Tag: Gender Disparities

Blog Posts (6)

August 25, 2016

More on the Male Pill: Social Reasons Why It Is Good for Women and Men

In my previous blog , I discussed how the lack of male contraception reduces men’s reproductive autonomy and burdens women with the health-related and financial consequences of being the one responsible for contraception. In this blog, I want to explore some of the social burdens women face when contracepting, especially those that men do not and would not face when using contraception.

Women face the social burdens of contraception, which include medicalization of one’s reproductive health, the stress and worry about the possibility of an unintended pregnancy, social repercussions of one’s contraceptive decisions, and possible moral reproach for contraceptive failures. While men could potentially face some of these social burdens, several of them are specific to women. For example, since pregnancy occurs in a woman’s body, she will physically embody the stigma and shame of an unintended pregnancy whereas the man will not carry any physical reminder of it.

Another burden unique to women is the double-bind they face regarding contraceptive use. Women who use contraceptive may be seen as violating the feminine norm of chastity. Yet, if single women do not use contraception, they risk an unintended pregnancy, which is associated with irresponsibility and trying to “trap” a man.

Since men are not held to the norm of chastity, but rather are frequently lauded for sexual promiscuity, they are not socially penalized for engaging in sexual activity and using contraception. Thus, the development of male contraceptives could help women avoid this no-win situation while empowering men to control their reproduction.

The need for male contraceptives is often looked overlooked because contraception is often conflated with women, thereby marginalizing and even ignoring men. For instance, unmet need for contraception is generally calculated using only women’s information: their fertility intentions and their contraceptive use. Excluding men from questions about unmet contraceptive needs fails to recognize their role in and responsibility for contraception both in their personal relationships and on the social level. It moreover fails to acknowledge that men may also have unmet contraceptive needs.

One study in Western Africa that interviewed both women and men regarding unmet contraceptive need found that between 15 – 23% of husbands had unmet contraceptive need even though their wives did not. These men were not interested in having children, at least at that time, but the dearth of reversible male contraceptives limited their options for controlling their reproduction since their partner did not have unmet contraceptive need and was consequently not using female or shared methods (and the male condom is frequently considered a shared method).

One of the benefits of female LARCs is that the woman’s partner does not need to be involved in or even know about their use. This is a good option for women if they and their partner disagree about contraceptive use. Unfortunately, men have no alternative available to them that they can use without their partner’s involvement or knowledge, which raises justice concerns and highlights men’s diminished reproductive autonomy.

 

 


 [LC1]Hyperlink to my previous blog.

August 25, 2016

More on the Male Pill: Social Reasons Why It Is Good for Women and Men

In my previous blog , I discussed how the lack of male contraception reduces men’s reproductive autonomy and burdens women with the health-related and financial consequences of being the one responsible for contraception. In this blog, I want to explore some of the social burdens women face when contracepting, especially those that men do not and would not face when using contraception.

Women face the social burdens of contraception, which include medicalization of one’s reproductive health, the stress and worry about the possibility of an unintended pregnancy, social repercussions of one’s contraceptive decisions, and possible moral reproach for contraceptive failures. While men could potentially face some of these social burdens, several of them are specific to women. For example, since pregnancy occurs in a woman’s body, she will physically embody the stigma and shame of an unintended pregnancy whereas the man will not carry any physical reminder of it.

Another burden unique to women is the double-bind they face regarding contraceptive use. Women who use contraceptive may be seen as violating the feminine norm of chastity. Yet, if single women do not use contraception, they risk an unintended pregnancy, which is associated with irresponsibility and trying to “trap” a man.

Since men are not held to the norm of chastity, but rather are frequently lauded for sexual promiscuity, they are not socially penalized for engaging in sexual activity and using contraception. Thus, the development of male contraceptives could help women avoid this no-win situation while empowering men to control their reproduction.

The need for male contraceptives is often looked overlooked because contraception is often conflated with women, thereby marginalizing and even ignoring men. For instance, unmet need for contraception is generally calculated using only women’s information: their fertility intentions and their contraceptive use. Excluding men from questions about unmet contraceptive needs fails to recognize their role in and responsibility for contraception both in their personal relationships and on the social level. It moreover fails to acknowledge that men may also have unmet contraceptive needs.

One study in Western Africa that interviewed both women and men regarding unmet contraceptive need found that between 15 – 23% of husbands had unmet contraceptive need even though their wives did not. These men were not interested in having children, at least at that time, but the dearth of reversible male contraceptives limited their options for controlling their reproduction since their partner did not have unmet contraceptive need and was consequently not using female or shared methods (and the male condom is frequently considered a shared method).

One of the benefits of female LARCs is that the woman’s partner does not need to be involved in or even know about their use. This is a good option for women if they and their partner disagree about contraceptive use. Unfortunately, men have no alternative available to them that they can use without their partner’s involvement or knowledge, which raises justice concerns and highlights men’s diminished reproductive autonomy.

 

 


 [LC1]Hyperlink to my previous blog.

August 15, 2016

Why We Need a Male Pill: Enhancing Men’s Reproductive Autonomy and Unburdening Women’s Contraceptive Responsibility

One of the key tenets of reproductive autonomy is being able to control if, when, and with whom one reproduces. Men’s reproductive autonomy is inhibited by the lack of good contraceptive options available to them. Whereas women have 11 types of contraceptives—including barrier, hormonal, permanent, and long-acting reversible—men only have two types—the male condom, a barrier method, and vasectomy, a permanent method. It is not just the number of methods that is problematic; it is also the lack of long-acting reversible contraceptives (LARCs). Many men want to maintain their future fertility, thus ruling out vasectomy, but do not want to rely on condoms, especially if they are in a long-term monogamous relationship. While part of the reason some men do not like condoms is because they can decrease sexual sensation, another reason is that the failure rate for actual use is so high: 17%. Female LARCs, in contrast, have much lower failure rates for actual use, which enhances their reproductive autonomy because they are equipped with effective methods to enact their reproductive desires (i.e. avoiding pregnancy).

The lack of male LARCS causes some men to rely upon their female partner to contraceptive since she has more and better contraceptive options. Yet this dependence on his partner may also comprise his reproductive autonomy because he has to trust that she is consistently and correctly using female methods. If she does become pregnant, he has no recourse and, in many settings, is legally responsible for any offspring, including financial and even social obligations to the child.

Placing the majority of contraceptive responsibility on women due to the lack of male methods is not just bad for men; it is also bad for women. Women have to shoulder the health-related side effects of contraception, which tend to have more serious side effects than male methods because they include hormonal methods. Not surprisingly then, the most common reason for nonuse of modern contraceptives among women with an unmet need is health concerns and side effects. Additionally, side effects are the most cited reason why women discontinue contraceptives and most forms of contraception have discontinuation rates near 50% after one year of use. The fact that women continue to use a particular method does not mean she is happy with it; she (and her partner) may simply see it as their best option among poor choices.

In addition to the health related side effects of contraception, there are also the financial burdens of contraception. In the US, although the Affordable Care Act requires health insurance companies to cover female contraceptives, not all women are aware of this and very few women realize that certain forms of contraceptive, such as IUDs and tubal ligation, are covered. Even if the cost of contraception is covered, women still have to invest the time to acquire contraception: all methods except the female condom and the sponge require at least one health care provider visit and hormonal methods require an ongoing prescription. In the global South, women may face difficulty affording contraception, especially if their government does not prioritize reproductive health services.

May 9, 2016

Bad Moms, Blameless Dads: Examining How the Media Portrays Age-Related Preconception Harm

As I discussed in a previous blog, the blame for fetal harm is generally directed at women. Some of my colleagues and I, including AMBI faculty member Zubin Master, were interested in examining how fetal harm, and more specifically age-related preconception harm, is portrayed in the media. Our findings were published earlier this year in the American Journal of Bioethics Empirical Bioethics.

Given the significant social change that many people today are delaying childbearing in comparison to previous generations, it is relevant to examine the media portrayal of older parental age and risk to future offspring. Furthermore, there is clear evidence that older parental age carries certain risks to offspring: older age in women and men leads to an increased risk of having children with autism and Down syndrome and older paternal age has also been linked to higher rates of children with schizophrenia. Many people get most of their scientific news from the media, so it is important to examine the accuracy and biases of the information.

Our results indicate that reproduction is still largely seen as the domain of women, rather than of couples or of men. We rarely found articles discussing reproduction as it relates to both women and men as the majority of articles were maternally focused. Even among the articles that were paternally focused, they almost always discussed maternal harm as well. However, the reverse – maternally focused articles containing discussions of paternal harm – were almost nonexistent. This pattern suggests that men alone are never seen as solely responsible for fetal harms, but rather that this responsibility is always shared with women.

Responsibility and blame typically go hand-in-hand and not surprisingly articles were four times more likely to blame women for fetal harms than men. The infrequency of paternal blame suggests that authors either do not recognize men’s contribution to harm due to ignorance or denial, or do not want to hold men responsible for harm. Even when men’s contribution to harm was acknowledged, the authors were more likely to absolve men from responsibility for harm by presenting reassuring information, such as the overall risk of fetal harm is quite low, in conjunction with factual information stating that older paternal age can increase risks to future children. The same sort of reassurance was not seen for women.

Although reproductive blame and responsibility is still typically assigned to women, newspapers are increasingly discussing the relationship between paternal age and preconception harm: no articles discussed this relationship in the 1970s or 1980s, 20% discussed it in the 1990s, and nearly 40% discussed it between 2000 and 2012. The increase in articles on paternal harm in the 2000s may be due to the increase in scientific data showing the connection between paternal age and harm, the growing body of social science literature on male reproduction, the rising medicalization of men’s sexuality and reproduction, as well as changes in social norms that make discussions of paternal role and responsibility in reproduction more commonplace.

However, despite the fact that newspapers are actually acknowledging and discussing paternal age and preconception harm, the primary focus of newspaper articles regarding preconception harm remains concentrated on women and articles are more likely to blame women than men for any harm. In short, our analysis of age-related preconception harm reflects the broader gendered social patterns regarding reproduction that tend to minimize, and even ignore, men’s role in and responsibility for reproduction.

 

 

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.

August 28, 2015

Marketing Trumps Science, or How the Pink Pill Does Not Even the Score

<p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">This month’s blog is going to be a bit of a rant. I don’t generally consider myself a rant-y person, but some of the commentary surrounding the recent </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm458734.htm">FDA approval</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> of the sexual desire disorder drug Addyi has proven too much for my delicate constitution.</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">First, what I am NOT doing: I am NOT denying the existence of hypoactive sexual desire disorder (HSDD), or that for women who are so afflicted it can cause serious distress or otherwise negative consequences. I am NOT challenging the notion that HSDD is a medical problem that warrants seeking a medical treatment or medical solution. I am NOT arguing against pharmaceuticals in general, or here specifically, as a potentially viable medical treatment for HSDD. I am NOT saying all pharmaceuticals should have absolutely no risks or side effects, or should be required to produce overly substantial benefits for it to be appropriate for them to be FDA-approved and released to the market. I am NOT calling into question the claims that there are very real sex and gender disparities in medicine, human medicalization, and medical treatment. And I am NOT disputing the value of empowering women with greater control over their own bodies and their own healthcare.</span></p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;">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 <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
August 18, 2014

Viagra Versus the Pill

<p>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. </p> <p>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. </p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">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 <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20.399999618530273px;"> </span></p>