Overkill Can Be an Excellent Thing

I read a blurb on Feministing about the prospect of a male birth control pill; specifically, that research on such a pill is now being funded with the understanding that men would actually take it. So that's good.

But then the discussion veers into whether and to what degree women are comfortable sharing the responsibility for contraception. To which I would like to say, are you kidding me? Ladies, this need not affect your contraceptive choices at all. A male contraceptive pill could be used in conjunction with any current method of contraception on the planet.

The fact that we view this as some sort of either-or proposition is the result of our tendency to see birth control as a one-method process. I've harped on this before, but the numbers are not great. If you really don't want kids right now, it is an excellent idea to use multiple methods. Doubling up on methods has always seemed like a blindingly obvious thing to do to me, anyway, and it amazes me to find how many people automatically assume that one method, regardless of effectiveness, is good enough.

Part of this attitude could arise from what our doctors tell us. I was recently discussing barrier methods with a gynecologist, and asked whether the diaphragm could be used in conjunction with condoms. She gave me a funny look and told me that would be overkill. You guys, assuming that diaphragms don't reduce the effectiveness of condoms (or vice versa), the two together have a typical use failure rate of 2%, greater than that of an IUD. That is not what I would call overkill. More like possibly not enough kill. (Remember, failure rates are yearly.)

I suspect that this one-method attitude also contributes to the lack of options we generally have. For instance, as far as I can tell, there is exactly one brand of contraceptive sponge available in the entire world. It is the Today sponge, which has a caustically high concentration of nonoxynol-9. Let me tell you, that sponge can fuck your shit up. Though Wikipedia will tell you there are two other varieties, both of which have either less nonoxynol-9, or none at all, and supposedly are less irritating (and in the case of the Pharmatex sponge, possibly STI-reducing), it took me an extended internet search to figure out that both the Protectaid and Pharmatex sponges have been discontinued. Cervical caps have a similar issue; there is exactly one you can buy (FemCap), and it is one that is poorly rated for comfort compared to earlier models.

This is one of those issues that the free market should ideally solve by producing a wide variety of products. But our assumption that one method is good enough means that most people are going to use the pill or condoms, leaving a relatively small customer base for alternative methods. Given that products have also to be approved by the FDA, that probably kills most of the incentive for birth control innovation. Which is a terrible, terrible thing if you have any difficulty with the most popular methods. And they all have issues.

I've rambled on a bit here, but my point is, for the love of god yes please male birth control pill. More options are a good thing, especially when they can be taken simultaneously with existing methods. And I haven't even touched on how very awesome it is to let men take more responsibility for their own reproduction: if I was a hetero cis dude I'd be all over that.

And just for fun: what's the best you can do layering contraceptive methods? The best I can come up with is pill + copper IUD + female barrier method + condoms = 0.0015% annual typical use failure rate. Now that, my friends, just might be overkill.