In 2016, the results of an international medical study on birth control injections for people with sperm were made public.1 According to the study, the method had a 96% success rate accounting for all 320 participants. But some participants reported mild to moderate mood disorders, acne, injection site pain, and increased libido.2 The main adverse effects (AEs AKA side effects) of the 320 cis men were recorded as follows:

Sixty-two of the 65 registered emotional disorders were reported at 1 center (Indonesia), with all of these AEs at this center rated “mild” [...] There was 1 death by suicide in the efficacy phase that was assessed as not related to the study regimen. The participant received 3 injections and committed suicide 1 month after the last injection. The family indicated that he could not cope with his academic pressure. Other nonfatal serious AEs were 1 case of depression (assessed as probably related) and 1 case of intentional paracetamol overdose (assessed as possibly related) during the suppression phase [...] Twenty men discontinued the study due to product-related side effects. Of these 20, 6 men discontinued only for changes in mood, and 6 men discontinued for the following single reasons: acne, pain or panic at first injection, palpitations, hypertension, and erectile dysfunction. Eight men discontinued for more than 1 side effect, including multiple reasons related to changes in mood.3

In the US, magazines published articles lambasting the participants’ inability to stick with the trial. Cosmopolitan ran an article titled: “Men Quit Male Birth Control Study Because It Was Giving Them Mood Swings. Welcome to the club, dudes. Also: WOMAN UP.”2 The title points to the double standard of birth control in relationships that can result in pregnancy—men are spared from side effects while people with pussies* are expected to deal with them.

To be fair to the “dudes,” their trial was shut down by an independent board organized in part by the World Health Organization—not because they quit. In fact, over 80% of participants said that they would use a similar method of contraception if it became publicly available.3 Still, the independent board stopped the trials because “the risks to the study participants outweighed the potential benefits to the study participants.”3

In 2016 a study was also published about the effects of long-term hormonal birth control on the mental health of over 1 million women in Denmark. The results showed that many products people with pussies* have used for decades have side effects similar to those experienced by men in the World Health Organization study.4 The researchers point out that the correlation between hormonal birth control and depression had not been examined on a large scale before, despite clinical evidence of negative side effects.4

The 14-year study concluded, “increased risk for first use of an antidepressant and first diagnosis of depression was found among users of different types of hormonal contraception, with the highest rates among adolescents” across multiple forms of hormonal pills, patches, and rings approved for birth control.4

So, why are side effects that people with pussies* have been expected to “woman up,” and tolerate unacceptable when they happen to cis men?

At the root of the double standard is that hormonal birth control for people with pussies* was approved by the FDA around 1960, when the process of testing drugs was much less rigorous.1

In the original studies many people did complain of side effects, some even died due to heart failure and blood clots, issues that were not considered linked at the time but were later proved to be connected.2 In fact, side effects were reported by a researcher on the team named Dr. Edris Rice-Wray, but her findings were dismissed by the researcher’s overseer, Dr Gregory Pincus. A Planned Parenthood pamphlet on the history of the birth control pill states:2

Dr. Edris Rice-Wray, who was in charge of the first trials in Puerto Rico, reported early on that 17 percent of the women in the first cohort had significantly unpleasant side effects [...] In her first report, Rice-Wray concluded that although the pill provided nearly 100 percent protection against unintended pregnancy, “it causes too many side reactions to be acceptable generally.” Gregory Pincus, the head of the research team [...] ignored Dr. Rice-Wray’s concerns about side effects. Perhaps because Pincus was a biologist, not a physician, he had little clinical empathy for what he regarded as hypochondria among the women in the trials.

The FDA changed its requirements in 1962 after a sleeping aid called thalidomide caused major birth defects in thousands of babies in Europe.5  The organization started to required that drugs be proven effective before marketing. Strict testing was instituted overnight, and required manufacturers to report unexpected harm and obtain consent from study participants—none of which was required before.6 FDA Historian Suzanne White Junod noted, “After thalidomide, any drug [such as birth control pills] with such widespread potential use in women of childbearing years would have encountered a far more cautious regulatory environment.”7

The number of subjects in the original trials and the amount of time subjects were observed would not be considered acceptable today.2 So, different tests would have to be done for current pills for people with pussies* to pass today’s more rigorous standards.

Another reason is that people with pussies* are the ones who get pregnant, and therefore the side effects they experience are “more justified.” In the 60’s, supporters of birth control pills were in a tough position: they had to convince the FDA to approve a drug for people who were healthy overall. Birth control drugs and devices do not fix an existing problem, they are meant to prevent a future outcome. Birth control supporters had to argue to the FDA that the pill was actually beneficial for healthy women, because complications from birth are often more risky than the pill’s side effects.8 FDA Historian Junod writes:            

"The benefits of the pill compared to the risks of childbirth were calculated and defended openly during the approval process and used to defend the approval decision. As critics have charged in another context, it may well be that the drug’s extraordinary effectiveness made these truths self-evident to scientific reviewers."

So, because women can become pregnant it is also justifiable that they avoid the complications of pregnancy, even if they suffer some side effects to do so. From a strictly scientific perspective, it is harder to argue that a healthy person should risk side effects in order to prevent a harmful medical outcome in someone else, ie a sexual partner.9

Society has changed in many ways since the 1960’s, but our bodies have not. We have different biological roles, which can mean different medical needs. But birth control options have yet to catch up with the ways many people are thinking about partner responsibility—especially in heterosexual cis relationships. As we continue to push toward gender and sex equality, our biological differences will surely continue to present us with these kinds of challenges. Creating a better reality will mean both creative solutions and directly confronting old biases.

Author’s Dedication: To Ninna Gaensler-Debs and Mo Steelman, two people who I will always love to spend hours talking with, dancing with, and laughing with, until we are about a hundred.