Penises were all over the news as I sat down to write this column. On May 22 faces blushed scarlet in New York State when it came to light that over the past five years Medicaid has handed out free Viagra to 198 sex criminals. Apparently the state thought federal rules required no less. The next day, researchers released a study showing excellent results for Johnson & Johnson's dapoxetine, a drug that prevents premature ejaculation and intensifies the male orgasm. True, rapists' access to taxpayer-funded stiffies vanished within hours, and they will probably have to buy their own dapoxetine too. But you have to admit, men are moving right along, sexually. They have drugs to help them get up and stay in and get out in a shower of sparks, and an array of private and public health plans to pay for these fleshly maneuvers: Last year Medicaid laid out approximately $38 million for impotence drugs; Medicare will start providing them for seniors next year at an estimated cost of nearly $2 billion over the following decade. Even the Defense Department covers them. Need I add that men don't have to worry that their pharmacist will ask to see a marriage license or plug their name into the sex offender registry before handing over those little blue pills?
No, the double standard still waves over the nation's bedrooms. The only new birth control method coming up soon is actually a nostalgia item, the Today sponge, beloved by Seinfeld's Elaine, which will be returning to drugstores later this year. Two decades into the AIDS epidemic, the only woman-controlled means of protection against HIV--now the leading cause of death among black women age 25-34--is the aesthetically repulsive, cumbersome and hard-to-find female condom. Hormone replacement therapy, promoted since the 1950s as the fountain of feminine youth and sexual vitality, looks to be mostly hype, with the possibility of heart attack, stroke and breast or ovarian cancer.
And what about sex aids for women? Where's that female Viagra they're always promising us? Most newspapers didn't even report that in December an FDA panel turned down Procter & Gamble's application for Intrinsa, a testosterone patch intended to raise libido in women whose ovaries have been removed. The problem wasn't that Intrinsa didn't work (the panel voted 14 to 3 that the manufacturers' trials showed a meaningful improvement in desire and pleasure); the issue was health risks as well as the potential for "off-label use" by women who had simply lost their mojo. A "lifestyle drug" for women! Can't have that. Men, of course, have been known to use Viagra recreationally, and Viagra, moreover, is not without risk: It has been associated with fatal heart attacks and eye damage. Here's what gets me, though: FDA panelist Dr. David Hager voted against Intrinsa. Yes, that David Hager--the right-wing Christian Ob-Gyn accused of persistent marital rape by his former wife and now under scrutiny for his secret role, first revealed in The Nation, in killing over-the-counter status for emergency contraception. Maybe there are enough questions about Intrinsa's safety to justify the turn-down--but letting Hager vote on female sex drugs is like letting the Taliban vote on women's hemlines.
It didn't have to be this way. When it first came out, it looked like Viagra was going to be women's best friend. So precipitately did private insurers and government programs rush to cover the magical impotence remedy, the longstanding refusal by many insurers to cover contraception stood out, finally, as indefensibly sexist. (Viagra coverage was justified because impotence makes men depressed--poor Bob Dole! As we all know, fear of pregnancy has no such effect on women.) Pushed by feminist activists, twenty-one state legislatures since 1998 have mandated that private insurers cover birth control the same as other drugs. Even in those states, however, coverage remains spotty, thanks to business-friendly loopholes. And federal coverage is far from perfect: Medicare, which insures not just the elderly but also many young disabled people, does not cover contraception.
The biggest threat to contraception, though, is the right-wing Christians who have put themselves in charge of the nation's wombs. (Viagra is pro-life, the Pill is pro-death--sperm rules!) It's not enough that they call emergency contraception--high doses of certain birth control pills, taken within seventy-two hours of intercourse--a "mini-abortion" (in fact, as I wrote last time, studies by the Population Council show that EC does not work by blocking implantation of a fertilized egg; it prevents ovulation). Now they've persuaded states to shift funds from family planning to "abortion alternatives." For the past two fiscal years and the upcoming one, Missouri has abolished state funding for family planning and boosted programs intended to encourage childbirth. More than 30,000 women who relied on state-funded birth control are now on their own--though if they get pregnant, the state will be happy to kick in some baby clothes or arrange an adoption. Likewise, the Texas legislature has just voted to divert funds from family planning to antichoice "crisis pregnancy" centers, and Minnesota is considering a similar move.
It's all enough to make a girl go on sex strike--at least until Intrinsa gets the OK. After all, as President Bush seemed to be suggesting in a photo-op with babies who had been "adopted" as abandoned embryos, why get hot and bothered when you can be implanted with one of the thousands of leftover embryos languishing in fertility-clinic freezers, and save that clump of cells from certain death in the lab? Yes, thanks to the wonders of reproductive science, if you pay attention in abstinence-only sex ed you too can have a virgin birth.
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Dept. of Corrections: In my last column, I wrote that condoms do not prevent transmission of the human papilloma virus. In fact, condoms do provide some protection against HPV, although not as much as against HIV. I also erred in writing that 70 percent of cervical cancer is caused by HPV; actually, according to Planned Parenthood, HPV is responsible for 93 percent of cervical cancer; the 70 percent figure refers to the percentage caused by the two strains of HPV targeted by the vaccine.