Three Important Questions About Men's Sexual Health, Answered

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In this week's Sex IDK column, Emma McGowan, certified sex educator and writer, answers three big questions about men's sexual health.

I usually cover one big topic here at Sex IDK, but this week we’re going to do a lightening round of questions whose answers aren’t quite long enough to warrant an entire column of their own. The topic? STI testing and birth control methods for men with penises and other people with penises.

The people want to know: What’s up with STI testing for guys? What about HPV? And why the @#%# aren’t there more birth control options for people with penises? Some of the answers are simple and quick, some are a little more complicated, and all of them will make you more knowledgeable about sexual health as we dive into the new year.

But first, as always, quick note about language. The question-askers referred to people’s gender, which is common. But since sexual health is almost always about the genitals people have (i.e. penis or vulva/vagina) and not your gender (i.e. man/woman/non-binary/etc.), I’m going to be responding using words that refer to genitals (i.e. “person with a penis”). For the majority of people with penises, their gender is “male,” but that’s not the case for everyone. And when I’m talking about sexual health, I always want to include as many people as accurately as possible. So with that taken care of, let’s dive in!

1. Why Don’t Guys Need To Be Checked Once A Year Like Women?

STI testing is one of those topics that seems really obvious but, the more I dig into it, the more complicated it is. And one thing that honestly took me by surprise is the fact that the CDC doesn’t have STI recommendations for people with penises who sleep with people with vaginas. (Or, in their wording, “heterosexual men.”)

My first reaction was: WTF? Shouldn’t EVERYONE be getting tested at least once a year? That’s what I’d been taught growing up. And, granted, I’m a woman with a vagina — but still. People with vaginas who only sleep with people with penises aren’t getting STIs from the air. So shouldn’t the burden of testing fall on the shoulders of both groups?

I immediately assumed that the reason was just sexism, but it turns out it’s more complicated than that. A 2017 investigation by writer Shayla Love in Vice found that the reason the CDC doesn’t recommend regular testing for people with penises who have sex with people with vaginas is because there’s no proof it would reduce infection rates. One expert she spoke with said that there’s no scientific proof that screening “asymptomatic, heterosexual men” would reduce the rate of STI transmission more than simply screening asymptomatic, heterosexual women.

The other reason? Money. According to Vice, the CDC has limited funding for STI screening. And the consequences for many common STIs are more severe for people with vaginas than for people with penises. As a result, the CDC is choosing to focus their funding on the places its most needed: people with vaginas and people with penises who have sex with people with penises.

And there’s one more thing we need to address, question-asker, and that’s people with penises who have sex with other people with penises (or, in their wording “men who have sex with men.”) For that group, the CDC recommends getting tested at least once a year for syphilis, chlamydia, and gonorrhea. They also recommend that these people get tested every three to six months if they have multiple or anonymous partners. Finally, the CDC says that this group “may benefit” from HIV testing every three to six months, but should be tested at least once a year.

2. How Can Men Be Tested For HPV?

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They can’t. There is currently no test for HPV for people with penises.

And if you’re stressing out about HPV (and, trust me — you’re not the only one) please read this piece I wrote about why I tell everyone I have HPV.

3. There Has To Be More Options For Male Contraceptives Other Than Getting A Vasectomy And Using Condoms?

Yes! I am 100 percent all about people with penises taking more control and responsibility when it comes to preventing pregnancy! Unfortunately, though, the options are pretty limited at this time.

Condoms and vasectomy are out there — and both great options that are super effective for pregnancy prevention. And, as of this moment, still the most reliable options for people with penises to prevent pregnancy.

But, they’re not the only options. The pull-out method is another way that people with penises can help prevent pregnancy. It can be used in combination with other contraceptive methods — like the Pill or condoms or a diaphragm, for example — or it can be used on its own.

And yes, I know all of the jokes about the effectiveness — or lack thereof — of the pull-out method. But studies have shown that pulling out is 96 percent effective with perfect use and 72 percent effective with actual use. Are those odds great? Nope. But they’re not bad enough to disqualify the pull-out the method as a contraceptive method for people with penises.

Finally, there’s a product called Vasalgel that is like a reversible vasectomy. Instead of going in and surgically blocking the vas deferens by cutting it, a gel is inserted instead. That gel can then be dissolved if and when that person decides the want to have kids.

Sounds great, right? Unfortunately, it’s not yet available. The company behind Vasalgel is trying to develop it as a social venture and so far they don’t have enough money to take it to human testing. If you want to learn more about it — and maybe throw them a couple of dollars — you can check out their website.

Those are just a few, quick questions readers have sent in about sexual health for people with penises. Don't worry, though — we'll come back to these topics (and so much more!) this year.

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