Courtney Martin asks of the recent and trending buzz about effective hormonal contraception for men

...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?

Source: Feministing

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.

Martin also semi-snarks

"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.

First of all, 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 trying to show off I’m pretty sure that's never going to be anyone's deciding factor for hookups.

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.

Quick question for Martin: would it be so snarky if the bicep flexers were showing off not to potential hookups but to other men who hadn't yet gotten theirs?

Speaking of the intersection of technology, STIs, contraception,

Jennifer Welsh of Discover Magazine’s Discoblog says UK researchers are working on inexpensive, disposable pee-on-a-stick type tests for sexually transmitted diseases. She says they’d be used in combination with cell phones (presumably to transmit results for analysis?)

Diagnostic sticks for chlamydia, gonorrhea, and herpes are estimated to cost a little over a dollar, and could be sold in pharmacies and vending machines in night clubs. A worried person would take the test by peeing or spitting on the computer chip-enabled diagnostic stick, connecting it to their phone or computer, and would get the results in minutes. (This microfluidic device sounds similar to other “lab-on-a-chip” devices under development.) The mobile or computer app could also recommend doctors.

Source: Discover Blogs

This is pretty cool. As with a lot of immediate-situation testing the key will be the rate of false negatives — situations where the test fails to detect existing disease. False positive STI tests are obviously annoying but nowhere as consequential(!!!) in the long run.

Along the same lines, as I’ve mentioned elsewhere, when hormonal contraception for men becomes available I think it would be very good if on-the-spot confirmation of effectiveness was available as well. It would be very nice if the proposed pee-on-a-stick sort of testing for STIs can be extended to include that.

Em & Lo report that according to an AskMen.com survey with close to 100,000 responses…

If a male birth control pill became available, 68% of men would take it.

Read the quote in context here.

There are usually dozens to hundreds of reasons to dismiss the credibility of online surveys, not least surveys conducted by the likes of AskMen and it’s sister publication Cosmopolitan. And even more reason to be leery of the results given that neither the publishers nor the readers AskMen or Cosmo are particularly highly placed on the progressive/feminist enlightenment scale.

In this case, for this answer on this survey, I think that’s actually a bonus rather than a liability. Because if 68% of self-selected AskMen readers in the 18-30 age demographic say they’d take a male birth control pill that’s…

Well, that’s just incredibly encouraging.

Ordinarily that’s precisely the demographic skeptics point to while claiming that R&D on male contraceptives is a waste of time.

With almost no encouragement whatsoever (least of all encouragement from either AskMen or Cosmo!) roughly 68,000 out of 100,000 nominally callow youths said yes they would. Imagine how many more would say yes with even a modicum of marketing.

You know that little statistic about the first-year reliability rate for vasectomies is 99% instead 100%? Fade to Numb, who had a vasectomy about three months ago, has an important public service announcement that’s strongly related to that.

In the meeting with the doctor at the time, as well as from the papers I brought home afterwards, I learned something interesting. Evidently, no more than half of the guys that get vasectomies actually go back into the lab at a later date to make sure their specimen is all clear. (“Specimen is all clear” could be translated as “all the little spermies are completely gone from the semen system.”)

And (surprise surprise) it can take many months and upwards of 20 ejaculations before they all get cleared out. So some of those people that have “miracle children” after vasectomies? I suspect some of them are less “miracle” and more “didn’t bother to follow up after an operation.”

...

Long story short (or, rather, less long), I got a letter back from the doctor the next week. Sadly, it stated that I’ve still got some sperm swimming around in the system, and I need to take another specimen back to the lab in another three months, and until that time I need to make sure I use proper protection during sex.

Read the quote in context here.

Point being that vasectomies actually are extremely good for keeping new sperm cells out of semen. But you’re not sterile till the last of the old cells are out of your system.

For the record there’s a very, very small chance that his vasectomy really didn’t work and that sperm is somehow getting past the snips. If so then his follow-up check will detect that and he and his partner can decide what to do next. meanwhile, though, they’re not going to make assumptions about whether he is or isn’t still fertile.

Cool post.