Here’s something you probably haven’t heard much about in a while: the female condom. Why talk about it now? Because finally, someone has had the sense to redesign it.
The female condom has never caught on in the United States. But in the third world, where it was introduced in the late 1990s, public health workers hoped it would overthrow the politics of the bedroom, empower women and stop the AIDS epidemic in its tracks.
It did not. Female condoms never really caught on there, either.
Only about 12 million female condoms are delivered each year in poor countries, compared with about 6 billion male condoms. Couples complained that the female version was awkward, unsightly, noisy and slippery — or, as Mitchell Warren, who was one of its earliest champions, now says, “the yuck factor was a problem.” Many women tried it, but in the end, it was adopted mainly by prostitutes.
Actually, I hadn’t heard before that the female condom was popular among sex workers. Does anyone know if this is true? In any case, I’m not nuts about the tone of the statement, which seems to imply that it’s a useless victory. Of course we want any contraceptive to have a wider market, but I’d say that if sex workers are using it as a way to protect themselves, that’s a win.
Anyway, I digress. The point is, as almost everyone agrees, the original sucked and was weird. I’ve never tried one; in fact, I don’t know anyone who has ever admitted using one to me. If you have, let us know about it (you’re more than welcome to leave your comment anonymously). So there’s a lot of room for improvement, to say the least, and the new design certainly sounds interesting:
The redesigned female condom is made of softer, thinner polyurethane to better transmit warmth. It is easier to insert; one end is bunched up as small as a tampon, an improvement on the old design, which resembled the stiff rubber ring of a diaphragm and had to be folded into a figure 8 for insertion.
During sex, the new female condom also moves more like a vagina than the old design did, according to couples in Seattle, Thailand, Mexico and South Africa who tested a series of prototypes, said Joanie Robertson, project manager for the condom at PATH. The old design hung passively from the rubber ring, which could shift around and sometimes hurt; the new design has dots of adhesive foam that adhere to the vaginal walls, expanding with them during arousal.
According to PATH, more than 90 percent of the couples were satisfied with the ease of use and comfort of the new condom, and 98 percent found the sensation of sex to be “O.K. to very satisfactory.”
You can also check out a drawing of the new design in the article itself.
. . .
Though the new condom sounds a lot more comfortable and easier to use, it’s certainly not without its problems. Namely, there’s the issue of consent in regions where a female-controlled form of HIV prevention is most necessary:
However, the new design does not overcome the glaring drawback that doomed the first to be a niche product: it cannot be used secretly. For that reason, married women, now one of the highest risk groups for AIDS in poor countries, rarely use it.
“I don’t want my husband to know that I am wearing a condom,” said Lois B. Chingandu, the director of SAfaids, an anti-AIDS organization in Zimbabwe.
“Condoms are almost undiscussable within a marriage” in Africa, she added. “It is something associated with casual sex. If a wife uses a condom, the message is that you have been unfaithful. If she even initiates the discussion, it tips the power scale. Men resist quite a lot, and it can result in violence.”
Indeed. I’d say that if a man refused to wear a condom himself, the chances of him agreeing to sex while his partner is wearing a condom is also fairly slim. The issue of men refusing to wear protection is, of course, a huge part of the problem. The fact is, not all women get to decide when they would like to have sex with their husbands, and they often live in regions where HIV/AIDS is a major problem. And though we would like nothing more than to abolish socially sanctioned spousal rape, it’s a social process. And until we get there, the least we can do is make sure that women in these situations are safe from deadly disease. Quite frankly, the ability to use protection while keeping it a secret from their male sexual partners is often a must. And that’s why the failure of the diaphragm experiment was so devastating.
That all being said, there are many uses for the female condom, and it certainly can be a lifesaving device and is quite imperative to the cause of female sexual autonomy. In fact, female-controlled contraception has been shown to shift other social values about women’s rights, so while it’s not exactly likely that a usable female condom might have some effect on the situations that currently make it a bad option, it’s not hugely off the wall, either.
But the drawbacks of the device itself are also not the only problem preventing it from being distributed to women. What is? Cliche as it may be, it’s the U.S. government and and the greedy corporations. Sigh.
PATH is seeking approval from the Food and Drug Administration so the condom can be sold in the United States. And with the drug agency’s approval, it would be much easier to license the condom in poor countries or get a World Health Organization endorsement.
While the F.D.A. designates male condoms as Class 2 medical devices — meaning that a new maker has to pass tests only for leakage and bursting — it puts female condoms in Class 3, the same category as pacemakers, heart valves and silicone breast implants.
That decision was made in 1999 — after much debate, and well after the condom was in use overseas — because there was no clinical data on the effectiveness of female condoms, and failure could be life-threatening if the woman’s partner had AIDS. An advisory panel suggested not even calling it a “condom” and instead labeled it an “intravaginal pouch,” but the agency rejected that advice.
Names notwithstanding, the Class 3 listing means that any new design must pass clinical trials, which would cost $3 million to $6 million.
“That’s a huge, huge impediment, close to a 100 percent block, because no one’s willing to put up that sort of money,” Dr. Free said.
The United States Agency for International Development, the Bill & Melinda Gates Foundation, the Lemelson Foundation and others paid for design costs and prototypes, but they are not willing to pay for clinical trials and the cost of building a factory. Private investors have also balked because the American and European markets for the original design proved smaller than had been predicted.
The fucking FDA. Please, don’t get me wrong. The female condom needs to be tested and we need to make sure that it’s safe and effective. But are we to believe that the decision had only to do with “safety concerns?” Yeah, about as much as the stalling over EC over-the-counter access and the fact that it’s still not available without a prescription to minors was about a “safety concern.” The fact is, I cannot see any reason why the female condom has to undergo more rigorous testing than the male condom, other than the fact that the FDA has a beef with female sexual autonomy, and the fact that U.S. government has a problem with both sex and condoms, period. Oh, and they also have an issue with providing financial assistance to poor people of color, even more so when they’re foreign.
But even if we assume that the tests are necessary, and hell, even if they aren’t, the fact that they are not being tested is complete and utter bullshit. I’m sitting here, staring at those figures — $3 million to $6 million — and very honestly wondering if it’s a typo. If it said billion instead of million, I would understand. If that was not a mistake, though, I don’t even know what to say.
Six million dollars, to the U.S. government, major investors and the Bill and Melinda Gates foundation, is quite literally pocket change. The government spends that much money every time a Senator blows his fucking nose. And though the Bill and Melinda Gates foundation has done a lot of good, and because of that I do hesitate to criticize them . . . they’re Bill and Melinda fucking Gates. Six million dollars sounds like a lot of money to you and me. It is a lot of money. But in the schemes of public health, philanthropy, investment and government spending, it is a tiny little drop in an ocean-sized bucket.
So I hope that it’s a typo. I hope to go back to the article later on in the day and see a correction. Because if six million dollars is what’s holding back a prophylactic that can and will save lives of many, many women — and, it must be said, mostly black women and other women of color — well, I don’t think that I’m being overly-dramatic in asking, what the hell kind of hope is there for anything?