Men, women and contraception

Here’s a quick quiz, courtesy of the Centers for Disease Control and Prevention: What are the two most commonly used forms of birth control in the United States?

If your reply includes “condoms,” you’re wrong. Oral contraceptives are the top method, and tubal ligation comes in a close second. And they’re both used by women, not by men.

That’s the fundamental fact that we still ignore in our culture wars over contraception. Last year, conservatives denounced the Obama administration for requiring employers to cover female contraceptives in their health plans. Meanwhile, liberals condemned Health and Human Services Secretary Kathleen Sebelius for insisting that women under 17 possess a prescription in order to purchase the so-called “morning-after pill,” or emergency contraception.

Earlier this month a federal judge ordered the Food and Drug Administration to rescind the age restriction, which he called “arbitrary, capricious, and unreasonable.” He was right. There’s no good scientific reason to require younger women to have a prescription for emergency contraception.But we still need to ask why contraception remains mostly a “women’s issue.” And it’s not just because women can get pregnant, and men can’t. When it comes to sex, to quote James Brown, it’s still a man’s world.

When oral contraceptives were first approved for use, in the early 1960s, they were hailed as a symbol of female equality. Indeed, a young journalist named Gloria Steinem devoted her first full-length feature article to “the Pill.” For Steinem, the future feminist icon, the Pill signaled a new generation of “autonomous girls” who “are free to take sex, education, work and even marriage when and how they like,” Steinem wrote in 1962.

Just as many men resisted women’s equality, though, so did they reject the Pill. Invoking the era’s notorious double standard, some male critics charged that oral contraceptives would encourage female promiscuity. At the same time, they worried, the Pill would dampen male interest in sex.”A man . . . used to be able to give his wife babies—lots of them—whether she wanted them or not,” a psychologist warned in 1966. “But the pills take this last bit of masculinity away from him.” Another mental health expert agreed that middle-aged men would be threatened by the Pill, but he hoped that younger men might drop “some of their parents’ sex hangups” and embrace it.

Leading that charge was Playboy magazine and its inimitable publisher, Hugh Hefner, who became one of the best-known champions of the Pill and other reproductive services for women, including legalized abortion. Yet Hefner’s real interest lay in male sexual access, not in female sexual autonomy. When some women resisted taking the Pill, citing health risks and side effects, Playboy dismissed the women as neurotic prudes who refused to “take responsibility” for contraception.

So the Pill could promote male domination, not just female liberation. “Please let us women have a rest from pills and put the cure where it belongs—on men,” one woman told physician John Rock, who had helped develop the Pill. In reply, Rock confidently predicted that scientists would soon create a male oral contraceptive, too. “It will not be long now when you can feel that you are getting even,” Rock wrote.

We’re still waiting. Over the intervening five decades, millions of dollars have gone into developing patches, injectables, and other female contraceptives. Only a trickle has been devoted to the quest for male ones. Last year, researchers in Texas announced that they had created a drug that lowers the sperm count of male mice so much that the animals were rendered infertile. But we still don’t know if it would work in humans.Most of all, we don’t know if men would take it. Some scientists have speculated that a male contraceptive might lower sex drive, which would be the kiss of death for any approved product. Never mind that many women report that oral contraceptives blunt their libidos. We’re talking about guys here.

Or consider that nearly three times as many women report getting sterilized as having a male partner who did. Tubal ligation is serious surgery, usually requiring hospitalization and general anesthesia. A vasectomy? Mine took 15 minutes.

Of course women should have full access to any contraception they choose, including the Pill. But I’m still troubled by the idea that contraception is their responsibility, not just their right. Don’t women do enough already? It takes two people to make a baby. It should take two to prevent one, as well.

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Jonathan Zimmerman teaches history and education at New York University. He is writing a history of sex education around the world.