The FDA Approved OTC Birth Control, But Why Aren’t Men Taking an Equal Role in Unwanted Pregnancies? 

Contraceptive pills and condoms on color background

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“If there was a large and loud group of powerful men demanding a contraceptive pill for men, I have no doubt one would exist.”

Reproductive rights activist Gabrielle Blair is thrilled that an over-the-counter birth control pill for women has been FDA-approved, but she’s still singing the praises of condoms. Why? Because the author of Ejaculate Responsibly believes men should be held accountable for unwanted pregnancies — and should be working just as hard as women do to prevent them. 

“I was delighted to hear the news,” Blair tells Katie Couric Media in response to the announcement that the FDA approved the birth control pill Opill to be available over the counter, making it the first non-prescription pill of its kind in the United States. “I’m a big fan of anything that makes contraception more accessible to more people.” 

The Mormon mother of six, known for her viral tweets about abortion rights, is celebrating the development but can’t help pointing out how it continues to put the burden of birth control on women. We spoke to Blair about why this happened before any breakthroughs in birth control pills for men, and how she thinks the OTC pill will affect the abortion debate.

Katie Couric Media: Why do you think birth control for women was approved for OTC use before birth control pills for men?

Gabrielle Blair: The short answer: Patriarchy. Our patriarchal culture has little to no interest in anything that might inconvenience men, especially if there’s an option to put burden and responsibility on women instead. While some men express interest in a birth control pill, there doesn’t seem to be a huge cultural demand for this, and if pharmaceutical companies don’t see a ready market, it seems unlikely that they’ll push research in this area. If there was a large and loud group of powerful men demanding a contraceptive pill for men, I have no doubt one would exist. 

Beyond the economics of a pill, men already have really good contraception options. I know they don’t have a pill, but they have condoms, and honestly, it’s really hard to beat condoms; there’s no hormonal birth control option that protects against STIs, but condoms do. And unlike the pill, you don’t need to use a condom on days when you’re not having sex. Condoms are inexpensive — every state has a free condom program — can be stored for years, don’t require a doctor visit or prescription, and have no side effects. 

Additionally, condom manufacturing gets better and better as technology improves. So many men report that once they take the time to figure out which condoms they like best — the size, the material, the brand — that sex with a condom and sex without a condom feel so similar, that they’d never risk ejaculating irresponsibly.

If someone can come up with a pill for men that beats all of those condom advantages, that would certainly be a world-changer.

And of course, men also have vasectomies: I’m a huge fan of them and have been delighted to learn that vasectomy procedures have been increasing ever since Roe v. Wade was overturned. So many men want to do the right thing and don’t want to put their partner at risk, but haven’t had to think about their role in causing unwanted pregnancies, because abortion was always an option. 

Now that they know abortion may be off the table, depending on where they live, suddenly they are faced with the reality that their sperm does indeed cause pregnancy. And if they don’t want to cause a pregnancy, a vasectomy is an excellent option. A simple, safe, 15-minute procedure that’s almost painless — and then they never have to worry about causing a pregnancy again. Vasectomies for the win.

How does the Opill news affect your stance on men taking more accountability when it comes to family planning?

This news doesn’t change my stance that men need to be 100 percent responsible for their own bodies and bodily fluids. But it’s a good reminder that couples can and should share the work of pregnancy prevention. While men can’t take these OTC pills, they can certainly cover at least half of the costs of the medication, and half the costs of dealing with any of the side effects of the medication — which may include time off work, childcare, and medical costs to address any side effects. Certainly, men benefit from their partner taking the pill just as much as their partner does.

Based on your research and experience in this space, how do you think OTC hormonal pills will affect the way women think about their sex lives moving forward?

Women are really, really good at taking responsibility for their own bodies; they already prevent millions of pregnancies each year. Our $8 billion birth control industry, which is almost entirely focused on products made for women and paid for by women, attests to this fact. I hope this news will make it even easier for women to continue this behavior. In our culture, women are expected to do all the work of pregnancy prevention — I’m trying to change that, but we’re not there yet — and I hope this news makes the work of pregnancy prevention a bit easier for women to carry.

What’s your response to people who say this decision is another reason abortion should be illegal?

According to anti-abortion advocates, abortion should be illegal because they want to reduce the number of abortions. There are only two proven ways to radically reduce abortion: free and accessible birth control, and age-appropriate, fact-based sex ed at every grade level. An OTC pill falls under “more accessible birth control,” which means it has the potential to actually reduce abortions. If someone is interested in radically reducing abortion, making abortion illegal is a waste of time. They would see much more success focusing on proven programs that prevent unwanted pregnancy. 

Of course, if they claim to want to reduce abortion, but have no interest in working on the proven birth control and sex ed programs, then perhaps they’re more interested in controlling women than in actually reducing abortion.

Why are abortions still important, even though this option is now more readily available?

As we’ve clearly seen since Roe v. Wade was overturned, abortion is healthcare. Every day, there’s a new story reported of a girl or woman denied a life-saving abortion and the horrific medical complications that result from this denial. Abortions will always be necessary, and keeping abortions legal is the only way to ensure bodily autonomy for half of the population. Sometimes birth control fails, sometimes people are raped, sometimes complications come up, sometimes the fetus dies in utero, sometimes the woman’s health is at risk, and sometimes the woman doesn’t want to have a baby. 

I believe “a mother’s instincts” are a real thing. If a woman’s instincts are telling her this is not the time to have a baby, I trust those instincts.