Begatting and Begetting: The Issue(s) of Men

By Lisa Jean Moore and Monica J. Casper

Semen. Vas deferens. Penis. Scrotum. Glans. Ejaculation. Testes. Prostate gland. Epididymis. Seminal vesicles. Pubic hair. Erectile function. Falling asleep after. Dicks and cocks. Jism, seed, and cum. Phallic.

Okay, now that you’re paying attention, we’re here to tell you about male reproduction and sexuality. Well, maybe not all about it, as we’re only partial experts on the subject; for example, we’ve got sperm and testicular cancer covered. Our primary task here is to alert you to the earth-shattering fact that men actually have something to do with human reproduction. Aside from the occasional, once-in-two-millennia episode of birth-sans-semen, men’s seed is still required to fertilize the human egg. Yes, that’s right: humans, just like the birds and the bees, need to get it on, usually, to make babies. But some can now take advantage of sperm extractive technologies (e.g., erotica and a cup), sperm placement technologies (e.g., a syringe or micropipette), and storage facilities (e.g., sperm banks and refrigerators) for DIY reproduction, no sex required. For single mothers by choice, lesbians, and the infertile, these practices may be revolutionary.

Replicating the species, then, is not the sole province of Woman-qua-womb or of individual women—notwithstanding a desire for parthenogenesis among some feminists and scientists or dedicated efforts by conservatives to keep women barefoot and pregnant (while also identifying all women who seek reproductive care as prostitutes). Indeed, one need only attend to the furious debate about the HPV vaccine, for example, especially the ludicrous statements of Tea Party pin-up Michele Bachmann or the convoluted policy positions of Texan Rick Perry, to grasp that the Right views all things sexual and reproductive as both inherently female/feminine and a danger to society. This, despite the risks for boys and men of HPV.  Given the wide gap between reproductive realities and ideological fantasies, it is worth commenting here on the ways in which men’s sexual and reproductive bodies are making the news lately, and in what ways. Or, as Time put it, “male contraception may be a reality sooner than we think.” (Curiously, the Time editors illustrated their story with a picture of a ripe, yellow banana. Is the banana now a contraceptive? Tasty.)

An anecdote: For the past ten years, an assignment in Lisa’s undergraduate class, “Birth and Death,” has required students to bring in a contraceptive device and discuss their relationship to and impressions of this device with other students. Lisa is clear that students do not need to be users of the device; they simply must bring in any form of contraception for discussion. Fascinating stories have emerged from this assignment: the time a student came with nothing and cleverly claimed her device was abstinence, adding “speaking from experience, it doesn’t work”; the virginal student who brought a bottle of coke because he claimed his brother told him that douching with coke after intercourse killed sperm (he really just wanted to know what douching was); the gay sophomore who brought in his sister’s diaphragm and offered a sophisticated lecture about contraceptive efficacy.

However, a consistently remarkable trend in Lisa’s class has been that female students bring in a range of devices, including condoms (male and female), diaphragms, cervical caps, pills, rings, foams, jellies, and patches, each accompanied by a passionate explanation of use. In contrast and almost universally, male students share male condoms and mumble through a litany of expected complaints about sensation. Of course, everybody already knows that condoms diminish men’s pleasure, right? Or do they? At least, that is what men seem to be compelled to say.

These examples, taken from the cohort of 18–22 year olds, are true to national trends. In most heterosexual encounters and relationships, contraceptive responsibility adheres to a gendered division of labor, whereby women and girls are primarily in charge of preventing pregnancy. And women disproportionately experience the consequences, including decisions about abortion, when prevention fails. Social scientists contend that typically men and boys lack direct knowledge of the couple’s contraceptive use and tend to rely on assuming that their female sexual partners have “taken care of” pregnancy prevention. Yet men’s degree of participation in contraceptive responsibility varies widely, with men in long-term committed relationships more likely to share in the decision-making and use. (Men with multiple sexual partners may be more likely to use the condom that also protect against STDs.)

Andrologists, medical practitioners of a sub-specialty of urology that focuses on male sexual health and fertility, recommend that the most effective method of male contraception is vasectomy. According to the Centers for Disease Control, roughly 500,000 American men annually obtain vasectomies—yet there are typically far more tubal ligations than vasectomies in the United States.  However, despite its statistical popularity, vasectomy clearly frightens many men—perhaps leading to higher rates of sterilization among women. For example, the Dad Labs (“Taking Back Paternity”) somewhat humorously describe vasectomy as “a fancy medical term for having your balls cut completely off.” True to the phallocentric heterosexual prerogative, many men are concerned with erection after vasectomy, their volume of “baby batter” or ejaculate, and potentially not being orgasmic. In addition, male virility is tied to cultural notions of successful heterosexual masculinity: consider, for example, the historical imperative to create heirs and the personal shame of “shooting blanks.”

On the heels of World Contraception Day, celebrated on September 26^th, we pose this question: what of male contraceptive alternatives to the condom and vasectomy? The technology to create a male hormonal contraception (MHC) has been around since the 1970s. However, the pharmaceutical industry was challenged in finding willing male users to be test subjects. (Never mind that the history of female contraceptives is full of unethical practices and shoddy treatment of women-as-guinea-pigs.) Lack of male volunteers, and pharmaceutical fears about limited markets, stalled the clinical trials necessary to move research on the male pill forward. Yet globally, the World Health Organization has charted a shift, and men are increasingly interested in MHC. Chinese clinical trials could make MHC commercially available in three years in some markets, and possibly in five years in the United States.

In its favor, unlike vasectomy MHC is a reversible form of contraception (but its reversal has evidenced varying degrees of success). And it is not a barrier method, so penile sensation remains unsheathed. Most types of MHC either eliminate or block male sperm through altering the levels of testosterone and progesterone in male bodies through pills, gels, creams, injections, or patches. While many men have indicated they might be willing to adhere to MHC, a large consideration is if their female partners will trust that men actually are using these devices and using them properly and consistently. Since pregnancy occurs inside of women’s bodies, the stakes are of course significantly different for men and women during and after sexual intercourse. Of course, men have historically been in—or placed themselves in—the position of never being able to fully ascertain that their female partners are using contraception. Indeed, there has been historically an anti-feminist discourse and cultural mythology attached to women “tricking” men into pregnancy.

But will men take the pill? Will minor boys, providing parental consent is not required, take the pill? And if consent is required, will male contraception play out with the same furor as that surrounding the HPV vaccine? Will obdurate gender structures actually be challenged and/or changed by possible future use of MHC, in the United States or elsewhere, such that men will have increased responsibility in reproduction?  What would it mean for both men’s and women’s lives if there were sustained collaboration (if so desired) in reproducing the species, rather than the current “hit and run” strategy by which, in heterosexual relationships, men deposit sperm and then leave the “dirty work” (as sociologist Everett C. Hughes termed it) of pregnancy, labor, child-rearing, and domestic chores largely to women?

As qualitative sociologists, we’re not in the business of making predictions; we leave that to our quantitative kin who traffic in numbers. Thus, we offer here no guarantees, or even suppositions, about whether men and boys will actually use male contraception, although we hope they do—in no small part because, between the two of us, we have five daughters and it’s possible, indeed likely, that at least a few of them will someday engage in sex with men. But we can state unequivocally the following: there will be vociferous debates and conversations about male birth control (just as there were about the infamous pregnant man) and any public dialogue will reflect already vexed gender relations.

It’s instructive that in an article about MHC, one man commented that being on contraception was exciting to women. In his words, “If I were single, I probably would have been able to use that as a dating thing.”

Male contraception as aphrodisiac: one more thing for the Right to obsess about.

Lisa Jean Moore is a medical sociologist and Professor of Sociology and Gender Studies at Purchase College, State University of New York.  Her scholarship is located at the intersections of sociology of health and medicine, science and technology studies, feminist studies and body and animal studies.  She is the author of Sperm Counts: Overcome by Man’s Most Precious Fluid and the co-author of Gendered Bodies: Feminist Perspectives and Missing Bodies: The Politics of Visibility and numerous articles in journals such as WSQ, Social Text and Body and Society.  Additionally she has co-edited a collection The Body Reader and is the co-founder of a successful book series at NYU Press entitled Biopolitics: Medicine, Technoscience, and Health in the 21st Century.   She is currently at work on the forthcoming co-authored Buzz: The Culture and Politics of Bees.  She lives in Brooklyn with her husband and three daughters.