, one might reasonably ask? Elaine Tyler May has a great chapter on the history of science on the male pill in her book, America + the Pill. She writes:

The emphasis on women is embedded in the institutional frameworks of science, medicine, and pharmaceuticals. Both women and men think of reproduction in terms of women’s bodies and of birth control as women’s responsibility. The fact that hte medical profession generally considers reproduction a female concern has let to a scarcity of doctors trained in male reproduction medicine and a shortage of scientists interested in working on male contraception.

In other words, it’s not so much a problem of science as culture. Because we make reproduction a “woman’s issue,” fewer dollars, attention, and societal pressure get put in the direction of developing technologies that might help men share the load of contraception in more diverse ways. After all, women are supposed to be the responsible ones, right? The New York Times points to an underlying fear haunting the development of the male pill:

Of course, women may have to trust that their partners are using birth control, as men do now. But at least one method, hormone implants, visibly bulge from a man’s bicep. “Guys like it because they can show it off,” Dr. Amory said. “Proof that the male is contracepting.”

I can already hear the craptastic pick-up lines. Lordy.

So the question remains: if you’re the kind of gal who partners with men, would you trust them to take oral contraception responsibly or would you rather keep the pill in your court, so to speak?

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20 Comments

  1. Posted July 25, 2011 at 4:24 pm | Permalink

    Definitely. I’ve got a hereditary blood clotting risk and apparently some doctors are saying even the mini-pill may be too risky for people with this clotting factor to take, which throws my options back to the less reliable and primitive barrier methods (or continuing to take the mini pill, baby aspirin, and hope to god I’m active enough to ward off blood clots). I’m in a long term committed relationship so if my boyfriend could be the one “contracepting”, that would be fantastic- and something he’d be on board with. He takes an active role in OUR contraception now anyway. He always checks that I’ve taken my pill before I leave house and pays for half of the prescription. He was even paying for half my yearly exams before my insurance paid everything!

    • Posted July 26, 2011 at 12:39 pm | Permalink

      Hey Natalie. I was in a similar situation as you… due to a history of classic migraine I am at an increased risk of blood clots while on the pill. This said, I was able to find a better, more effective form of birth control than the pill… the IUD. The IUD got a bad reputation due to one defective model in the 70s, but evidence based studies are showing that it is safe to use in women who have and who have not yet given birth. I just got my IUD last week and I love it already. It is the most effective reversible form of birth control (even more than the pill). I am using the Mirena IUD, which does contain progesterone, however it is only local (not systemic) so there is no increased risk of blood clots and none of the other hormonal side effects of the pill. If you absolutely are uncomfortable with hormones, there is a model made out of copper called the Paraguard you can look into which is hormone free. Best of all, it is no fuss and effective for a long time. Once the IUD is inserted it is good for 5 years (off label can be used for 7 yrs; the paraguard is good for 10 years), however it can be removed early at any time the user wishes. This means I won’t have to worry about birth control until July 2018. I no longer have to take a pill everyday, in fact I don’t have to do anything! I paid 85.00 canadian for my Mirena IUD and my insurance covered the remaining $315.00- that works out to $1.00 per month over the next 7 yrs. For some reason North Americans are reluctant to use the IUD (only 1% of North American female contraceptive users choose this as their method), however this method is very popular elsewhere. In Europe about 1 in 3 women use it. In Scandinavia and Sweden 40% female contraceptive users use it. Until there are more male centere options available, if you want no fuss, affordable, extremely effective birth control, I would recommend you ask your ob gyn about IUDs.

  2. Posted July 25, 2011 at 4:28 pm | Permalink

    As a lady who is monogamously married to a man, I would really love for there to be a male contraceptive pill, either so that we could be doubly safe, or so that we could each give our bodies a break from the side effects of hormonal birth control.

    But if I had multiple partners, especially ones I didn’t know super well, I think I would still rely on my own hormonal birth control (and insist on a barrier method to guard against STIs), but I would consider it an extra boon if a partner was also using hormonal contraceptives.

  3. Posted July 25, 2011 at 4:32 pm | Permalink

    I am a man, and I am excited as Hell at this idea.

  4. Posted July 25, 2011 at 4:35 pm | Permalink

    I think it’s fabulous that hormonal birth control methods will become available to men. It’s a really big step towards reproductive equality, so I’m all for it.

    That being said… Just because prospective male partners would be able to take a pill, it’s no reason for us to stop taking our own pills. I love being in control of my birth control and I would just feel safer knowing that I’d be doing my part to avoid having the “b” word. All birth control methods have some margin of error, anyways– If you’re sick and take another pill, it may diminish the effects of whatever hormonal birth control you’re taking; or even if you’re just a smidgen late taking the pill, it can do the same thing. That isn’t even taking into consideration how reliable your partner is at taking the pill… My boyfriend is a great guy, but he forgets his current medications enough without having to worry about birth control.

    I guess what I’m saying is: Men should have access to reliable hormonal birth control (and it’s great that they will!), but it doesn’t change the importance of our own.

  5. Posted July 25, 2011 at 4:55 pm | Permalink

    Personally, I’m a guy, but I come from an incredibly fertile family. Already, my fiancee and I use both oral contraception (her) and condoms (us). If this becomes available, we’ll just add that in to our overall anti-baby regimen.

    I can’t imagine ever trusting the other person to do everything properly.

  6. Posted July 25, 2011 at 4:56 pm | Permalink

    Both me and my partner are the types of people who, despite being on the same medication regimen for years, still forget to take pills, so I would not trust him to take pills every day at the right time. Likewise, he would not trust me to do the same…so we don’t use the pill, obviously, for that among other reasons. I trust him to do things that I know he can do (make delicious falafel, be honest and respectful to me)…that just isn’t one of them.

    I really really hope male contraceptives gain ground in the US. Reversible male sterilization (with a polymer injection) seems like an awesome, viable thing for a lot of young men, particularly those like Mister Third Wave Housewife, who are in long-term partnerships with no foreseeable plans to procreate. Since it isn’t a viable option now, I don’t think he has ever given much thought to it…and he definitely hasn’t given any thought to hormones, because that seems pretty far off. Even if he were to get, say, an implant, I would still consider it a shared commitment (we’d split the cost, I would still be tracking my fertility like a hawk) for us to rely primarily on that implant for contraception.

  7. Posted July 25, 2011 at 4:57 pm | Permalink

    @Courtney: “if you’re the kind of gal who partners with men, would you trust them to take oral contraception responsibly or would you rather keep the pill in your court, so to speak?”

    All things considered wouldn’t it be better if you both kept the pill in your respective courts?

    Because while even the low-dose versions of The Pill for women are quite reliable when taken conscientiously in practice the risks of fertility can be higher. It does sound like most of the mechanisms for hormonally deactivating sperm or blocking its production (testosterone, progestin) might create a little more room for slackers. But while there’s no reason believe men would be any less reliable than women about taking The Pill for men, there’s also no reason to believe they’d be any more so.

    There’s a reason reasonably cautious people always rely on two forms of contraception. And the advent of a male Pill isn’t going to magically change that.

    What it will change is that it’ll give men a third contraceptive option beyond condoms and vasectomies. And since it’ll almost certainly be more reliable than condoms for contraception, and waaaay more reversible than vasectomies, I’m guessing the uptake will actually turn out to be pretty high.

    One thing I think will be really important about a male Pill, is a verification method to make sure it’s working. Comic imagery not withstanding, a chip in a bicep would be good. Even better though would be one that could be checked on the spot pregnancy-test style with, say, tagged-antibodies for active presence of either active or inactive sperm in semen or pre-ejaculatory secretions. (Extra credit if saliva or urine could be used instead.)

    Anyway, not only would something like that be useful confirmation for women in couples who are just initiating sex with each other, it would be useful for men to confirm that their contraceptive is working correctly.

    And finally, I feel quite confident that when a reliable but easily reversible form of non-barrier contraception becomes available for men that it’ll transform men’s relationship with our fertility, it will reduce our odd indoctrinated fatalism about pregnancy being “in the woman’s hands,” and it’ll definitely reduce peer male sympathy when another man’s partner has an unplanned, unwanted pregnancy.

    I’ve mentioned this before elsewhere but I think for once MRA-style paranoia about “paternity fraud” and forms of pregnancy-related learned helplessness can be used to increase demand for a male Pill! Although even then over time I suspect having more pragmatic control over their own fertility will tend to mellow a lot of those guys out and/or make it more difficult for them to play the victim card if they choose to avoid it.

    figleaf

    p.s. Based at least on my experience with a vasectomy at age 21, while my partners tended to be interested that I had one I don’t believe knowing I was infertile changed anyone’s decision one way or the other. So while there may be some bicep-flexers I’m pretty sure that willl never be the deciding factor.

  8. Posted July 25, 2011 at 6:06 pm | Permalink

    I don’t know that this is something I’m in favor of. However, that has more to do with the fact that I’m not crazy about hormonal contraceptive. The tests that a scientist in India has been running are a lot more interesting to me.

    I’m not super well versed in it, but basically a guy has this gel inserted into the tube (or whatever) that the sperm comes out of and that slows them down so they can’t reach the egg. It can be reversed at any time with another injection, but it’s effective for up to 15 years.

  9. Posted July 25, 2011 at 7:58 pm | Permalink

    On a population level, I think more contraceptive options = positive.

    For me, I’ve always liked to use a me-controlled method of contraception, sometimes in addition to whatever my partner at the time might be using. I’m not always monogamous and when I have multiple partners with whom procreative potential exists, it’s been more convenient for me, organizationally, to use a method that I control.

  10. Posted July 25, 2011 at 8:09 pm | Permalink

    Quick question for Courtney regarding “‘Guys like it because they can show it off,’ Dr. Amory said. ‘Proof that the male is contracepting.’”

    What makes you think men would only be showing off to women? What would be the impact if they instead were showing it off to men who didn’t (yet) have theirs?

    And again, how do you think the social messaging for contraceptively irresponsible men when they can’t count on the kind of passive-aggressive peer commiseration they’ve been able to rely on for, oh, the last 6,000 years?

    I’m just saying please don’t discount (or deprecate!) the possibility of positive peer pressure when this finally (finally!) becomes a reality.

    figleaf

    p.s. Kind of weird to think that not a single new form of male birth control was developed during the entire 20th Century! Withdrawal is ancient, condoms are around 500 years old, vasectomies were developed early in the 1800s.

  11. Posted July 25, 2011 at 8:21 pm | Permalink

    I’d definitely be interested, if only because at present, with my boyfriend (who I would definitely trust with contraception, if it came to that), we’re relying on a single method (my pill) for contraception. I think it would depend on the potential side effects, but it’s definitely something we’d discuss if it became available.

  12. Posted July 25, 2011 at 8:26 pm | Permalink

    In a committed, monogamous relationship with a man, heck yes I’d trust him to take his pill each day. If I wanted to hook up with somebody as a one-night-stand or friends-with-benefits or any other sort of casual sex sort of thing, not only would I not necessarily trust the guy to be taking a pill, I would also not trust that he is STD-free, and condom use would be a must.

    In any case, I don’t think I’d stop taking my own pill no matter what the man is doing. I have experienced only positive side effects (most notably, lighter periods) and even if I knew I was going to be single for the next five years I’d continue taking my pill for those side effects.

  13. Posted July 25, 2011 at 8:56 pm | Permalink

    I didn’t see this mentioned: http://www.pbs.org/newshour/bb/health/july-dec11/birth_07-18.html but it sounds far superior to the hormonal options.

  14. Posted July 25, 2011 at 11:41 pm | Permalink

    As much as I’m an advocate for birth control, I would never trust a man with my sole contraceptive device. Men simply don’t have the same level of vested interest in preventing pregnancy that women have.

    • Posted July 26, 2011 at 10:31 am | Permalink

      As a man I think you’re a little off with this comment. I long ago decided I didn’t want to have children outside of a committed relationship. Since my options to prevent that once a child is conceived, anything that gives me an additional ability to ensure a child is not conceived is of great interest to me.

      I think the media also has a role in this. It seems in maybe 80% of the articles I read always find a woman to quote who says something along the lines of what you just did, that they wouldn’t trust a man to take it reliably. Somehow this is interpreted as a lower demand.

      I’m going to throw this out there. Pharmaceutical birth control for men has as much to do with women as pharmaceutical options for women have to do with men. Whether or not men “trust” women to take their pill reliably should have no bearing on availability or affect the importance of such options. It’s about taking personal responsibility for your reproductive choices.

  15. Posted July 26, 2011 at 4:17 am | Permalink

    “In other words, it’s not so much a problem of science as culture. ”

    It isn’t that simple. There are vast biological differences that make the development of a pill for men harder.

  16. Posted July 26, 2011 at 11:46 am | Permalink

    I would adore it if male contraceptive existed! That would mean that both parties could take responsibility for their birth control! No more “She told me she was on the pill!”, no more “I think she stuck pin holes through the condoms!”, personal responsibility on both ends of the spectrum. Plus, you could double up and be extra safe if both partners were on birth control. If you manage to get pregnant through male BC, female BC, AND a prophylactic, at least nobody can say you weren’t being responsible! :D Although, to be fair, there’s probably some jerk out there who would say it anyway!

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