Does the future of birth control lie with men?
Leaders of the conference The Future of Male Contraception, held in Seattle just two weeks ago, think it's a possibility.
The conference, sponsored by the National Institutes for Health, the University of Washington, and the World Health Organization, among others, presented a new world of contraception for men – beyond vasectomies and condoms.
According to a Science Daily article, birth control methods familiar to most women in the U.S. were discussed – a "testosterone-like" oral pill and a Depo-Provera shot (a once/every three month injection of progestin). And a vasectomy alternative, the Intra Vas Device (IVD), was presented, fresh from tests in its first U.S. study. A set of plugs inserted into the vas deferens that block sperm from traveling through the tube, the Intra Vas Device was successful at the end of six months in ensuring that 92% of the men studied had no sperm (or very little sperm) in their ejaculate. Longer term studies would need to be done to guarantee that fertility would return after the IVD was removed.
Despite these successes, drug trials and studies are only a first step towards making male contraceptive methods widely available.
"We could have something like the IVD on the market in four to five years, if we make an all-out effort with funding and focus. But if we continue with just a study here and a study there, it could be an eternity," says Elaine Lissner, director of the Male Contraception Information Project. Even with adequate funding for studies, buy-in from policy makers, pharmaceutical companies and the increasingly politicized FDA may extend that time line to five to ten years.
But is male contraception appealing to males?
Lissner says it should be. "If I were a guy, I'd want [birth control treatments] when I turned sixteen," Lissner told the University of Washington Daily Newspaper. She also says that not only will male contraception ensure that women will "no longer have to suffer through unpleasant hormonal side effects," but that "men will no longer have to contend with unplanned parental responsibilities."
Male contraception as a remedy for men needing to take on unplanned parental responsibilities seems like a stretch; when a man chooses to have sex with a woman, he is also choosing to take the risk that she may get pregnant and decide to keep the baby. Male contraception may make it less likely that a woman is purposefully able to get pregnant without her partner's knowledge, but "forced" fatherhood is a reality with which men who choose to have sex with women must contend.
As for the idea that women will no longer have to experience side effects from birth control, if women don't want to tangle with hormonal side effects, why should we expect or encourage men to? Heading straight to the source, I asked men and their partners if they would use more "diverse" methods of contraception for men. Jon, a 35-year-old, recently married man, says, "I do have concerns about ingesting hormones or chemicals… I would want to do a healthy dose of research before I started on any of them. Are there known risks? How effective are they?" But another man I spoke with said simply: "If I can eat a Twinkie, I can surely have doctor-approved hormones in my body to ensure responsibility."
Thirty-nine year-old Tracy, married with a child, when discussing the possibility of her husband using a male contraceptive, says, "It would be part of a conversation we'd have together about…his willingness to expose his body to whatever potentially harmful or benign side effects of hormones/chemicals might exist…I don't think I'd want him to be exposed to synthetic hormones and their side effects." On the whole, however, Tracy would consider using a male contraceptive with a long-term, monogamous partner, or with a non-monogamous partner but only if they were also using a method of sexually transmitted infection prevention as well.
All things being equal, though, male contraception may have a lot to add to family planning, releasing women from the stranglehold birth control can wield over their lives. Malecontraceptives.org, an informational web site that is now a project of the International Male Contraception Coalition (and originally founded to build upon the work of Elaine Lissner's Male Contraception Information Project) says "…we think that some experimental male contraceptives promise to be safer, more effective, more convenient, and easier to reverse than any existing female methods." That might just be music to a lot of women's ears (and eggs).
The development of contraceptive technology is only a first step towards embracing a more balanced responsibility for family planning and birth control. Will men use contraception that requires more effort than just stopping off at the pharmacy for condoms or more frequent attention than a one-time vasectomy?
Jon says, "I wouldn't use the plugs, let me just put that out there. But if the Depo shot stood up well I'd go for that one, just for the convenience of only having to do it every three months." Another man I spoke with said: "I love the idea of getting a shot or a pill or a plug and then being able to concentrate on having fun."
But will women trust men when they say are "on the pill"? Malecontraceptives.org says yes:
"In a survey of 450 Scottish women, 94% said "a male hormonal contraceptive would be a good idea" (Martin 1997). A later study that included Cape Town, Shanghai and Hong Kong showed that only 2% of the women surveyed would not trust their partners to use a male pill (Glasier 2000)."
When asked whether she would trust a man who told her he was using a contraceptive method, Alex, a 34-year old woman from Seattle, says, "I would trust him if he said he was taking it whether or not we were in a relationship." Tracy, however, says, "I would still assume that I should be taking charge of my own fertility with my method of choice. After all, no contraception is fool proof, and if I really did not want a pregnancy, I should take of care of myself…and doubling up could only provide extra assurance!"
Studies also show that men want better access to contraception. Again, from Malecontraceptives.org:
"In a recent study of British men, 80% placed a hypothetical male pill as one of their top three contraceptive choices (Brooks 1998). Another study found that over 60% of men in Germany, Spain, Brazil and Mexico were willing to use a new method of male contraception (Heinemann 2005)."
The political implications of male contraception are to be considered as well. Would the anti-choice activist community raise their hackles over contraception for men in the same way they do over women's birth control? In a Seattle Post-Intelligencer article, Dr. Bill Bremner, chairman of the Department of Medicine and director of the male contraception research center at the University of Washington, says, "This country has a pretty repressive history as far as reproductive use." Why haven't anti-choicers already taken note and made moves to block studies and funding or developed a political strategy against the development of these technologies? Their reaction (or inaction) on this subject may only serve to magnify their anti-contraception stance as a smoke-and-mirror for their fear and hatred of women's sexuality.
Also, will male contraception in some way allow women and the reproductive health movement to more thoroughly address the contradictions inherent in birth control access in this country? Women have struggled for decades to gain and retain access to birth control as a road to autonomy and equality. But while access to contraception is still a challenge for many, current methods can leave women in the United States fantasizing about throwing out their pills, taking out their IUDs or sitting for their last Depo-Provera injection. In other words, birth control is a burden, it's a hassle, and it frequently comes with some serious physical and psychological side effects. Is this what we want to "share" with men? For now, it certainly seems like our best option.
Jon says, "I do think this could be a shared responsibility between men and women, and really should always be a shared responsibility. I know that wouldn't work in every situation, but I also think that the situation where a shared responsibility will not work points to other large problems in the relationship." Another man I spoke with said, "Women have been bearing the burden for a long time now. It's about time that men started taking responsibility for where they do or don't put their sperm."
Supporting the development of more diverse and usable forms of male contraception will help expand the idea that family planning is a shared responsibility. An exciting and encouraging advancement for sure. But shared responsibility, while certainly a positive progression, does not mean equal responsibility. Whether or not more convenient and varied forms of male contraception become a reality, women may always need to shoulder most of the burden of birth control. As one woman I spoke with put it, "I would love this option, but if I was a single girl out there, I don't think I'd take my partner's word for it. The consequences are just too high for me. What if he forgot? I'd have to bear the burden of pregnancy or abortion."