March 7, 2013 | Posted By Lisa Campo-Engelstein, PhD

One of the reasons pharmaceutical companies give for not pursuing male contraceptive research and development is that there is no market for it. However, recent empirical studies have shown that men are concerned about pregnancy prevention and are interested in using male contraceptives. For example, a survey of 9,000 men in 9 nine countries in 2005 revealed that 55% of men were willing to use male hormonal contraceptives, while only 21% were unwilling. Another study showed one third of men would use male contraception as their main form of contraception. Further evidence that there is indeed a market for male contraceptives is the fact that men are already responsible for contraception, as approximately 27% of heterosexual couples in western nations use a male-dependent form of contraception (condoms or vasectomy).

Despite this empirical evidence, however, there remains a strong cultural belief that men won’t use contraception because they don’t value the end of preventing pregnancy as much as women do. This cultural trope is usually presented as fact without much or any empirical backing in the lay literature and even in the academic literature. One explanation for this phenomenon is that reproductive prowess is an important component of masculinity. It’s true that fatherhood, especially biological fatherhood, is important to many men. However, the desire to be a father should not be conflated with a lack of reproductive responsibility or with the biological determinism to “spread one’s seed” and have as many children as possible mentality. 

Another explanation, and one that is quite ubiquitous, is that men aren’t the ones who get pregnant. Since men are not at risk for pregnancy and thus don’t have to deal with all the challenges and harms of pregnancy (e.g. the decision whether to carry to term or abort, the bodily changes, the stigma of being a single mother, etc.), they’re less concerned about pregnancy and hence less willing to make the sacrifices (i.e. use contraception or abstain) to avoid it. It’s often claimed that most women aren’t willing to trust men with contraception because they don’t believe men sufficiently value pregnancy prevention and they don’t want to suffer the consequences (that is, get pregnant) due to men’s perceived lack of commitment to pregnancy prevention. (See my previous blog for a discussion of trusting women with contraception.)

The case of a long-term, committed relationship may be an exception because the woman knows her male partner well and so she doesn’t have to defer to cultural narratives to determine if her male partner sufficiently values the end of pregnancy prevention. Instead, the woman can judge her partner’s commitment to this end based on his individual characteristics and not based on social perceptions about men generally. Looking at individual characteristics rather than general social beliefs will enable women to recognize if their partners do not fit the stereotype that men are less interested in preventing pregnancy. If their partners don’t adhere to this social norm but instead sufficiently value avoiding pregnancy, then women can trust them to contracept. And in fact, empirical studies demonstrate that most women do trust their monogamous partners to use contraception; one study found that 98% of women of various cultures would trust their partner to use contraception.

Even though we have solid empirical support that men are interested in new male contraceptives and that women trust their partners to use contraception, the cultural narrative that men are not interested in contraception because they don’t value pregnancy prevention remains strong. Furthermore, and problematically, this cultural narrative is often given as one of the main reasons pharmaceutical companies don’t want to consider researching new male contraceptives.

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4 comments | Topics: Gender Disparities , Reproductive Medicine , Women's Reproductive Rights

Comments

Heddy-Dale Matthias, MD

Heddy-Dale Matthias, MD wrote on 03/08/13 9:40 AM

I would be interested in reading studies that show that 55% of men would be willing to use hormonal contraception. My informal survey today in an operating room full of educated males says they sincerely doubt that number. So do I.
Trevor Ray Slone

Trevor Ray Slone wrote on 04/02/13 8:41 PM

First of all, good job on a nicely written article Lisa! Personally, as someone who has always placed a high value on celibacy before marriage and monogamy, even I have, twice, been intimate with someone who I was not married to without using contraception (of course I made sure that both of them were on the pill first), and I didn't think much of it, so I know that even those who say they are willing to use it are not necessarily doing so, nor would they necessarily should the opportunity of hormonal contraception present itself to them. Having said that, I am inclined to believe that many more men would be using contraception if there was a relatively safe hormonal option for them, as condoms are very uncomfortable and they tend to kill the mood quickly for a lot of guys. Women do not have this problem if they take the pill, and so this is, in my opinion, one of the main reasons that women tend to use contraception more than men. As I said above, should their ever be a hormonal option for men, I strongly believe that many, many more men will start using contraception of that type, for in my experience men are just as afraid of their mate getting pregnant as their mates are afraid of getting pregnant themselves. I know that is one of the the reasons that I practiced abstinence until I was in my early twenties!
Dr Rajesh, MD

Dr Rajesh, MD wrote on 12/17/15 12:24 PM

Male Involvement in Birth Control and Family Planning

Can men be blamed for sitting back and letting women take the lead in handling birth control? Biology has never forced men to bear the consequences of pregnancy. Nor has our society also asked men to shoulder this burden. The 2005 Debt Reductions Act reduced federal funding for state-run child support enforcement agencies – so men have been with even fewer reasons to be sexually and socially responsible. Meanwhile, the Child Support Protection Act of 2007 has stalled. But even the paternalistic US government is not solely to blame for men playing too small a part in the prevention of unplanned pregnancy. Medical research has been slow to provide contraceptive options for men and because many men assume that women have already secured a birth control method of their own, they have not demanded them for themselves. Current options that men have to prevent pregnancy are limited to condoms, periodic abstinence, withdrawal, and vasectomy — and these options are woefully inadequate, when compared to options available to women. Yet even if there existed a better birth control option for men, the difficulties public health organizations have had convincing men to use condoms belie a more desperate situation, in which, for many men, possible consequences of sexual activity are considered only after sex takes place.

But men can do better and women should expect this of them. One simple and very concrete way men can take more responsibility for reproductive health and family planning has been made possible by the FDA approval of over-the-counter provision of emergency contraception.

Dr. Rajesh

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