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December 2017 Web POPULATION Volume 49, Issue 4 CONNECTIONDecember 2017 MALE CONTRACEPTIVE OPTIONS AND MEN’S ROLE IN FAMILY PLANNING President’s Note opulation growth is often called the “elephant in the At the time of our founding as Zero Population Growth in 1968, room.” Too many fine people continue to steer a wide there were only four nations on Earth at or below “replacement berth around the topic for fear of being tagged with one rate” — which is just above two children per woman in places Pnegative label or another. with low mortality. Today, there are nearly 100 such nations. With the exception of China and Peru, (and, to a lesser extent, It may be uncomfortable to talk about population growth. But India) which have engaged in widespread, deplorable coercive it’s absolutely essential. In fact, real elephants are endangered practices, it’s been accomplished through voluntary methods. today because of the soaring population and shameful behavior Empowering women works. Smashing all barriers to reproduc- of our own heedless species. tive healthcare works. A big part of the problem arises because many decent, intel- Yet this mission remains far from accomplished. We’re still add- ligent people don’t quite know how to talk about population. ing a billion people to our already overcrowded planet every And, yes, some do tend to worry a bit too much that they might dozen years. Species are vanishing. And climate chaos is a direct offend someone, somewhere. result of population growth. Let’s start by acknowledging up front that horrific things have We simply can’t afford not to talk about population growth. Not been done under the false flag of “population control.” Some if we care about our living planet. 70,000 American women were forcibly sterilized over the first seven decades of the 20th century. The spurious pseudoscience The right way to talk population is the rights way: Every person of eugenics was deployed to promote ideas and practices as a everywhere has the inalienable right to determine their own repro- cover for racism. Like some infectious disease, eugenics fever ductive destiny. No exceptions, no conditions. Rights are rights are swept up many otherwise estimable people in the late 19th rights. and early 20th centuries, including Charles Darwin, Teddy Roosevelt, and even Helen Keller. When the population issue was percolating a century ago, we humans lacked the technology to manage our fertility. Times These accomplished, yet imperfect humans were sadly all too change, and we need to change with the times. Women now willing to consign their fellow imperfect humans to fates they have a wide array of effective options — or they would if it did not deserve. weren’t for retrograde politicians. And this magazine issue highlights the vital, unfinished business of male contraception. Now we know better. Social engineering is a blind alley when it comes to that most personal and private of matters — the deci- We need to tell the honest truth that population growth threat- sion about when and whether to bear children. ens our planet. Silence is not an option. John Seager We’ve now amassed an avalanche of evidence to demonstrate [email protected] incontrovertibly that, when we successfully uphold all indi- vidual reproductive rights as an ethical imperative, population challenges evaporate. Population Connection — December 2017 VolumePopulation 49, Issue 4 Connection December 2017 Features Board Chair Estelle Raboni, MPH 10 A New Push for the Male Board of Directors “Pill” Aaron S. Allen, PhD Andreea Creanga, MD 12 What Do Men Have to Do Amy Dickson with Women’s Reproductive Katie Ferman Padgett Kelly, PhD Rights? Anna Lawson, PhD Nejla Liias 14 Men in Rural Ethiopia Show Sacheen Nathan, MD That Family Planning Is Not Bob Pettapiece, PhD Dara Purvis, JD (Vice Chair) Just a Women’s Issue The Hon. Tom Sawyer (Treasurer) Carol Vlassoff, PhD 16 Can Niger Break Out of Its Kevin Whaley, PhD Cycle of Poverty? Hania Zlotnik, PhD (Secretary) President and CEO 20 In West Africa, Clinics John Seager Confront Suspicion, and [email protected] Husbands, One IUD at a Time Editor Marian Starkey 22 For Nigerian Mothers, Escape [email protected] From Boko Haram Shakes Up Contributing Authors Gary Barker, Abraham Gelaw, Kieran Guilbert, Childbirth Customs Alastair Leithead, Dina Fine Maron, Stacie Murphy, John Seager, Serra Sippel, Marian Starkey, Ike Swetlitz, Rachel Walker, Pamela Departments Wasserman 2 Editor’s Note Proofreader Skye Adams 3 Letters to the Editor Population Connection (ISSN 2331-0529) Population Connection is the national grassroots 4 Pop Facts population organization that educates young people and advocates progressive action to 6 In the News stabilize world population at a level that can be sustained by Earth’s resources. 8 ZPG Society Members Annual membership ($25) includes a one-year subscription to Population Connection magazine. 26 Washington View All contributions, bequests, and gifts are fully tax- deductible in accordance with current laws. 28 Field & Outreach Population Connection 2120 L Street, NW, Suite 500 30 PopEd Washington, DC 20037 (202) 332-2200 • (800) 767-1956 32 Cartoon [email protected] PopulationConnection.org 33 Editorial Excerpts PopulationEducation.org Cover Image: Chum Dam, a 41-year-old Cambodian father, sits in an assessment room prior to his vasectomy procedure. Photo: Marie Stopes International, Courtesy of Photoshare www.popconnect.org December 2017 — Population Connection 1 Editor’s Note “What about men?” is one of our members’ most frequent refrains when it comes to talk of family planning — and not in the Portlandia sense of the phrase (tinyurl.com/PortlandiaMen). ight now the chemical burden for contraception deferens — the tubes that get snipped in a vasectomy — relies solely on the female. That’s an unfair balance and blocks sperm from traveling from the testicles to the in the equation,” says Charles Easley, an assistant urethra, thus preventing sperm from leaving a man’s body. “Rprofessor at the University of Georgia, who is involved in the The gel can theoretically be dissolved when a man wants to development of a male pill. resume his fertility. Another version of the gel, RISUG, is expected to launch in India over the next couple of years. I agree with this understatement. I think most people would • Bimek SLV is a valve operated by a switch that is implanted agree that it’s about time there was an effective, reversible in each vas deferens (there are two, corresponding to each method of male birth control besides condoms. Instead, it testicle) and can be manipulated through the skin by seems like we’re always a couple of years away from a pill or the user. The only test subject at this point is its creator, injection that will temporarily suspend male fertility. The drug Clemens Bimek. Obviously. trials continue without producing anything market-ready, and that’s been the case for many years. For now, men are stuck with condoms, vasectomy, and with- drawal, and whatever method of birth control their female A male pill remains elusive for a couple of reasons, Easley says. partners may be using. “I think there’s not much activity in this field because we have an effective solution on the female side.” Others describe the Vasectomy is an excellent option for those who do not want infinitely more difficult job of halting sperm production — biological children or have already had as many as they want. millions are created in the testes every single day — over stop- The Affordable Care Act doesn’t require vasectomy to be cov- ping the release of one egg per month or preventing a fertilized ered by insurance companies, so it’s up to individual insurers egg’s implantation in the uterus. whether to cover it and to what level. (Three states — Illinois, Maryland, and Vermont — have laws requiring vasectomy cov- Here are the reversible methods that have reached the stage of erage at no cost to the insured because their leaders understand clinical trials (but don’t hold your breath — they’re still at least that preventing unintended pregnancy is always the fiscally and a few years away from FDA approval): socially responsible thing to do.) • An injection to stop spermatogenesis (the creation of And although not a perfect solution for everyone, the effective- new sperm) was very effective in a multi-country trial, ness (when used perfectly) of condoms at preventing pregnancy but caused such unbearable side effects that the study was and sexually transmitted infections cannot be beat. ended early. (To the jeers, it should be noted, of women who have endured the side effects of hormonal contracep- In the meantime, the role of men is primarily to support their tion for over 50 years.) female partners in using whatever method of contraception is • Vasalgel has tested effective on monkeys but has not yet right for them. That’s the majority of what the articles in this been tested on humans. The gel is injected into the vas issue explore. Marian Starkey [email protected] 2 Population Connection — December 2017 Send correspondence to Letters to the Editor [email protected] . Attn: Marian Starkey Letters are also accepted via Population Connection postal mail. Letters may be 2120 L St, NW, Suite 500 edited for clarity and length. Washington, D.C. 20037 Just want you to know how pleased I am with the work you avoids partisan electoral activity, while Population Connection continue to do — sometimes in the face of great opposition. Action Fund engages in that area as a sister organization). Eliezer T. Margolis, PhD Unfortunately, the Republican party (with sadly rare excep- tions) has abandoned its once-strong support for programs Over these past few years of reading your magazine, I’ve come that advance our mission of population stabilization.
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