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3 November 2016

Are you man enough for birth control?

A collective cultural resistance has halted scientific progress on the male contraceptive pill.

By Laurie Penny

When I heard the news that trials of hormonal birth control for men had been halted because the men in question could not cope with such side effects as “acne and mood swings”, I happened to be flat on the floor with pain. Specifically, I was halfway through the regular 24-hour hell period that has been my monthly reality ever since I changed my contraception. It’s a hardcore enough experience that if men had to go through this on a regular basis, they’d be boasting about it. I did the research for this article while trying not to vomit through the sensation of my insides being slowly gouged out with cold metal hooks of biological inequity. I’m sorry if that’s uncomfortable to read. It’s even more uncomfortable to have happen to you, and hundreds of millions of women and girls go through something like it every month and more, and that’s the point. We cannot talk about reproductive science without getting into the messy, painful stuff that a lot of people would rather women dealt with in private.

Given that my uterus appeared to be losing a bar-brawl with my kidneys, I was in no mood to feel anything but womb-aching contempt for anyone prissy and precious enough to flake out of a birth control trial because they weren’t man enough to deal with a bit of grumpiness and the odd spot. The new male contraceptive injection — considered more marketable than a daily pill, because nobody, apparently, is about to trust a bloke to remember his meds — has been halted because of “side effects”. Among the side effects in question were acne, mood swings and libido changes — other rarer ones included testicular pain, night sweats, and confusion. These are some of the same side effects, that women who take hormonal contraception have been dealing with for decades, alongside blood clots, major depression, weight gain and, very occasionally, death. These risks have always been considered an acceptable tradeoff for women — but men apparently demand a higher quality of life.

Or do they? Here’s where it gets interesting. Reading some of the coverage, you’d think that every man in this trial was a Rubbish Sitcom Male from central casting who ran screaming at the first stray chin-spot. In fact, only 20 men out of a trial of hundreds dropped out — and 82.3 per cent of participants said that if they had the option, they would use the contraceptive jab in future.

That’s the key point here: it was not the actual men involved who halted the trials, but the researchers running the study. It seems to have been determined that these side effects are too arduous to make the product commercially viable.  We can only speculate as to why this conclusion was arrived at. The bottom line is the assumption that men should never have to put up with even a fraction of the unpleasantness that so many women go through on a monthly basis in the name of preventing pregnancy — even if they’re willing to do so.

Which, it seems, many of them are. Speaking about this with friends and on social media, I was stunned by the number of men who said they’d be prepared to try out hormonal contraception — for all sorts of reasons. Some of them had partners who were unable to take the pill. Others simply wanted better protection from unwanted pregnancy. More than a few, seeing how their wives and partners suffered with hormonal birth control, said they’d be happy to take on that burden instead. Suspicious as I am of the “gentlemanly” agenda, that impulse strikes me as genuinely chivalrous in the most modern of ways.

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Sadly, there is still huge cultural resistance to the idea of men and boys taking responsibility for birth control. We have had the technology to create a male hormonal contraceptive for decades, but the will has been lacking — even as products such as Viagara make billions every year. The received wisdom is that that they simply can’t be trusted, it’s the kind of popular misandry that goes unremarked so long as it gives men a gym pass from social engagement. I suspect that there may be a little more to it than that. I submit that the fundamental principle is that contraception, reproduction, all the messy, difficult, painful parts of human life are women’s work, and it is undignified to ask men to get involved. When it comes to gender and sexuality, is it the science that’s lagging behind — or is it social attitudes?

The history of contraceptive research and technology is a hundred-year story of medical science botched and scuppered at every stage by bigotry, misogyny, racism and religious intolerance. When the pill was finally approved for use in the US in the Sixties — initially only to married women — it took over a decade for doctors to accept that the hormones being prescribed were far stronger than necessary. The women complaining of mental health problems and nightmarish physical symptoms were assumed to be either hysterical or driven mad by promiscuity — either way, they were ignored until the Seventies. To this day, there exists a cultural tension between not wanting to know about the bloody business of female reproduction and at the same time wanting to control it.

Women’s right to control their fertility is under attack across the world, and in those places where access to birth control is legal, it is still assumed that anyone with a uterus should suffer for their sexuality. We should take what we’re given and be grateful for it. We should make the tradeoffs, take the risks, and clear up the mess so men don’t have to, just like we always do. If we’re given the option of freedom from unwanted pregnancy, it is natural that we should have to give something up — our health, our wellbeing, our lives. The notion that men might be asked to give up something too — and worse, that they might be willing to do so — is too threatening to contemplate.

The story of a male contraceptive jab halted because men were too distressed by the side effects to stay the course is as disappointing as it is familiar. It fits the cultural narrative whereby men can’t possibly be trusted with traditionally female responsibilities — from washing up to changing nappies, if you leave it to the guys, they’ll either flake out, fuck it up or both. We should simply let them off the hook, and let the women get on with it, grit their teeth though they may. That’s nature’s way, or God’s, depending on who you ask. But that’s not what happened here. The real story is more interesting. The real story — of research halted despite most of the men involved being enthusiastic, and a great many people all over the world wondering why the hell male hormonal contraception isn’t a thing yet — is a story of collective cultural resistance to scientific progress. Once again, technological advances that could improve people’s lives are on hold because we’re too socially backward to tell a different story about sex, love and gender.