Condomologist

all things condoms

Withdrawal as effective as condoms. Let’s be honest.

Posted by Condomologist on June 9, 2009

While I try to stay focused on condoms on the blog, the fact is that such a focus stems from my larger goal of promoting safer, more responsible sex. And that means providing a forum in which I discuss a means of contraception that can prevent both pregnancy and STDs. But occasionally the word “condom” keeps popping up amidst discussion of some other related topic — in this case the act of withdrawal, or “pulling out”, prior to ejaculation as a means to prevent pregnancy — and I can’t ignore it. The blogosphere is rife with debate and commentary since a piece came out in the June issue of the journal Contraception outlining data which shows withdrawal to be comparably effective to condoms: Couples will get pregnant 18% of the time with typical use of withdrawal, compared to 17% of condom users.  Props to my hometown Philadelphia Inquirer not just for summarizing the issue fairly well, but for highlighting the hypocrisy and dangerous views of some of the sex-postive sexual educator crowd. 

Science isn’t perfect here, as the data collection methods leave something to be desired in terms of providing greater insight and detail into how exclusively withdrawal is used, how exactly it’s used, how often it’s even reported as a method of contraception…but I won’t get into details, as the larger point stands that withdrawal is not only a decent option, but it’s fairly commonly used. Check out the blog from one of the co-authors of the study for a good synopsis of the debate. My goal is simply to bring awareness to the issue and make the point that we need to start addressing all forms of contraception openly and honestly and then believe that users — young people included — have the ability to make an informed decision. That includes information on condoms, of course, and it definitely includes information on abstinence and monogamy.

Still, we see and hear too much from professionals in my field espousing their own personal biases and essentially committing the same sin as the abstinence-only crowd by denying their students the truth — something they vehemently claim to support and practice. Case in point, from the above Philadelphia Inquirer article:

“I’m certainly not outraged by the article, but I’m concerned about how it could be interpreted,” said Dayle Steinberg, CEO of Planned Parenthood of Southeastern Pennsylvania. “The whole thing about withdrawal is that it’s hard to control yourself when you’re in the middle of the act. For someone who has no access to anything else, sure, it’s better than nothing.”

The “better than nothing” rap is one of several misconceptions about withdrawal, Jones and her coauthors say.

Really, the CEO of Planned Parenthood, for which I volunteer as an educator, is on record as saying withdrawal is simply “better than nothing?” She’s not arguing with the data — although, to be clear, Planned Parenthood hasn’t yet updated their website to account for this story, which summarizes data which has been around for quite some time — but rather arguing that men simply aren’t that good at controlling themselves. Well most men I know do know when they’re about to ejaculate, but regardless, the point here is that the numbers speak for themselves.

But Steinberg is not alone, and her company includes other very prominent sex educators:

“For plenty of young couples using withdrawal, it doesn’t take long to get to a time when a male partner decides to go without withdrawing on purpose – often without consulting his partner,” wrote Heather Corinna, a Seattle sex educator who runs Scarleteen.com, a popular sex advice Web site.

Yikes! All the comprehensive sex ed crowd is running for cover, quick to rationalize their years of avoiding the withdrawal discussion with stories of irresponsible, incompetent men who can’t be counted on to make withdrawal effective. It’s fair to mention the downsides of a contraceptive method, as Steinberg sort of does, and as we all do in our programming. But if we’ve reached the point where we’re essentially telling women that men can’t be trusted and that their intentions are selfish — and, as such, implying that men have little role to play in the safer sex process — then we’re a long way from doing our job.

Part of our failure to find common ground with the abstinence-only crowd is a failure to address the need to address the cultural values and sexual mores of young people that contribute to astronomical teen pregnancy rates in this country. And one step in that huge process of achieving meaningful dialogue involves accepting young people’s sexuality while encouraging them to engage in meaningful relationships in which they can communicate with and trust their partners. Achieving progress on that front means continuing on with our goal of making sexuality less taboo, but in the process treating teens like human beings capable of making difficult decisions; that might (and often should) mean postponing sexual intercourse until they’ve known their partner for some time, and then it will follow that, if and when they engage in vaginal intercourse, they’re able to discuss condoms, rings, patches, IUDs, pills, and — yes! — withdrawal. But as long as men are pushed to the side and dismissed as pointless in the reproductive health world, and as long as we condescendingly treat young people as not worthy of science-based information, then we have a long, long way to go.

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2 Responses to “Withdrawal as effective as condoms. Let’s be honest.”

  1. Dare said

    At the risk of being crass, I have to say that if our sex-positive collegues really had any interest in being relevant they would acknowledge that the many women who will be whispering to their lovers “Cum on my tits” tonight deserve better guidance then “I don’t care who you think you’re fucking, don’t trust him as far as you can throw him.”

    It’s tired and it’s obvious that it doesn’t work. The Jones article was apposite and well researched and had the support of James Trussell himself, who is probably the most respected expert on contraception and has published multiple times on contraceptive failure rates.

    It makes me sad that so many people commenting on this have so obviously not done their homework. The information that makes her point is not new data. The paper establishing there’s no (measurable) sperm in pre-cum came out in 2003 and the 18% failure estimate was published in 2008.
    Here’s the deal- until 1999 the failure rate for withdrawal had always been cited at 19% in Contraceptive Technology. Then Fu et al published a revision that put it at 27%-the now widely publicized number. That number, by the way, is still better than spermicide alone (29% typical failure) which the same people who disparage withdrawal seem to have no problem promoting. The issue here is seriously one of whether we should trust men to pull out.

    In sum though, Jones et al deserve serious kudos for taking on this shit storm which, despite her demurring of surprise in the blog you mention, anyone could see a mile away. I know that many others would not have had the cojones.

    Ultimately, the reason why these failure rates are so different is because it is difficult to do research on this. Many people who use withdrawal combine it with other contraceptives, surveys don’t ask very good questions about its practice, there are a lot of myths and misconceptions around it that make it difficult for people to admit using and probably most important, there’s no pharmaceutical money funding studies on it.

  2. Mr J Smith said

    The idea that a guy doesn’t know when he’s about to cum, and for some reason can’t pull out in time, is pretty crazy. I dated a girl for quite a while who was on the pill, and we also did the pull out thing. I actually prefer it, as its visual and makes you feel that much safer about what’s going on.

    This is a hard issue to convince people of. I just started dating a girl, and I can tell from the way she talks, that the idea of pulling out verses using a condom isn’t even going to be discussed. She does at least recognize that condoms, regardless of how good they claim to be, are all pretty bad for the guy (from an enjoyment perspective). However, it seems like everybody is of the opinion that the “pullout method”, or as my former roommate referred to it, the “Camaro method” (as in the method most likely to be used in the back seat of a Camaro), is the lowest common denominator and will probably result in a pregnancy in the near future.

    I’ve tried every major condom out there. Some are better than others, like I’m sure some tax auditors are better than others. However, in both cases, not having one, from an enjoyment perspective, is far, far better. There is this strange folklore about guys being dumb. Like condoms are just as good, or possibly better, than “natural”, and its just guys being stupid when they don’t want to use them. I’ve had girls tell me that condoms are just as good as no condom (to be clear, I do not campaign for “no condom” with women I’m sleeping with. This is just general conversation). Its like if we just keep saying that, it’ll be true. But its not.

    Also, many people do not understand that condoms do not prevent, to a large degree) a lot of the stuff you can get (herpes, hpv, etc). It sounds like something an abstinence-only person would say, but its true.

    I’m rambling. Anyway, its good to see people actually attempt to consider facts rather than knee-jerk-react into an opinion.

    I’d like to see some stats on combinations. Like pull out and calendar methods. On their own, they’re OK, but maybe together they’re pretty darn good?

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