In the opening scenes of acclaimed Netflix series Master of None we see the show’s protagonist Dev and his partner Rachel dash off to the pharmacy after their condom breaks during sex.
Picking up Plan B, as the US brand of emergency contraceptive pill is known, seems as normal to young(ish) New Yorkers as drinking coffee or taking an Uber. Not only that, it is portrayed as a dual responsibility. Both Dev and Rachel take the cab to the pharmacy and the morning-after discussions between Dev and his friends show that the men consider themselves equally accountable when it comes to choosing – and communicating about – contraception.
So far, so on-message. But the stats tell a different story. A study published last month in the Journal of Adolescent Health showed that less than half of young men have even heard of the morning-after pill.
The study of 93 males at Children's Hospital Colorado between the ages of 13 and 24 showed that while 84 percent thought avoiding a partner’s pregnancy was “somewhat or very important”, only 42 percent had heard of emergency contraception.
It is tempting to say the picture looks better in the UK. The morning-after pill has been available over the counter since 2001 (as opposed to 2013 in the US) and last year NHS policy was updated to make ellaOne, a drug effective up to five days after unprotected sex, available to under-16s.
In reality it's hard to know since the research is patchy and frustratingly unbalanced. The most recent ONS survey on Contraception and Sexual Health was conducted in 2009. It showed that over 90 percent of women over 18 had heard of emergency contraception and 17 percent had used it in the last 12 months. Men, on the other hand, were not asked.
The imbalance continues when you look at other contraceptive methods. The same survey asked men but not women over 18 whether they had heard of long acting reversible contraception (LARC) which include intra-uterine devices and systems, injectable contraceptives and implants (forty percent had not and of the ones who had, 70 percent did not know how they worked).
As the Family Planning Association notes, “there are no comprehensive published health service statistics on patterns of contraceptive use in the UK” so it is difficult to draw conclusions about that but as we look at the research that is out there, one pattern does seem to emerge: men get asked about their awareness, women get asked about their behaviour.
Furthermore, when men are asked about their contraceptive use, they tend only to be asked about condoms and occasionally vasectomies.Meanwhile women are quizzed on condom use, hormonal pill use, LARC, patches, caps, diaphragms and even natural methods.
This does nothing to help dispel the notion that contraception is a female problem. A survey last summer showed only one in ten British men would take a male contraceptive pill if one was available. Of those a quarter said they thought women should take responsibility for contraception. The poll, conducted by VoucherCodesPro.co.uk of 2,681 British men over the age of 18, also revealed that just under a quarter did not use contraception at all. A further ten percent said it depended if they had any “to hand”, showing once again that when men talk about contraception, they talk only about condoms.
And 2007 report by the FPA observed that “Both young men and young women speak openly about the importance of contraception, in terms of protecting against sexually transmitted infections and unwanted pregnancy. However, it emerges that unwanted pregnancy is perceived to be more of an issue for young women, and there is therefore a sense that the responsibility for preventing pregnancy lies ultimately with them.”
Anecdotal evidence also supports this. Personal accounts such as this one and this one show that men are only just starting to catch on to exactly what the contraceptive burden actually entails on a physical and mental level.
This is something we need to address. With a male contraceptive injection promised in just two years time and the male hormonal pill coming ever closer to completion, the narrative around birth control needs to change and soon. We all – male and female - have an imperative to start talking more openly and honestly with our partners about our sexual needs, of which contraception is an aspect.
Comprehensive sex and relationships education would be one part of that change. A more balanced approach to data collection would be another. When it comes to contraception, we need to be asking men and women the same questions if we want to start seeing anything like parity in the answers.
By Franki Cookney