No More Larking Around! Why We Need Male LARCs

Modern contraceptives—especially long-acting, reversible contraceptives, or LARCs—are typically seen as a boon for humanity and for women, the majority of their users, in particular. But the disparity between the number and types of female and male LARCs is problematic for at least two reasons: first, because it forces women to assume most of the financial and health-related responsibilities of contraception, and second, because men’s reproductive autonomy is diminished by it. In order to understand how to change our current contraceptive arrangement, I want to look at some of the historical and contemporary factors that contribute to this disparity, especially gender norms that associate women with reproduction and distance men from it.¹

Why Should We Develop Male LARCs?

One reason we need male LARCs is that most of our current contraceptives target women’s bodies. Today, there are eleven contraceptive options for women and only two for men.² This means that women assume all associated financial and health-related burdens. On the whole, female methods tend to be more expensive than male methods³ because most require at least one physician visit, and some involve a renewable prescription. Many insurance plans do not cover contraception,⁴ and a man cannot bill his partner’s contraceptives to his plan (assuming his plan covers them) since, according to our individualistic medical model, they are seen as being only for her use and benefit.⁵

Side effects for female methods are more serious than for male methods, as well, in part because various contraceptive methods for women involve hormones, while no methods for men do.⁶ The most common reason women discontinue contraceptive use is unwanted side effects,⁷ and most forms of contraception have discontinuation rates approaching fifty percent after one year of use.⁸ Also, side effects not only cause women to stop using contraception, but fear of them also prevents women from starting new methods.⁹ Finally, the two available male forms of contraception, condoms and vasectomy, also carry fewer health risks than their corresponding female methods, female barrier contraceptives and tubal ligation.¹⁰ It is no wonder that women sometimes continue to use a particular contraceptive even if they are not happy with it simply because it is their best worst option.¹¹

Another reason we should develop male LARCs is so that men can more feasibly and effectively share contraceptive responsibility with their partners. Neither of the two male contraceptives currently available is well suited to the contraceptive needs of men in long-term, monogamous relationships. And for men who still want to maintain the possibility of having biological children, the only method available to them is the male condom. Yet given the condom’s high failure rate of 16 percent during typical use, men are not able to regulate their reproduction as effectively as women can—many female hormonal methods and IUDs have failure rates under three percent.¹² The lack of effective and reversible options for men leads many men to rely on their partners for contraception. And even if men use a condom, they often depend on women to use another form of contraception concurrently to minimize the possibility of pregnancy.

This dependence on women reduces men’s reproductive autonomy. Men have to trust that their partners are correctly and consistently using contraception. If a pregnancy unintended by either or both partners does occur, men have no recourse. They cannot mandate that a woman get an abortion. Regardless of the circumstances under which the pregnancy transpired, men are still held socially and financially responsible for any children they father.

Why Are There So Few Male LARCs?

Women tend to be more associated than men with reproduction in general, and relatively recently, particularly with contraceptive responsibility. Prior to the invention of the birth control pill, contraceptive use was tied to the actual sex act, and for this reason men had to participate in it (for example, by using a condom or withdrawing). Additionally, men were often involved in decisions about and use of contraception because of their traditional role as heads of their households...