Immaculate contraception: ground-breaking male birth control is within reach

Taken from the autumn 25 issue of THE FACE. Get your copy here.

Logan Whitehead was mindlessly scrolling Instagram one afternoon when a post caught his eye: ​“You share the chores. Why not share the birth control?” He clicked through. ​“It was just: meme here, photo there, and then this ad asking: ​‘Do you want to be part of a male birth control study?’” the 25-year-old recalls at the home he shares with his partner, Ulyssa, in Los Angeles.

For the previous 18 months, Logan had watched as Ulyssa struggled with various forms of birth control, all the while being reassured by doctors that her side effects – which often left her doubled over in pain, sobbing – were ​“normal”. The experience had shaken the couple, leaving Ulyssa feeling especially hopeless about a system that was consistently downplaying what she described as ​“gut-wrenching discomfort”. ​“I’d be on the floor, crying, for hours. When Logan first found the trial, I was like: ​‘Is this actually real?’” she recalls.

Exploring the opportunity further was a no-brainer. After registering their interest, the couple were quickly enrolled into the program at The Lundquist Institute for Biomedical Innovation in Torrance, California, to test a brand-new male contraceptive drug: NES/​T. In signing up, they made a commitment to use the product as their sole form of birth control for a minimum of one year and make monthly visits to the clinic to monitor Logan’s sperm count and general health.

So, what is it? NES/​T is made from a combination of testosterone and progestin, the latter being the same synthetic version of the oestrogen that’s found in the combined hormonal birth control pill for women. The mixture of these chemical substances sends a signal to the brain that temporarily halts the production of sperm in the testes. Oh, and the form this apparent wonder drug takes? A topical gel, rubbed daily into the shoulders. ​“It’s literally like putting Purell [hand sanitiser] on your shoulder,” Logan laughs.

NES/​T users spend several weeks in a pre-efficacy period until their sperm count has reduced to the safe range to have unprotected sex. For added peace of mind, couples in the trial were provided with at-home test kits to confirm, as Logan put it, he was ​“shooting blanks”.

Once users stop applying the gel, their sperm count gradually returns to normal. And judging by the results so far, the developers are largely confident that using the drug presents no long-term threats to virility. In fact, multiple couples who took part in the trial conceived immediately after coming off the medication – some much quicker than they were expecting to.

Overall, participants have reported vastly fewer side effects than hormonal birth control has been shown to cause for many women, some of which include weight gain, skin problems, hair loss, mood swings, migraines and a decreased sex drive. Data even suggests that the drug has a higher efficacy rate than the pill.

All of which kind of sounds too good – too simple – to be true. Doesn’t it?

As a society we have long accepted the idea that those who physically shoulder the consequence of unplanned pregnancy should be the ones to take birth control. But refusing to question this logic pushes a harmful narrative.

Today, people who produce sperm are presented with two contraceptive options: get a vasectomy or wear a condom. The latter has, for decades, been culturally coded as an inconvenience or, if you will, a necessary evil – associated less with pleasure and more with compromise. This depiction of condoms as a vibe-killing, sensation-dulling afterthought has been sustained through a damaging mix of mainstream media, pornography and playground lore, underscoring the idea that male sacrifice is an impermissible notion, even in the face of the potentially earth-shattering consequences for their partner.

A 2016 study of 1,247 men, conducted by Cosmopolitan and the National Campaign to Prevent Teen and Unplanned Pregnancy, reflects this: 42 per cent of men admitted they wouldn’t offer to use a condom, even if they had one handy, unless their partner insisted.

The issue, then, isn’t just limited options. It’s a culture that’s conditioned men to believe they shouldn’t have to compromise. And to better understand how we got here, we have to start at the beginning.

The introduction of the combined pill in the US in 1960, and the year after in the UK, is largely considered to be one of the most pivotal moments in feminism. For the first time, women were able to take control of their bodies and start families on their own timeline. Perhaps more pivotally, the drug suddenly presented women with options: to pursue higher education, professional careers, and, broadly, to define their lives beyond the era’s traditional, stratified gender roles.

But despite this newfound freedom, critics of the pill argued that it didn’t symbolise blanket empowerment as much as it did medical exploitation and male control over women’s bodies.

Prior to the approval of the drug by the US Food and Drug Administration (FDA), its formulation and initial trials were rushed and profoundly unethical. Fearing that conservative religious attitudes in the US would render a large-scale human trial impossible, scientists chose Puerto Rico as their testing ground. The trial exploited the island’s population – largely low-income women of colour – by touting the pill as a kind of miracle drug, but neglecting to mention the trial’s experimental nature.

When women began to report severe side effects, their concerns were disregarded as hysteria, with the doctors (yes, white, male) claiming that the issues were ​“psychosomatic”. Even after several women died, their deaths were never investigated in connection with the drug. Instead, the dosage was quietly adjusted and the trials marched on.

Then, once Enovid, the first brand-name pill on the American market, became available, its growth was exponential. Within two years, 1.2 million women were using it. By 1965, it was more than five million. But women weren’t the only ones benefiting from its popularity.

Doctors were buying stocks in companies that manufactured the pill, profiting directly from the prescriptions they wrote for their patients. No wonder then, that as women continued to report unpleasant side-effects, the medical community failed to listen.

In January 1970, following the publication of activist Barbara Seaman’s book The Doctor’s Case Against the Pill, a congressional hearing was finally convened in Washington to examine Enovid’s safety. Naturally, no one who had actually taken the pill was invited to testify. Outraged, members of the D.C. women’s liberation movement disrupted the proceedings – much to the visible discomfort of the male pharmaceutical reps who sat squirming on the stand. ​“Why is there no pill for men?” ​“Why is it that scientists and drug companies are perfectly willing to use women as guinea pigs in experiments, but as soon as one of those women gets pregnant, she’s treated like a common animal? She can’t get an abortion!” ​“Women are not going to sit quietly any longer. You are murdering us, for your profit and convenience!”

Their efforts led to lasting and historic change. The pill’s hormonal dosage was gradually but significantly reduced, easing the side effects for many users, and the FDA introduced its first mandate for patient information inserts – now standard in all medical packaging. The Senate hearings remain a powerful reminder of the change that’s possible when individuals refuse to stay silent. And, today, we stand at a similar crossroads.

Like most of the NES/​T gel test participants I spoke to, Logan and Ulyssa told me that their experience didn’t only dramatically improve their relationship. It also completely transformed their perception of reproductive responsibility.

​“At the beginning of dating, I feel like I was almost pushing the birth control on Ulyssa,” says Logan. ​“That was before I knew what the IUD [intrauterine device] procedure even consisted of. It‘s pretty barbaric, to be honest.”

The last three years have seen this awakening thrust into mainstream consciousness. In 2022, a viral TikTok trend saw hundreds of women filming themselves having their IUDs inserted, a procedure that is standardly performed without anaesthesia. Videos of them screaming out in pain flooded For You pages, underscoring a long-ignored reality: birth control, for women, often comes at a devastating cost.

Since completing their time in the study, Logan and Ulyssa, now engaged, have had to return to more traditional methods of family planning. Like many of the others who enrolled, they told me, rather passionately, that if the product became widely available, they would jump at the chance to use it as their primary contraceptive and have eagerly added their names to lists for future trials. And in post-Roe America, where vasectomy demand spiked by a staggering 1,200 per cent the day after Trump was re-elected as president alone, the public demand for better contraception is undeniable, too.

But is the current regulatory system in the United States, still deeply entangled with Big Pharma’s interests, capable of approving something that has the potential to rewrite the reproductive rulebook?

So far, NES/​T gel has been developed without backing from any major pharmaceutical companies. The primary organisation behind the drug is a global non-profit called The Population Council, which is dedicated to research into HIV and fertility, as well as contraception.

In lieu of Big Pharma budgets, its researchers have been largely reliant on federal funding and charitable grants to push forward the global human trial phases for the product. Both Phase I and Phase II of these trials far exceeded scientists’ expectations in terms of efficacy and tolerability. Now, the FDA must create, from scratch, the guidelines for a hitherto unheard of Phase III trial – completion of which would pass the medication as safe for public use and sale.

Never before has a male birth control product made it this far along the approval pipeline. NES/​T is in completely uncharted waters.

Dr Brian Nguyen is a practising gynaecologist and associate professor at the University of Southern California, where he also leads the Fellowship in Complex Family Planning. He also serves as one of the lead trial investigators for NES/​T gel.

We meet at The Lundquist Institute, the facility to which trial participants come for routine testing. Around us in the laboratory, their sperm samples are rushed between different departments for speedy analysis.

Dr Nguyen is part of a small but dedicated global community of male contraceptive researchers, many of whom operate within under-resourced academic settings, facing myriad hurdles in sustaining their work. The political volatility in the US over the last few years, combined with the pandemic, has led to severe delays and unpredictability about how quickly we may see these new methods out in the world. It’s a frustrating situation for Dr Nguyen and his colleagues, who describe themselves as ​“very concerned about the future of contraception”. They have seen, first-hand, the efficacy of these new products and their capacity to improve lives.

​“For a long time now, people have talked about this five-to-10-year window between when our trials would finish and when we would see a marketed product,” Dr Nguyen says. ​“At this point, I no longer rely on these goalposts.” But if anything, he adds, the remarkably quick development of Covid vaccines – albeit in response to a deadly and world-changing pandemic – ​“has taught me that if there was enough will, enough desire… enough political push, you could have a method out within a year”.

Though technically tasked with ensuring the safety and efficacy of new drugs, the FDA is, you might say paradoxically, dependent on the pharmaceutical industry for a substantial portion of its funding. Drug makers pay hefty fees to have their products reviewed, and for decades there have been huge concerns about the objectivity of what is actually presented to the agency – especially by the companies with big money, power and influence.

The mechanics of this have been widely known since the opioid crisis was exposed, with large-scale pharmaceutical campaigns trickling directly into American doctors’ consulting rooms, where physicians often have a vested interest in prescribing specific drugs. What’s less well known is that this very same conflict of interest has been at the centre of birth control since the 1960s.

Today, female hormonal contraception is a multi-billion-dollar industry, cashing in on recurring monthly prescriptions and trusted (albeit flawed) long-acting devices, some of which are billed at $1,800 for those without insurance. Advances in male contraception don’t only threaten the lucrative pre-existing model, which a select few companies have a strong monopoly over. They also force us to confront a devastating reality: that it never needed to be this way.

Someone intimately aware of this fact is Elaine Lissner, founder of the San Francisco-based Parsemus Foundation, a leading force in lobbying for male contraceptive options. She’s spent decades advocating for overlooked and often deliberately sidelined alternatives to the birth control status quo. During her first year at Stanford University, she came across a book describing male contraceptive research dating back to the 1930s. A Swiss doctor, Marthe Voegeli, working in India had discovered that regularly heating the testes in hot baths lowered sperm count to a degree that could prevent pregnancy. But due to the limited potential to create a marketable product, the method, which was admittedly somewhat low-tech, presented little financial incentive to pharmaceutical companies.

In addition, the gender attitudes of the era rendered male contraceptive research, for the most part, a non-starter. Unfounded concerns around a reduction in libido and a loss of so-called ​“manhood” made it difficult to recruit men for trials – let alone challenge the broader societal norms of the mid-20^th century. Ultimately, Voegeli’s research was never published. Several decades on, the stark realisation of the ongoing injustice within the space led Lissner to make it her mission to present a better alternative.

Much of her work has focused on the development of a non-hormonal, long-acting method, which her team hope to call Plan A (Plan B being the brand name of America’s most widely used emergency contraceptive). The procedure would involve an injection into the vas deferens – the tube that carries sperm from the testicles to the urethra – and blocks the flow of sperm. Their clinical trial earlier this year was completed with a 100 per cent success rate.

Today, this belief has all but been disproven. Numerous market research studies have quashed the notion that men would be reluctant, or even unwilling, participants in birth control. As with Logan and Ulyssa, many men have seen the toll that current methods take on their partners’ bodies and minds. A survey of more than 12,000 men backed by the Bill & Melinda Gates Foundation found that 61 per cent of Americans would be interested in trying a male contraceptive during its first year on the market. In Nigeria and Bangladesh, it was an even more reassuring 76 per cent. Inarguably, these moves are not a minute too soon. In the US of 2025, the need for increased access to birth control has taken on a new sense of urgency. The result: numerous trials, including NES/​T gel, are seeing an uptick in applicants. Contraline, a medical startup who will be managing NES/T’s Phase III trials, reports a waiting list of close to 19,000 people hoping to be considered for the gel as well as another of their products, a non-hormonal, sperm duct implant called ADAM.

But within the context of this social and political climate, challenging pre-existing birth control methods is contentious. For decades, Republicans and conservative groups have propagated an anti-birth control rhetoric, hinging on misinformation and moralisation of the user. Now, with access to abortion for millions of American women gone, many progressives fear that questioning the safety of available birth control methods could be counter-productive, posing a threat to what remains a critical line of defence for women in Trump’s America.

This valid fear has made it difficult to have honest conversations about the burden that birth control has long imposed on us. But a collective reluctance to interrogate these products’ risks only perpetuates a landscape in which women are continually encouraged to ignore or accept side effects and procedures that are outdated – and, for some, intolerable.

Hormonal birth control for women has been linked to depression, strokes, blood clots, heart attacks and a higher risk of cancer. Scientists are only beginning to scratch the surface of the potential impact these drugs’ long-term use has on the brain, with new evidence suggesting that it can actually alter its structure and volume, especially among teenagers. There is a delicate line to tow when stating these facts, especially during a time when fearmongering could have such catastrophic consequences.

Millions of women use the pill without issues, and many find benefits in the medication even beyond its ability to prevent pregnancy. But 65 years after its introduction, it feels like we’re working backwards in understanding its potential ramifications, as opposed to exploring the new, male-centric drugs on the horizon. Which, as Dr Nguyen stated, are held to an entirely different standard.

​“If you compare concerns about this drug as compared to [those about] female contraceptives from decades ago, the standards have changed,” he says. ​“It’s as if there is a moving goalpost for male contraception.”

So, what happens now? The science is here. The interest, too. What’s missing, however, is the will – political, commercial and cultural – to take male contraception seriously.

With reproductive rights under siege in America in 2025, advocacy from men is crucial to the success of this late-breaking progress. They can start by signing up for trials, sharing research and refusing to treat contraception as someone else’s responsibility. Because if we want more options, we need to say so – and not just in private, but publicly, and loudly, like the women who spoke out in the Senate 55 years ago. If progress continues to stall, it won’t be because the research failed. It will be because we failed: to challenge the assumptions, the power structures and the quiet misogyny that have kept things exactly, ruinously as they are.

​“I mean, this would be so, so much better for everybody,” Logan says, almost in disbelief. ​“And I’m not going to say just for women or just for men. Everybody would benefit from this.”

A documentary by Billie on the subject, It’s Different For Girls, premiered at this year’s HotDocs Festival in Toronto, where it was nominated for Best International Short. More international screening dates will be announced soon.