How Birth Control Can Help Us Reimagine The Future

Authors and former io9 majordomos Annalee Newitz and Charlie Jane Anders have a fortnightly podcast called Our Opinions Are Correct, which covers all sorts of nerd culture and science-related topics. In the December 3 episode, "Birth Control of the Future," Newitz and Anders discuss reproductive and contraceptive technologies, both real and imagined, and the various ramifications they might have on society.

There's a lot of interesting ground here, from artificial wombs to morning after pill vending machines to the impact of coronavirus (and potentially other pandemics) on child-rearing responsibilities. Also the fact that human penises are curiously not designed for aggression, unlike many other mammal phalluses. But Newitz and Anders offer two observations over the course of the 45-minute podcast that really stood out for me.

First, in terms of language. For the sake of both clarity and simplicity, the hosts deliberately refer to "People with Eggs" and "People with Sperm," rather than by sex or gender. Because sex and gender are complicated; basic reproductive requirements, less so. "Male/female" and "man/woman" have always been frustratingly opaque terms—not just because the words have such a binary dependent relationship with each other, but also, because of how we define them. Despite what some people think, "biological sex" (for lack of a better term) has been determined solely by an X or Y chromosome; that's true for humans as well as other animals. Hell, humans are as likely to be intersex as they are to have red hair—it's a minority, sure, but it's something most of still encounter on a fairly regular basis (when not in quarantine). When you're specifically talking about people in terms of reproductive functioning—and you need a shorthand, catch-all way to broadly refer to them—"People with Eggs" and "People with Sperm" is inclusive, and efficient.

I was also struck by this notion—discussed throughout the podcast—that while technological advancements in birth control can shape the future of our societies, it's just as important to change the ways that we currently view and think about sex and reproduction. Our perceptions are inherently limited by our pre-existing assumptions about these things, and that frames how we approach issues like healthcare (read: abortion). It made me think about an article I wrote in 2016 about a male birth control pill study that was cancelled, sending the internet into a furor. The details that got picked up (and mocked) in the headlines were the fact that the study was cancelled, and that some of the men involved had reported PMS-like symptoms. The joke, as it were, was that this was a clear case of masculinity-so-fragile—that these people with sperm couldn't handle something that people with eggs dealt with on a regular basis.

While I certainly understood the Schadenfreudic satisfaction there, the problem was: it wasn't true. The study was cancelled was because it was a shit study that neglected to control for things like diet, culture, and pre-existing mental health conditions. And of the few hundred people involved in the study, some were permanently sterilized, some of them died by suicide, and some of them tried to die by suicide. It reached a point where there was simply nothing else that be gained, learned, or achieved by continuing a study that also risked harming people.

Where it gets even messier, however, is the fact that the invention of birth control for people with eggs was just as—if not more—inhumane than that 2016 birth control study for people with sperm.

The short version of the story: Puerto Rican women and asylum inmates were forced to participate in early trials for female birth control pills in 1955. In fact, in Puerto Rico, where contraception and abortion were legal and available but forced sterilization was also occurring, the researchers specifically sought out the "ovulating intelligent" in medical school, where the trials became a required part of their curriculum. If they dropped out or refused to participate, they'd be expelled from school.

Later, when the drug was tested under slightly more humane circumstances, there were still some big problems: The researchers enticed women with the "no pregnancy" part while conveniently leaving out the details about the potential side effects of the pills. If the recent male trial that got everyone up in arms was bad by modern standards (which it was), then these adverse effects were monstrous: 17% of participants had serious complaints, three people may or may not have died as a result, and one of the researchers even straight up admitted that there were "too many side reactions to be generally acceptable."

This, I think, represents a good microcosm about why our pre-existing assumptions about reproductive and contraception cloud the way that we approach them in the future. First, there's how we actually conduct our studies. As I wrote in 2016:

The Food and Drug Administration requires 20,000 menstrual cycles' worth of safety data for women. But since men don't cycle, no one has determined how long men's birth control would need to be tested to be deemed safe.

Coupled with the difficulty of establishing placebo controls for contraceptives (giving someone a sugar pill and telling them it's fine to have unprotected sex is generally frowned upon), the potential rewards of this particular study were really, really unreliable.

In other words: our current regulatory framing of "birth control pills" is inherently gendered, in a way that does not translate to people with sperm. In order to create a birth control pill for those people, we need to completely eradicate and reconstruct that framework. We can't use the past to build a better future.

There's also the fact that the OG birth control pill for people with eggs was a byproduct of violent eugenics that exploited people because of their race, class, and gender. But hey, it all worked out in the end, right? With a largely positive outcome for everyone else who wasn't involved in those trials? Sure. Maybe. But if we're going to use that same oppressive foundation to address birth control for people with sperm, then what are we really gaining by building a "better" future on a pile of corpses?

Anyway. Check out the podcast. You can also checkout the hosts' new books. Annalee Newitz's upcoming nonfiction book, Four Lost Cities: A Secret History of the Urban Age, comes out in February 2021. Charlie Jane Anders released a novel titled The City in the Middle of the Night last year, and has the first book in a new YA series, Victories Greater Than Death, coming in April 2021.

Birth Control Of The Future [Our Opinions Are Correct]

I looked into the backstory of male birth control. Turns out, it's a racist, sexist mess. [Thom Dunn / Upworthy]

Image: Ceridwen/Wikimedia Commons (CC-BY-SA 2.0)