The birth control pill just celebrated its 50th anniversary. The pill’s impact on women’s health, reproductive choices, and thus society in general has been enormous. And under the Affordable Care Act (Obamacare) insurers must cover the pill as well as other forms of contraception such as diaphrams, sponges, IUDs, Plan B, and sterilization (having her “tubes tied”).
Insurance doesn’t typically cover men’s reproductive health, however, and vasectomies are unaffordable for low income men (though Vermont just added vasectomies to the list of contraption that insurers must cover). The only other male contraception – condoms – can be bought over the counter and are relatively affordable. But condoms are also a real bummer.
Why do men have so few birth control options? A huge part of the reason is the cultural attitude that birth control is a woman’s responsibility. Obamacare, by covering female but not male contraception, seems to reflect this attitude.
Related to that is a greater focus overall on women’s health. Though the federal government has had an Office of Women’s Health since 1991, there is no government program for men’s health despite the fact that men (on average) die years sooner than women. For instance, about 12% of women will develop breast cancer at some point while 14% of men will develop prostate cancer, but prostate cancer receives the least amount of funding of any other cancer while breast cancer gets the most funding. The men who run Congress could increase prostate cancer funding, but men are not taught to focus on their health (a social norm that is slowly beginning to change).
But there’s hope on the horizon. Earlier this year the WebMD men’s health newsletter ran an article about male contraception. They identified additional reasons why men don’t have more birth control options. Scientifically it’s a tougher nut to crack (sorry, couldn’t resist a bad joke). Early hormonal treatments failed miserably. And pharmaceuticals, despite making money hand over fist, are reticent to push products not knowing if men will go for it.
But the company developing Vasalgel says it has 31,000 men on their waitlist. Vasalgel is sometimes referred to as a temporary vasectomy. A gel is injected into the vas deferens, blocking sperm’s pathway to the outside world. A later injection can dissolve the gel.
Other forms of male contraception being studied are retinoic Acid pill, H2-Gamendazole, nestorone gel, and testosterone gel, each of which in different ways decrease sperm production, possibly enough to prevent pregnancy. And EP007, which is non-hormonal and stops sperm from swimming.
Will greater reproductive choices for men transform society the way the pill did for women? I doubt it. Only women can get pregnant, so the female pill had a much bigger impact on women’s lives than a male pill will have on men’s lives. But it will change the conversation. Men’s lack of options will no longer be an excuse. And many women don’t like the pill’s side effects, so male birth control will provide other options, thus increasing women’s choices as well as men’s.
Moreover, I hope that the conversation about male contraception isn’t narrowly focused on men’s responsibilities to women. Instead, I want to see a larger discussion about men’s health, including the establishment of a government Office of Men’s Health and equal funding for male specific cancers.