Who should take care of birth control in relationships?

“Men and penis owners should be taught to ejaculate responsibly from an early age. It’s a different way of looking at things that can rightfully shift more of the responsibility of safe sex.”

As a self-proclaimed feminist, I’m constantly horrified by all the times I’ve had to take the lead with birth control in sexual encounters. But the unfairness of this doesn’t change the fact that it’s been my job and my job alone for basically the entirety of my sexual life.

I consistently use contraception regardless of my sexual activity for a number of reasons. But at the end of the day, it’s the only measure I can take that usually prevents me and a sexual partner from conceiving. So seeing as it takes two to get pregnant, why have I been the one taking sole responsibility for so long?

Interested to hear how others navigate the world? Head to our Life section.

Emma Boulton, Director of the reproductive health clinic Clinic 66, ardently believes the burden of contraception should be equal between all parties. This refers to both committed and casual sex, as she believes avoiding pregnancies and STIs is always a shared responsibility regardless of your relationship status.

“The genes that make up a new individual come 50 per cent from the X chromosome and 50 per cent from the Y chromosome, so the responsibility should be 50/50 between those parties,” Emma says. “Unless you’re planning a pregnancy, if you’re having unprotected sex, it needs to be a mutually shared decision.”

In terms of why it’s been the woman or uterus owner’s job to avoid pregnancy for so long, the answer is fairly obvious. As the ones whose bodies are physically at risk, our sense of caution and immediate danger is far greater, so our investment in preventing pregnancy is higher. Given our bodily involvement, we’re also then expected to take the lead in child rearing too.

“People with uteruses have to go through so much to avoid pregnancy,” Hallie*, 28, says. “I believe that if the person you’re having a sexual interaction with doesn’t acknowledge or isn’t sensitive to that, or is unwilling to help, then they don’t deserve to share that sexual experience with you.”

Penis privilege

Hallie also recognises that no matter how supportive a partner is, because women and uterus owners are the ones who fall pregnant, they’re expected to bear more of the burden. “I think a good name for it is ‘penis privilege’,” she says.

This idea of ‘penis privilege’ ties in with what Emma calls responsible ejaculation. “We really need to collectively treat sperm as the serious, potentially hazardous material it is, and so [it] should be dealt with responsibly,” Emma urges. “When a man or penis owner ejaculates, they need to be completely aware of what’s going to happen to that semen.”

In fact, one could argue that instead of leaving it to a woman or uterus owner to block and prevent insemination, we should be thinking more carefully about how and where to direct sperm in the first place.

“I’ve had one night stands or casual sexual relationships when men would simply say, ‘You’re on the pill, right?’, says Caitlin*, 26. “They expected me to be taking care of it alone. Sometimes I feel that since the penis ejaculates, they should be responsible for all [the] risks associated with birth control. But since they cannot carry pregnancies, uterus owners usually want to be in control.”

The emphasis on pregnancy being a by-product of having a uterus negates the very critical role the penis and sperm play. “The irony is women and uterus owners are only fertile for 12 to 20 hours each cycle, whereas men and penis owners are fertile all the time,” Monica Cook, sexologist and educator of psychosexual therapy at Reconceived, tells me. “Yet they are primarily the focus of most birth control interventions.”

Olivia*, 23, admits she’s never really thought about the inequality of it until now, and it’s something she’d like to bring up with her partner. But she’s worried that in some ways, it will be a hard thing to hand over. “At the end of the day, it’s my body and mostly my future that will be affected if things go awry,” she tells me. “In a perfect world, yes, it would be an equally shared responsibility. But being able to articulate the burden that comes with having a uterus to someone who doesn’t is hard.”

So what contraception should we be using?

The ‘perfect’ contraceptive is 100 per cent reliable, immediately irreversible, free, and has no side effects. But in reality, there’s no such thing. Taking into consideration all the pros and cons of different contraceptives, as Emma informs me, long-acting reversible contraception is widely regarded as the safest and most reliable option (otherwise known as hormonal IUDs and implants).

But for all its merits, this kind of contraception still places an unfortunate amount of the burden on women and uterus owners, as there’s currently no equivalent option on the market for men or penis owners. There’s been male hormonal contraception on the production pipeline for many years, and lots of talk about the ‘male pill’.

“There’s probably something out there already that would be effective in slowing down sperm production,” Emma tells me. “But anything like this would cause side effects. And because of this, according to the studies, men won’t buy it.”

Leah*, 23, tells me about how difficult her contraception journey as a woman has been. “My body and mental health were burdened by the impacts of the pill for almost a decade, compared to condom usage which has no implications,” she tells me. “It makes it difficult when most contraception is designed for women or people with a uterus, specifically contraception that is more harmful. It’s a major structural barrier to making contraception an equal responsibility.

“Part of the issue is that symptoms and pain with birth control seem to be acceptable in our society for women,” Monica adds. “They [women] just accept that they may have reduced libido, mood swings, nausea, headaches [and an] increased risk of blood clots. Whereas men found these symptoms unacceptable. It’s here that we see the inequality, even within the research.”

It begs the question: are women and uterus owners just better at dealing with these side effects, or have we just been taught that pain is part of our experience and not to complain? Honestly, both answers anger and sadden me.

In terms of what’s next, and how to move forward, Emma has some practical thoughts which centre around the importance of equal and thorough sexual education. “Men and penis owners should be taught to ejaculate responsibly from an early age. It’s a different way of looking at things that can rightfully shift more of the responsibility of safe sex,” she tells me.

“Penis-centred sexual education has revolved purely around pleasure for far too long. It needs to focus on teaching responsible sex and the hazardous consequences of unsafe sex, to all genders.”

*Names have been changed.

For more on sharing the responsibility of birth control, try this.