Male birth control: A promising new trial in California, and why reproductive autonomy matters
Good morning, and welcome to the Essential California newsletter. It’s Tuesday, Dec. 21. I’m Justin Ray.
Last week, the Food and Drug Administration decided to permanently drop its longstanding requirement that abortion pills have to be picked up in person. In California, lawmakers have begun preparing countermeasures to expand access to abortion for those who live both in and out of the state.
These developments — along with questions about the future of Roe vs. Wade simmering in the background — have brought reproductive rights to the forefront. However, one aspect of that topic not often discussed is male birth control.
The most advanced progress in male contraception is on the hormonal front, Dr. Brian Nguyen, an Ob-Gyn and assistant professor with the Keck School of Medicine at the University of Southern California, tells The Times.
He is on a team conducting clinical trials with the Center for Male Contraceptive Research and Development, an international network of professionals supporting advances in male contraception. It is sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
But the quest for birth control to be used by sperm-producing partners means so much more than giving people options; it’s about equality for everyone, experts say. They argue that discussions tend to portray reproductive rights as a women’s rights issue. While that is true, both men and women benefit from expanded reproductive autonomy.
“We’re only really giving half of the population the tools they need to prevent an unintended pregnancy,” Heather Vahdat, the executive director of the Male Contraceptive Initiative, tells The Times.
A new gel, and the ol’ snip-snip
One of the most promising ongoing trials conducted by Nguyen’s team at the Lundquist Institute in Torrance involves a gel that men can apply to their shoulders. The hormonal gel combines both a progestin and testosterone, which together block the body’s signals for producing its own testosterone and sperm, he explains. The testosterone in the gel replaces the body’s own testosterone, preventing negative effects on libido, sexual function, muscle mass, and energy.
“The trial has been going for two years now. We’ve had lots of participants, no pregnancies yet, so we’re really excited about it,” he says. The gel is able to decrease men’s sperm counts to undetectable levels. The treatment is also reversible.
Nguyen explains that there is a misconception about male birth control: that it is too difficult to pull off. This comes from the belief that, with female birth control, you are targeting one egg. Meanwhile, developing male birth control is akin to playing a really difficult game of Space Invaders, where you have to zap tens of millions of sperm.
But the truth is, you don’t have to get a sperm count to zero to make a person infertile. A count of 10 million to 20 million greatly reduces the likelihood of pregnancy.
“Your normal semen contains about 40 million to 300 million sperm per milliliter, which is huge, right? And if you ask yourself, why evolutionarily does a man need that much sperm per milliliter of semen in order to impregnate women? That’s because you need that many. The process of getting that sperm and egg is extremely perilous,” Nguyen says. “So even at 10 [million] to 20 million, you’re expecting this man is going to have difficulty achieving a pregnancy.”
One form of male sterilization that is better known than the rest is the vasectomy, a procedure which blocks the vas deferens, the tubes that carry sperm during ejaculation. You might be wondering, if that procedure is available, why develop anything else?
“Vasectomies are designed to be permanent,” Vahdat says. “So if you are a young man, or even a middle-aged man, who doesn’t want to have a child now but isn’t 100% sure they don’t ever want to have a child, it eliminates that for you. The young men will say, ‘Well, I’ll just get it reversed.’ And yes, you can reverse a vasectomy, but it is not easy and it is not guaranteed. That is not something you should be going into a vasectomy intending to do.”
Why this matters
Male birth control is a simple subject with big implications. Nguyen highlights the fact that unwanted pregnancies are concerning to everyone. “This idea that men are not affected by the risk of unintended pregnancy is preposterous,” he says.
He explains that if men had their own birth control, it would give them more agency. They wouldn’t have to trust that their partner had remembered to take theirs (or were using some other form of contraception).
Another point that is obvious but still important: Giving men more birth control options would allow people to have sex without fear of getting anyone pregnant (of course, there are still sexually transmitted diseases).
But the topic also relates closely to the debate around abortion, Nguyen says.
“If you are not personally affected by abortion and there’s no kind of contraception that you can use, then you’re not really thinking about all of the ways in which it can affect you,” Nguyen says. “That is not part of your, like, your color palette of reproduction, and therefore you see the world in black and white…You see abortion as more of like good versus evil kind of narrative as opposed to something more gray. The fact that men have not been made to feel culpable for an end to their pregnancy really contributes to the polarization of abortion.”
Vahdat says that making male birth control available could help end unwanted pregnancies, which in turn could dramatically impact education, income inequality, and so many other problems facing society. It could have even more impact in other countries.
“It equals the playing field on a reproductive health level in ways that we’ll continue to recognize that we wouldn’t have even thought of. There is a cascading impact of just making it not a gendered discussion anymore,” Vahdat says.
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And now, here’s what’s happening across California:
Omicron has raced ahead of other variants and is now the dominant version of the coronavirus in the U.S., accounting for 73% of new infections last week, federal health officials said Monday. The Centers for Disease Control and Prevention numbers showed nearly a six-fold increase in Omicron’s share of infections in only one week. In much of the country, Omicron’s prevalence is even higher. Los Angeles Times
With Omicron rapidly spreading and its implications unclear, how should people approach the coming holiday season? Some experts think it would be prudent to make some adjustments, although many health experts this year are also emphasizing the importance of seeing family and friends after many people spent the last winter holiday season following stay-at-home orders. “If we fail to take common sense safety measures right now, we could find ourselves in a dangerous place by the end of the month and into January,” Los Angeles County Public Health Director Barbara Ferrer said. What should families do? What kinds of gatherings are higher risk? We answer all this and more. Los Angeles Times
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Police searching for those responsible for the fatal stabbing of Drakeo the Ruler. The hip-hop artist died of injuries he sustained at the Once Upon a Time in L.A. concert at Banc of California Stadium on Saturday night. The suspect (or suspects) was not identified, but a person with direct knowledge of the incident told The Times that Drakeo the Ruler had been attacked by a group of people. One source said that video from after the stabbing showed people running up on stage and security trying to break up a fight. No arrests had been made as of Sunday morning, said Officer Luis Garcia, an LAPD spokesman. “Detectives are still trying to figure things out,” he said. Los Angeles Times
The city of Los Angeles has accused the operator of a gun store located within the Los Angeles Police Academy of negligence in its operations and breach of contract, the latest twists in a widening scandal involving stolen firearms landing in the hands of LAPD officers. The claims, made in multiple court cases in the last week, mark the first time since the broader scandal broke last year that the city has taken direct aim at the Los Angeles Police Revolver and Athletic Club, or LAPRAAC, a nonprofit organization and gun store with which the city has maintained a relationship for more than 85 years. Los Angeles Times
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POLITICS AND GOVERNMENT
How a massive nursing home penalty eluded consumer detection. An inspection report revealed that Northpointe Healthcare Centre in Fresno had issues: residents had bedsores; staff told inspectors they skipped treatments and failed to distribute medication because they were stretched too thin; one resident was hospitalized after missing four doses of an antibiotic. Then the federal government levied a massive fine: $912,404, the largest penalty given to any California nursing home in at least a decade, according to a CalMatters analysis of federal data. But for years, consumers had little way of knowing that fine even existed. That’s because state and federal systems responsible for overseeing nursing homes often fail to publicize critical information. CalMatters
CRIME, COURTS AND POLICING
Richmond police used force that caused significant injuries 122 times over a six-year period — and more than half of those were caused by police dogs. Richmond’s canine squad violently apprehended many kinds of suspects: from dangerous felons to petty thieves, to people acting “suspicious.” Sometimes, innocent bystanders got hurt. Some dog-bite injuries appear relatively minor, but others were so severe they required surgery. One canine tore off a man’s lip. Another punctured the scalp of an 8-year-old boy. Yet, Richmond has celebrated its dog squad’s crime-fighting prowess, taking pride in the department’s long history as one of the oldest canine units in California. East Bay Times
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HEALTH AND THE ENVIRONMENT
A river of secrets: The battle over Reservation Ranch. Today, the Smith River is the last major waterway in California that runs freely without a single dam — a precious refuge for salmon, for steelhead and a bygone timber community still searching for a future. For more than six generations, one family has held the keys to 1,668 acres of pastureland right by the river mouth. Known as Reservation Ranch, this coveted property has been off limits to most. So when the ranch suddenly went up for sale, chaos ensued. The subsequent battle over the land has unearthed an uncomfortable truth: “California, like the great American West, was largely built on violence — violence to not just the land, but also the native people of the land,” Rosanna Xia writes. Los Angeles Times
As temperatures rise in California due to climate change, scientists expect poison oak to become even more abundant. The woody or shrub that’s common in western regions of California at elevations below 5,000 feet is most often encountered on grassy hillsides, in forests and by the coast. For those who are allergic, which includes most people, exposure results in a rash about one to six days after coming in contact. The best way to deal with poison oak is to avoid getting it in the first place. SF GATE
A deputy showed images in a bar of Kobe Bryant’s body. That set off a bitter legal fight. Two days after Kobe Bryant was killed in a helicopter crash in 2020, a young man walked into a Norwalk bar and took a seat at the counter. His name was Joey Cruz, a deputy trainee at the Los Angeles County Sheriff’s Department. Cruz, who had been on patrol just two months, had stood sentry at a trailhead leading to the debris field in the hills above Calabasas in the frenzied aftermath of the crash. At Baja California Bar and Grill, he had photos of the carnage on his phone, forwarded to him by another deputy. About 9:30 that Tuesday night, bar surveillance footage captured him showing his phone to the bartender. It turns out that a real estate investor who was also there heard about the photos and took a gutsy step that led to a lawsuit by Bryant’s widow now being fought in federal court. Los Angeles Times
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Los Angeles: 66 San Diego: Cloudy, 63 San Francisco: Rainy 53 San Jose: Rainy, 62 Fresno: Overcast, 54 Sacramento: Rainy, 47. Have you ever seen that video of that reporter getting interrupted by cat sneezes?
Today’s California memory is from Jack Ross:
At my first Yom Kippur services at Stephen Wise Temple above the 405, I thought I was having a religious experience when the rabbi entered carrying the torah and singing in the most beautiful baritone I had ever heard. All the hairs on my neck stood up. My father leaned over and whispered in my ear: “That’s Barbra Streisand’s vocal coach!”
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