America and the Pill: A History of Promise, Peril, and Liberation (12 page)

While Asian leaders called for a male pill to control popu- lation, feminists called for the development of a male contra- ceptive so that men could share the risks and responsibilities of birth control. Barbara Seaman, author of
The Doctors’ Case Against the Pill
, insisted that the problem was sexism: “If you doubt that there has been sex discrimination in the develop- ment of the pill, try to answer this question: Why isn’t there a pill for men?. . . . It is because women have always had to bear most of the risks associated with sex and reproduction.”
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Not all feminists agreed that women should relinquish con- traceptive responsibility to men. In fact, from the very begin- ning of their efforts to develop the birth control pill, Margaret Sanger and Katharine McCormick were adamant that contra- ception be entirely in the hands of women. McCormick said she “didn’t give a hoot for a male contraceptive.”
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The two pi- oneers strongly believed that women should decide when and

if they wanted to have babies, and that they should have a safe and effective means to prevent pregnancy. They pushed for the pill because it would give women that control.

Within a few years of the pill’s FDA approval, however, risks and side effects emerged that Sanger and McCormick had not anticipated. By the mid-1960s, angry women were writing to John Rock and Gregory Pincus demanding a pill for men. “Why don’t you men take the contraceptive pills?” wrote one irate woman. “Stop making us—the women—guinea pigs in this experiment. . . . Why don’t men mature and understand that there are desires in life besides excessive use of your love- stick?” Another wrote, “Why is it that the billions of words being written, printed, [and] spoken now on the subject of the Population Explosion [are] directed to WOMEN? All about what Women can and should DO, but NOT ONE WORD have I read or heard directed towards MEN.” One letter writer suggested clamps for men “such as cattlemen use on bulls.” A mother of three and grandmother of nine wrote in 1963, “The women more than do their share. The men are the most pas- sionate, so why not control them for a change? . . . Please let us women have a rest from pills and put the cure where it be- longs—on men.” Rock responded with the optimism charac- teristic of the researchers at the time: “It will not be long now when you can feel that you are getting even.”
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Rock was wrong. The male pill was nowhere in sight. Re- searchers felt stymied by what seemed to be insurmountable hurdles standing in the way. The most intractable were the men themselves. In 1970,
Boston Globe
columnist Dr. Lindsay

R. Curtis relayed a conversation he had with a woman he iden-

tified as Helen, an ardent feminist who was “disgusted” with the lack of progress on a male pill. “It’s the same old story, male domination. . . . Why not let the ever-loving husband take his turn and allow a few experiments performed on him for a change?” Dr. Curtis responded by explaining that there were male contraceptives in the works, but that more time was needed to test their safety and effectiveness. He also noted that men do not have the same stake in contraception: “What it boils down to is this: Women can get pregnant; men can’t.” There were also psychological effects. “Generally speaking, a man equates his ability to impregnate a woman with masculin- ity. And all too often the loss of such ability really deflates his ego.” Helen replied, “Might be just what a lot of egotistical males need.”
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Needed or not, the male libido seemed to be the primary preoccupation in any discussion of a pill for men. Al- though there was evidence that the oral contraceptive could negatively affect women’s sex drive, that particular side effect was dismissed as unimportant.

As early as 1965, Gregory Pincus articulated the problem: “Male volunteers for fertility control studies may be numbered in the low hundreds, whereas women have volunteered for sim- ilar studies by the thousands. . . . He [the human male] has psy- chological aversions to experimenting with sexual functions. . . . Perhaps experimental studies of fertility control in men should be preceded by a thorough investigation of male attitudes.”
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In the 1970s, sexuality remained a central concern in the male con- traceptive trials. A 1974 report to the World Health Organiza- tion urged researchers to develop a reversible male contraceptive that would not compromise libido or potency. Even though

male sexual functioning improved in clinical trials as researchers experimented with new compounds, worries about reduced li- bido continued to discourage men from volunteering for studies. One researcher believed that extensive education would be nec- essary because the “delicate male psyche equates virility with fer- tility.”
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As late as the 1990s, a Dutch researcher noted, “The Pill for men inhibits libido. This might be considered an advan- tage—refraining from sex constitutes a perfect contraceptive— but men don’t take the Pill to refrain from sex.”
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In spite of men’s reluctance to tamper with
their sexual functions, news of problems associated with the oral contraceptives for women put new pressures on them. Senate hearings in 1970 on the safety of the pill prompted 18 percent of women taking oral contraceptives to discontinue use, leading to a renewed interest in male options. But men themselves were not clamoring for a pill. They remained con- spicuously silent on the matter. Many did step up to the plate to take responsibility for contraception, but they turned to tried-and-true methods: the condom and vasectomy. Accord- ing to a 1970 headline in the
Washington Post
: “Pill scare, lib movement place birth onus on male.” The article pointed out that condoms, after declining in sales in the mid-1960s, were selling better than ever following the Senate hearings. Now women as well as men were buying them. Ads for condoms also began to appear in the popular press, with catchy messages such as “90 percent of all people are caused by accidents.”
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At the same time, articles in the popular press began to pro- mote vasectomies. In 1971,
Look
magazine’s column “For Men

Only” touted “Foolproof Birth Control” and claimed that a “simple 15-minute operation is putting the pleasure back in marital relations.”
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Although the procedure was growing in popularity, many men were still uneasy about going under the knife. One nervous man wrote to a doctor at the
Boston Globe
asking about the effectiveness, reversibility, and side effects of the operation: “And most important, is there any decrease in a man’s sex drive or potency?” The doctor reassured the man that his libido would not be affected.
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Not all the press coverage was so reassuring. The cover story of
Esquire
in June 1972 carried the headline “All about Vasec- tomies (scared?).” Evoking men’s anxieties about both feminism and vasectomies, the photo on the cover pictured a woman sur- geon in scrubs, gloves, and mask, with surgical scissors in one hand and scalpel in the other. The long article, titled “The In- cision Decision,” covers “a burgeoning brotherhood of men who had taken the ultimate step in contraception: . . . vasec- tomy.” While most media coverage of vasectomies emphasized the relative safety and effectiveness of the procedure,
Esquire
detailed all the dangers and side effects, along with physical, psychological, and psychosexual difficulties. Chastising leaders for their failure to develop safe and effective alternatives to the frightening procedure, the author concluded that “vasectomy is a direct indictment of our refusal . . . to develop, test and dis- tribute an entire spectrum of contraceptive drugs and devices that would allow individual men and women to choose one they can use without playing roulette with their health.”
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In spite of calls for new methods, research on male contra- ception continued at a snail’s pace. Whether or not men would

actually take a contraceptive pill if one were developed, the sci- entific community assumed they would not. Contraceptive de- velopment was falling victim to the increasing skepticism and scrutiny directed at the pharmaceutical industry and the med- ical profession. In 1970 an article in
Today’s Health
noted that the “Pill Panic” caused by recent revelations of the dangers of oral contraceptives would inhibit research efforts to find a male method, just at the time when women were clamoring for men to share the risks. The pill had simultaneously raised the bar for effective and convenient birth control and aroused fears of health consequences.
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More significant than the research hurdles to developing male contraceptives was the widespread and continuing belief that women would accept the risks, discomforts, and physical in- trusions required to sabotage their fertility, but men would not. These ideas were so deeply held that reversals of this arrange- ment seemed absurd. Two widely circulated parodies of contra- ceptive guidelines make the point. In 1971, a spoof in the
Village Voice
offered a fictional guide to men to help them choose an ap- propriate form of birth control. To select among the “fine meth- ods available to the modern husband,” the author advised, “Consult a qualified urologist. She will explain to you several methods. . . . One widely used method is the insertion of sperm- killing liquid into the urethra before intercourse. She (your doc- tor) will show you how. . . . The other widely used method is of course the Capsule. . . . There are minor undesirable side-effects in some men: you may gain weight around the abdomen or but- tocks, get white pigmentless patches on your face (which you may be able to conceal with a beard or face-bronzer), or suffer

some morning nausea. But be patient—these effects often de- crease or even disappear after a few months. The one serious drawback of the Capsule is that you are several times more likely than otherwise to suffer eventually from prostate cancer or fatal blood clots. But these ailments are relatively uncommon anyway, so that many couples consider it worth the risk, especially since this is the one method that is 100 percent effective.”
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In 1980, after the Dalkon Shield disaster, in which eighteen women died and hundreds of thousands others suffered serious infections of the uterus requiring hysterectomies as the result of the faulty design of the widely used intrauterine device (IUD), another satire circulated in the alternative press. With a graphic illustration covering half the page,
Spare Rib
announced a new male contraceptive, the IPD (intrapenile device), to be marketed under the trade name “Umbrelly.” At the “American Women’s Surgical Symposium in Ann Arbor, Michigan,” a “Dr. Sophie Merkin” announced the results of a study of the Umbrelly con- ducted on 763 male students at a large Midwestern university. The IPD “resembles a tiny folded umbrella which is inserted through the head of the penis and pushed into the scrotum with a plungerlike instrument. Occasionally there is perforation of the scrotum but this is disregarded since it is known that the male has few nerve endings in this area of his body. The under- side of the umbrella contains a spermicidal jelly, hence the name ‘Umbrelly.’” Dr. Merkin reported that of the students tested with the device, “only two died of scrotal infection, only 20 experi- enced swelling of the tissues. Three developed cancer of the tes- ticles, and 13 were too depressed to have an erection.” She also noted cramping, bleeding, and abdominal pain, but insisted that

these symptoms were probably temporary and would likely dis- appear within a year. Although there were a few cases of “mas- sive scrotal infection necessitating the surgical removal of the testicles,” this complication was too rare to be statistically im- portant. “She and other distinguished members of the Women’s College of Surgeons agreed that the benefits far outweighed the risk to any individual man.”
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The biting satire gave voice to the concerns of many women that if men faced the same sorts of discomforts, dangers, and complications that women risked from recently developed contraceptives, such products would never reach the market. This spoof effectively made the point that men would never approve, much less consume, products that would cause them such pain and danger.

Although an intrapenile device remained in the realm of fantasy, researchers worked on a number of male contraceptive compounds and devices. In 1972,
Life
ran a story on “Male Contraception with a Twist.” Illustrating the article was a magnified image of two tiny, T-shaped, gold and stainless steel “sperm switches.” “The long tubes of these microvalves . . . fit snugly inside a sperm duct. In a simple procedure, a doctor merely adjusts the stem to turn sperm flow on or off.” The good news for men was that “these new sperm switches will let a man have his fertility turned on and off at will. They do not interfere with normal sexual function.” Louis Bucalo, a micro- component engineer, designed the devices, which were tested at New York Medical College on thirty volunteers. At the time, it appeared that the device was safe and effective. “Con- ceivably . . . a man might have the devices implanted when he

is young, and then have them turned on only once or twice in his lifetime when he wants to produce children.” The author predicted that if the testing continued to go well, “the sperm switches will be available within 18 months.” The device was expected to be expensive, “but so is an unwanted pregnancy and so, over the years, is a regimen of birth control pills.”
Life
also noted that vasectomies were becoming increasingly popu- lar, encouraged in part by the establishment of sperm banks across the country and observed that “over 400 normal chil- dren have been produced by artificial insemination using frozen sperm.”
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The “sperm switches,” however, never reached the market. Although research continued, the risk of scar tissue causing permanent sterility was never successfully resolved.

Another group of researchers tried to develop a reversible va- sectomy by using a temporary implant inserted into the vas that could be removed. In theory, the process could be reversed sev- eral times as the man wishes to be fertile or infertile. But the re- searchers were unable to say when such an operation might be available for use on a human male.
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By 1983, other promising designs were in the works. One was a contraceptive cream that combined testosterone with estrogen that men would rub onto their abdomen and chest. The compound would inhibit sperm production without affecting male sex drive and potency. But some scientists were cautious about its efficiency because the cream had not been shown to turn off sperm production com- pletely. Although it seemed to hold some promise, the contra- ceptive ointment never made it to clinical trials.
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