Gender Disparities: The role of contraception in women’s and men’s lives

Throughout history, humans have sought to control birth rates to optimize quality of life and survival chances. During the Greek and Roman empires, plants such as silphium and ferula were prized for their contraceptive properties. Demand for silphium became so intense that it drove the plant to extinction, demonstrating that, contrary to what certain political ideologies suggest, contraception has always been a fundamental human concern.

Other cultures employed physical barriers and metals like copper to prevent pregnancy. While copper remains in use today, these early methods often proved fatal for the women who bore the primary burden and risk of contraceptive practices.

This knowledge was traditionally passed down from woman to woman as essential wisdom for survival. During the Middle Ages, however, the witch hunts led to its systematic erasure. What followed was an era marked by the spread of sexually transmitted diseases and the transformation of sexuality into something shameful and inappropriate for discussion, especially among those who before were the primary carriers of that knowledge: women.

The sixteenth century brought the invention of the first condom, made of linen to protect men who frequented brothels. Yet women, completely dispossessed of control over their own bodies, had no power to require its use for protection against disease and unwanted pregnancy; only men could decide if it was necessary for their own safety. Only in the 1920s, with the invention of the first intrauterine device, did a new era of reproductive freedom begin, allowing women to earn back the control over their own bodies. 

Men’s contraceptive: earning the right to choose 

The condom has remained the most widely used male contraceptive method since its modern refinement in the nineteenth century. Originally made from animal intestines and later from rubber following Charles Goodyear's vulcanization process in the 1840s, condoms became more accessible and reliable. The introduction of latex in the 1920s further revolutionized their use. However, for centuries, condoms have stood virtually alone as the only available contraceptive option for men, aside from vasectomy, which has been performed since the late nineteenth century but gained popularity only during the twentieth century as a more permanent solution.

Today, scientists are successfully testing pills, gels, and implants that could enable men to share contraceptive responsibility with women. Many of these methods are more convenient and effective than condoms, more easily reversible than vasectomy, and some don’t involve hormones at all.

A study published in early 2023 in Nature Communications presents promising prospects for an “on-demand” contraceptive pill that could be taken approximately thirty minutes before intercourse, with effects wearing off after about a day. 

Yet while these innovations progress, a troubling disparity persists in how we discuss contraceptive side effects. While cisgender men express concerns that male contraceptive pills might have physical and mental consequences on their sexual experience, the debate rarely acknowledges that female contraceptives carry even more invalidating side effects.

This resistance reveals deeper cultural narratives about masculinity and sexuality. Male sexuality is heavily publicized in media and popular culture, but predominantly through a lens of violence and unrealistic performance. Men are expected to be virile and unconcerned with consequences. A man who worries about sexually transmitted infections or unintended pregnancies is somehow considered less masculine. This toxic framework reinforces the notion that contraception is exclusively a female responsibility.

These stereotypes deny men agency over their own reproductive health while simultaneously burdening women with the full weight of family planning decisions and their physical toll. 

A global survey shared during a World Health Organization webinar in September 2022 suggests that men are more than willing to take responsibility over reproduction and to be accountable on contraception use. Importantly, the data revealed that the majority of women interviewed would trust their partner if he were taking a contraceptive.

These findings suggest that many men are ready to challenge outdated notions of masculinity. Times have changed, and it’s time for men to own their own bodies and become active participants in family planning. Expanding male contraceptive options isn’t just about equity; it’s about recognizing men as full partners in reproductive decisions, capable of thoughtfulness, responsibility, and care. When we free men from the confines of traditional masculinity, we create space for healthier relationships, shared burdens, and genuine choice for everyone.

Women’s contraceptives: the burden of reproductive responsibility 

Throughout  history, women carried the totality of reproductive responsibility, yet research on women’s bodies and health remains surprisingly limited. This disparity manifests in many ways across contraceptive development and care, reflecting what scholars identify as the broader feminization of family health work in heterosexual relationships. Research on contraceptive counseling visits reveals that healthcare providers contribute to normative ideas about reproduction and often construct contraceptive responsibility as primarily women’s work. 

The situation becomes more complex when examining how contraceptive pills are promoted. In particular, a double standard emerges when examining the male pill. Clinical trials have been discontinued due to side effects including depression, acne, and weight gain, the same side effects that are considered acceptable for women using hormonal contraceptives.

Contraception involves substantial mental and emotional labor. The typical American woman will spend three decades of her life trying to avoid pregnancy, constituting what researchers call fertility work, unpaid labor that encompasses not only the physical burdens of contraception but also the associated time, attention, and stress. This work includes remembering to take pills at the same time daily, scheduling regular appointments for injections, obtaining refills, checking IUD strings monthly, and managing the emotional stress of anticipating side effects or pain during procedures like IUD insertion.

In contraceptive counseling visits, healthcare providers routinely discuss these requirements as basic features of methods. They offer management strategies, suggesting phone alarms for remembering pills or pain medication before IUD insertion, but rarely question why these responsibilities fall disproportionately on women. While some clinicians promote long-acting reversible contraceptives by highlighting their lower maintenance burden, this approach still constructs women’s assumption of contraceptive responsibility as normal.

The structure of healthcare itself reinforces this inequality. Contraceptive counseling typically involves only women. This structural reality, rooted in the fact that most available methods operate in female bodies, makes the assignment of fertility work to women seem like common sense. Yet research demonstrates that men and women are equally engaged in initial discussions about whether to use contraception and which method to choose. 

The emotional fluctuations and identity shifts associated with hormonal contraceptives can present genuine mental health challenges. Some public health initiatives, such as the Youth Contraceptive Awareness Campaign, have begun addressing this by promoting integrated care models that include emotional and psychological screening alongside contraceptive counseling. Anxiety, depression, and mood disorders are frequently reported in connection with certain contraceptive methods, highlighting the need for better monitoring and individualized approaches. While the relationship between hormonal contraception and brain function has begun receiving research attention, much more work is needed.

Addressing these inequalities requires both practical and structural changes. Healthcare providers could reduce some burdens by supporting practices like improving the shape and insertion processes of IUD or providing year-long supplies of oral contraceptives. 

Conclusion

Birth control methods enabled people to make deliberate choices about reproduction and family size. For women especially, contraception has been transformative, allowing them to decide when, or whether, to have children and to pursue education and careers on their own terms. The ability to prevent pregnancy has been recognized as essential to human well-being and autonomy. Yet the inequalities in contraceptive research, development, and responsibility reveal deeper patterns of gender inequality that shape the life of one specific gender. Women continue to bear not only the physical burdens of contraception but also the mental and emotional labor of preventing pregnancy.  

True reproductive freedom requires both women's and men’s access to safe, effective contraceptive methods with minimal side effects, accurate information, and the social permission to make reproductive choices without shame or judgment.  

The future of contraception must be built on equal research investment, equal consideration of side effects, and equal respect for bodily autonomy. Women deserve to be treated as full human beings whose opinion and mental and physical health matter, not as vessels whose discomfort is considered a necessary part of the process. Men deserve to be recognized as capable of responsibility and care in reproductive decisions, freed from restrictive notions of masculinity that deny them agency in family planning.

No society can call itself equal when the burden of controlling fertility falls disproportionately on one gender.