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Monday, June 18, 2007

"...you can use sex to sell jewelry and cars, but you can’t use sex to sell condoms."

That post heading is  a quote from this NYT piece, which reports that CBS and Fox have refused to run a Trojan Condoms commercial described in the article as follows:

In  a commercial for Trojan condoms that has its premiere tonight, women in a bar are surrounded by anthropomorphized, cellphone-toting pigs. One shuffles to the men’s room, where, after procuring a condom from a vending machine, he is transformed into a head-turner in his 20s. When he returns to the bar, a fetching blond who had been indifferent now smiles at him invitingly.

Directed by Phil Joanou (“State of Grace”), with special effects by the Stan Winston Studio (“Jurassic Park”), the commercial is entertaining. But it also has a message, spelled out at the end: “Evolve. Use a condom every time.” [You can watch the ad here.]

The quote is catchy, but it is wrong. Using sex to sell condoms is apparently only problematic if there is a focus on women's issues. David S. Cohen blogged an appropriately critical take on CBS and Fox's  refusal to run the ad here.  The NYT article points out that both CBS and Fox had run advertisements for Trojan Condoms before, "which urged condom use because of the possibility that a partner might be H.I.V.-positive, perhaps unknowingly," and the article's author, Andrew Adam Newman concluded that those networks found a disease prevention message much more palatable than a pregnancy prevention one.   He based this conclusion in part on Fox's written statement to Trojan asserting: "“Contraceptive advertising must stress health-related uses rather than the prevention of pregnancy.” Since pretty much every use to which a condom is put (excepting filling them with water and throwing them from the roof) involves sex,  this rigid preference for a focus on disease prevention seems to be based in a very male oriented view of condom utility.

Another related and gendered  anomaly is the fact that condoms are advertised as tools to reduce the risk of catching or spreading H.I.V. and other STDS, but rarely if ever specifically mention HPV.  In a very provocative  essay entitled "The Left, HPV, and Cancer," Richard Leader writes:

Conservative men would rather their daughters die of cervical cancer than give them a vaccine that would allow them to make their own sexual choices in life. That’s the theory given by any number of liberal writers in the political debate over Merck’s Gardasil product. They very well might be correct.

What about men on the Left though? What would we prefer for women? All evidence seems to point to the fact that we really don’t care what kind of cancer they die from, so long as they keep putting out.

He notes that the causal link between HPV and cervical cancer has been known for well over a decade, there has never been a campaign aimed at stopping the spread of HPV through condom use, and his theory is this is because it causes cancer primarily in women, the people with cervixes. It is only now that cervical cancer has become a commodity as a consequence of the marketing campaign for Merck's Gardasil, he asserts, that HPV is receiving sustained media attention.

Like Leader, I have been struck by the fact that the Gardasil vaccine is recommended only for women and girls, and in fact has only been tested for safety and efficacy on women and girls, a clear signal that stopping the spread of HPV is viewed as the sole responsibility of females.  Leader concludes:

Inflicting cervical cancer upon someone was never a consideration  of men. HPV strains that did not burden a male with unsightly warts were deemed not worth testing for by the medical establishment; out of sight, out of mind. There were no marches. Penises were never called “the original cancer sticks.” No man ever curtailed his sexual behavior on account of it, admitting that even condoms not might prevent its transmission.

And yet that same generation of Leftist men, cure in hand, now accuses religious fundamentalists of murderous indifference.

It is only now that women can be saved—and pockets can be lined—that women are allowed to fear HPV and the very worst of its effects. Indeed, they are even encouraged to fear it. Before, it was merely part of heterosexual life for women, an uncommon yet ordinary consequence of all we ordained as “natural.” Bad luck, or the Will of God, cancer was seen as outside the domain of male control.

I know that Leader's essay will strike non-feminist Prawfsblawg readers as somewhat extreme, and perhaps difficult to read and process, but agree or disagree, he will make you think about this issue in ways you probably haven't before.

Posted by Ann Bartow on June 18, 2007 at 03:14 PM in Gender | Permalink

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Comments

I think the ad is simply offensive. It suggests that single men who want sex are pigs and single women who want sex are not. By characterizing the man as a stereotypically dirty animal in contrast to an attractive woman, it suggests the only plausible disease-carrier in the context is the male. In other words, the condom is for the woman's protection from the dirt and disease of piggish men, not the mutual protection of both parties. The ad is sexist and Professor Bartow's attempts to justify the sexism of the ad by accusing of its denial being to the benefit of males is sexist, not to mention adopts an oppositional view toward gender that is zero-sum and basically essentialist. The ad should not have been run simply because it demeans a sizeable minority of the population: men. It is obscene. I would think if public broadcasters can choose not to air a commercial featuring a misogynistic rant by Andrew Dice Clay during Saturday morning cartoons, they can choose not to air this misandrist garbage.

Posted by: Professor Bartow is a sexist | Jun 22, 2007 3:42:40 PM

Although empirical tendencies in this case may be more accurately described as anecdotal impressions I will concede that refusing contraception while dispensing Viagra is not *necessarily* sexist. Nevertheless, I suggest that at least in some cases it is entirely sexist.

Posted by: Jim Green | Jun 20, 2007 5:01:35 PM

Jim:

Knowing pharmacists, and Catholics (and both) it is my experience that among those with reservations as to the dispention of contraception, the overwhelming majority of them hold such reservations because of what it does to sex, regardless of the nature of the couples' association. (In fact, if joint-procreation without marriage is a vice, then it would seem to me that pharmacists would WANT to dispense contraception to the un-wed, as it would prevent such procreation and possibly prevent an abortion...)

Not to discredit Adam Sonfield of the Alan Guttmacher Institute -- I'm sure there are such pharmacists who just don't like sex before marriage, and who accordingly "hold prescriptions hostage." But in my experience they are the exceptions among the "hostage-takers," not the rule.

Furthermore, while there is little data either way as to whether and how men are refused Viagra, it is still not necessarily sexist for a pharmacist to refuse contraception and freely dispense Viagra, even though he or she feels that the un-wed shouldn't have sex.

Viagra tends to be used by men who are older -- like 50 or 60. Contraception is more often used by women of child-bearing ages, meaning younger. All else being equal, an older man having sex is more likely to be married, in today's age, than a younger woman having sex. (In fact, many married couples I know stopped using contraception once they got married, which I doubt can be said for Viagra. Viagra tends to get used with more frequency as the marriage progresses).

Thus, based on empirical tendencies, and the fact that a pharmacist lives in a world with a finite amount of time during which he or she can question patients or refuse medications, it is possible for a pharmacist to refuse contraception and dispense Viagra freely, without necessarily being sexist. They can't question everybody, or refuse all sex-medications, else they'd be out of job.

Posted by: Joel Smith | Jun 20, 2007 4:45:51 PM

Joel, if I take your point correctly you are suggesting that those whose religious beliefs tie sex to procreation do not have a similar tie between procreation and marriage. I am not Catholic and therefore may be mistaken but I thought that the Church regards marriage as a prerequisite to moral procreation. I similarly presumed the same of most other conservative religions.

In any event an anecdotal example of unmarried couples being denied birth control does little to support your assertion that the lack of marriage rarely plays a role in these pharmacists decisions. In fact the article supports Prof. Bartow's point that for some pharmacists marriage is the deciding factor. ("There are pharmacists who will only give birth control pills to a woman if she's married.") For those making the determination based on the marital status of the woman Prof. Bartow's suggested conclusion is at least plausible.

Finally, if these same pharmacists prescribe Viagra without requiring the man to be married then I would have to conclude that their attitude is not toward "sex qua sex" but is indeed a sexist approach.

Posted by: Jim Green | Jun 20, 2007 3:28:33 PM

Mr. Heerter:

The religious belief to which I am referring -- that sex should be tied in some way to procreation-- is an attitude toward sex qua sex, and is thus gender neutral. By my count, gender-neutral attitudes cannot be sexist, by definition. If by "sexist" you are intending another meaning then we are simply using the term differently.

Posted by: Joel Smith | Jun 20, 2007 12:24:26 PM

Ann bartow:
Does the risk of pregnancy truly make sex less enjoyable for women?

"Birth control generally, and EC specifically, reduce the risk of pregnancy, thereby making sex more enjoyable for women."

I mean, pregnancy is always a risk when reproductively healthy men and women have sex. Does this mean that women inherently enjoy sex less than men, who have no risk of pregnancy? I don't think you think that.

Posted by: josh heerter | Jun 19, 2007 6:50:49 PM

Joel Smith:
The religious belief to which you refer is a sexist one.

Posted by: josh heerter | Jun 19, 2007 6:39:38 PM

"[S]ome pharmacists refuse to fill birth control prescriptions because they think birth control is immoral when used by unmarried women, see e.g. this WaPo article. Yet there is little evidence that men with Viagra prescriptions are asked about their marital status ... One might conclude from this that some hold the view that men are more entitled to enjoy sex than women are."

Professor Bartow:

Those who disfavor the use of birth control -- particularly by the unmarried -- tend to do so on moral or religious grounds. Sex, they believe, should be a least partly tied to its natural purpose, which is procreation. See, e.g., Catholicism. The very opening sentence of the article you cite states that these pharmicists believe "that dispensing the medications violates their personal moral or religious beliefs." It rarely has anything to do with being unmarried, as evidenced by the articles anecdotal story of the married couple who were denied contraception.

In this light, birth control, which by nature removes sex from its natural purpose, is complete different from Viagra, which in fact aids procreation. Hence, those with certain beliefs refuse to dispense birth control but are willing to sell Viagra.

It's not a sexist belief -- it's a religous one.

Posted by: Joel Smith | Jun 19, 2007 5:49:38 PM

You’re right Professor Bartow, I couldn’t read past Leader's rhetoric. Also, I was imprecise in suggesting HPV is asymptomatic in men, as obviously some strains of HPV cause genital warts. But, according to the Brown site you linked to, those types don’t cause cervical cancer. So the strains of HPV that are linked to cancer are symptomless in men.

If Leader’s complaint is really that men aren’t advocating hard enough for a male HPV test, I suppose he might have a point. But I don’t see how that can possibly be equated, even implicitly, to “murderous indifference”.

If he’s faulting men for not wanting the vaccine, I suppose he might have a point there too. But I’d think the question of whether someone should take a costly and potentially risky vaccine that won’t benefit him (and which will benefit his partner only if she has decided the vaccine isn’t worth it) requires at least some analysis.

Posted by: Nathan | Jun 18, 2007 7:53:50 PM

Paul, I appreciate your candor. But if your doctor didn't even know to do a vinegar wash after you made your request, you need a new doctor. Again, that there isn't a widely available test specifically targeting men is a marketing issue, not a technological one. I believe the same DNA test used on women can be used on men (it is after all the same virus!), but its use in this fashion simply has not been officially approved or validated by research, due to lack of interest. I'm not a doctor, though!

Posted by: Ann Bartow | Jun 18, 2007 7:40:59 PM

Ann Bartow - Please do not misrepresent what I said. I did not "dishonestly imply[ ] efforts to decrease breast cancer somehow undermine efforts to address prostate cancer." Your man Leader suggests that "Leftist men" are hypocrites because they aren't addressing HPV. If you google "breast cancer" you get 53 million results. If you google "prostate cancer," you get 10 million. How you could interprete my comment above as anything but a tongue in cheek reference to the fact that if I apply Leader's spurious logic, our society clearly hates men, right? I mean, gosh, how could we explain the chilling silence surrounding this vital issue to men, which after all, kills more men than breast cancer kills women, and FAR more than cervical cancer kills women. The article was dumb, I appreciate your point in so far as it raises an interesting question of who the targets of the vaccine should be--it might even be the case that HPV has a negative effect on men that we don't know about, making it a sound move, even apart from overblown discrimination claims, to vaccinate men--but Leader is way conclusory on shakey evidence.

Actually, I don't want to get into a pissing match with you over this. I think you raise some good points about societal focus. That Leader article is just totally over the top, though. Its like some overenthusiastic campus feminist group saying that five hundred thousand women a year die from anorexia or something. All these cancers are horrible, and four thousand deaths a year is nothing to sneeze at, but the emphasis given to the vaccine seems to be OK. I mean, as a "Leftist man" myself, I was wondering where the hell I mislaid my monocle and cane.

Now, what would be a better way to think about this? Well, perhaps we could exploit that crazy extreme Christian conservative sexism to the advantage of eliminating the virus by telling those folks, fine, you don't want your daughters vaccinated? How about your sons?

Posted by: Bart Motes | Jun 18, 2007 7:33:41 PM

Nathan, I meant to also address the EC/Viagara disaprity. Birth control generally, and EC specifically, reduce the risk of pregnancy, thereby making sex more enjoyable for women. [NB: EC DOES NOT cause an abortion. It works pretty much like regular birth control pills - you can learn more here.] Yet some pharmacists refuse to fill birth control prescriptions because they think birth control is immoral when used by unmarried women, see e.g. this WaPo article. Yet there is little evidence that men with Viagra prescriptions are asked about their marital status, or denied the pills they seek. One might conclude from this that some hold the view that men are more entitled to enjoy sex than women are.

Posted by: Ann Bartow | Jun 18, 2007 7:30:06 PM

Ann,

That's partially a fair point -- where I think Leader goes wrong is in assuming that the average male on the street (of whatever political orientation) could have done anything about it. The average male on the street just didn't know.

This makes the HPV situation importantly different from other kinds of sexually disparate social facts. The average male on the street can't claim that he just doesn't know that he's making passes at the drunk fourteen-year-old or paying his female employees less than his male employees. In those cases, ordinary men are both the causes of the disparity and aware of all the relevant facts. Leader confuses that kind of situation with the HPV kind, where the agents of the disparity aren't aware of it, but I think we'd all agree that the latter kind of case is cause for much less moral condemnation and anger.

The real finger ought to be indeed pointed at Planned Parenthood, and other organizations and leaders, male and possibly even female, including gynecologists and other medical professionals and organizations, who actually knew but didn't make public. Their culpable failure to do so, however, doesn't even come close to meaning that ordinary leftist men "really don’t care what kind of cancer [women] die from, so long as they keep putting out."

I have a personal account of this, actually. Recently, on meeting a new partner, I went in for the usual round of STD tests. Being (thanks to the publicity brought about by the vaccine) more aware than I was previously about the risk of cervical cancer, I asked my doctor if there was an option for male HPV tests. The doctor told me there wasn't one. Not even the doctor knew about the specialty labs you noted. (Incidentally, do you have any idea where to find one?) But it wasn't as if neither he nor I gave a good goddamn.

Posted by: Paul Gowder | Jun 18, 2007 7:24:45 PM

Paul,
I think he is charging all men with fomenting (or at least complicity in) a conspiracy of relative silence with respect to HPV, because it causes cancer only in women. Slowing the spread of HPV before Gardasil would have required screening of everyone (not just women) for HPV, an active educational campaign about the risks of the disease, and responsible precautions by the people who are infected. None of this happened.

I have a lot of respect for Planned Parenthood and I think the organization does great work in many contexts, but I agree with Leader that it let women down with respect to HPV. Why, I do not know.

Posted by: Ann Bartow | Jun 18, 2007 7:07:48 PM

Nathan, I think you misread Leader (though I agree his rhetoric is fairly pitched in places.) For one thing, he never says HPV is always symptomless in men (sometimes it causes genital warts, as he notes) or that men can't be tested for the disease. He says there is "no standardized screening test," and this is because there is apparently no demand or market for one. Leader's point is that men don't seem to want to know whether they have the disease.
This site notes: "Men are not routinely screened for HPV infection unless they fall into a high-risk category. The current commercially available tests – the Pap smear and DNA HPV tests – are not approved for testing samples from males. However, some specialty labs have validated DNA tests for analyzing anal swabs from males."

Meanwhile, this site says: "Genital warts are diagnosed by a visual inspection from your medical provider. They might also perform a vinegar wash to make the warts easier to see. For women, the Pap smear will also be performed to detect any changes in the cervical cells caused by HPV infection. If the Pap smear results indicate abnormal cell changes, a woman will typically will require a colposcopy (a procedure used to magnify cervical and vaginal tissue) and a biopsy (a procedure that removes tissue samples to be examined under a microscope).

Most men with HPV don't have any symptoms and so diagnosing HPV in men is difficult. Since there is no treatment for asymptomatic HPV, most men are not treated. It is possible for men to think they have no symptoms when they actually do. Sometimes a medical provider can see small warts that have gone unnoticed, particularly if they are right inside the opening of the penis."

I don't think Leader is saying that a man has all the responsibility with respect to keeping his sexual parters safe from HPV, but that men should take SOME responsibility for it, and they haven't. As I noted in the post, Merck didn't even bother testing Gardasil on men before seeking FDA approval to begin selling it to women, apparently believing there is not a profitable pool of men who would purchase the vaccine.

Posted by: Ann Bartow | Jun 18, 2007 6:57:24 PM

Ann,

As a leftist male, I'm not really sure I understand what Leader is criticizing us for. Before the advent of the vaccine, what did we fail to do that we could have done (collectively or individually) to address the cervical cancer risk? Leader explicitly disclaims monogamy and abstinence, so I'll leave those out.

- Increased condom use? But condoms are only partially effective at guarding against HPV. Moreover, all the other diseases plus pregnancy already mean that every even slightly rational sexually active person is using condoms.

- Stop "fetishizing younger women?" The causal relationship here is very dubious, at best. Suppose men started preferring older women? That wouldn't prevent younger women from getting HPV: if the young women are having sex with anyone (male), they're doing so with men who have probably had other partners (again, monogamy and abstinence are out), and if those other partners are older, there's the disease vector. Only if people only had sex with people their own age would the disease be cabined. But that's little more than an exhortation to reduce the number of one's sexual partners, and comes close to the monogamy/abstinence thing again.

- Raise public awareness of the sexual risks before the drug was invented. This would be a good thing, of course. But I don't know why leftist men are blamed for failing to do so. The absence of public awareness goes both ways: it's not like this was some secret that leftist men kept from women: "public knowledge of HPV was limited at best." Leader offers us no reason to believe that leftist men had special access to information about the risks posed to their partners.

What Leader does offer us, though, is a really insulting accusation: "If Planned Parenthood, prior to the advent of Gardasil, ever described cervical cancer as a frequent result of sex with men, that condoms were no panacea, and advised women to act in accordance with that knowledge... Leftist men would have swiftly killed an organization that has survived the pipe bombs of the Right." What's his evidence for that slur?

- Advocate for more funding for research, testing of the vaccine on males, etc.? After the vaccine came out, that's exactly what we've been doing. Before the vaccine came out, yes, it would have been good for leftist men to support more funding for research. However, in light of Leader's earlier point that there wasn't much public knowledge about the risks, how could we have done so?

None of this is meant to suggest that there wasn't any problematic sexism in the development of the HPV situation as it stands today. Surely, there was: without a certain level of male privilege, men (leftist and otherwise) wouldn't have been able to be so uninformed about it for so long -- those gynecological discussions Leader mentions would have been transmitted to men. But that's a far cry from the widespread contempt and outright conspiratorial malice (as in the Planned Parenthood thing) that Leader seems to want to charge us with.

Posted by: Paul Gowder | Jun 18, 2007 6:56:46 PM

I found a lot to dislike in Leader's essay, but one of the most troubling to me was that he seems to regard a woman’s health as her partner’s responsibility.

Why should a man “curtail” his sexual behaviour because he might have a symptomless disease he can't be tested for, but which would harm his partner? It’s her health, and she can assess the risks as well as he can. Ought it not be entirely her decision if she wants to take the risk?

(I suppose Leader could be arguing men ought to be less slutty so there’s less chance they’ll catch HPV in the first place. But I don’t see how this argument works, because women are equally to “blame” here, and Leader says the risk of HPV didn’t influence women’s sexual behaviour either.)

On a side note, why is sexist for a pharmacist to sell Viagra but not birth control? Obviously it could be based on sexism, but couldn't it also be because the pharmacist is opposed to birth control, but not sex between married partners? I don't doubt sexism is the reason sometimes, I just don't see how it's necessarily sexist.

Posted by: Nathan | Jun 18, 2007 6:26:09 PM

Bart Motes - Interesting that you would ignore the actual substance of the post in favor of dishonestly implying efforts to decrease breast cancer somehow undermine efforts to address prostate cancer. Many scientists believe that the main reason breast cancer has declined recently is that researchers finally figured out that hormone replacement therapy was causing breast cancer, rather than preventing it. Women were previously assured that hormone replacement therapy was useful and relatively safe for decades before these claims were debunked. See e.g. this article. In addition, much of the "societal attention" being paid to breast cancer is an effort to commodify and profit from the disease, and the women who have it. See e.g. this article, or this book. That the same has not been done for prostate cancer is probably a mercy.

Posted by: Ann Bartow | Jun 18, 2007 5:54:05 PM

I guess what I was getting at, Jim Green, my old nemesis, was that I don't really think that the emphasis on cervical cancer prevention proves one thing or another about our society's objectives. And I found that article to be comically strident.

Posted by: Bart Motes | Jun 18, 2007 5:15:29 PM

I think the bias comes into the Fox response:

In a written response to Trojan, though, Fox said that it had rejected the spot because, “Contraceptive advertising must stress health-related uses rather than the prevention of pregnancy.”

Apparently, Fox doesn't see pregnancy as health-related. I don't see pregnancy as a disease, but it certainly has an impact on health.

Posted by: dolmena | Jun 18, 2007 5:08:44 PM

Bart, I didn't see anything in that article that bespoke of such a relative silence. The relative reductions doesn't seem to bear out much if any disparity either. I have neither done nor seen any studies comparing the level of attention given to breast cancer and prostate cancer but anecdotally it I know they both receive some. So my question is, are you basing the relative silence on your own personal perceptions or do you have some support for that assertion?

Posted by: Jim Green | Jun 18, 2007 5:01:33 PM

# Prostate, 28.0 per 100,000, down from 28.9.
# Breast, 25.4, down from 26.0.

http://www.msnbc.msn.com/id/10577835/

Its really a damn shame that our society doesn't care about men, as evidenced by our strange preoccupation with breast cancer and relative silence on prostate cancer.

Posted by: Bart Motes | Jun 18, 2007 4:19:40 PM

That is precisely why it is male-focused, because it protects men. The implication is that a message that is only pregnancy focused (a condition tied inextricably to women) is an insufficient justification for promoting condom use.

For what it's worth, I see similar double standards in a related arena: the campaign by conservative pharmacists to be allowed to decline filling prescriptions that they feel interfere with their religious or moral beliefs. These complaints center almost exclusively on a refusal to fill prescriptions for birth control pills (despite the fact that some women take these pills for medically therapeutic reasons). I have yet to see the pharmacists outraged about requests from men to fill viagra prescriptions.

Posted by: prawfette | Jun 18, 2007 4:08:26 PM

I'm a little confused how a disease prevention message is male-focused, since condoms reduce the spread of disease in both directions. Am I missing something?

Posted by: Jason | Jun 18, 2007 3:45:30 PM

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