Female Condoms, a Mea Culpa

by Alanna Shaikh

Published January 06, 2009 @ 09:22AM PT

(photo credit: wikipedia France)

It’s been accepted wisdom in global health for quite a while that nobody likes the female condom. It’s bulky. It makes a squeaky noise while in use, and you can still see it after it has been inserted. It’s expensive. It’s difficult to put in. It is, all in all, profoundly unsexy. (admit it - you even find that picture up there vaguely icky)

And despite all that, it looks like accepted wisdom has been wrong. Here’s the thing we forgot – for a huge slice of the female population, sex has nothing to do with “sexy.” Sex is paid work, coerced work, a form of slavery, or an unpleasant duty for one’s husband. In those circumstances, a little insertion effort in return for protection from HIV or Herpes is well worth it.

Which makes those of us who scoffed (And yes, I was one of them. I bought a female condom, found its looks and feel hideous, and never thought about it again except as a very bad idea.) look like insensitive jerks that can’t get past our own experience.

I was put in my place by a recent Oxfam paper that someone recommended to me on Twitter. Called “Failing Women, Withholding Protection,” it thoroughly debunks the idea that the female condom is hated by users. It says that the reasons for neglecting female condoms “mirror the common reasons for not using a male condom: responses formed by ignorance, culture, denial, ‘poverty’, and conservatism. Added to this are overarching errors of a lack of leadership, a huge funding bias against existing forms of primary HIV prevention, failure to scale up programming, and failure to invest in strategies to lower the cost of female condoms.” Ouch.

South Africa’s Mail & Guardian online was way ahead of me on this discovery. It was already making this point in 2005, when it said that “Sniggering at the (female condom), it seemed, was a privilege only for those lucky enough to have a choice about whether to sleep with a man who wouldn’t wear protection.”

It’s pretty clear at this point that neglecting the female condom is a public health embarrassment. A commenter on the From Poverty to Power blog pointed out that it really doesn’t matter if most people hate the female condom. Most contraceptive methods have trouble with acceptance. The question is – even if it is hated – why has no one supported efforts to improve the design? It could make a major difference in female empowerment, and yet it hasn’t been pursued.

If you want to do something about this neglect, you can join Prevention Now, a global anti-AIDS campaign that promotes the female condom.

About the female condom
The female condom was developed by a Danish physician named Lasse Hessel, who is really pretty eccentric. He also invented two kinds of diet pills, and used MRI technology to determine how women could better experience sex.

It consists of two rings, connected by a polyurethane or latex sheath. One ring is inserted into the vagina, while the other remains outside. It serves as a barrier method against HIV and sexually transmitted infections. It is less effective than the male condom, but far more effective than using no protection. You can find more information about female condom effectiveness here, and instructions for use here.