Collection: Burning Rubber(s)

My teenage nephew came to visit last summer, and I asked him if there was anything he needed from the drug store. “Uh, condoms?” he said. It was easier to ask liberal Aunt Val than Grandma, who is raising him. We hopped in the car. At the local Walgreens, we found the display and we lingered, picking packages up and putting them back. “Wow, there’s a lot of choices,” he enthused, exchanging a rainbow of colors for a fruit-flavored variety pack. I bit my tongue to keep from pointing out that we were seeing a lot of packaging but only a single type of latex device, vulnerable to misuse and rupture. I was determined to focus on the positive, making our shopping excursion as normal and playful as possible—to make condom buying (and wearing) an absolutely ordinary thing to do. For 20 years, ever since the HIV epidemic swelled to global proportions, aunts, parents, schools, public health agencies, and governments around the planet have been trying to do the same thing: indelibly pair condoms and sex. Condoms are the best thing we have going for prevention of sexually transmitted diseases.

Unfortunately, all the focus on HIV and condoms has drawn attention away from another reality: from a contraceptive standpoint condoms are mediocre at best. While the top tier of female birth control methods (IUDs and implants) have an annual pregnancy risk as low as 1 in 1,000, the annual risk for a couple using condoms is closer to 1 in 5. Multiply that by almost 40 years of female fertility! Reliance on condoms is one of the reasons that 1 in 3 American women has had an abortion by the time she hits menopause.

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Safe, effective birth control for men is long overdue. Consider a tale of two siblings:

When Mary hit middle school, she began having such painful periods that her father once called the paramedics, thinking she had a ruptured appendix. At age 14, she got a state-of-the-art hormonal IUD that cured her terrible monthly cramps. Over time the IUD not only would virtually eradicate her bleeding and pain, but would also provide top tier contraception through college with minimal side effects. Once Mary became sexually active, her annual pregnancy risk would be around 1 in 700. By contrast Mary’s college-age brother, who was relying on condoms (annual pregnancy risk 1 in 5), had to share the emotional and monetary burden of an unwanted pregnancy and abortion.

No parent wants a son to have to depend on the young women he dates to prevent a surprise pregnancy, but the options stink. As one mother of three boys put it,

Every day teens are having sexual relations, and the method of birth control is either left to the girl (most of which aren’t on anything because they don’t want their parents to know), condoms (which are horribly unreliable, especially in the hands of teens), or most often nothing. If parents were more involved and more teens had access to new methods of contraception… more kids would have the ability to make a future. Boys need that option as much as girls.

In the past 50 years, birth control for women has been refined to the point that there are now dozens of alternatives that are far safer than pregnancy, many of which have added benefits like reducing menstrual symptoms, acne, or even cancer risk. The array includes three kinds of long acting “fit and forget” contraceptives that are over 20 times better than the familiar Pill but allow a quick return to normal fertility. But, after all this time, men are still stuck choosing between two century-old choices, condoms and vasectomies.

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