Let’s talk contraception: two accounts of a single workshop

Ophelia Wach (the convener)

Contraception is neatly structured along the lines of gender. The meteoric rise of the pill in the 1960s has reinforced hormonal methods for those born as women as the heteronormative default for contraception worldwide. Feminist movements question not only the well-known side effects, but also the unequal distribution of contraceptive work. Bridging between autonomy and control, the workshop on contraceptive equity in practice at gd:c asked doctors, counsellors and users how they navigate the deeply gendered practice that is contraception. Our two authors paint two pictures of the discussions, one from the perspective of a research student (Samara Relkovic) and the other a curious journalist (Romy Hölzel). The dis:connectivity lies in the divergence between the equal roles of the two people involved in conception and the social norms that apply to them as gendered subjects when it comes to contraception.

Negotiating reproductive responsibility

samara relkovic

Photo by Christoffer Voigt

Contraception is considered a private matter. It is decided between two people, organised as discreetly as possible, and is thus negotiated in seeming silence. Yet it is precisely this apparent privacy that conceals a central tension: while decisions about contraception are made in intimate contexts, their prerequisites, risks and consequences are anything but private. They are unequally distributed, politically framed and shaped by institutional conditions. In feminist theory, this shift is nothing new: ‘the personal is political’,[1] especially where questions of bodies, sexuality and reproduction are negotiated. Because contraception often appears as an individual issue related to self-determination, it is simultaneously outsourced to the private sphere, while its societal facets slip out of view. Who bears the risks? Who has access to knowledge? Who has access to methods, counselling, resources, and who does not? These questions concern not only individual bodies, but also interpersonal relationships and political structures, and thus the question of justice and equality. These very questions were addressed at the workshop on equitable contraception in practise, which took place in November 2025 at the Käte Hamburger Research Centre global dis:connect. It became clear that contraception magnifies gender roles, attributions of responsibility, economic logics and political priorities. Contraception was not discussed as a purely technical issue, but as interwoven processes of negotiation between individuals within societal structures, within political-regulatory institutions and within discourses.

Still no pill for men? Questioning the contraception gap

A central question of the workshop concerned the so-called ‘pill for men’. While the pill for women*[2] has been established as a contraceptive method since the 1960s and has become a standard method alongside the condom, the ‘pill for men’ has remained largely a utopia despite decades of research. At the same time, contraceptive methods such as the IUD and sterilisation for women* are becoming increasingly popular,[3] indicating growing demand for expanded contraceptive options – a trend that scholars associate with falling acceptance of the contraceptive pill. Meanwhile, the contraception gap between genders remains persists, with research and medical options for men*[4] remaining limited. This gap refers to the structural inequality in contraceptive options, the distribution of responsibility and the medical assessment of risk. While a wide range of medically recognised hormonal and mechanical contraceptive methods exist for women* – from the pill to IUDs to implants and sterilisation – men* are left with only condoms or vasectomies.[5] This structural inequality is due not merely to technical feasibility; it’s a symptom of the interplay of ethical, institutional and economic factors.

The politics of contraceptive risk evaluation or why responsibility remains gendered

One example of contraception for men is thermal contraception, in which the testicles are heated by external sources or daily elevation into the inguinal canal, significantly reducing sperm production. Smaller studies in France and Switzerland, alongside widespread self-experiments conducted outside official testing modalities, report effective contraception with comparatively minor side effects.[6] We lack large-scale clinical trials, reliable Pearl Index data and systematic long-term studies. Theoretical risks, such as a potential association between undescended testicles and cancer, are frequently cited as reasons against systematic research, despite the absence of solid evidence. In France, thousands of men* already use thermal contraception, sometimes under medical supervision, without regulatory approval. The discrepancy between actual practice and regulators’ caution reveals how the evaluation of contraceptive methods is strongly shaped by institutional priorities and risk perceptions and delimited to what is deemed investigable. Moreover, by prioritising pregnancy as the central metric of contraceptive risk, biomedical and regulatory systems reinforce structural gender biases, marginalising men’s* reproductive role and framing contraception as a predominantly female responsibility. A single-organism risk model prevails in pharmaceutical regulation. Benefits and side effects are assessed solely in relation to the body being treated. For male contraception, this means that hormonal and other body-altering methods are measured against a healthy male body; any deviation from this presumed ‘normal state’ is automatically regarded as problematic. By contrast, women’s* risks are evaluated primarily in light of potential pregnancy: side effects of hormonal methods, for instance, are deemed acceptable when weighed against the medical risks of pregnancy, thereby legitimising their market approval. A shared-risk model would instead assess benefits and harms relationally, relating male side effects to the health and social risks borne by a partner who could otherwise become pregnant, thus accounting for both individuals’ risks. If contraception were holistically understood as a shared responsibility in (hetero)sexual partnerships, men*, too, would be recognised as risk-bearing participants. Scholars advocate this relational model because it exposes how current standards obscure the distribution of risk between partners and thereby reproduce structural inequality.[7] Since regulators tend to neglect this relational model, health risks continue to be assessed differently depending on whose body is impacted. The result is a biomedical double-standard in which physically invasive interventions for men* appear ethically more problematic than comparable methods for women*.

Photo by Samara Relkovic

The contraception gap under the lens of invisible labour, heteronormativity and sexual health

The contraception gap is therefore not merely a technological deficit, but a product of divergent standards in biomedicine and ethics that materialise in everyday negotiations between sexual partners. It involves continuous planning, information management and risk assessment, much of which remains invisible. Coordinating appointments, researching potential side-effects, calculating costs and monitoring adherence all constitute a cognitive and emotional load. While contraception is formally framed as a shared responsibility, in practice this labour is often carried disproportionately by the woman*, reinforcing the contraception gap. Moreover, when reproductive health is normatively framed around pregnancy prevention, medical risk assessment and public discourse reduce contraception to a heterosexually defined practice. Other dimensions of sexual health are systematically neglected: prevention and testing strategies for sexually transmitted infections are treated as secondary, despite being relevant irrespective of gender, relationship structure and reproductive capacity. Queer lives and sexualities are marginalised, as dominant contraceptive discourses remain organised around heteronormative assumptions of pregnancy risk. This narrow focus matters. While reproductive risks continue to be framed predominantly as pregnancy risks, European public health authorities have reported sustained increases in bacterial STIs such as syphilis and gonorrhoea in recent years.[8] The shift in attention towards hormonal pregnancy prevention, coupled with the relative neglect of barrier-based protective strategies, therefore constitutes not just a discursive imbalance but an epidemiological concern. A contraceptive policy oriented towards the management of reproduction fails to address central aspects of collective sexual health and simultaneously reproduces a heteronormative constriction of sexual responsibility. Taken together, these dynamics reveal the contraception gap as a structural phenomenon rather than a mere technological absence. It is sustained by regulatory standards, research priorities and entrenched assumptions about whose body is expected to bear reproductive risk. As long as biomedical evaluation remains individualised, pregnancy prevention dominates sexual-health discourse, and the mental load of contraception is unevenly distributed, responsibility will fall asymmetrically. Closing the contraception gap therefore requires not only new methods, but a shift towards a genuinely relational understanding of reproductive risk and shared responsibility. [1] The slogan is attributed to second-wave radical-feminist Carol Hanisch. [2] This term refers to women and people who can become pregnant, and the associated contraceptives for ovulation suppression. [3] See the recent survey by the Federal Institute for Public Health (BIÖG) on sexual education, contraception and family planning: Faktenblatt: Sexualaufklärung, Verhütung und Familienplanung, Bundesinstitut für Öffentliche Aufklärung, 7, https://shop.bioeg.de/pdf/DL-20251027-1600.pdf. [4] The term men* refers to men and sperm-producing people. [5] Although the condom is the most widely used contraceptive method in Germany and often reflects shared responsibility in practice, its comparatively limited efficacy under typical use means that an additional method is required anyway. [6] See Samuel Joubert et al., 'Thermal male contraception: A study of users’ motivation, experience, and satisfaction', Andrology 10, no. 8 (2022) https://doi.org/10.1111/andr.13264; Jean-Claude Soufir, 'Hormonal, chemical and thermal inhibition of spermatogenesis: contribution of French teams to international data with the aim of developing male contraception in France', Basic and Clinical Andrology 27, no. 3 (2017) https://doi.org/10.1186/s12610-016-0047-2. [7] Christopher ChoGlueck, 'Still no pill for men? Double standards & demarcating values in biomedical research', Studies in History and Philosophy of Science 91 (2022) https://doi.org/10.1016/j.shpsa.2021.11.010. [8] 'STI cases continue to rise across Europe', European Centre for Disease Prevention and Control, 2025, accessed 19 February 2026, https://www.ecdc.europa.eu/en/news-events/sti-cases-continue-rise-across-europe.

bibliography

ChoGlueck, Christopher. 'Still no pill for men? Double standards & demarcating values in biomedical research'. Studies in History and Philosophy of Science 91 (2022): 66-76. https://doi.org/https://doi.org/10.1016/j.shpsa.2021.11.010. Faktenblatt: Sexualaufklärung, Verhütung und Familienplanung. Bundesinstitut für Öffentliche Aufklärung. https://shop.bioeg.de/pdf/DL-20251027-1600.pdf. Joubert, Samuel, Jessica Tcherdukian, Roger Mieusset and Jeanne Perrin. 'Thermal male contraception: A study of users’ motivation, experience, and satisfaction'. Andrology 10, no. 8 (2022): 1500-10. https://doi.org/https://doi.org/10.1111/andr.13264. Soufir, Jean-Claude. 'Hormonal, chemical and thermal inhibition of spermatogenesis: contribution of French teams to international data with the aim of developing male contraception in France'. Basic and Clinical Andrology 27, no. 3 (2017). https://doi.org/https://doi.org/10.1186/s12610-016-0047-2. 'STI cases continue to rise across Europe'. European Centre for Disease Prevention and Control, 2025, accessed 19 February 2026, https://www.ecdc.europa.eu/en/news-events/sti-cases-continue-rise-across-europe.

Responsibility, trust, contraception

romy hölzel

‘Contraception is about far more than just means and methods — it's about decision-making, responsibility and justice,’ says Samara Relkovic.[1] Murmurs of agreement ripple through the rows. The participants, a diverse mix of experts, students and people from other fields, are busily taking notes, nodding in recognition or simply watching attentively as the two workshop leaders, Samara Relkovic and Ophelia Wach, deliver their opening speech for the workshop Equal Contraception in Practice. The workshop, which took place at the Käte Hamburger Research Centre global dis:connect, focussed on a topic that is often swept under the rug, taboo or dismissed as a ‘women's issue’: contraception. Over the course of eight hours, participants gained concrete knowledge from experts in various fields from sociology and gynaecology to activist organisations. With these diverse and interdisciplinary insights, participants engaged in discussion rounds on various aspects of contraception, developing both expertise and a better sense for the subject matter — a matter that most people will face sooner or later.

Photo by Christoffer Voigt

Fabian Hennig provided the first intervention, considering developments and research in contraception, such as hormonal and thermal methods, as part of his dissertation. The mood became more relaxed, and smiles spread across the participants' faces as Hennig presented his first slide showing current common contraceptive methods for men, which turns out to be rather short: ‘Condom, vasectomy,’ it read. Fortunately, the list of contraceptive methods for men currently in testing is somewhat longer. Hennig explains various methods to the audience, from sperm flow blockage to vasectomy to hormonal and thermal approaches. A ‘pill for men,’ as Hennig put it (though without much enthusiasm for the term), seems to have stagnated in research. ‘Historically speaking, men weren't really trusted to take the pill daily’ — followed by amused giggling that ran through the rows of participants. But then the atmosphere became more tense, with almost a hint of anger and frustration in the air, as Hennig explained that the side effects that might occur for men, which were identified while testing this pill, were considered ‘unreasonable’. The mood swings, depression and loss of libido were deemed too great a risk. ‘With male contraception, there are unrealistically high expectations — namely zero risk’, Hennig said. Further, the pressure in Germany to advance research in this direction is unfortunately not yet insistent enough. The almost palpable frustration of those present is interrupted — it's time for the first breakout session. In the first breakout session, participants with overlapping areas of interest came together. One or two experts also joined the discussion rounds to provide input, though even participants without particular expertise engaged enthusiastically in the exchange. Under the topic of Where is the progress?, one of the small groups exchanged opinions and thoughts relating to education: ‘What's missing is the impetus to question the status quo and the entire system in such a way that you think: “What can we do differently?”‘ said Louis Happel, a student and workshop participant. Gynaecologist Cornelia Höß also noted regarding education: ‘The topic of contraception should be part of young people's upbringing and should be discussed equally’. In schools and at home, contraception should not be taboo but actively addressed. The goal of the group work — getting to know other workshop participants and consciously engaging with the topic of contraception while simultaneously gaining new knowledge — seemed to have been fully achieved in the first session. The second presentation came from Louisa Lorenz, an education coordinator for sexuality and society. Her short presentation focussed on the topic of responsibility in contraception, which is famously one-sided: ‘Women are the main bearers of responsibility for pregnancy prevention’, Lorenz explained. The audience nodded in agreement. When Lorenz discussed one of her slides showing that men apparently massively overestimate their own engagement and responsibility regarding contraception, the listeners broke into brief, rather irritated laughter, as if the entire room were soberly shaking its head. The weight of responsibility for contraception that women usually shoulder became particularly clear when Lorenz listed the various steps necessary for the contraceptive method one by one or the preferred approach to be used. From going to the gynaecologist to constantly remembering to have the pill, condom or other means along when needed, the list is long. ‘Then you really notice why the burden is so high,’ said Lorenz, and the participants nodded in agreement. The third breakout session also revolved around the theme of responsibility. In the context of gender-specific differences in contraception, a lively discussion took place in one of the groups, with the focus not only on responsibility, but also on trust: ‘Contraception is very much about trust. Regarding contraceptive methods for men, women are confronted with the question: “Can I trust my partner, even when the most serious consequences rest with me?”‘ said Christoffer Voigt from the European Network for Shared Contraception. The group found that trust, along with a certain level of knowledge, education and, as banal as it may sound, money, are the most crucial prerequisites for contraception to proceed as fairly and equitably as possible between genders. But something else is needed too: communicating with each other, as the groups agreed. The negotiation of contraception is also based on compromises. As diligently as the workshop participants discussed, took notes and though, their concentration inevitably began to wane after eight hours. And yet everyone gathered for a final breakout session, this time on the topic of research and development. Even after almost eight hours of active participation, the energy was high, which is thanks to what Hennig reported in the ‘Research and Development’ group about ongoing research. Hennig talked about the barriers that are sometimes put in the way of developing male contraceptives. From lacking funds to lacking demand: research faces numerous restrictions. The conversation became particularly charged when it returned to side effects. ‘For other medical developments and research, the standard regarding side effects is not as high as for contraceptives for men’, Hennig explained. A statement that revived everyone again. After a day full of new knowledge, exchange, discussions and — as is to be expected with such a topic — anger and frustration, the workshop Equal Contraception in Practice came to an end. Despite visible exhaustion, it was obvious that all the education had stirred something in the participants’ minds. And even though the issues surrounding contraception can certainly drive one to despair, there remains hope. As workshop leader Ophelia Wach put it, ‘There is movement, even if there are always setbacks’. [1] The text was originally published in German, and all quotations have been translated. Continue Reading

31 March 2026