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The Gendered Double Standard of Contraception and Mental Health

Late last year my social media accounts were inundated with posts from different news outlets describing a failed male contraceptive study. The sad irony associated with the outcome of this study provoked many angry and hilarious reactions, all grounded in the same ‘what the fuck’ mentality. As a heterosexual woman who has spent thousands of dollars and the better part of my twenties on ‘the pill,’ these posts naturally caught my attention.

What was most newsworthy about the study was not the fact that the trial, which provided cisgender men with regular hormonal injections, was highly effective (which it was), but rather that the trial ended abruptly due to the prevalence of adverse side effects seen in a small percentage participants. Some of the side effects in question? Mood changes, depression, and increased libido. Hm.

The study’s cancellation set an important precedent in furthering our cultural perceptions of gender identity and mental health; in fact to me, this is the most revealing aspect of the study’s revocation.

To better understand this, let’s briefly consider where women and hormonal contraceptives stand today. Currently, headaches, mood swings, anxiety and depression are all side effects attributed to the pill. These symptoms, which parallel those that were identified by cis male participants during the aforementioned trial, have been reported by women since the pill was first conceived (pardon the pun). Although the risks associated with hormonal contraception have reduced since the mid twentieth-century, some women continue to experience the side-effects of birth control-induced depression.

Knowing this, a group of researchers set out to examine how strong the present-day link between birth control and depression is. The study, which was published in JAMA Psychiatry in 2016, found that women who took oral contraceptives were more likely to use an antidepressant, or to be diagnosed with depression, than those who did not. In fact, they found that women were between 23-34 percent more likely to experience symptoms of depression while on the pill.

The rates by which some women experience such side-effects illuminates the significant sacrifices a woman is often required to make in order to regain control of their uterus.

Unquestionably, the desire for reproductive freedom has fuelled the decision for many women to continue taking hormonal contraceptives despite the well-understood risks. In the 1960’s, the pill was a huge part of the women’s liberation movement as it gave women more control over their own bodies, and consequently, more freedom when deciding when or if they wanted to have children. Today, women are still reaping the countless benefits associated with the sovereignty they possess over their reproductive organs.

In spite of this, for some, the aftermath of the failed study has worked to devalue the complicated history that women and uterus-owners have had with hormonal contraceptives. The responsibility and financial burden associated with hormonal contraception has traditionally fallen solely on women, demonstrating that, though men have an equal responsibility to prevent unwanted pregnancies, some don’t share equally in the consequences.

It is important to note here that I wholly recognize the immense social, political and physical advantages that a considerable number of women derive from the pill, and I am not attempting to criticize it’s utility. In fact, for many, hormonal contraception will continue to be a good option with limited side effects. What I do find to be problematic however, is the fact that, for years, women have been forced to make a decision between their mental health and their reproductive freedom. In my opinion, this trend is reflective of a broader concern in which the prevalence of certain mental illnesses is seen more in women than in men. The normalization of this has implications for all genders.

In two separate 2016 studies, researchers found that women are twice as likely than men to report having suffered from an anxiety disorder and/or depression. Although these articles do not specify whether hormonal contraception affected their results, investigators did note that environment (political and otherwise) has a significant impact on women’s self-esteem or self-worth. This trend is further highlighted by Simon Davis, a University of British Columbia instructor and a manager in mental health and addictions at the Vancouver Coastal Health Authority. In a discussion with him, he suggested “…depression is diagnosed twice as often in women as men. The difference may be due to the differential impact of psychosocial factors on women, such as abuse, domestic violence and poverty.” In highlighting this, Davis acknowledges the hundreds of years of structural and systemic oppression that women have endured, and the effect that this has had on their well-being.

Notably, the long, complicated and well-documented history between women and depression or anxiety, has made the link scientists have drawn between mental illness and birth control appear less severe to pharmaceutical companies. In effect, this means that the side-effect of depression is deemed to be ‘too risky’ for cis men, but is thought of as acceptable when reported by women. To me, this is likely attributed to the fact that this is a predictable narrative that many are already used to.

In turn, Davis also notes that the higher rates of depression seen in women “…could also be because women are more willing to seek psychiatric help than cis men, which could be seen as a willingness to normalize the experience…” This hypothesis alludes to the fact that cis men are often much less likely to seek support for mental health issues than women.

Several psychological studies have demonstrated that men who relentlessly adhere to certain stereotypically masculine behaviours have less favourable attitudes towards pursuing psychological help. Importantly, this is largely due to the way in which our culture constructs and understands masculinity. The socialization of masculine gender roles sometimes makes cis men less likely to admit they need help, or more afraid that others will look down on them for not being able to ‘tough it out.’ This normalized version of masculinity, in which men exist without depression or anxiety, may be why rates of suicide and addiction are higher in men than they are in women.

Importantly, what all of these examples highlight is the impact that our gendered assumptions of mental health have on all people. Not only does it mean that women will continue being subjected to unequal mental health expectations, but it also means that many men will remain repressed without an adequate or safe outlet to express their emotionality. This is made vividly clear by the contraception study.

The difference between the way that cis male reactions to hormonal contraceptives were addressed, and how the decades-long suffering of women is often dismissed, provides a clear example of this mental health double standard. As discussed, this double standard is toxic to all genders.

Considering this, it is necessary to remove gender from the equation to ensure that all people are receiving the same mental health and contraceptive support they both need and deserve. In saying this I am not suggesting that cis men should be forced to remain on a hormonal contraceptive that largely does not work for them, that they deserve to suffer through painful side effects, or that women should not seek help for anxiety, depression, or anything else; rather, I feel our gendered understanding of mental and sexual health needs to be disrupted. By canceling such important studies as the male contraception study, and therefore conflating or tangling mental health with our deeply entrenched gender binary, everyone loses.


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Written by Jennifer McDermid

Jenn McDermid is a graduate student and writer currently residing in Vancouver, B.C. She has a strong interest in issues pertaining to social justice and community building, and has spent the majority of her professional life working with women in Vancouver's Downtown Eastside. More recently, her work has focused on destigmatizing sex work, and advocating for sex workers rights. Beyond this, Jenn has written for Megaphone Magazine, Voices of the Street, The Talon and co-authored a report on homeless deaths in B.C. entitled Dying on the Streets. In her spare time, she runs a collective for female artists called the Downtown Eastside Women's Art Collective. Jenn is excited to be involved with Fembot, and to illuminate issues relating to gender inequality.

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