America and the Pill

Of the many hopes that greeted the possibility of hormonal contraceptives, none was more elusive than the promise of a pill for men. While the arrival of the oral contraceptive for women made headlines around the world, scientists were quietly working on a similar pill for men. But the male pill never made it to market. In fact, since World War II, thirteen new contraceptives for women became available—including various oral contraceptive compounds, IUDs, injectables, and patches—but not one new male method. By the mid-1990s, only a fraction of the funding for contraceptive research was dedicated to male methods.² Yet, for more than half a century, researchers proclaimed that a pill for men was just around the corner.

In 1969, Good Housekeeping enthused, “The notion of a birth control pill for men strikes some people as a kind of science-fiction idea. Actually, development of a male pill is easily possible in the near future—probably within the decade, according to some experts.” Describing the many research projects under way to develop a new contraceptive for men, the article concluded that “remarkable progress is being made.”³ In 1976, three scientists predicted that with adequate support, a male pill would be on the market in fifteen years. When that did not happen, the prediction was postponed another twenty years. But the optimism that a male pill would become available “soon” never disappeared and, in fact, still prevails.⁴

Although researchers often questioned whether men would be receptive to a contraceptive pill, surveys indicated that men were willing to share the responsibility for birth control.⁵ In 1973, 70 percent of men surveyed in three states and the District of Columbia said they would use a male contraceptive other than condoms or withdrawal. The methods favored by most of the respondents was a pill or injection; 19 percent favored a reversible vasectomy; 84 percent believed that both partners have a responsibility for birth control; and 77 percent said they would help, “financially and morally,” in the event of a pregnancy if contraceptives used by either partner failed.⁶ But as a practical matter, a male contraceptive would need to have acceptable side effects—and most of the methods being developed did not.

From the outset, the problem of side effects plagued the development of a pill for men. As was the case with the female pill, research on a male hormonal contraceptive began in the 1950s and grew out of efforts to treat infertility. Gregory Pincus, while working on the female pill, conducted a small-scale study testing the effects of Enovid on eight male patients in a mental hospital. This ethically reprehensible research, though standard at the time, demonstrated that Enovid had a “sterilizing effect” on men, suggesting that it might provide the basis for a male contraceptive. But the subject pool, besides being very small, was made up of psychotic men, which made it difficult to collect semen. They all suffered serious side effects, such as shrunken testicles. A similar clinical trial took place in 1958 among twenty “healthy adult males” who were prisoners at Oregon State Penitentiary. The study tested two testosterone preparations and one progesterone compound (Enovid). The compounds reduced sperm production to zero. But all the subjects lost sexual desire and had difficulty getting erections and producing seminal fluid.

In 1963 another study tested a male contraceptive on thirty-nine inmates at the same prison. The compound halted sperm production without affecting libido. But when a man who took the pill was released from prison and went out drinking, he became violently ill and had to be hospitalized. Although it was possible for men taking the pill to refrain from alcohol in order to avoid serious health risks, the potentially dangerous combination of alcohol and hormones put an end to this birth control alternative.

Additional small-scale tests continued through the 1970s in the United States and Europe. Male prisoners were commonly used in these trials—a standard practice that continued well into the 1980s. All of these studies showed promising results, but problematic side effects remained.⁷ Moreover, the advantages of using institutionalized men who could be frequently monitored were diminished by the fact that these subjects were not having sex with women. The controlled experiments, therefore, did not demonstrate how a particular compound might work in a typical heterosexual relationship.

The problem of overpopulation motivated and legitimized research for a male pill, as it had for the female pill. As one scientist warned, “Because of the immensity and seriousness of human population growth every avenue should continue to be explored and we should be unwise to neglect the male approach.” ⁸ In the developing world, especially in overcrowded China and India, governments pushed for an effective male contraceptive. In the 1960s, Premier Chou En-Lai of China and India’s Prime Minister Indira Gandhi called for new technologies. In 1961, Gandhi tried to pass a law for large-scale forced sterilization on men. The proposal generated such protest it resulted in the fall of her cabinet. Gandhi then turned to promoting new methods of birth control: “Family planning programs are awaiting a big breakthrough; without a safe, preferably oral drug which women and men can take, no amount of government commitment and political determination will avail.”⁹

China did not wait for such a breakthrough. Starting in 1972, China began clinical trials of Gossypol, a male contraceptive, on 14,000 men. China was able to recruit these men because of the one-child law, which made contraception mandatory. News of the study finally reached the West in 1979 when a group of American researchers visited China. Gossypol seemed promising until toxic side effects began to appear, including diarrhea, circulatory problems, heart failure, and permanent sterility.¹⁰

Funding for the Gossypol study and other research on male contraceptives came from the World Health Organization (WHO). A 1978 article in the WHO bulletin explained, “In the past, emphasis has been placed on the development and use of contraceptive methods for women but, with increasing publicity on the problems associated with the use of oral estrogengestagen contraceptives, the role of the male in contraceptive practice is re-examined . . . and research into new methods is being stimulated.” On the need for this shift in emphasis, WHO officials and Western feminists agreed.¹¹

While Asian leaders called for a male pill to control population, feminists called for the development of a male contraceptive 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 development 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.”¹²

Not all feminists agreed that women should relinquish contraceptive responsibility to men. In fact, from the very beginning of their efforts to develop the birth control pill, Margaret Sanger and Katharine McCormick were adamant that contraception be entirely in the hands of women. McCormick said she “didn’t give a hoot for a male contraceptive.”¹³ The two pioneers 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 passionate, so why not control them for a change? . . . Please let us women have a rest from pills and put the cure where it belongs—on men.” Rock responded with the optimism characteristic of the researchers at the time: “It will not be long now when you can feel that you are getting even.”¹⁴

Rock was wrong. The male pill was nowhere in sight. Researchers 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 identified 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 masculinity. 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.”¹⁵ Needed or not, the male libido seemed to be the primary preoccupation in any discussion of a pill for men. Although 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 similar studies by the thousands. . . . He [the human male] has psychological aversions to experimenting with sexual functions. . . . Perhaps experimental studies of fertility control in men should be preceded by a thorough investigation of male attitudes.”¹⁶ In the 1970s, sexuality remained a central concern in the male contraceptive trials. A 1974 report to the World Health Organization 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 libido continued to discourage men from volunteering for studies. One researcher believed that extensive education would be necessary because the “delicate male psyche equates virility with fertility.” ¹⁷ As late as the 1990s, a Dutch researcher noted, “The Pill for men inhibits libido. This might be considered an advantage—refraining from sex constitutes a perfect contraceptive—but men don’t take the Pill to refrain from sex.”¹⁸

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 conspicuously 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. According 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.”¹⁹

At the same time, articles in the popular press began to promote 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.”²⁰ 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.²¹

Not all the press coverage was so reassuring. The cover story of Esquire in June 1972 carried the headline “All about Vasectomies (scared?).” Evoking men’s anxieties about both feminism and vasectomies, the photo on the cover pictured a woman surgeon in scrubs, gloves, and mask, with surgical scissors in one hand and scalpel in the other. The long article, titled “The Incision Decision,” covers “a burgeoning brotherhood of men who had taken the ultimate step in contraception: . . . vasectomy.” 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 distribute 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.”²²

In spite of calls for new methods, research on male contraception continued at a snail’s pace. Whether or not men would actually take a contraceptive pill if one were developed, the scientific community assumed they would not. Contraceptive development was falling victim to the increasing skepticism and scrutiny directed at the pharmaceutical industry and the medical 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.²³

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 intrusions required to sabotage their fertility, but men would not. These ideas were so deeply held that reversals of this arrangement seemed absurd. Two widely circulated parodies of contraceptive guidelines make the point. In 1971, a spoof in the Village Voice offered a fictional guide to men to help them choose an appropriate form of birth control. To select among the “fine methods 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 doctor) 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 buttocks, 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 decrease 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.”²⁴

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 conducted 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 underside 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 experienced swelling of the tissues. Three developed cancer of the testicles, 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 disappear within a year. Although there were a few cases of “massive scrotal infection necessitating the surgical removal of the testicles,” this complication was too rare to be statistically important. “She and other distinguished members of the Women’s College of Surgeons agreed that the benefits far outweighed the risk to any individual man.”²⁵

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. “Conceivably . . . 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 popular, encouraged in part by the establishment of sperm banks across the country and observed that “over 400 normal children have been produced by artificial insemination using frozen sperm.”²⁶ 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 vasectomy by using a temporary implant inserted into the vas that could be removed. In theory, the process could be reversed several times as the man wishes to be fertile or infertile. But the researchers were unable to say when such an operation might be available for use on a human male.²⁷ 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 completely. Although it seemed to hold some promise, the contraceptive ointment never made it to clinical trials.²⁸

Even the lowly jockstrap seemed to offer contraceptive potential. In 1975, Esquire, hostile to the idea of vasectomies, waxed enthusiastic about this benign undergarment: “The jockstrap, its place in sports history already snugly secure . . . will be credited with contributing mightily to the protection of mankind from grievous pain, injury, insult and, it now appears tantalizingly possible, overpopulation.” The article quoted John Rock, who noted that sperm output declines when the testicles are heated. “Daily wear of a well-fitting, closely knit jockstrap results in infertility after four weeks.” Although the jockstrap was hardly foolproof, Esquire found it to be much preferable to other methods that might emasculate the man. According to Dr. Sheldon Segal of the Population Council, “A man could take his wife’s oral contraceptives and he’d be incapable of fertilizing her within fourteen days, but his libido would be shot to hell, too,” and another researcher warned, “Start interfering with sperm production and before you know it you’ve got a pussycat.”²⁹

Theoretically, however, the jockstrap idea had potential. According to Dr. Mostafa S. Fahim, a reproductive pharmacologist, “If we’re ever going to have any impact on world overpopulation, we’ve got to have a contraceptive that is neither surgical nor pharmacological, something even the poorest and most illiterate can make use of.” Using the concept of heat to develop new male methods, he constructed a device to warm the testicles to the level that would inhibit sperm production. It was a “wateractivated battery” that could heat up to 230 degrees Fahrenheit. “Inserted in a spongelike material, it can easily be shaped into a pouch suitable for heating the testes.” The pouch was to be worn half an hour at a time and then discarded. Fahim pointed out that the device was preferable to a vasectomy because it was nonsurgical and reversible. “Things look very good now, but we must still perform complex, long-term genetic and biochemical tests on a large number of subjects. We mustn’t be hasty. We don’t want this to be like The Pill and now, perhaps, vasectomy, where troubles begin to manifest themselves years after millions of people have already become involved.”³⁰ This device, like the others, never made it to market.

While these various alternatives were being studied, researchers continued their efforts to develop a contraceptive pill, injection, or vaccine for men. In the late 1960s, one drug under consideration was Agent U5897, a “common industrial compound used in the manufacture of dynamite” that promised to be free of the serious drawbacks that had hampered the development of the male pill, especially the problem of reduced libido. U5897 was not ready for human trials, however, because of toxic side effects. The silver lining in the research was the discovery that the drug was effective in stemming the fertility of laboratory rats, suggesting that even if the drug was not practical for humans, it could be used to reduce the population of rodents. The Minneapolis Tribune reported this finding under the unfortunate headline, “Antifertility Drug Developed for Men, Rats.”³¹

With all the hormonal methods being tested, scientists actually discovered an effective vaccine that completely stopped the production of sperm without interfering with sex drive. But it had an unacceptable side effect. According to the researchers studying the vaccine, “There is one drawback which indirectly affects libido, and because of this drawback, I quite honestly doubt we’ll ever be able to use the vaccine. The testes get smaller—about a third smaller—so this approach will never work. The psychological trauma of shrinking testes just cannot be overcome.”³² Antifertility injections were also under scrutiny as early as the 1960s, but they had the same problem. Good Housekeeping reported that investigators were searching for methods that would not reduce the size of the testicles. Other promising possibilities included a capsule containing a synthetic male hormone that would be implanted under the skin to prevent sperm formation. Removing the capsule would restore fertility (much like Norplant for women).³³

In 1981, researchers at Vanderbilt University reported tests of a daily injection for men of the drug luteinizing hormone- releasing hormone, or LHRH, that suppressed sperm production and lowered testosterone. When it was tested on eight men between the ages of twenty-eight and forty-two, the injections were found to be nontoxic, and all subjects regained their fertility after discontinuing use. But yet again, some of the volunteers experienced a loss of sex drive, impotence, and “momentary increases in body temperature, or so-called hot flashes, such as those experienced by women after menopause.” The scientists began working on a compound that would eliminate the side effects and said that it could take several years before the drug would be considered safe for marketing.³⁴

Six years later, the New York Times reported that researchers were testing another birth control injection for men, which used a synthetic form of testosterone to inhibit the production of sperm. Under the auspices of the World Health Organization, the medication was being tested in several countries, including the United States, where thirty Seattle men were involved in the trials. Though the results didn’t show any negative effects on sex drive or other “personality factors,” the injections were not 100 percent effective. Researchers were trying to refine the dosage to lower the failure rate to less than 1 percent. The major hurdle was that the contraceptive required a weekly injection. Of course, those scientists did not seem to consider it impractical for women to consume a pill every day. But they believed that men would be unwilling to take an injection every week.³⁵

SCIENTISTS WHO DEVOTED YEARS OF WORK TRYING to develop an effective and acceptable male contraceptive bristled at the accusation that chauvinism prevented the introduction of a contraceptive for men. Writing in 1972, Dr. Sheldon Segal explained that it is much more difficult to intervene in the physiological and chemical constitution of the male reproductive system.³⁶ A quarter of a century later, researchers made a similar point: “All you have to do with women is to knock out the production of one egg per month, but men produce something like 250 million sperm cells per ejaculation. Suppressing this gigantic factory of sperm production in men is a lot more difficult.”³⁷

Other scientists dissented from this view, arguing that it was not necessarily more complicated to prevent sperm production than to inhibit ovulation. Nevertheless, most agreed that for a variety of reasons, ranging from human biology to funding and testing constraints, the development of a male pill would be difficult. In 1983, in her column in the New York Times, Jane Brody supported the claim that physiology was the greatest barrier to male contraception. Noting that many feminists believed that “male researchers feel more comfortable tampering with a woman’s physiology than with their own,” she nonetheless agreed with the view that “basic biology remains the greatest barrier to developing male contraceptives.” Taking on the single most controversial point in any discussion of a male pill, she continued, “The organ that produces sperm also makes the male sex hormone testosterone, which is responsible for libido, potency and secondary sex characteristics. . . . By contrast, ovarian function need not be wholly suppressed to prevent ovulation. And since a woman’s libido is not a function of ovarian hormones, but of other sex hormones produced in the adrenal glands, side effects are more easily avoided.”³⁸

A month later, the New York Times editorialized that while men and women should share the responsibility for birth control, it would probably be twenty years before a new male contraceptive would be available. The editorial promoted vasectomies and cited a study showing the procedure to be safe and effective. Yet it concluded that the ideal birth control was still a long way off: “Someday somebody somewhere will develop the perfect contraceptive, suitable for both sexes with no health risk whatever.”³⁹

There were, of course, cultural reasons for the relative lack of attention to male contraception. The emphasis on women is embedded in the institutional frameworks of science, medicine, and pharmaceuticals. Both women and men think of reproduction in terms of women’s bodies and of birth control as a woman’s responsibility. The fact that the medical profession generally considers reproduction a female concern has led to a scarcity of doctors trained in male reproductive medicine and a shortage of scientists interested in working on male contraception. Ronald Ericsson, one of the researchers in the field of male contraception, complained in 1973 that male contraceptive research “is almost an illegitimate specialty within reproductive biology.” As late as the 1990s, male contraceptive researchers complained that they were considered “second-class scientists.”⁴⁰

Some researchers speculated that the heightened scrutiny of new pharmaceuticals made it more difficult and time-consuming to gain approval for human trials and bring new methods to market. As early as 1977, Dr. Don Fawcett of the Harvard Medical School warned that it would be many years before “she will ask him, ‘Did you take your pill today, dear?’ ” He noted that since the FDA approved the pill in 1960, much stricter regulations governing experimentation on human subjects had been put into place, hampering the search for a male pill. “When [the FDA] didn’t approve thalidomide [the drug that caused thousands of severe birth defects in Europe] for marketing, that put them on the map, and so now the tendency is to be extra cautious. If the FDA official has even the slightest doubt, the easiest thing for him (sic) to do is to say, ‘go back and do 1000 more rats.’ ” (The FDA official who blocked approval of thalidomide was, in fact, a she—Frances Oldham Kelsey.)⁴¹ Regulations aside, there was still the problem of the men themselves. “There is nothing inherently difficult about finding chemicals to inhibit male reproductive capacities,” Fawcett explained, but the question remained, “Will they use it? Will men, even in a pill-popping society like ours, take to taking the pill?” He predicted that older men might resist but that young men would be open to the idea.⁴²

Indeed, he may have been right. A generation after Fawcett’s prediction, men’s reluctance may be declining. In the wake of the feminist challenge to traditional gender norms, a new concept of manhood that includes qualities of caring and taking responsibility has eroded earlier attitudes that equated masculinity with sexual conquest. Although none claimed that male contraceptives would contribute to men’s freedom or reproductive rights, men who participated in clinical trials of new contraceptives saw themselves as caring partners. In 2008, twenty-three-year-old Erin M wrote in response to an online survey that it was “unfortunate that male hormonal contraceptives are not on the market, because my husband would volunteer for it (we’ve talked about it).” She worried, however, about its safety: “I would be uncomfortable with that until male birth control had been well tested, though.”⁴³

To persuade volunteers to participate in studies, researchers appealed to their sense of masculine bravery and heroism. Making this point explicit was a poster used to recruit volunteers in Edinburgh, Scotland. Next to an image of an astronaut perched on the surface of the moon were bold letters proclaiming, “FIRST MAN ON THE PILL.” By the early twenty-first century, as researchers continued to work on developing a male contraceptive pill, most believed that men would be receptive, especially those in stable relationships. Noted one doctor: “It won’t work for the 17-year-old at the nightclub looking for a contraceptive but will for men in relationships.” Another noted that the question of trust would be all important: “A woman would be mad to believe a chap she met in a night club who said: you’re all right love, I’m on the Pill.”⁴⁴

By 2008, that scenario seemed not so absurd. Kansas City journalist Jonathan Bender wrote that with new male contraceptives due within a year, “The hotel bar pick up will have a delightfully different spin. So next year when a guy says, ‘Don’t worry, I’m on the pill,’ you can relax.” Bender welcomed the introduction of a male pill, injection, or patch. Noting that the major side effects appeared to be weight gain and increased muscle mass, he quipped, “But hey who doesn’t like bigger pecs?”⁴⁵ (The comment echoed the happy responses of some female pill users who discovered that the pill enlarged their breasts.)

NO LONGER A SPOOF OF ABSURDLY REVERSED GENDER roles, in the twenty-first century many of the leading physicians and scientists involved in developing male contraceptives are women. Dr. Andrea Coviello, one of the researchers involved in testing a microcapsule injected under the skin that releases testosterone over three months, noted that the technology has been developed but cautioned that the availability of the new method depended on continued funding. Using methods similar to the oral contraceptive for women, the male compound would use hormones such as testosterone and pro - gestins to turn off sperm production. According to Dr. Christina Wang, who is directing the study at Harbor-UCLA Medical Center in Los Angeles, the first male hormonal contraceptive would probably be an injectable or an implant similar to Norplant for women. Studies under way suggest that the implants are “safe, effective, inexpensive, and entirely reversible.” She predicted FDA approval within five years. The California researchers are collaborating with scientists in China, where 1,000 men are involved in clinical trials to develop low-cost, effective, and reversible male contraceptives with minimal side effects. Dr. Wang notes that there is greater interest in male contraception, and more funding available worldwide, than ever before.⁴⁶

Within the United States, men involved in the studies reported positive results. Larry Setlow, a thirty-nine-year-old computer programmer in Seattle, volunteered for three different clinical trials of pills and injections. “I never had any real noticeable side effects. I didn’t notice any mood changes. I may have put on a little weight. . . . They all worked really well and I was able to look at my lab results and see my sperm count drop to zero.” Forty-five-year-old Quentin Brown, a married father of three who lives in Los Angeles, reported no significant problems after taking hormonal contraceptives for more than a year. His motivation for helping to develop the pill was hardly in support of feminism, however. “It is time for men to have some control. I think it would empower men and deter some women out there from their nefarious plans. Some women are out there to use men to get pregnant. This could deter women from doing this. An athlete or a singer is someone who could be a target and they could put a stop to that.”⁴⁷

Men were not the only ones to raise the issue of trust. Twenty-eight-year-old Mary B saw the other side of it: “I have heard women say that they’d be against a male pill because they wouldn’t trust men to take it. Of course that’s silly. The point of a male pill isn’t that it allows you to stop taking it. It’s just that you have twice the protection. Also, I think that it will force men to be more responsible towards children they did father. No longer would the ‘she tricked me’ option be on the table.”⁴⁸

While some men perceived potential benefits, others remained reluctant. Forty-year-old Stuart H, a single college administrator, said he would welcome a method for men but not one that involved taking hormones: “I would rather rely on a solution that doesn’t involve medicating myself, and the problems women have had with hormone therapy doesn’t make me anxious to want to sign on to taking a hormone-type therapy.”⁴⁹ Many women, however, see it as a matter of fairness and equality. Kelly H was “amused and pissed off” to hear that “men refused to consider a male contraceptive until there was some non-chemical breakthrough because they were afraid of what the chemicals and hormones might do to their bodies and ‘masculinity.’ I told my mother that they obviously weren’t worried about the damage to women’s bodies over multiple years of ingesting ‘dangerous’ chemicals and hormones. Sexist fuckers.”⁵⁰

In keeping with the values of her Southern Baptist upbringing in rural Oklahoma, twenty-eight-year-old Cathy S and her husband of seven years married as virgins. But her traditional ideals did not stand in the way of her belief in equality for women. “I like the idea of a male birth control pill—something that would give men the freedom and responsibility of reproductive choice. It would be one more step toward egalitarianism.” ⁵¹ Rachel A, age twenty-eight, resents “that birth control is now my sole responsibility. I’d feel better about it if [my boyfriend] had to pop a pill everyday at the same time too.” At age seventeen, Donna H was already annoyed and frustrated: “I have to take a pill and use hormones to control fertility but men do not.” Susan G, a twenty-two-year-old student, lamented, “What kind of a culture thinks it’s okay to mess with a woman’s chemistry and fecundity, but to even consider a pill that does the same for men is completely ludicrous?”⁵²

In 2008, MSNBC repeated a decades-old claim: “For the first time, a safe, effective and reversible hormonal male contraceptive appears to be within reach.”⁵³ Studies remain under way all across the globe. The World Health Organization, which has long supported research on male contraceptives, reports a great deal of success with compounds under study and no difficulty finding recruits to volunteer for the clinical trials. Optimistic scientists proclaim that a new male contraceptive is just around the corner, as they have predicted for half a century. But the same question remains: Will men take it?

No such question stood in the way of another pharmaceutical product aimed at men’s sex organs: Viagra. In the midst of continuing efforts to secure funding for the development of a hormonal contraceptive that men would take, the pharmaceutical industry poured massive resources into developing a pill for men that would do just the opposite. Viagra hit the U.S. market in 1998 and quickly became the most successful prescription drug ever launched in the United States, despite the fact that it carries serious health risks.⁵⁴ Apparently, a pill that enhances the potential for men to impregnate women is considerably more marketable than one that diminishes that possibility.