* This blog was originally posted on The Good Man Project, May 3, 2018.
Birth control is a common concern for women and men. While women have many options when choosing a birth control method, men have fewer options. However, research has long shown that men influence their partner’s contraceptive choices or whether they even use contraceptives.
Do women really want men more involved in contraceptive decision making and use?
A 1997 survey by the Henry J. Kaiser Family Foundation, an American health research and education organization, found that more than 66% of respondents (male and female) believed that men should play a bigger role in the choice and use of contraception. Healthy sexual and reproductive knowledge, practices, and access to clinical services play critical roles in promoting males’ well-being and facilitate their roles as key partners and vital allies in pregnancy prevention efforts.
So, why aren’t men more involved in contraceptive choice and use?
In some part, because there have been limited options for male contraceptives, but more importantly, male sexual and reproductive health needs are often insufficiently addressed in clinical settings. Research into an array of male birth control options has been underway for years. When developing contraceptives, scientists look at all the steps of successful reproduction and find one specific point at which to interfere with the process and render it unsuccessful. After 40 years of research, there are three promising methods of male contraceptives making their way through clinical trials: the male contraceptive pill, nestorone-testosterone, a daily gel that stops sperm production, and vasagel, a long-acting, nonhormonal polymer gel that blocks sperm.
These male contraceptive options could drastically change the game. It could help reduce the prevalence of unintended pregnancies in the US, and provide a much cheaper option for lower-income individuals disproportionately affected by unintended pregnancy. It could also offer an alternative to female hormonal contraception, freeing women from potential side effects associated with chemically altering the menstrual cycle.
Traditionally perceived as a female domain, family planning and reproductive health (FP/RH) services have focused primarily on women, resulting in “no comparable [medical] specialties and few settings that focus on the sexual and reproductive health needs of […] males.” Multiple barriers that impact accessibility of FP and RH services for males result from this gender bias, including general unawareness of the availability of male services, male discomfort in utilizing female-focused clinics, and a lack of trained male staff to work at FP and RH clinics.
Other reports discuss “very significant structural and attitudinal issues within family planning clinics that limit their ability to provide services to men.” Furthermore, there are no generally accepted standards for sexual and reproductive health services for men, so even when men do receive services, studies have found them to be fragmented and not comprehensive. A growing body of literature and research supports that increased male involvement in family planning (FP) and reproductive health (RH) is essential to addressing reproductive health issues facing men and women, especially unplanned pregnancies. The challenge, however, has been translating this objective and research into a pragmatic application of increased gender equality in the field.
Based on research that other staff at JSI and I have conducted, young men feel passively engaged in preventing pregnancy. Two key findings about male reproductive health services came from JSI studies that explored factors associated with choosing birth control methods and unintended pregnancy in two Colorado counties. The first is that young women and men want information to make healthy choices when they decide to become sexually active. The other is that men have a role and responsibility to prevent pregnancy. These results are similar to survey findings by the Kaiser Family Foundation, which found that 71% of men in the U.S. said they would consider at least one male birth control option. Of these men, 66% would be willing to try the pill.
Through our project, JSI interviewed various men, and the majority stated that it was their responsibility to provide the birth control in a relationship. Some participants stated that it was the responsibility of both people involved. One participant explained, “I want to be more involved but I don’t feel like I have much of a role except for using a condom. I think there should be more forms of birth control for men, other than just condoms.” With the advent of these male contraceptive options, men now have the opportunity to be more engaged in contraceptive planning and preventing pregnancy – something that many men state they want.
These new male contraceptive options seem quite promising; easy to use, affordable, and effective. Although surveys show that a majority of men are open to the idea, there are social influences, such as masculinity and gender roles that can be barriers to males seeking services. There are also structural barriers, including the lack of clear and consistent guidelines, inadequate provider training, and lack of male-friendly health centers and providers. These barriers must be overcome before theory can become practice.
Yvonne Hamby, MPH, is a senior consultant focusing on reproductive and sexual health programs. As a public health researcher in the area of sexual and reproductive health, Yvonne believes that promoting reproductive health entails addressing its biological, medical, social, and cultural contexts in which people live. Much of her work in recent years has focused on developing best practices to provide clinical reproductive health services to men.