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Posted on August 18, 2014 at 9:08 PM

Given the continuing controversy surrounding insurance coverage for female contraceptives, I want to point out another drug that also targets sexuality and reproduction yet does not generate the nearly same degree of controversy. In fact, insurance companies began covering it immediately upon approval by the FDA with no fanfare. I’m referring to erectile dysfunction drugs. The public’s different responses to female contraceptives and male sexuality medications have been discussed in academic circles as well as in the media. Here I want to present some feminist perspectives on this topic. 

Some feminists argue that part of the reason we understand and treat pregnancy and impotence differently is because we have different standards for women’s and men’s health, which result from the traditional gender norms at play in our society. We (as a society) expect women to adhere to norms of chastity (e.g. fall on the “virgin” side of the virgin/whore dichotomy by not having sex until marriage) and one way we do this is by limiting their access to sexual and reproductive health care. In contrast, because our notions of masculinity are tied into sexual prowess, we are more receptive to providing health care for men who are not able to maintain an erection. 

Abstinence is frequently suggested as an easy and free way for women to avoid pregnancy, but not as a treatment strategy for dealing with erectile dysfunction. While abstinence will not cure men’s problems with erectile dysfunction, by not engaging in any sexual activity, they can avoid the issue altogether. In a similar vein, people with Celiac disease may be able to minimize their health problems by not eating gluten and people with a severe dog allergy may be to minimize their health problems by limiting contact with dogs. This strategy may be unsatisfying for people who love gluten and dogs, just like the strategy of abstinence may be for people who enjoy sexual activity. However, avoiding the activity that leads to physical and/or psychological health problems may be a good or even the best option for some people depending upon their circumstances. What feminists find troubling is that abstinence is usually only raised in discussions about women and preventing pregnancy and not for men in general and specifically in the case erectile dysfunction. 

In response to those who argue that erectile dysfunction is a “real” disease whereas pregnancy is a “normal” part of a woman’s life, feminists highlight the various health risks associated with pregnancy. Pregnancy is an acute condition and one that can have serious and even life-threatening side effects (childbirth is still the leading cause of death women in certain places in the world). In contrast, impotence, while psychologically devastating in many ways for men (and perhaps even their partners), does not lead to other physical health conditions. It is worth noting that pregnancy, especially an unintended pregnancy, can also lead to significant psychological problems for women, their partners, and their family as well as social and financial concerns. 

Another point that feminists often raise is that insurance companies cover medications that prevent health risks from developing (e.g. drugs to lower hypertension to avoid heart attacks) and pregnancy prevention should be covered just like these other medications. The Affordable Care Act (ACA) covers a variety of preventive treatments (e.g. vaccinations), screenings (e.g. diabetes testing), and doctor visits (such as the annual physical) with the goal of preventing health future health problems. The ACA includes contraception as a form of preventive care because it recognizes the risk unintended pregnancy poses to the women, their partners, the children, and their families, as well as the public more broadly. Indeed, some feminists argue that pregnancy prevention is a public health matter. Over half of all pregnancies are unintended and this has serious consequences for the individual health of women and their future children and for the health of the public at large. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website. 

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