Changing the Culture: From Consent to Contraception

On September 1st, 2021 Texas adopted into law the, “Heartbeat Bill” prohibiting abortions over 6 weeks of gestation – often times before a female even knows she’s pregnant. For so many reasons as a Physician and a male, in general, I 100% stand against this and am publicly extremely disgraced and disappointed in this legislation. The church and state should be and were designed to be separate entities, especially for those very set on following the archaic foundations of the United States and its Constitution.

But, that point is all a different conversation for another day.

The passing of this LAW brought with it a revived conversation and question from a fellow Pediatrician on management of Contraception choices for female patients; and, this reminded me of something that I haven’t posted publicly about but which NEEDS to be a focus for medical professionals, educators and families: Discussions on consent and contraception among Males.

Outside of the lack of general education in school amongst children in many parts of the world and US about sex and consent, and the biased religiously-based attempts at “abstinence only” education, which has been shown to clearly not work, there tends to be a general focus many times towards putting the onus on females. The sentiments extend to overall culture to the point of vilifying females and ignoring or even praising males for sexual conquests. While, yes, many parts of the world and the US are progressing away from these outdated close-minded trains of thought, it is overwhelmingly transparent in gender-specific legislation, conversation and lack of innovation – since September 1st, other states have sought to enact similar laws to the Texas Heartbeat Bill which unfortunately punishes a female more for being pregnant than whoever it was that contributed to her being so, even if by nonconsensual acts, a.k.a. Rape.

On the other hand, male contraception hasn’t really changed much in the United States in the last 200 years, yet we make more and more drugs, devices and commercials to limit the contraceptive abilities of females – condoms have been around 5,000 years and vasectomies since 1823 (See: Why we don’t have birth control for men; Brief history of vasectomy). While there’s supposed mechanical/anatomic rationale as to the lack of the ability for innovation in this sphere, there lacks funding and largely public or political impetus given a majority of those in power or decision-making roles being male.

Sex scandals from which accused men go inadequately punished are rampant throughout the US and in some countries females are punished for male-initiated sexual harassment, including Rape. The #MeToo movement helped to surface many problems that have been ignored for decades and it has become harder for people to publicly plead ignorance on the matter, but still lacks a focus on placing more responsibility and ownership on males, or to be crude yet transparent, the Penetrators.

So… What do we do?

My job as a Physician and specifically as a Pediatrician, is to help take care of humans and raise ‘our future.’ I see thousands of males and females the moment they come into existence, I watch them in their innocence as they grow and I hope to guide their development as they become increasingly autonomous and venture out into the open world, making their own decisions, good or bad. While I generally focus on the positive potential, I’m well aware that at some point along the way, I come across an individual that may one day commit a crime, an individual that will violate the basic human rights of another, or an individual that may one day cause harm, pain and suffering. Unfortunately, i’m not clairvoyant, i’m overly optimistic and I lack the ability to prognosticate who it will be – this isn’t The Minority Report.

So, in the meantime, I do the best that I can in trying to change the culture. I talk to my male patients (on any part of the gender fluid spectrum or non-binary point of view) about the importance of them taking self-ownership of contraception and safety, the fact that consent is not only “no means no” but that it should also be a requirement that “yes means yes” (the movement, not the literal phrase; since, I still think cautious consent isn’t quite that yes means yes to everything) and that they have a responsibility to stand up against anyone that says or boasts otherwise. Sadly, at the end of the day, I’ve realized that, I am but one person and also have a very small moment of time to talk to them about these things. So, I hope that if anyone reads this it strikes importance with parents, families and educators to empower males to take these personal stances towards Consent, Contraception and everything in between, even if the majority rhetoric still says something different. Change the Culture, so we can Change the Future.

Don’t be mad at Greg Abbott, be mad at the fact that so many people voted to support him.

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