The Pill, the Condom, and the American Dream
theatlantic.com
theatlantic.com
My girlfriend and I have stopped using hormone-based contraceptives, for nearly 2 years now, I believe. The main reason is that the hormone-stuff had really messed up my girlfriend, and at some point, we were actually starting to get worried about not having the opportunity of having kids.
When we met, she had an IUD (with hormonal stuff), which was uncomfortable to me, so she switched to an implant. The next nearly two years were fairly difficult because she would have extremely irregular periods (for up to two months at a time, in one case), and it messed with our relationship in more ways than one.
At our request, her gynæcologist removed the implant, and she switched to the pill. This helped stabilise things, but it was still messed up. In the end, we decided to stop any hormone-based contraceptive, and decided to use condoms. Yes, it's annoying, and everything you want, but it's still a lot better than whatever we had before.
The reason I'm telling this, is that I don't really understand the taboo around it. It's a normal part of a normal relationship---there's no point in pretending we're farting rainbows all the time. I'm also fairly annoyed at the fact that women have to put up with this, whereas us men get the sweet end of the deal. We don't have to pay a luxury tax for something which really is essential for most women, we don't have to worry about whether something works or not, or whether getting laid is worth having trouble at that level for the next 6 months. Note that I'm saying "oh poor women, you have to deal with periods," I'm only discussing the technical/monetary aspects of this.
I understand that there's very little interest by most men to have a male contraceptive, but I for one would love to have one. Not necessarily hormone-based, and preferably not something that requires having that part of my body be approached by a scalpel. I seem to remember reading an article some time ago explaining why there was no male contraceptive available to those who wanted it. If I remember correctly, according to the labs/vendors, there was simply no market for it. The products existed, but either they're making too much money out of the female variants, or the male variants simply wouldn't sell.
In any case, the situation is messed up.
What makes you think that? I believe the opposite, many men would be extremely glad not to have to rely on trusting another person to not make a baby, or having an additional fallback in case the condom breaks.
And there is not yet a really succesful idea for a reversible treatment.
Tbh, there would be a market. If the side effects are not too bad, and if it is reversible. Female contraception works because the side effect of not taking it are worse than the one of taking it.
For male contraception, the side effect of not taking it are low. This is a sad thing about human, but i sadly don't see it change in the coming years :(
What do you think about RISUG/Vasalgel? Reversible, cheap, safe (so far), effective (so far). The only issue is that it lasts a really long time, so there's not much profit in it, resulting in little-to-no incentive to actually bring it to the market.
Besides, with a stranger or early in a relationship you should be using a condom anyway, even if your partner insists they're clean. Because STDs. Never mind pregnancy.
It's exactly the other way around.
If I get a woman pregnant by accident and she wants it and I don't, I lose $1000+ a month for the next 18 years.
If it's the other way around, she can get an abortion and be back to normal in a couple of months. Not that this is easy on her, but it's easier than earning $200k...
For what it's worth, I do agree with you that no sane woman would ever trust a man who said "I'm on the pill, don't worry." The difference is that I think it's a bad idea for anyone to rely on these assurances.
If you only rely on this method for a few days each month immediately after the end of menses, the chances of it failing are MUCH lower than if you rely on it for a week prior and a week after menses.
That said, wiki claims[1] that the latter approach is >95% effective in perfect use, and 88% effective in typical use.
Compare this to withdrawal[2], which wiki claims is 96%/78% effective respectively.
[1]: https://en.wikipedia.org/wiki/Calendar-based_contraceptive_m...
> "fertility awareness" (on its own) is a less reliable means of contraception than most other options
You're absolutely correct, of course - but some people's situations don't require such a high level of reliability. For instance, my wife and I used the rhythm method for four years after marriage without incident, until we decided to try for our first child.
During that time an unexpected pregnancy would not have been unwelcome. We weren't where we wanted to be financially, but we would have been fine. Our ballpark assumption of a 10% chance of conception per year was an acceptable level of risk to outweigh the negatives of a barrier method or hormone-based option.
People capable of passing high school biology should also grasp the concept of a) "whoops!" and b) sex being enjoyable enough to risk even if ovulation is possible.
http://www.patheos.com/blogs/lovejoyfeminism/2012/11/lets-ta...
> According to the Guttmacher institute, the typical use failure rate of NFP is around 25%. Of course, Catholics have taken issue with this number, insisting that it is way too high. So I looked around and another number sometimes used for NFP’s typical use failure rate was 12%. One Catholic writer suggested that it was 2% to 5. Note that even that last number shows that the typical use failure rate for NFP is higher than IUDs and implants.
[1] http://www.contraceptivetechnology.org/wp-content/uploads/20...
That means fertility awareness has worse odds than Russian roulette.
I'm not the slightest bit interested in perfect use failure rates, because humans are rarely perfect (especially not the ones who think they are), and the consequences of a whoops are pretty immense, both for the couple and for the unwanted child that results.
Meanwhile, an implant has a 0.05% typical use failure rate, and an IUD 0.2%. I'm not taking any chances - I'm infertile, have had a vasectomy, and my wife has an IUD. My current set of twins (via donor sperm) are plenty of work for my liking.
But what other people do is of no interest or consequence to me. I know what I do, thus I am interested in perfect use rates. Which are better than condoms.
According to actual studies rather than people trying to push an agenda, failure rate is comparable to condoms: https://en.wikipedia.org/wiki/Comparison_of_birth_control_me...
http://www.cdc.gov/reproductivehealth/contraception/unintend...
Condoms are also pretty crappy in typical use, so I wouldn't consider that a success even if the number lined up. IUDs and contraceptive implants are massively more reliable than either in typical use.
That is because they are dishonestly presenting the data on the rhythm method and fertility awareness combined as fertility awareness. That is obviously silly, as one method is significantly more reliable than the other.
>Condoms are also pretty crappy in typical use
Typical use matters for population control, not for a responsible individual's personal use. I know if I am putting a condom on or not. The large percentage of people who do not put one on despite relying on them as their sole contraceptive does not lower the failure rate for me, it merely brings down the average failure rate across the population. Other people's failures do not cause me to fail.
Hormones cloud all sorts of otherwise reasonable judgement as well - I'm guessing if you pay attention, you'll notice it in yourself as well.
In addition, this can be dangerous for those that shouldn't get pregnant for health reasons, yet can't get sterilized (there are many doctors that won't sterilize childless people, nor folks that are young - and it is often not a covered procedure).
Folks that have reasonable intelligence, pass high school biology, and have a reasonable understanding of health should understand these down sides. A bit of understanding of risks and statistics would probably lead the person to assume it is a lesser risk to use another form of contraception or two.
there are many doctors that won't sterilize childless people, nor
folks that are young - and it is often not a covered procedure
I know it wasn't covered by insurance when I was younger (I'm in my late 30's), though I didn't know it would be somewhat risky for me to be pregnant at the time, if it is possible at all. I've simply never wanted children, and the procedure wasn't covered by insurances let alone finding a doctor that would do it. I don't know if they became something covered under the recent health care changes as I don't live in the states any longer. I'd often not been able to pay the copayment anyway, unfortunately.
From an insurance perspective, the cost-effective and less risky option is to do birth control, either pills, shots, or IUD's to prevent such a thing from happening, I'd think.
You don't need to have regular periods, I am not talking about the rhythm method, I am talking about fertility awareness. You accurately detect the hormonal changes which precede ovulation. It does not matter if you ovulate early or late, because you are detecting the changes that precede it, not guessing when it will happen based on days passed.
And there is absolutely no doctor who will refuse to sterilize a woman whose life would be at risk from pregnancy.
But hey, the pill is also only 91% effective when improper use is taken into account. [1] So, really, relying on any birth control you don't control is crazy.
So your excuse for not using a condom isn't mathematically sound. Using it as the sole method is perhaps risky, but you control it. As a second-layer check against potential (unintentional) improper used contraception on the part of your partner, it still severely decreases your risk.
[0] https://www.plannedparenthood.org/learn/birth-control/condom...
[1] https://www.plannedparenthood.org/learn/birth-control/birth-...
The other caveats: I don't want children, and married a like-minded individual. In addition, I have a higher than normal risk of death during pregnancy (didn't know until a few years back though, and I'm in my late 30's). I'm happy this happened to me instead of someone that has always wanted children.
But back to the point: I'd have been the one insisting a man take contraceptive if it were available. I think my spouse would have taken this in any relationship he's been in before we met as well. It actually makes me somewhat angry that this isn't a viable option by now.
I've read there is no market, among other things - like in this list http://www.telegraph.co.uk/men/active/mens-health/11693171/F.... But I also tend to view some of this as ridiculous - surely, if they can market some of the crap we are currently buying, they can market this as well.
I always imagine it is much more noticable to men, mostly because of where nerves are located. A penis has many more feeling nerve endings than vaginal walls, so the points where a woman would notice a condom are somewhat less than where a man would. Spouse says it is a huge difference :: I imagine it is since Bill Gates put up money to try to improve them so that use was higher.
Edit: I forgot the percentages. I'd say it probably knocks off 20-40%: Thankfully female physiology allows for different sorts of "pleasure points", as compared to likely 40-60% for men, from what I can tell.
The other thing is that we're getting to a place in our life where we're thinking about kids on a more serious note, so a long-term contraceptive doesn't seem as appealing any more.
I do keep the copper IUD on the shortlist of long-term contraceptives, if required. Thanks.
The women in her family also had a history of complications with hormonal approaches and after all her research she settled on the copper IUD for her. Said it hurt like hell for a few weeks and made periods rougher than usual for the next 6 months but she was happy to trade (relatively) temporary physical difficulties for emotional/mental ones. Obviously different for everyone but worth looking into all the different options.
He observed this choice seemed more common in the military.
From what I have read, it is generally easier for a man to get a vasectomy than for a woman to get a sterlization procedure. They are less picky about age and parental status. Women under age 25 and/or with fewer than two kids tend to run up against barriers. I did a college paper some years ago in one of my law classes. I don't know if the laws have changed, but, at one time, this was not just due to sexism or societal bias. It was encoded into law that women under age 25 or with fewer than two kids needed a compelling medical reason to get sterilized. I have known women with serious medical conditions who had trouble getting the procedure approved. It is galling.
No hormones
Not necessarily in order to lower the average level of education but to battle perceived unfairness or racism within education.
The underlying assumption is that if you find that some minority or group is not represented equally in any area of education then it is a sign that there must be institutionalized racism involved.
This process is still ongoing to this day, currently everyone is focusing on STEM fields and asking the question: Why do so few women choose to enter these fields?
You can bet that the quality of education you are going to get in 20 years in these fields will be worse in order to attract women to fields that they are generally less interested in. (if Mathematics is the reason for that then they will simply remove it or reduce it significantly)
Edit: It is by the way more likely that changes in the education system (of which there have been plenty) cause different results in education than attributing it to something like contraception.
That could be the reason. Or it could be that this article is referring to an increase in pre-school readiness in poor children. It makes clear that there was no drop in readiness of rich children over the same period. Therefore the chances of this effect being due to some form of educational dumbing down doesn't make much sense.
Now the authors of the article it's based on believe that the effect is likely due to improvements in parental education pre-school and that that may be, at least partially, due to government campaigns. I that sense it is conceivable (excuse the pun) to attribute it to the education system but not in the way the GP is suggesting.
Children that previously performed better still perform well, children that performed worse now perform better than before.
I'm not rejecting that contraception could be a reason, it's just that you have to show convincing evidence for it. The more counter intuitive your theory is the more evidence you need to produce.
Imagine I declared that all of this is correlating with the size of Big Mac menus and has nothing to do with changes in the educational system. It wouldn't be unreasonable for you to question my theory, especially if I do not provide any evidence.
> Not sure why people feel a need to downvote things they don't agree with
I have no problem with that. If I'm just regurgitating what everyone is already believing then my comments would be pointless. I happen to have a different opinion and I know that for some this is offending. (but thats really their problem, not mine)
To get a spot as a student in most universities you have to take a test first and only the best are selected.
What they found was that there were comparatively fewer women passing the test for medical schools. So they removed many questions that were about logic or knowledge and replaced them with pictures of faces where the student has to read the emotion. (for example: is the person angry or happy?)
The reasoning is that physicians need to be empathic towards their patients. It worked and now there are more female than male students passing this test.
If I was female I would be deeply insulted by this. They literally believe that women are too stupid for logic related tasks so lets have them answer questions where they have to read emotions from faces.
Imagine there are two classes of human - high quality and low quality, and this quality is hereditary (likely genetic). Low quality humans have a lot of unplanned births and their children are also not very good at school.
The bottom 20% of humans will always consist of low quality humans, plus a chunk of the remainder high quality humans (assuming low quality humans make up < 20%).
Previously low quality humans had a lot of children - say 15% of children were low quality children. Now if low quality humans have performance 1, and high quality humans have performance 2, then the performance of the bottom 20% would be (15% x 1 + 5% x 2) / 20% = 1.25.
Now suppose condoms reduce the number of children had by low quality humans. Then the number of low quality children is reduced to 10% - so the performance of the bottom 20% of people would be (10% x 1 + 10% x 2) / 20% = 1.5. That's a 20% improvement even though no group has improved their quality at all.
This effect is rather more plausible, given what we know about intelligence/adult outcomes being hereditary, and given what we know about the uselessness of "enrichment activities" (e.g. google how ineffective Head Start or early childhood education is).
Such an effect would also have a significant eugenic [1] effect, i.e. massively positive long term effects as well.
[1] The word "eugenic" is overloaded, and means both the opposite of dysgenic and also human intervention into genetics to improve them.
But that's mostly a guess on my part, I don't have data on hand to validate any of that.
But yes, considering how our high-IQ elites don't reproduce, it's probably just a reduced dysgenic effect rather than a eugenic one.
For example, if I'm right, then an appropriately weighted average of contemporary children's performance (weighted so that low quality children make up the same proportion as before) will show no change.
Do you have any intellectual issues with my comment, or are you simply engaging in highbrow dismissal?
That's a hypothesis, not a theory.
And similar epistomological variants.
But a bit of googling suggests that a distinction is made between a generally accepted and well tested theory, and one that's in the early stages and not well tested (which is termed a hypothesis as you note).
In any case, this is just disputing definitions, rather than testable propositions about the underlying reality.
There technically is no such thing as a "good" or "bad" gene, only an advantageous, disadvantageous, and neutral variant of a gene. Given that some genes can be read forwards and backwards, and that simple environmental causes, aka just changing an environment, can turn a disadvantageous gene expression into neutral or positive, it's hard to say something is eugenically good in a population unless it is a 1 gene mutation with 99% penetration that always causes death. (Huntingtons would be in this group)
Genomics says what you are saying is frankly impossible. If it weren't A) there would be no such thing as incomplete penetrance B) or traits linked to multiple genes C) or ways to manipulate social science statistics with simple experiments, like subsidizing iuds for high school students and seeing what happens. That's a purely environmental factors, and yet your supposed "bottom 20" stops acting like it as thier environment changes in one subtle way
Where did you get the Idea that any of what you are saying is scientifically sound?