Shared Pleasure, Unequal Risk: Gender Bias in Contraceptive Development
A Collaboration Between Girl Up Universitas Indonesia and Universitas Indonesia Biology Science Communication (BioScienCation)
Written by Nadra Syafaziel
Pregnancy happens by the presence of both sperm and egg — so why is birth control overwhelmingly treated as the responsibility of only the egg bearer?
When we talk about contraception, we will think about the widely available methods such as pills, IUD, implants, etc–which most are designed for women. Even as shown by/in insert source around insert data of contraceptive users are women. If we think about it, biologically speaking, individuals with ovaries (typically women) produce one ovum per menstrual cycle while those with testes (typically men) can produce millions of sperm per day. A single man is therefore biologically capable of contributing to multiple pregnancies in a short period of time, whereas women can only get pregnant–and give birth–once in nine months. So in theory, it’s actually more efficient to suppress male fertility. However, in practice, the burden has been placed almost entirely on women. Decades of research has been done and yet contraceptive development disproportionately burdens women, including the risk of side effects it carries. In contrast, male contraceptive options remain limited to condoms and vasectomy, with few reversible alternatives accessible.
What Women are Asked to Endure
Contraception is made to prevent unwanted pregnancy. Yet in a research conducted by Khan and Islam (2022), more than 20% of 4.126 women included in their analysis reported that their most recent pregnancy was unintended.
Women have every right to choose when to get pregnant, how many kids to have, the spacing between their pregnancies, and to access information needed to do so safely and freely (UNFPA 2010).
With that being said, it is very important for contraceptive development to be equal, especially with the fact that present contraception for women often comes with side effects, ranging from common side effects such as pelvic pain, hormonal changes, depression, to rare but serious risks including metabolic and cardiovascular effects, tumor, cancer, even death (Lee et al. 1989). Not just that, the procedures women have to go through to obtain contraception are often uncomfortable and painful. Nearly half of women report experiencing moderate to severe pain during IUD insertion–yet this experience remains frequently under-addressed in clinical practice, as no consistently effective pain management strategy identified across studies (Aissat et al. 2019; Gemzell-Danielsson et al. 2013).
Beyond the physiological burden, women are also expected to bear the social consequences of pregnancy prevention. In today’s societies, it is still a common belief that contraception is primarily women’s responsibility, especially in situations shaped by economic insecurity. Women are often expected to endure the pain of contraception side effects, while simultaneously carrying a disproportionate share of childcare, and domestic labor. At the same time, public perception regarding male contraception persists to be deeply stigmatized. It is often associated with fears of infertility, a form of weakness, or permanent reproductive damage.
Whose Side Effects Matter?
Although the thought of suppressing male fertility may appear more efficient in theory due to their capability to produce millions of sperm daily, from a biological perspective, inhibiting the continuous production of male’s enormous gamete cells is more complex than straightforwardly suppressing a single ovulatory cycle. Still, this does not justify the inequality in contraceptive development because research on male contraceptives has shown promising results for decades.
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So, why do we still lack options of male contraceptives? One of the most frequently cited reasons for the discontinuation of male contraceptive trials is the occurrence of adverse side effects. In a review by Abbe and Roxby (2020), reported side effects included mood changes, acne, altered libido, and emotional disturbances. Sounds familiar? Yes, those are the side effects that women also experience. In fact, this review found that adverse event frequencies among male contraceptive participants were generally similar to–or even lower than–those experienced by women using hormonal contraception. This illuminates an insidious double standard: side effects that have long been normalized for women were considered significant enough to slow or even discontinue the development of male contraceptives.
Shared Pleasure, Shared Risk
So, what can we do? As a society, we can start by unlearning the idea that contraception is automatically women’s responsibility. We can stop treating male contraceptives as something emasculating and dangerous while sustaining the normalization of pain and side effects women experience through contraception. We can start questioning why reproductive responsibility has long been distributed unevenly in the first place.
Greater investments towards male contraceptive research is undoubtedly necessary. However, scientific progress means little without cultural shifts. As long as male contraception continues to be associated with weakness, infertility, or threats to masculinity, the expectation bordering on contraception will continue to be prejudiced against women, regardless of how many new methods are developed.
REFERENCES
Abbe, C.R. & Roxby, A.C., 2020. Assessing safety in hormonal male contraception: A critical appraisal of adverse events reported in a male contraceptive trial. BMJ Sexual & Reproductive Health 46(2):139–146. https://doi.org/10.1136/bmjsrh-2018-200206.
Aissata, R., D., Veillard, D., Raia Barjat, T., Munoz, M., Bruel, S., Trombert, B. & Chauleur, C. 2019. A prospective, randomized study evaluating the pain felt during intrauterine device insertion by the direct technique vs conventional technique. Journal of Gynecology Obstetrics and Human Reproduction 48: 719–725. http://dx.doi.org/10.1016/j.jogoh.2019.05.010.
Gemzell-Danielsson, K., D. Mansour, C. Fiala, A. M. Kaunitz & L. Bahamondes. 2013. Management of pain associated with the insertion of intrauterine contraceptives. Human Reproduction Update 19(4): 419–427. https://doi.org/10.1093/humupd/dmt022.
Khan, M. N. & M. M. Islam. 2022. Women’s experience of unintended pregnancy and changes in contraceptive methods: Evidence from a nationally representative survey. Reproductive Health 19: 187. https://doi.org/10.1186/s12978-022-01492-w.
Lee, N. C., H. B. Peterson & S. Y. Chu. 1989. Health effects of contraception. In: Parnell A. M., editor. Contraceptive use and controlled fertility: health issues for women and children. Washington (DC): National Academy Press: 48–85.
Reproductive Health and Rights: Perspectives for Further Development in Africa. 2010. The United Nations Population Fund. https://www.unfpa.org/press/reproductive-health-and-rights-perspectives-further-development-africa.
United Nations Population Fund (UNFPA). 2025. World Population Dashboard. https://www.unfpa.org/data/world-population-dashboard.
