Emer McLysaght: Trust is the crux of the issue when it comes to the male pill

There are oodles of takes on how the world would be if men could get pregnant. Morning-after pills delivered straight into their mouths like frisbees, abortions dispensed from ATMs, paid matenity leave until the child is old enough to drive, contraceptive pills sold in packets at the newsagent like Skittles or Smarties. If men could conceive and thus shoulder the burden of pregnancy – or preventing it – and the decision to bring a child into the world, that world would be their oyster, or so the quips go.

It’s a somewhat redundant pastime, imagining this world, given that a pregnant man is a medical impossibility (except in the case of trans men). It’s fun to suppose though, if one’s idea of fun is to induce the blood pressure spike we’re warned about on the back of a packet of contraceptive pills. Considering the idea of a male pill never fails to induce cynicism. Last week when a significant advance in the research into male birth control – the ability to temporarily halt sperm motility in mice, but not yet men – was announced, I must admit my immediate reaction was “as if you could trust them to take it”. The men. Not the mice.

Can you blame me? Historically, control over reproduction has not been plain sailing for those who are most affected by pregnancy. Dodging conception is something humans have been doing at least since the ancient Egyptians and Mesopotamians were using honey, plants and a range of barrier methods to indulge in some family planning. For most of the thousands of years since, religion, politics and the patriarchy have endeavoured to force people to stay pregnant and prevent them from preventing it.

Maybe my cynicism is unfair. Every time a male pill update is announced, the idea that men will never be expected to deal with side effects comes to the fore, even though more recent data often suggests that the majority who take part in clinical trials would commit to the contraceptive. Still though, the stakes for partners with a penis are substantially lower than for those with a uterus. It tracks that taking on the burden of birth control has naturally fallen to the latter.

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It’s also presumably medically simpler to prevent the release of one egg as opposed to the flow of millions of sperm, and thus the development of a female contraceptive pill was the more obvious option back in the 1950s. Research into a male pill didn’t take off until the 1990s, and since then there have been promising developments but none that have yet made it through human trials and onto the market. There’s a hormone injection. There’s a gel that can produce the same effect as a vasectomy. This new drug the mice are taking only works if taken shortly before sex. If it makes it into the hands of men they’d have to be trusted not only to carry it, but to take it in a timely fashion.

Trust is really the crux of the issue here. Placing sole responsibility for birth control in either partner’s hands raises the stakes. In established couples where there’s a penis and a uterus, a male pill could work well given the assumed trust between partners.

Vasectomy is also an option for individuals or couples who either don’t want or have enough children, and I know many who have gone down this route, which is now promised with minimal invasion and pain. Sterilisation for women and trans men on the other hand is infinitely more difficult to both procure and carry out so most opt for pills, intrauterine devices, implants, injections, disciplined condom use, ovulation awareness and a range of other techniques to avoid pregnancy.

The morning-after pill was only made available over the counter in Ireland in 2011 and while abortion is now available here, access to it remains restrictive and feels perilous in an international context.

It’s the ones who can get pregnant who carry the most burden. I doubt there will ever be a time when updates about a male pill aren’t met with at least an eye roll and redundant Skittles or Smarties quip. As for the mice, they might have no option but to take their pill, but I’m fairly certain they’d eat the sweets with no hesitation.