In the recent controversy over a male contraceptive injection and the suspension of medical trials due to unwelcome side effects, everybody seems to have forgotten that there is a a safe, effective and reliable male contraceptive with minimal side effects already in existence: the condom.
In the 21st century women can choose from up to 11 different contraceptive methods, either barrier or hormonal, most of which come with their own delightful menu of side effects including, but not limited to: headaches, mood-swings, weight-gain, sore breasts, depression, nausea, reduced libido, an increased risk of blood clotting and menstrual cramping. While not all women will experience these side effects, the threshold for what women are expected to put up with is much higher than most men are willing to go through, as evidenced by the failure of recent medical trails.
Despite over 60 years of major advances in birth control for women, there are still only two viable options in existence for men: the condom or the vasectomy. The argument goes that women are the ones who have to deal with the immediate physical consequences of an unplanned pregnancy, so women have to protect themselves; they can’t rely on their partners to do so. Hence the unbalanced emphasis on contraceptives for women. This, however, only addresses half the story. Hormonal contraceptives, the IUD and the diaphragm only protect against pregnancy, they still leave women vulnerable to sexually transmitted infections.
The condom, male or female, when used correctly, is up to 98% effective in preventing pregnancy and, after abstinence, it is the only method that offers protection from sexually transmitted infections. It has no side effects (unless you are allergic to latex, in which case there are alternatives), it does not interfere with the fertility of either partner and it is immediately reversible – meaning if you want to get pregnant, you just stop using it. In countries where condoms are freely available, they are relatively cheap and easily accessible. Men and women can buy them and, if treated well, they have long expiration dates. So why are we not shouting ‘Condoms for all, long live the condom’ from the roof tops?
A little bit of history
The condom, or condom-like devices, date back to 3000 BC when our ancient ancestors used materials like fish bladders and animal intestines to sheath their penises. It wasn’t until 1838 that the first rubber condoms were invented and 1938 when they were finally legalised for sale and distribution in the US.
In Ireland the sale of condoms was legalised in 1979 but they were only available with prescription and to people who could prove they were using them for family planning. Following years of campaigning by the Irish Family Planning Association and Irish feminists, contraception was finally legalised in 1985 but it wasn’t until 1992 that they could be bought by minors, outside of pharmacies and without a prescription. Thankfully in 2017 they can be found everywhere from pubs, to supermarkets, to clothing stores.
The politics of condom use
In countries with a strong macho culture, negotiating condom use with a casual or long term partner can be difficult to impossible for many women. Men see it as a insult to their virility or masculinity or even accuse their partners of wanting to use it so they can sleep with other men. In Guatemala, for instance, women are often expected to have as many children as ‘god sends’ (not so different to the Ireland of my Grandmother’s generation) and men often forbid their wives from using any kind of family planning method.
Many women begin having children from as young as 14 and can have up to 12 or 14 children in some rural communities. This, coupled with a lack of accessible health services and the criminalisation of abortion, means that Guatemala has one of the worst maternal mortality rates in Latin America. Some women in this situation opt for hormonal contraceptives, particularly the monthly injections, or IUDs, because they will continue to menstruate, therefore avoiding their partners’ suspicions. Nevertheless, these methods do not protect women from STIs.
When ‘Nice Guys’ say no
Meanwhile in the Western world, we’ve got all those issues covered, right?
How many of us have heard the, “Oh but you’re on the pill, right?” question as if our sexual health begins and ends with our possible reproductive capacity. Or have had experiences where our partners simply “forgot” to put one on (like in that movie Knocked Up – this is actually a violation of consent), or assured us they would “pull out” in time?
During one particularly drunken and misjudged one night stand I was informed by my self declared ‘feminist’ partner that he had had a vasectomy and there was no need to use a condom; as if pregnancy was the only thing we needed to be concerned about. Needless to say I did not hang around before making an appointment in the local GUM clinic (not one of my brightest moments).
On another occasion, this time in a more serious relationship, the condom broke and I headed straight to the pharmacy the next day for the morning after pill. The first thing the ‘nice guy’ said to me as we left the pharmacy, having just been grilled by a prissy pharmacy technician about my sexual history, was “Now we don’t have to use condoms for the next few days, right?” This comment was not without precedent; while he had never refused to use condoms, he always made some sort of fuss about it and constantly insinuated that I should consider using the pill. And FYI, the morning after pill is just that, for the morning (or up to 72 hours) after you have unprotected sex. It is not a prophylactic that protects you from future encounters, that is what the pill is for. We broke up shortly after.
My first serious boyfriend and I had been going out a year and were living together when, in a love-fueled haze of poor judgement, we spontaneously decided to stop using condoms. And what do you know, a month later I had chlamydia. Thankfully, I caught it early and was treated immediately. Life lesson: do not stop using condoms until both partners have had a full STI screening.
A male friend of 40 or so years recently commented, in a justification for not using condoms, that it is, quote, “very unlikely that women will get an STI.” In fact, the physiology of the vulva and vagina is far more vulnerable to STIs and many STIs like chlamydia and HPV are symptomless for men but can lead to infertility and cancer in women. The prevalence of STIs on Irish campuses is increasing, signaling perhaps the failure of current sexual education in the Irish education system to address what it means to have healthy, consensual and responsible sexual relationships.
So even for the most “liberated” of us, we can face situations where sexual partners, either casual or long term, will find a way to cajole, pressure, lie or use emotional blackmail, to get out of using condoms. I can say from experience that negotiation over condom use is not always easy, it takes practice and belief in ourselves and our needs. In those difficult moments always remember that we have a right to protect ourselves and our health. A partner who is not willing to respect this by wrapping it up, is perhaps a partner not worth entertaining.
The condom is 98% effective with correct use, but of course many people do not use it correctly. With typical use (like not putting it on properly, putting it on too late or using the wrong size) its effectivity drops to 85% and so accidents can and do happen. For those moments, we can thank our lucky stars for emergency oral contraception. In Ireland it is now finally available in pharmacies without prescription.
Of course, the morning after pill does not always work, and other forms of birth control can and do fail. And for that reason, thousands of Irish women and men have been campaigning ceaselessly for a repeal of the 8th Amendment as the first step to allowing Irish women to access safe and legal abortion services in Ireland.
Long live diversity
Condoms come in ribbed, flavoured, extra-sensitive, extra-lubricated, extra-safe, delayed response, strawberry, cherry and chocolate flavored, glow in the dark, small, medium and large; all the variety you can imagine to spice up your sex life. For those of us with latex allergies or environmental consciousness there are non-latex and eco friendly fair trade
Condoms also have other uses: they make great water bombs and funny balloons at music festivals. But seriously, I don’t actually encourage wasting precious condoms for these kinds of uses. You can also use them for safer oral sex with women by cutting them into squares to use as improvised dental damns, if these are hard to come by where you are.
So, have I convinced you yet, that the humble condom is in fact the the Queen of contraceptives?