Putting Men on "The Pill"?
In 1963, John Rock, the physician most responsible for developing the first birth control pill for women (Enovid), optimistically said that “it will not be long now” until scientists create a contraceptive for men. Rock, who died in 1984, would have been thrilled by reports by the Endocrine Society two weeks ago of promising phase 2 clinical trials for a new contraceptive gel for men and other people whose bodies produce sperm. Participants in the study applied the gel to their shoulder blades each morning for at least several weeks and in many cases for a full year. By week 15, most (86%) of the participants had a sperm count of 1 million or fewer per milliliter of semen, which scientists deem the point of contraceptive efficacy. (Sperm counts usually range between 15 and 200 million sperm per milliliter of semen.)
Key to the gel’s enthusiastic reception by contraception-minded researchers was that is did not appear to dampen men’s sex drives. Too much testosterone not only leads to low sperm counts but can kill the libido. Earlier versions of a male contraceptive gel had high doses of testosterone that reduced sperm counts, leading to many complaints about a loss of sex drive. The gel in this study was effective despite much smaller doses of testosterone than those earlier formulas because it combined testosterone with segesterone acetate (named Nestorone), one of the hormones found in vaginal ring contraceptives. Trials of other methods of reducing sperm counts are ongoing, with a variety of nonhormonal options under development. One of the reasons it has been more than six decades since the first Pill for women went on the market and yet a male option is not yet FDA-approved is that men’s complaints about low libido drove away potential funders.
Male sex drive has been cited as a reason to avoid female contraceptives, too. After the FDA approved Enovid in 1960, sexual health experts from across the political spectrum warned that it might damage the libido—of men. As I wrote a few weeks ago:
As the historian Elaine Tyler May writes in her excellent book, America and the Pill, these experts associated women’s use of the pill with male impotence. According to psychotherapist Rollo May, “being able to get a woman pregnant is a much deeper proof of manhood than anything else our culture has to offer.” As a result of growing use of the pill, “impotence is increasing. Men feel like drone bees.” What Rollo May and, unfortunately, quite a few health experts of the time believed was this: When women initiate sex, look forward to sex unconcerned about an unplanned pregnancy, and adopt an enthusiasm for sex as a source of personal and relationship pleasure, men suffer.
These experts worried not at all about the effect of hormonal contraceptives on women’s sex drives. Far from it; only a media blitz in the late 1960s in response to a controversial book by Barbara Seaman, The Doctor’s Case Against the Pill (1969), shifted the conversation. By exposing serious health risks associated with Enovid, Seaman drew eyes and ears to women’s well-documented complaints of blood clots, severe cramps, weight gain, bloating, and drastic mood swings, side-effects aired in a series of high-profile Senate hearings about the medication’s safety in 1970. Researchers have since developed lower dose options that reduce the likelihood of those side effects. But until Seaman wrote her book, the major complaints about the pill were its effects on men’s sexual enjoyment, not the suffering it caused many of the people who took it.
Yet women’s pleasure is central to the history of legal birth control in the United States. Margaret Sanger, founder of the American Birth Control League, the predecessor organization of Planned Parenthood, belonged to a community of leftist artists, writers, and activists in Greenwich Village, New York when she started her campaign for legal birth control in the 1910s. For Sanger, women’s ability to get fitted for a diaphragm would enable them not only to have some control over the frequency of their pregnancies for the sake of their health or home finances, but would also enable women to enjoy sex, freed from the nagging fear of an unwanted or mis-timed pregnancy. Russian-born anarchist, free lover, and birth control activist Emma Goldman similarly described women’s ability to access contraception as a means of both liberating the working classes and liberating women to pursue the sexual pleasures they desired.
Lately, much of the public debate over access to abortion and contraception has framed the issue as a matter of women’s health. (And, to be clear, I think that’s a hugely important reason why full spectrum health care is so essential.) Some of the most effective—and heart-rending—accounts of the Dobbs decision’s disastrous consequences have been from married women who sought medically necessary abortion care for a much-wanted pregnancy. This focus on married women’s health echoes many previous campaigns for contraceptive access. In the second half of the 1800s, a small group of women’s rights activists began to champion “Voluntary Motherhood,” by which they meant the preservation of a mother’s health to enable her to provide better care to the children she already had. That’s partly why the modern birth control movement was such a dramatic departure from what came before it. When Sanger and Goldman stood atop soap boxes in Union Square to hand out leaflets explaining women’s need for birth control, they well understood that what they pursued was not limited to women’s health or the eradication of poverty within the working classes. For them, contraception was at once a political necessity and a means of defending their right to erotic freedom.
It’s clear from the conversation about male contraception—and the difficulty scientists have had securing adequate funding to research it—that Americans recognize that contraception should never impinge on the enjoyment of sex, at least when the enjoyment in question is men’s. We need to talk about women’s access to full spectrum reproductive health care in terms of their pleasure, too. Lately I’ve been thinking a lot about the history of pleasure in the United States — who has been permitted or denied the ability to have fun. As we stand up for reproductive freedom, we might speak out as well for everyone’s right to the (consensual) pleasures they pursue.
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Book News! As many of you know, I have a book due out September 3, Fierce Desires: A New History of Sex and Sexuality in America (W.W. Norton). Pre-orders are hugely important to a book’s successful launch, so if you haven’t yet ordered your copy (or one for all of your friends), please consider doing so now! And thank you!
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