Around the world, condom use is on the rise. In India, increased willingness to use condoms has led to a dramatic drop in new HIV infections; in the USA, rubbers are one key reason that the teenage pregnancy rate has fallen sharply in recent years. Yet even as more people use them than ever before, condoms retain their unfortunate image as a "transitional" form of contraception – something from which couples ought to "graduate" as their relationship becomes more stable. For women, this stigma against condom use in enduring monogamous relationships may often be a raw deal.
"The typical pattern among women," the New York Times reported in 2010, "is to rely on a male condom at first intercourse, the pill to delay birth and sterilization once a woman has had all the children she wants." As more and more women delay having children until their 30s (and, increasingly, their early 40s), the last of these options gets pushed further and further into the distance and the duration for which women use the second grows longer and longer. For decades, the assumption has been that married (or otherwise heterosexually monogamous) women would switch to hormonal methods of birth control once they'd found a committed relationship. When doing interviews for this story, I heard over and over again from married/monogamous women that they'd been encouraged by gynecologists and other health care providers to transition onto oral contraceptives or the IUD. "It was just assumed that I'd want to stop using condoms as soon as possible, and that it was only a question of finding the ideal replacement," one married 32 year-old told me; "the doctor never considered the possibility that condoms might still be the best choice for me."
Part of that assumption is rooted in the condom's celebrated dual role as both contraceptive device and barrier against sexually transmitted infections. Of course, heterosexual monogamy holds out the promise of an end to the worry about the latter. As one 23 year-old woman I spoke to for this story told me, "condoms are what you use when you don't fully trust the guy you're with. Once you've both been tested and committed to being exclusive, you stop using them." Numerous studies have borne out that perception that sexually active teens and adults alike rely much less on condoms once they move into committed relationships. "Too many people think that insisting on a condom symbolizes a lack of complete trust in a partner", said Mia Herron, the director of marketing and communications for Sir Richard's, a high-end condom company based in Boulder, Colorado. That sentiment seems widespread. "Having sex without a condom is a sign that you're committed," said a male student of mine, aged 20; "the first time you do it without one is almost as big a deal as the first time you have sex."
The romanticization of "bareback" sex as a sign of greater intimacy isn't just fueled by beliefs about trust. It's also driven by men's notorious complaints that condoms reduce sensation. Men are generally "much more eager than women to move past ‘the condom stage' of a sexual relationship," said Melissa White, CEO of Lucky Bloke, a premium condom subscription service. "Men and the medical profession work together to pressure women to get onto hormonal birth control as soon as possible," said one sex educator with whom I spoke; "for the guys, they just want a form of contraception that doesn't require them to give anything up." Interestingly, White suggests that the chief reason men complain about the discomfort of condoms is because they're likely using one that's too big (or, less frequently, too small) for their penis size. White claims that 30% of men worldwide need a more "tailored" fit than what's offered by the "standard" condom while some 20% need something substantially larger. "The kind of condoms that are sold in most drug stores or given away at campus health centers at best fit only half the male population," White says; "just as the same bra won't fit every woman, neither will the same condom fit every man." White is convinced that much of the reduced sensation and annoyance men (and, sometimes, their female partners) experience with condom use is down to poor sizing. Get men the perfect fit, she suggests, and guys will be much more willing to use condoms throughout the life of a sexual relationship.
The unpleasant side effects of hormonal birth control in its various forms don't affect every woman, but they have virtually no direct impact on men. As a result, the widespread expectation that a heterosexual couple should stop using condoms and start using the Pill, an IUD, or the patch once they become monogamous shifts the burden for contraception almost entirely onto women. "A man who wears a condom is sharing with his partner in a more thoughtful way than if that female partner is taking the Pill," said one 37 year-old woman in an email. While many couples do "double up" – using condoms in conjunction with some other method – they are more likely to stop using condoms first if they switch to a single means of contraception.
Condoms have been around for hundreds (some claim thousands) of years. As ancient as they are, no product exists that offers a comparable level of protection against both pregnancy and sexually transmitted infections, and does so so cheaply and with so few adverse consequences. At the same time, the sense that condom use in long-term relationships symbolizes an absence of trust or a lack of total unity (the "we don't want anything to come between us" trope) means that what may be the best method of protection available — especially for women — gets unnecessarily abandoned.
Hugo Schwyzer is a professor of gender studies and history at Pasadena City College and a nationally-known speaker on sex, relationships, and masculinity. You can see more of his work at his eponymous site.
Image via Nixx Photography/Shutterstock.