Critical Response: Bloomberg Businessweek: Why We Can’t Have the Male Pill: A condom alternative could be worth billions.
The Bloomberg article ‘Why We Can’t Have the Male Pill’ by Emily Anthes attributes the absence of a male birth control pill to various factors within the scientific medical process and the distinctive male biology. Anthes frames the lack of a male birth-control pill as a purely mechanical problem despite its seeming economic allure, and that perhaps it would have been as widespread as its female counterpart if the scientific process had started earlier. However, Anthes fails to consider the variables that created the social conditions in which birth control operates. Anthes herself falls prey to faulty framing of the male birth pill, and assembles illogical arguments from inaccurate and incomplete information.. Arguments made by theorists Laura Mamo and Jennifer R. Fishman, Monica J. Casper and Adele E. Clarke, and Michel Foucault, collectively account for the failure to develop the male pill in ways Anthes cannot.
Anthes sets the stage by introducing initial applications of the male pill on American prison inmates in the 1950s.
“The results were astonishing. Within 12 weeks, the inmates’ sperm counts had plummeted. When the men stopped taking the drugs, sperm production returned to normal. Better yet, they experienced few side effects. Then one of the participants drank some contraband Scotch and became unusually, violently ill - The research was quietly abandoned. “(Anthes, 2017, 2).
This axiomatic abandonment of this potential path towards male-oriented birth control exemplifies all research surrounding the male pill. As John Amory, a research physician at the University of Washington School of Medicine working on male birth control, says, “the male contraceptive has been five years away for the last 40 years” (Anthes 2). Anthes devotes the majority of her article to explaining this stasis in biomechanical detail, but reductively juxtaposes these factors against their female equivalents. Side effects with birth control are nothing new, and Anthes establishes that contemporary scientific restrictions are stricter, so although a female contraceptive with these side effects and even worse may have passed in the 1950s, it would not today. However, Anthes conspicuously fails to interrogate why male contraceptives have not been pursued until now.
In Monica J. Casper and Adele E. Clarke’s “Making the Pap Smear into the ‘Right Tool’ for the Job” the history of the pap smear and its rise to a major cancer screening tool acts as the male pill’s inverse reflection. Although Anthes does partially address how the social allowances and paradigms discourage the male pill, she presents this as marginal rather than the root etiology of the issue.
“Our point is that it has always been possible to define the Pap smear as a ‘suitable’ screening technology, or to define it as ‘not suitable’. Our purpose here is to open up the question of how this procedure, which performed with such ambiguity even when measured against the agreed-upon criteria of the time, became a stabilized and widespread routine cancer-screening approach. -given that the Pap smear could just as easily be represented as the wrong tool for the job, its characterization as the right tool for the job came to prevail, and has been maintained” (Casper & Clarke, 1998, 263).
Coincidentally, or perhaps not, the Pap smear was brought to its epitome at the same time as the rejection of the early male pill Anthes discusses. Anthes misrepresents the obstacles as purely temporal. Even if we are to accept new modern regulations as the male pill’s axiomatic impediment, the first commercially available female birth control pill, Enovid-10, was only approved by the federal drug administration in 1960(Buttar & Seward, 2009). The key difference between the acceptance of female contraceptives and the perpetual delay of the male pill is not timing or biology, but the biopolitical detournements, different tracks taken from differing positions, as the state of sexuality and its relationship to the natural assigns the idea of male contraceptives and female contraceptives as categorically distinct.
“the contents of biology and physiology were able to serve as a principle of normality for human sexuality. Finally, the notion of sex brought about a fundamental reversal; it made it possible to invert the representation of the relationships of power to sexuality, causing the latter to appear, not in its essential and positive relation to power, but as being rooted in a specific and irreductible urgency which power tries as best it can to dominate; thus the idea of “sex” makes it possible to evade what gives “power” its power; it enables one to conceive power solely as law and taboo.”(Foucault, 1978, 155)
As Foucault states in his influential The History of Sexuality Volume 1, the stratification of sex warps and inherently influences power and how it operates within western biomedicine and its paradigms. This has fundamentally reoriented the paths contraceptives must take in relation to sex. While the female contraceptive may be seen as an empowerment to the female over her own body, the male contraceptive is seen as an imposition upon the pristine naturality of the male body; any additional side effects make any male contraceptive as too costly relative to what has been deemed meager non-naturalistic benefits it may provide within the biomedical frame.
Anthes references the perceived disjunction between the male and female “natural” state, Laura Mamo and Jennifer R. Fishman explore it further in ‘Potency in All the Right Places: Viagra as a Technology of the Gendered Body’.
“Female sexual dysfunction is rarely framed as a question of inability to have intercourse, but rather usually involves lack of desire. The assumption of male desire is thus pitted against feminine lack as a script of Viagra, which makes Viagra an appropriate technology for men, but not for women”(24)
“Viagra signals and perpetuates a return to a gold standard of male sexual activity”(30)
Viagra, functionally the opposite of a male contraceptive, has been the ‘par excellence’ of a commodified sexual drug for men. A biological difference Anthes deems important is that while the female body naturally stops ovarian production, the male body never stops producing sperm. This implies that the female pill has been successful in that it can tap into this ‘natural’ state of the female body, while the male pill cannot function analogously. However this completely discounts what can also be seen as the “natural” stoppage of male reproductive mechanisms, erectile dysfunction. Inherent to the term dysfunction itself, biomedicine frames this as something unnatural, a biomechanical mistake. What is considered natural and unnatural is completely determined and substantiated by the biomedical framing that precedes it. For this reason, Viagra, perceived as empowering naturalism in men, was immediately commodified, whereas many possible male contraceptives failed to advance due to having no such standing in biomedical naturalism. Female contraceptives, in contrast, were substantiated by biomedical naturalism.
Another important distinction between Viagra and female contraceptives is that Viagra has few side effects compared to female contraceptives, yet biomedicine presents them as equivalent. This is because Viagra and female contraceptives are substantiated by and in turn substantiate biomedical naturalism, and both follow the path of least resistance, regardless of the presence or absence of biomechanical obstacles. If something substantiates the western biomedical paradigm, the pharmacological industry will release it, then tinker with it later; made to fit. However, anything that does not easily fit into the biomedical paradigm, it must be tinkered with in advance to reduce side effects as much as possible prior to release, as it has none of the ethos of a drug with a standing in biomedicine and its accompanying western sexual naturalistic ideologies.
While the process of scientific research, time, and differences in biology between males and females do have some bearing in the development of the male pill, these variables were also almost equally present throughout the commodification of female contraception. The male pill’s various side effects operate in parallel to those of female contraceptives, and the other obstacles such as time and biomechanical differences are just walls propped up by the western biomedical schemas they exist within and protect. These are indeed barriers to entry, but potentially could be permeated just as easily as Viagra, the Pap smear, or female contraception if the product aligns with biomedical naturalistic assumptions. Scientific and biomechanical problems exist, but are not independent of biomedical power's relationship to sex and the natural body as outlined by Michel Foucault. The socio-political environment surrounding sex and the human body has invited double standards masquerading as fundamental biomechanical problems. Anthes is right in that the male pill currently is in a state of temporal ossification, always five years away, but fails to recognize the socio-political environment that shapes this status. Anthes only mentions the biomechanical factors that are real but leaves out and reduces the fact that these factors equally characterize female contraceptives and have simply been made to fit into the biomedical ideological mold.
Sources
Emily Anthes (2017) ‘The Biggest Monster’ is Spreading. And It’s Not the Coronavirus, The New York Times
Nolwazi Mkhwanazi (2016) Medical Anthropology in Africa: The Trouble with a Single Story, Medical Anthropology, 35:2, 193-202
Paul Farmer (2004) An Anthropology of Structural Violence, Current Anthropology, 45:3, 305-325
Elizabeth F.S. Roberts (2024) Grappling with Exposure in Mexico City, Current Anthropology