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Oudshoorn / ASTRONAUTS IN THE SPERM WORLD “Astronauts in the Sperm World”
The Renegotiation of Masculine Identities in Since the 1960s, the predominance of modern contraceptive drugs for women has disci- plined men and women to delegate responsibilities for contraception largely to women. Consequently, contraceptive use came to be excluded from hegemonic masculinity. The weak alignment of contraceptive technologies and hegemonic masculinities constitutes a major barrier for technological innovation in contraceptives for men. Based on an analy- sis of two large-scale clinical trials of hormonal contraceptives for men organized by the World Health Organization (WHO) in the late 1980s and early 1990s, the article shows how the development of new contraceptives for men requires a renegotiation of mascu- line identities. Technological innovation in contraceptive technology is, thus, not only a story about the making of a new technology, it is also a story about constructing Key words: gender; male contraceptives; masculinity; World Health Organization; CHALLENGING THE INVISIBILITY
OF MALE REPRODUCTIVE BODIES
We are living in challenging times. For the first time in history, male repro- ductive bodies are in the headlines, breaking the silence that made them largely invisible in the past. The most compelling sign of this change is the hype in the news media following the introduction of Viagra, a pill for the treatment of male impotence, in the late 1990s. Viagra nicely illustrates how a technology can be instrumental in rendering visibility to male reproductive bodies; the drug transformed male impotence from a private matter confined to the bedroom or the sexologist’s clinic, considered as the last sexual taboo of the twentieth century, into a health condition firmly entrenched in the pub- lic domain (Garschagen 1998). Ironically, feminist scholarship of the last decades has unconsciously contributed to making male reproductive bodies invisible. Until the mid-1990s, men’s bodies tended to be largely absent from much of contemporary feminist analyses of the body (Davis 1997, 16). As Annandale and Clark (1996, 30) have suggested, the invisibility of maleMen and Masculinities, Vol. 6 No. 4, April 2004 349-367 bodies can be understood as a consequence of binary thinking in feminist research on gender and health, which focused on women rather than gender.
There are, of course, good reasons for focusing on female bodies. A critical deconstruction of medical discourses on female bodies is a very important strategy for feminists concerned with bringing to light the problematic con- sequences of the medicalization of female bodies. The problem, however, is that by doing so, we still grant the emperor his clothes—in this case, the “nat- uralness” that protects him against critical and deconstructive stories.1 So, feminist scholarship has created the impression that only female bodies have been subjected to historical and cultural shifts in meanings and practices in medical discourse and culture at large. The male body appears as a stable cat- egory, untouched by time and place. Consequently, the male body maintains its naturalness—it is not a construct, it simply exists. By focusing too exclu- sively on female bodies, feminists have unwittingly reproduced the tradition in medical discourse that presents female bodies as exotic—as the Other— bodies that need to be scrutinized and explained to exist.2 Feminist discourse thus has reinforced the dominant image of men as the unmarked sex; in other words, male bodies and masculinities do not need to be questioned. The same tendency to neglect male bodies is reflected in scholarship in the newly estab- lished field of men’s studies, which scarcely addresses the relationship between technoscience, masculinities, and male bodies.3 The increased medical attention to the male reproductive body is not only visible in the hype around Viagra, a drug for the treatment of male impotence, but it is also exemplified by the attempts of reproductive scientists to develop hormonal contraceptive pills and injections for men, which is the topic of this article.4 The development of reproductive technologies for men must be con- sidered rather revolutionary. In the twentieth century, most attention in repro- ductive medicine has been focused on women rather than on men. Since the late nineteenth century, the female reproductive body has become firmly entrenched in the infrastructures of the medical world and beyond. Knowl- edge, diagnostics, and therapies concerning the female reproductive body have been strengthened by alignments across laboratories, gynecological clinics, pharmaceutical companies, family-planning policies, family-planning clinics, and social movements, particularly the women’s health movement.
Since the introduction of the female contraceptive pill in the early 1960s, these collective actors have focused almost exclusively on women, neglect- ing men as potential subjects of research, users, and clients. Since the Second World War, thirteen new contraceptives for women have been developed, including the contraceptive pill. This is in sharp contrast to contraceptives for men (Davidson et al. 1985) In the past century, no new male methods were developed, except for the improvement of existing methods—namely, con- doms and sterilization, both of which date back to the nineteenth century Oudshoorn / ASTRONAUTS IN THE SPERM WORLD (Schearer 1977, 178).5 The “contraceptive revolution” thus remained largely restricted to female methods. The currently available contraceptive technolo- gies exemplify Noble’s argument that “technology is hardened history”6, hardened in a literal sense; the asymmetry in contraceptive practice is materi- alized in institutions, medical professions, laboratory techniques, chemicals, The gender gap in contraceptives was first challenged in the late 1960s and early 1970s. As in the case of the pill for women, the request for develop- ing new male contraceptives came from outside the scientific community. In this case, social pressures came from two different sides: feminists in the Western, industrialized world and Southern governments, most notably in China and India. Feminists demanded that men share the responsibilities and health hazards of contraception, whereas governmental agencies urged the inclusion of “the forgotten 50% of family planning” as a target for contracep- tive development (Handelsman 1991, 230; Wu 1988, 443). In the 1970s and 1980s, the question, what about a male pill? appeared at regular intervals in newspaper headlines, particularly in periods during which the serious health risks of the female pill were reported (Anonymous 1984, 1108). Although research in male reproduction and the development of new male contracep- tives has increased as the result of these pressures, the pill’s “male twin” has As noted above, explanations for the asymmetry in medical interventions in female and male reproductive bodies usually mobilize essentialist views on gender, technologies and bodies. Thus, biomedical scientists and tradi- tional philosophers have encouraged us to assume that women’s bodies are simply closer to nature and consequently easier to incorporate into biomedi- cal practice. Adopting a constructivist approach to technology and gender, I view the gender asymmetry in contraceptive technologies as a reality created in practice rather than a reality rooted in nature. The practices of all actors involved in the development, diffusion, and use of contraceptive technolo- gies have been focused almost exclusively on women. Overcoming the gen- der gap in contraceptive technologies, therefore, requires hard work. The central argument of this article is that any technologies that conflict with hegemonic masculinity have to struggle to come into existence. Since the idea of a male contraceptive pill or injection was first articulated in the late 1960s, heterogeneous groups of actors, including scientists, clinicians, jour- nalists, feminists, and pharmaceutical entrepreneurs, have questioned whether men and women would accept a new male contraceptive if it were available, drawing on hegemonic views of masculinity. I show how making new contraceptive technology for men culturally feasible requires a destabilization of conventionalized performances of gender identities.7 CONTRACEPTIVE TECHNOLOGIES AND THE
CONSTRUCTION OF GENDER IDENTITIES
In the last two decades, scholars in the fields of gender studies and science and technology studies have provided important insights in the complex interfaces between gender and technology that go beyond essentialist expla- nations. Both traditions argue that neither technology nor gender have intrin- sic qualities rooted in nature. Sociologists of science and technology have challenged modernist philosophy in which scientists and engineers were conceptualized as discovering the truth about nature. Since Thomas Kuhn, philosophers and sociologists of science and technology have gradually rejected the notion that there exists an unmediated truth of nature that can be discovered by science. Instead, they introduced the idea that the naturalistic reality of phenomena is “created by scientists as the object of scientific inves- tigation” (Duden 1991, 22).8 In the last two decades, sociologists of science and technology have made a turn to practice and work to understand the pro- cesses of creating facts and artifacts (Timmermans and Leiter 2000). Instead of focusing on “brilliant” scientists discovering the “secrets” of nature, the analysis has shifted to exposing the concrete, often very mundane, human activities that go into the creation of facts and artifacts. In this view, technolo- gies do not reflect essentialist properties of bodies, but rather, they are the materialized results of negotiations, selection processes, contingencies, and technological choices, embodying socially and culturally constituted values As with technologies, gender has no intrinsic, fixed qualities rooted in nature. As Butler and many other feminist scholars have argued, gender is not something that we are but something we do. Gender is not fixed but produced as a “ritualized repetition of conventions” (Butler 1995, 31). In the last two decades, scholars in the field of gender and technology studies have shown that technologies play an important role in stabilizing or destabilizing such conventions creating new or reinforcing existing performances of gender.
Contraceptive technologies serve as a specific case in point. Prior to the intro- duction of new contraceptives for women in the 1960s, no stabilized, gendered conventions for the use of contraceptives existed. Since there were only a limited number of contraceptives available (condoms, spermicides, diaphragms, and sterilization), neither men nor women had many options for contraception.9 This situation changed drastically when new contraceptives for women became available. Since the Second World War, thirteen new con- traceptives for women have been developed, including the contraceptive pill.
This predominance of modern contraceptive drugs for women has disci- plined men and women to delegate responsibilities for contraception largely to women. Contraceptives thus function as important tools in delegating and distributing responsibility and control over conception. In Foucauldian Oudshoorn / ASTRONAUTS IN THE SPERM WORLD terms, contraceptives are “disciplinary technologies”: “they are part of the ‘socialization of reproductive behaviour’, that can discipline such behaviour in multiple ways” (Clarke 1998, 165; Rabinow 1992).
Another illustration of the performative and integrative capacity of tech- nologies to create and sustain gender identities is the emergence of the women’s reproductive health movement in the late 1960s and early 1970s. A major reason for the establishment of this social movement was the concerns about health risks of the first generation of the contraceptive pill and intrauterine devices (IUDs). Since then, women’s reproductive health groups have been important actors in lobbying against the introduction of contracep- tives considered as unsafe or having the potential for abuse, simultaneously advocating the development of better contraceptives for women. By contrast, a men’s reproductive health movement does not exist. The difference in emergence of social movements concerning reproductive health of women and men can be understood in terms of a technosociality, which suggests that people construct collective identities based on a shared experience with spe- cific technologies—in this case, contraceptive technologies.10 In the second half of the twentieth century, the idea of woman as the sex responsible for contraception thus became the dominant cultural narrative materialized in contraceptive technologies, in social movements, and the gender identities of women and men. Consequently, contraceptive use came to be excluded from hegemonic masculinity.11 Contraceptive technologies thus show a remark- ably distinct pattern compared to most other technologies that are character- ized by a strong cultural alignment of masculinities and technologies (see the other contributions to this special issue).
CLINICAL TRIALS AS A CULTURAL NICHE TO
RENEGOTIATE MASCULINE IDENTITIES
It goes without saying that the weak alignment of contraceptive technolo- gies and masculinities constitutes a major barrier for technological innova- tion in contraceptives for men. The advocacy for new contraceptives for men severely challenges these stabilized conventions. Technological innovation in contraceptive technology is thus not only a story about the making of a new technology but also a story about renegotiating masculine identities. The development of new contraceptives for men requires cultural interventions to create the cultural feasibility of this technology. The articulation and accom- plishment of the cultural feasibility of technical innovations is, however, a largely overlooked aspect of technological change.12 To be sure, some schol- ars refer to cultural interventions involved in the development of science and technology, but the emphasis in this literature is very much on the social rather than the cultural construction of technology. Most studies in this field describe how new technologies require the stabilization of complex socio- technical ensembles into networks (e.g., Bijker 1992). Sociologists of tech- nology have introduced the concept of networks to capture the heteroge- neous social, technical, economic, and political processes involved in the development of a new technology. Although the concept of sociotechnical networks is an important tool to study the development of new technologies, it conceptualizes scientific and technological change merely as a social pro- cess. Network approaches neglect the fact that cultural conventions are important in securing links of networks; they do not take into account the cul- tural norms and values that structure society and shape the relationships and experiences of people. The focus on the social rather than the cultural con- struction of technology is particularly problematic if we want to understand gender aspects of technological innovation. Studying technological innova- tion from a gender perspective requires a conceptualization of the dynamics of technological development that acknowledges the cultural embeddedness of technology. One way to include the cultural dimensions of technological innovation is not only to conceptualize technology in terms of networks of techniques, knowledge, institutions, experts, and social groups but also to include the relationships between technologies and the subject identities of To explore how actors try to create the cultural feasibility of technology, I focus on how innovators articulate gender identities of future users. The con- cept of user representations is a useful tool to capture the work that goes into configuring the users of a technology. As Madeleine Akrich and Steve Woolgar have suggested, scientists and engineers configure users and con- texts of use as integral parts of the processes of technological development. If they fail to do so, the technology will fail altogether. In the development phase of a new technology, designers anticipate and define the preferences, motives, tastes, and competencies of potential users, and inscribe these views into the technical design of the new product (Akrich 1992, 208; Woolgar 1991, 58). I suggest that articulating gender identities of users is an equally important but, as yet, unexplored element of the processes of configuring users. Creating the cultural feasibility of technology requires a mutual adjustment of technologies and gender (among other identities). Technolo- gies will only become successful if the future users actually perform the identities articulated by technological innovators.
From this perspective, the development phase of a technology becomes an intriguing new location for understanding interfaces between gender and technology; it can be understood as a cultural niche, a protected space in which experts and those participating in the testing of a technology articulate and perform (in this case) nonhegemonic identities to create and produce the cultural feasibility of a technology. In the development of new contraceptive technologies for men, the construction of masculinities is at the forefront of the design. Technological innovation thus becomes a process of co-designing technology and masculinity. Based on an analysis of two large-scale clinical Oudshoorn / ASTRONAUTS IN THE SPERM WORLD trials of hormonal contraceptives for men organized by the World Health Organization (WHO) in the late 1980s and early 1990s, I will show how the development of new contraceptives for men requires a renegotiation of mas- culine identities, both in terms of projected and subjective identities.13 I will describe how male contraceptive researchers configured trial participants by constructing specific representations of masculine identities. In their turn, men participating in contraceptive trials have performed and articulated mas- culine identities that largely matched the researchers’ projected identities.
This article is based on an analysis of the following three sources: (1) the rele- vant publications in key journals on reproductive and contraceptive research in the period between 1976 and 2000; (2) protocols, information materials for volunteers of clinical trials, and press bulletins of clinical trials in the United States and the United Kingdom; and (3) the results of so-called acceptability studies based on questionnaires and focus group discussions among male contraceptive trial participants carried out by Karin Ringheim, a social scientist at USAID, as part of the two large-scale, multicenter, clinical trials organized by the WHO in the late 1980s and early 1990s.14 THE RESPONSIBLE, CARING MAN
In the organization of clinical trials, male contraceptive researchers use several documents to communicate with the media and trial participants; posters and press bulletins were used to recruit trial participants, and leaflets were used to inform trial participants about the procedures of the trial. These documents functioned as important tools to motivate and stimulate men to take part in the trials. These documents can also be considered a means to provide trial participants with images to reconcile the new role of contracep- tive trial participant with their self-image and to legitimize this new role to their colleagues and friends. The rhetoric of these texts shows how male con- traceptive researchers and public relations officials constructed a specific image of the potential trial participant. In Seattle, men who applied to be trial participants received a leaflet entitled Questions and Answers (this was first introduced in 1994), which opens with the section “Why Is a Male Contra- ceptive Needed?” (Paulsen, Bremner, and Matsumoto 1994, 6). After a short description of the contribution male, the document continues to highlight the importance of male contraceptives for enhancing “equality between men and However, the primary value of a male contraceptive may be that it will allow couples to share not only the benefits but the responsibilities and risks of con- traception. While the development of contraceptive agents has allowed women to control their fertility and thus has been an important factor in freeing them from most traditional roles, the responsibility for contraception has remained Documents used to recruit men in the United Kingdom contain a similar em- phasis on sharing responsibility between the sexes as a major reason why it is worthwhile for men to participate in the trials. A press bulletin launched by the University of Manchester’s Communications Office on July 9, 1993, to recruit male trial participants for the second large-scale WHO clinical trial articulated the need for new male contraceptives: The move towards providing more options for male contraception is really reflecting social trends that equality between the sexes should extend to Family Planning. Of course, it also has important implications for the third world, where the population explosion is uncontrolled. (P. 2) As has happened in policy documents, researchers thus actively reframed the need for contraceptives for men as a tool to enhance equality between women and men in the expectation that this would appeal to men’s sense of altruism.
In both the documents quoted above, the potential trial participant is config- ured as a man who wants to contribute to helping his partner as well as people in Third World countries.15 The poster used in Edinburgh to recruit men for clinical trials in the mid-1990s exemplifies this altruistic image, although it also adds a third interesting motive. The poster begins with the following • Interested in helping develop a new contraceptive pill for men? • Fed up by the lack of choice for men? • Want to help your partner get off the female pill? In contrast to most of the documents used to recruit and inform male volun- teers, this poster explicitly addresses men in terms of their individualistic interests. Taking part in clinical trials is portrayed as relevant for men because it may increase their choice of contraceptives. Most researchers configure male contraceptive trial participants, however, as men who are willing to share the responsibilities and risks of contraceptives with their partners, thus, constructing the image of men as responsible, caring partners.
The way in which men who participated in the contraceptive clinical trials organized by the WHO between 1987 and 1994 articulated their motives to participate in these trials provided interesting insights in how these men per- formed and articulated masculine identities. Focus group discussions and questionnaires completed by men in five clinical centers in Bangkok, Edin- burgh, Manchester, Singapore, and Sydney show how the image of the responsible, caring men has become part of the identity of these men. Many men participating in this acceptability study portrayed themselves as men willing to take responsibilities for contraception (Ringheim 1996a, 6).
Oudshoorn / ASTRONAUTS IN THE SPERM WORLD It’s about time fellas start taking responsibility for this kind of thing. I hadn’t been wandering around with the burning desire to take part in male contraceptive tri- I think men have been allowed to be lazy about this. I don’t know who decided it, but it always seemed to be pushed on the woman to be responsible. (Ringheim A man should have 50 percent of the responsibility. This attitude is becoming more common. Women are not objects. They’re the same as us. We’re equals.
To some older guys, women are second-class citizens. In this country [the United Kingdom], they go to the pubs and leave the women at home. I think it will probably take twenty years before this dies away, but a male contraceptive would appeal to my circle of friends. They are like me and think men should be Demonstrating prior awareness of the potential for problems, the majority of men who participated in the acceptability studies (61 percent)—particularly men from the clinical centers in Edinburgh, Singapore, and Sydney—articu- lated their motivation in terms of helping their partners who experienced problems with the female pill (Ringheim 1996a, 6).
It’s got to do with the fact that my wife gets depressed when she takes the pill, and I saw this on the telly and I just rang up. That’s the main reason I came on the If she goes on the pill again there is always the risk, isn’t it? And my way of think- ing is, once she’s taken the risk for a few years, I’ll take the risk. Then you halve My wife taking estrogens was like the shrew that couldn’t be tamed. She would wake up depressed, . . . and after a period of time I said, “Honey, it’s the pill, stop taking it, I don’t care, I’ll use condoms, or other forms of birth control, I’ll go on the program that my friend is on, but you stop taking the pill right now.” Participants in the WHO trial in Bangkok also explained their motivation by referring to problems with the female pill, although they articulated addi- tional concerns about their partners forgetting to take the pill (Ringheim 1995, 77). Incentives to participate in the trials were expressed in terms not only of problems with the female pill but also of dissatisfaction with the use of condoms or vasectomy as a means of contraception in stable relationships (Ringheim 1995, 77; 1997, 5-6; 1996a, 81). The motives to participate in the trials thus also contained nonaltruistic components; that is, the trials could help men to avoid the use of condoms or vasectomy. Another motive that shows the self-interest of men participating in the trials is the argument that the trial enabled them to be in control of their own fertility (Ringheim 1996b, 86; 1995, 77). The dominant image articulated by male trial participants, however, was their interest in sharing responsibility for contraception with The language used by these trial participants reflects how they considered taking responsibility for contraception as a largely unfamiliar and excep- tional activity for men in long-lasting relationships or marriage. By taking part in contraceptive trials, men actively performed nonhegemonic mascu- line identities, which unmistakably reflected the researchers’projected iden- tities of responsible, caring men. Participants in the trials in Sydney con- structed a self-image portraying themselves as different from other men.
We all know that at this stage of time, it’s not socially acceptable for men to use male contraception. We are doing this because we are different. (Ringheim I figure that the people who are doing this program are a different kind of guy any- way, we’re not SNAGS (sensitive new age guys). I hate SNAGS. . . . I don’t think we are typicalofwhite Australianmiddle-classsociety.(Ringheim1993,22)16 Some of the Australian trial participants also explicitly articulated their new I think that men have always had soft sides, gentle sides, nurturing sides, but for a long time they have been repressed. To a certain extent all these norms, morals, and values are raised into prominence because we are precisely in that period of change so people are forced to think about “do men have to do things a cer- tain way,” and “what’s a typical male?” (Ringheim 1993, 11) In assuming nonhegemonic identities, male trial participants did not receive much support. Most male colleagues and friends considered their decisions to participate in a contraceptive trial as rather peculiar, as shown by the expe- You still get people who would say, “What are you doing that for, can’t your wife take the pill or something?” It seems like the abnormal rather than the normal, the idea that the bloke, apart from condoms, would actually take any part of sexual responsibility for contraception, particularly not one which involved I told a lot of males about it because . . . I felt quite proud about the fact that I was on it. I thought it was a great thing to do. Probably out of the maybe fifty guys I told, X [another man participating in the trial] was the only one who considered it. . . . I thought a lot more people would have said that sounds great. (Ringheim [They] were’t particularly interested in the contraceptive side effects, they were more interested in the anabolic effects. (Ringheim 1993, 23) They worry for us most of the time. My boss does. (Ringheim 1993, 23) Trial participants had to defend and negotiate their new identities with other men. It is interestingly that they received much more encouraging reactions from women, particularly their female partners (Ringheim 1993, 25). As I have described above, women played a crucial role in encouraging their part- Oudshoorn / ASTRONAUTS IN THE SPERM WORLD ners to participate in the trials (Ringheim 1995, 76; 1993, 13). Nearly a quar- ter of the participants in the acceptability studies (23 percent) mentioned the encouraging role of their partners as a main reason for participation (Ringheim 1996b, 76). As one of the British men expressed: Quite honestly, I never would have volunteered if my wife hadn’t complained. My motto is: “if it isn’t broken, don’t fix it.” I think most men are only too happy to have women use contraception. We know they have problems sometimes. Why would we want to share that? But when the wife says: “I’ve had it. Use a con- dom or get the snip [vasectomy]”, then we begin to look around and realise, there isn’t much else for men, is there? (Ringheim 1996b, 86) The reasons why women adopt this role is quite obvious; the participation of their male partners in the trial frees them, although only temporarily, from the use of contraceptives, at least if they are monogamous. In many studies on the subject, a substantial number of women express dissatisfaction with oral hor- monal contraceptives or other current methods, as is reflected in the previ- ously quoted remarks of men participating in the male contraceptive trials.17 To quote two female partners of the British trial participants: I thought it was absolutely brilliant. I loved it. The break from the pill really gave me a chance to get my head straight. I’ve always suffered from depression. I didn’t always know it was the pill until I went off of it. (Ringheim 1996b, 84) The trial was an interesting experience for him. We’d do it again. I found it great. I didn’t have to do anything. Nice not to have to think about it. I wasn’t worried about pregnancy. I was relaxed. We definitely had more sex, but I was also more receptive. I felt happy that he was taking responsibility. (Ringheim Thus, women used the clinical trials as a location to renegotiate the responsi- bility for contraception with their male partners. By doing this, they actively engaged in the construction of nonhegemonic masculine identities and prac- tices—that is, caring and responsible masculinities of various types.
“ASTRONAUTS IN THE SPERM WORLD”
To negotiate this nonhegemonic identity, contraceptive researchers and male trial participants also relied on hegemonic representations of masculin- ity. The illustration of astronauts in the sperm world on the poster used in Edinburgh exemplifies this imagery in a nutshell. The upper half of the poster shows a picture of an astronaut standing on the moon with a flag in his hand, with the word Exclusive in a balloon-text near his head. The left side of the picture says, in capital letters, “First Man on the Pill.” In a funny and clever way, the poster suggests that men who decide to become volunteers are per- forming a heroic act like the man who first set foot on the moon. Participation in a male contraceptive trial is portrayed as an exciting new endeavour.18 Potential trial participants are portrayed as adventurous men who want to explore a territory where no one has gone before.
Space metaphors were also adopted by trial participants. One participant in the second large-scale WHO clinical trial in Sydney described himself and his colleagues as “astronauts of the sperm world” (Ringheim 1993, 10).
Other male volunteers constructed images with similar connotations. They identified themselves as pioneers in the development of a new male contra- ceptive method for men, which they felt was important to them (Ringheim 1993). Others described “the excitement of trying something new and possi- bly risky” as the most important feeling of being a trial participant. Research- ers and trial participants thus transformed participation in a clinical trial into The way in which male contraceptive researchers and the female partners of trial participants described men participating in contraceptive trials also adds to this image of the brave man. In reports of the trials, male volunteers were praised for their commitment to the trial and their perseverance in enduring the demands of testing. In the report of a French clinical trial pub- lished in 1983, trial participants were given credit for their compliance: “The authors wish to thank the 6 men for their strict adherence to the protocol’s requirement in spite of the constraint of their professional lives” (Glander 1987, 631). Including trial participants in the acknowledgments section of a clinical trial report is rather exceptional; usually, only funding agencies, pharmaceutical firms providing drugs, technical assistants and secretaries, or laboratories that have performed specific tests are included in such acknowledgments. Other reports of male contraceptive trials included credits for their trial participants in the prefaces: “The volunteers . . . took a keen interest in the research and felt very responsible for fulfilling their part of the studies, although they were not paid” (Foegh 1983, 7).
In the report of the second large-scale WHO trial and the press bulletin reporting the results of the trial released by the WHO in April 1996, the trial participants were portrayed similarly. In the press bulletin, Dr. Benagiano, the director of the WHO’s Human Reproduction Program, praised all the The willingness of men to volunteer for the recently completed study, and other similar WHO-supported studies in the past, as well as their motivation and commitment to continue with the protocol of weekly injections, demonstrates the interest in and demand for a reversible male contraceptive of this type.
Here, Benagiano not only praised the volunteers for their commitment, he also used them as examples to articulate the need for the new method. Thus, male volunteers have a dual role in these reports. They figure as trial partici- Oudshoorn / ASTRONAUTS IN THE SPERM WORLD pants and as prototypes of future users. The rhetoric of publications in scien- tific journals exemplifies this transformation of trial participants into future users. In abstracts and method sections, these male trial participants are por- trayed as active agents rather than passive test subjects. Instead of the usual phrases, such as “the subjects were given an intramuscular injection,” (Belkien et al. 1984, 417) or “experiments performed on 10 normal volun- teers,” (Skoglund and Paulsen 1973, 358) or “a male contraceptive trial was undertaken in 23 men” (Bain et al. 1980, 365), trial participants are described as “men requesting contraceptives” (Guerin and Rollet 1988, 187; Foegh 1983, 7; WHO Task Force 1996, 821; Guille et al. 1989, 118). This subtle shift in discourse, in which agency is attributed to the trial participants, sug- gests that they have taken the initiative or asked for the trial, thereby trans- forming trial participants into initiators of the new technology.
Finally, the female partners and friends of the British men participating in the contraceptive trials also contributed to highlighting the special role these It’s absolutely noble. The man’s so brave. (Ringheim 1996b, 82) I thought it was very noble of him to have injections. I go hysterical with needles. I wouldn’t have been able to do that. (Ringheim 1996b, 82) Thus, researchers, trial participants, and their female partners and friends all actively constructed the image of the brave, pioneering man.
CONCLUSIONS
In summary, it is possible to conclude that clinical trials functioned as an important location in which to renegotiate masculine identities. Actors involved in the clinical testing of male contraceptives have actively engaged in articulating the image of the caring, responsible man. Most importantly, men taking part in the clinical trials of male hormonal contraceptives have, in turn, performed this projected identity. By participating in the clinical tests, men consciously or unconsciously performed an aspect of masculine identi- ties that conflicted with hegemonic representations of masculinity—that is, men are not inclined to take responsibilities for contraception. Therefore, male contraceptives challenge important aspects of hegemonic masculini- ties, particularly the image that fertility is an essential part of masculinity.
Family-planning discourse of the last three decades illustrates how this repre- sentation of masculinity has been continuously articulated and renegotiated in debates between the opponents and advocates of new male contraceptives and the involvement of men in family-planning practices. As I have described elsewhere, the work of family-planning organizations involved in changing family-planning discourses toward including men has been constrained by a machismo image of men that equates masculinity with fertility and by cul- tural narratives that portray men as being against family planning (Oudshoorn 2003). Similar hegemonic images are articulated by British and Dutch journalists who covered the WHO clinical trials of male contracep- tives in the news media in the mid-1990s. Journalists emphasized men’s unwillingness to use contraceptive injections and argued that men are unreli- able in matters of contraception. These debates show how male contraceptive technologies challenge dominant cultural narratives on masculinity, male Men participating in clinical trials of new male contraceptives are impor- tant actors in counteracting these aspects of hegemonic masculinities. As we have seen, a majority of the men participating in contraceptive clinical trials portrayed themselves as altruistic men who wanted to relieve their female partners from problems experienced with the female pill. We can conclude that the clinical trials have functioned as locations for the coconstruction of a new technology and a new masculine identity, one of the caring, responsible man. This image has dominated male contraceptive discourse in the scientific community and in policy circles since the late 1960s and was also adopted by clinical trial participants. This does not imply that hegemonic masculinities were completely absent from these narratives. To negotiate this new male identity, clinicians and trial participants relied on dominant cultural represen- tations of masculinity, which portray men as brave and pioneering subjects.
Remarkably, being in control of reproduction is not a central aspect of these narratives. This is in sharp contrast to other technologies recently intro- duced for male reproductive bodies, most notably Viagra. The discourses surrounding Viagra are dominated by a modernist rhetoric that foregrounds the capacity to be in control of one’s body as “the proper and appropriate order of masculine things” (Mamo and Fishman 2001, 16). Taken together, the debates on Viagra and the male pill show a reification of hegemonic mas- culinity, which emphasizes men’s mastery and control of sexuality rather than of reproduction as essential aspects of masculinity (Mamo and Fisher- man 2001, 17; Connell 1995). The virtual absence of representations of men being in control of contraception can be understood in the context of the con- tested nature of male contraceptives. An articulation of the users of the new technology in terms of men being in control of conception would run the risk of providing critics and opponents of new male contraceptives with argu- ments to reject the new technology. An image in which male contraceptives are portrayed as drugs that serve the interests of men, particularly if it emphasizes men’s control over contraception, conflicts with feminists’ advocacy of women’s autonomy in reproductive matters.19 Male contracep- tive technologies are playing an important role in articulating and renegotiat- ing both masculinities and gender relations in relation to heterosexual sex Oudshoorn / ASTRONAUTS IN THE SPERM WORLD 1. Ruth Hubbard has used the fairytale “The Emperor Doesn’t Wear Any Clothes” as a title of her paper in which she analyzed the impact of feminism on the biological sciences. Hubbard encouraged feminists to question the “scientifically proven facts of women’s biology” (see 2. For a similar conclusion, see Laurence Goldstein (1991, x). This does not imply that male bodies have been completely absent from feminist analysis of medical discourse. Some feminist scholars have included male bodies in their analysis as a strategy to show differences in represen- tations of male and female bodies—for example, in hormonal theories and therapies (Oudshoorn 1994), in fertility studies (Pfeffer 1985), and in anatomical representations of female and male genitalia (Moore and Clarke 1995). Most attention, however, is given to representations of 3. Notable exceptions are Morgan (1992), Connell (1995), and Sabo and Gordon (1995).
4. I thank Maria Lohan, Wendy Faulkner, and an anonymous reviewer for their comments on an earlier version of this article.
5. Condoms made of animal material have been in use as means of contraception since the 1600s. Rubber condoms were first introduced around 1860, whereas vasectomy (male steriliza- tion) dates back to the late 1890s. In the 1950s, improved condoms were developed, and in the 1990s, condoms made from polyurethane and other polymers were introduced on the market (Clarke 1998, 166-67). See Lissner (1992) and Setchell (1984) for a more extended analysis of the history of the development of male contraceptives.
7. A more extensive analysis of the construction of male identities in contraceptive dis- 8. See, for example, Latour and Woolgar (1979), Gilbert and Mulkay (1984), Bijker, Hughes, and Pinch (1987), Latour (1987) and Bijker and Law (1992).
9. The present day culture of contraceptive control has changed over the course of the twentieth century; where women are now deemed to take responsibility for contraception, previ- ously men seemed to have played a more important role. Although there are hardly any accurate statistics available on the choice of contraceptive methods and individual preferences before the introduction of the contraceptive pill for women, a study among married women in the United Kingdom and the United States in 1959 indicates that the condom was the most popular method.
Kate Fisher has described how, in the early decades of the twentieth century, working-class com- munities in the United Kingdom considered the use of contraceptives predominantly as a man’s job (Fisher 1998, 8). Today, traces of similar “male cultures” still exist in several African 10. With the term technosociality, I paraphrase Paul Rabinow’s concept of “biosociality.” Rabinow introduced this term to describe social movements that focus on health conditions of specific groups. He defined this term, stating that “persons having specific conditions (illnesses) are organized, coordinated,and feel a kinshipbased on their shared experience”(Rabinow 1992).
I prefer the term technosociality to explain the emergence of the women’s health movement be- cause it was contraceptive technologies, rather than the condition of pregnancy, that urged women to organize themselves in women’s health groups.
11. This does not imply that there are no men who actually practice contraception.Many men use condoms,and a minorityhas chosen vasectomy. Moreover, AIDS has drastically changed the practices of condom use to enhance safe sex. As Connell has suggested, the cultural ideal of mas- culinity does not necessarily need to correspond to the actual personalities of the majority of men 12. There exists, however, a rich literature on the cultural appropriationof technology, partic- ularly on reproductive technology. See, among others, Franklin and Ragone (1998) and Saetnan, Oudshoorn, and Kirejczyk (2000). These studies focus particularly on the ways in which women appropriatereproductive technologiesand on the transformative capacity of science and technol- ogy in creating new meanings and practices of gender and bodies; they do not analyze how domi- nant cultural narratives shape the cultural feasibility of technology.
13. Cockburn and Ormrod (1993) defined the distinction between subjective identity (the gendered sense of self as created and experienced by the individual) and projected identity (the potential, actual, or desired gender identity as others perceive or portray it).
14. This study is part of a larger research project in which I have analyzed the social and cul- tural work required to overcome the major barriers to develop new contraceptives for men (see Oudshoorn 2002). My original plan to interview male trial participants failed because research- ers were reluctant to cooperate in facilitating contacts with these men because they expected a negative interference with their own research. Although there are some disadvantages of relying on secondary data (particularly, the fact that I have not been able to ask my own questions), Ringheim’s published and unpublished reports of the interviews with men who participated in the WHO clinical trials includes very detailed and extensive quotes from these interviews, which enabled me to make my own analysis of the experiences and opinions of these men. Moreover, the WHO trials are the first large-scale clinical trials of new male contraceptives and included men from different geographical contexts, which made these trials an interesting case study for 15. Western women participating in clinical trials of contraceptive vaccines have articulated similar altruistic incentives—that is, to help women in developing countries (van Kammen 16. To be sure, not all participants of the group discussions in which these self-images were expressed considered themselves as different from other men. Men in Singapore and Bangkok considered themselves like “any other man on the street” or “more or less the same” as other men 17. A poll carried out among women in Europe for the European Society of Human Repro- duction and Embryology in 1997 reported that almost half of married women were dissatisfied with their current contraceptive method (Arlidge 1997).
18. This heroic imagery is also visible in flyers used to recruit homosexual men for clinical trials for the testing of anti-HIV vaccines in the Netherlands in the late 1990s (Keuken 2000).
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