Young Men’s Involvement in Hormonal Contraception: Paradox or Possibility?

By Ann M. Fefferman and Ushma D. Upadhyay

It may seem like a no-brainer that women tend to take care of hormonal contraception.  They should have the right to choose a method, use that method, and manage side effects in a way that works best for them. Women have a wide range of methods to choose from, including the pill, patch, vaginal ring, implant, and intrauterine device. These methods allow people to ditch the condom and enjoy increased sexual pleasure and spontaneity with lower chances of having an unintended pregnancy.

But does the fact that these contraceptive methods affect women’s bodies mean that men don’t see a role for themselves in pregnancy prevention?   No. Some men do see themselves as partners in contraceptive use and management. Our research identifies how young men are involved in contraceptive management in helpful and supportive ways. Our research focuses on young low-income men and women of color and the ways they work together to manage contraception without restricting women’s choices. We show examples of men helping with contraception, such as coming to appointments with their partners, discussing risk of pregnancy with partners, helping to choose a method, and reminding partners to take pills or to remove the vaginal ring. We also note how men and women work together to prevent pregnancy despite the different circumstances constraining their choices, such as immigration laws, gang membership, neighborhood violence, and poverty. In this way, our research works against the stereotypes often applied to young low-income men of color when people talk about unintended pregnancy.

While our research shows these positive examples of how young men can work within or against difficult circumstances to support women with contraception, we also show how they aren’t as “feminist”, or “egalitarian”, as they might think. Even though the men in our study were really involved in choosing and using contraception, they still thought women were the ones responsible for contraception and its effective use. Men were just helpers, much like many men “help” in the kitchen or “help” with taking care of the kids. Men used language that seemed equitable, saying that they were not responsible for contraception because they did not want to undermine women’s ability to make choices about their own bodies. Even women we interviewed agreed with these ideas.

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The assumption here is that men cannot respect women’s bodies and choices while still taking responsibility for the possibility of an unintended pregnancy.  Following this logic, men then can use their secondary place in contraception as a justification for assigning blame or shame to women when contraception fails. We aim to show in our research that m en’s involvement in contraception and men’s accountability for unintended pregnancy are not mutually exclusive. Men can help with contraception and also share in contraceptive responsibly (including when contraception fails). Men and women can work together to change these norms and help sustain a positive, respectful place for men in contraceptive management.

Ann M. Fefferman, MA is a PhD candidate in Sociology at University of California, Irvine. Her research interest focus broadly on gender, masculinities, reproductive health, the family and inequalities.  Currently, she is working on her dissertation, which investigates and compares masculinities in different stages of reproduction, with a focus on contraceptive management, pregnancy intentions, and abortion decision-making. In particular she intends to further her studies in medical sociology.

Ushma D. Upadhyay, PhD, MPH is an Associate Professor of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco and Director of Research for the University of California Global Health Institute’s Center of Expertise in Women’s Health, Gender, and Empowerment. She holds a National Institutes of Health Career Development Award to study gender-based power among young men and women and its effect on contraceptive use. Her current research focuses on the development and validation of the Sexual Health and Reproductive Empowerment for Young Adults (SHREYA) Scale.

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