Vasectomy Alternative

[Bubbles]

People would probably say I'm too young to be thinking about this but I know I don't ever want to have kids and I read about vasectomies a while back but almost threw up after reading about it because I get really queazy with medical stuff, especially relating to that area. It sounds awful, and there are side effects, and apparently it's painful afterwards and I don't really want to think about it anymore because it's making me feel sick again.

Is there a permanent alternative to vasectomies that makes sure you can never get anyone pregnant? Preferrably something that doesn't involve such a gruesome invasive operation.

[Sam W]

Hi Danny,

As of now, the options for someone with a penis who doesn't want to be part of a pregnancy are: abstaining from sexual contact that can cause pregnancy, vasectomy, condoms, withdrawal, and cooperating with whatever birth control is used by their partner. That means that currently there isn't anything permanent that can be done to your body to make sure you cannot get a partner pregnant.

[Bubbles]

I can't help but notice the only other option with a fixed, guaranteed 100% prevention chance is life-long abstinence from those types of sexual activity. Choosing that option seems like a pretty big life choice. I suppose there are plenty of types of sexual contact that can't cause pregnancy though so maybe it's not a big deal... is it? Could that cause relationship problems?

[Sam W]

You're absolutely right that there are lots of types of sexual contact that don't pose a risk of pregnancy. And there are plenty of people who manage to have healthy, happy sex lives without engaging in sexual activities that can cause pregnancy. That being said, if you were to choose that option it may remove certain people from your list of potential sexual partners because they do want to engage in those types of activities. But that's the case with pretty much any sexual preference: it will make you better a fit with some people and a worse fit with others.

It may also help to consider that, while we have to say that there is always some risk associated with activities like vaginal sex, there are ways of lowering that risk to be as close to zero as possible. For example, if a partner with a uterus has an IUD and their partner with a penis wears condoms for all sexual activity, the risk of pregnancy is incredibly, incredibly low. So something to think about is how close to zero does a risk need to be for you to feel comfortable. Does it have to be absolutely zero? Or can it be a .0001% chance?

[Bubbles]

A 0.0001% chance might be okay, maybe, but that eliminates even more people right?
I wouldn't be surprised to find out plenty of people wouldn't be comfortable getting an IUD and I would never be comfortable asking a partner to get one, for the obvious reason: it's not my choice to make. Plus I've heard some people can't due to reactions? And I've also heard that in long-term monogamous relationships where both partners have been tested, quite a lot people prefer not to use condoms.

That would be narrowing it down to only people who are both equipped with an IUD, and are also okay with never not using a condom even in long-term, monogamous relationships (And don't have allergies to them). And that's assuming that I fit that criteria as well; which I don't know yet. Maybe I'm not even comfortable with my own chosen restrictions. I may only be comfortable with abstaining but it's possible that I won't want that.

I guess perhaps that's my other concern: when your own standards for sexual safety clash with a partner's wants, you find a new partner. But... what happens when your standards for safety clash with your own wants?

[Bubbles]

(I'm surprised modern science still hasn't managed an easy, 100% effective contraceptive method that is safe and non-intrusive. Can it really be that hard? They sent a rover to Mars before managing that. )

[Bubbles]

I have another question: how can I increase the effectiveness to that 99.9999% exclusively with birth control methods which I would have personal control over? All the combinations I've found which reach that likelihood require a method used by the other person as well. I read that with spermicide it's still only 96%.

[Heather]

It isn't that science hasn't developed these methods, it's usually that enough men, by and large, still won't participate in studies of them -- the way women historically have of methods that can be used by those who can themselves become pregnant -- to get them to the next stage and then eventually to consumers.

Ultimately, there's really nothing you can use only on your own to get you to that level of effectiveness. However, you absolutely CAN have a limit that you will only be sexual in these ways with partners who are also using their own method. That is absolutely fair.

[Bubbles]

I had absolutely no idea there were studies like this active, that should be publicised more. I don't really understand why more men won't participate considering how important it is.

Do you know much about how someone could participate in studies like that? Are they safe?

[Bubbles]

And also, how far away do you think more reliable contraceptives for males are? Could there be a pill/IUD/shot etc equivalent be available in the next 10 years? The responsibility of having to manage contraception shouldn't fall on women as much as it does, men should be able to bear more of the responsibility as well. I'd feel more comfortable if I could, anyway.

[Heather]

I'm probably not the best person to ask, since I'm ultimately a layman in this department. You'd really want to talk to someone who works in pharmaceuticals and their development. But if an educated guess is helpful to you, I'd say that I'd think in the next 10-20 years is probably a reasonable estimate, so long as things change that have to to make that happen (which include more men showing up for studies, but also cultural changes like more pushback against the idea that contraception and directing other parts of sexual care and responsibility should still ultimately be mostly or entirely on women).

Per your previous question, medical studies in the current time tend to be very carefully monitored and safe. Historically, much of this study has NOT been at all safe or sound, especially where women and people of color were concerned, but that has changed. In terms of finding out where and when medical studies are landing, I actually don't know how that tends to work in AU.

[Bubbles]

Thanks for your response Heather. I see what you mean; I think your estimate is probably right. I looked some stuff up and apparently they've been running trials for various types of male contraceptives for decades but they all get cancelled because of minor side effects, despite the fact that those side effects are actually less than that of the contraceptive pill which women regularly take.

It sounds to me like there's a lot of bias in the process of drug trials there. It's like they won't release a male contraceptive unless it's side-effect-free, even though the same effort is not being made to improve the female contraceptives which are already in common use.

https://www.lifehacker.com.au/2017/04/f ... et-to-use/
http://www.independent.co.uk/voices/mal ... 84601.html

But, there's a new male one called "Vasalgel" that people seem to be optimistic about, which is actually beginning human trials this year apparently. It's an injection into the vas deferens which kills or blocks sperm passing through with a high success rate. Sounds a bit strange but... that could be promising maybe? Although some people are saying funding is a problem and that pharmaceutical companies haven't been interested in male contraceptives because most of them are one-off "long-term", and thus make less money than regularly selling the female contraceptive pill. (1 Vasalgel shot works for years apparently, and can be reversed with another injection if need be, which sounds impressive) And also, with monkeys, it's had a 100% success rate with preventing pregnancy apparently! 100%. Few or no side effects were found too. I still feel skeptical that it might get shut down like all the others, but... who knows?

https://www.parsemus.org/projects/vasalgel/
http://www.dailymail.co.uk/news/article ... -rate.html

You probably know a lot of this already but still, this is an interesting topic to discuss. I didn't know much about it and I think more awareness really needs to be raised about it, for 2 reasons: more funding, and more men willing to volunteer for trials. Thanks for exposing me to all this, I'll continue to look into it. It's just a shame that there's nothing I can really do individually to help currently, and that there's nothing on the market yet to use. The vasalgel developers are non-profit so maybe I'll donate or something. I just want problems like this to be gone, contraception feels like a problem society should have definitively solved decades ago.
Thank you for answering my questions by the way; it was helpful to me.

[Jacob]

hey danny101!

It looks like you've had some successful research!

As Heather says, the tech and the science is there. The things blocking this from happening are more social, and maybe some business decisions made by the big pharmaceutical companies (who are focused on profit)... and sexist ideas that it's women's bodily (and financial) responsibility to manage family planning and reproduction.

So supporing groups who fight sexism is probably something you can do... a more equal world is also one where people of different genders share responsibilities more equally too, and have access to the technology to do that.

Hopefully we get to a place!

[Bubbles]

Hey there Jacob.

You mentioned supporting groups who fight sexism. Could you maybe tell me about ways to support such groups, that really make a dent? And what some of those groups would be?

[Jacob]

So a good thing to do can be to look up local feminist organisations in your area... You can find out if they have any campaigns you also agree with, and email them to offer your help. It's not always easy to find groups that work for you right away, but starting to just investigate local activism is a good start and can give you a feel for how you could fit in!

[Bubbles]

I can't find anything suitable. I've been browsing for hours and the only organisations active in my city I've found either: only accept people who identify as women, require social work experience/relevant degree, or both. I'm moving city soon so hopefully there will be more there, but I'll keep my eyes open for something. Until then, the best I can do might just be to stand up against inequality whenever I witness an instance of it personally. My social anxiety also doesn't really make me the best fit for public campaigns either, sadly.

[Bubbles]

I've only just started looking though so I'll give it more time; seems silly to give up so soon. Something might come up. Thank you for the idea.

[Heather]

This showed up in my mailbox this morning, Danny, and I thought it’d be of interest to you: https://arstechnica.com/features/2018/0 ... male-pill/