The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Friday, March 11, 2011
How the inventor of the pill changed the world for women
Among certain people – Catholics, moralists, social conservatives – the urge to make Carl Djerassi regret his invention seems to be overpowering. He brought us the pill. The more you think about it, the more crucial it has been to the world as we now know it. We used to talk about it as the facilitator of promiscuity, the chemical agent behind sexual liberation. That's just the warm-up act. The rest is monumental: women taking on professional identities, waiting longer to become mothers, ageing populations, smaller families – every stamp of the household of the developed world can be traced back to this discovery. Furthermore, every new direction of the fertility industry – which, after the postponement of death, is the major focus of medical enquiry – can be attributed to this breakthrough. No one would be researching egg storage or ICSI (fertilising an egg with a single implanted sperm) or IVF if it weren't for this discovery.
"For the last 50 years, the leitmotif was contraception. The present 50 years, it's conception," says Djerassi, 88, as though it's the simplest leap in the world, which in a sense it is. Medicine follows the money – once people knew how not to conceive, the issue became how to conceive. It wasn't just ageing parity – women waiting until their mid-30s to have a child – that forced the change. The smaller, deliberated families of the developed world, post-pill, lent cultural credence to the idea of a child as a right and a necessity.
But besides the technology, it is also a conceptual leap larger than the fall of communism, larger than the advances in communication that we hold so vital. Women were hitherto enslaved by biology; and suddenly we weren't. To be in the presence of Djerassi, emeritus professor of chemistry at Stanford University, is so momentous that I fancy at one point I've gone a bit deaf in one ear.
And yet precisely because the world has changed so much, hinged on one discovery, what you want to know is: has he any regrets? Knowing how much can be attributed to his work, at 26 years old, 60 years ago, is there nothing he would change? "To me, the greatest disadvantage is what it has done in the 80s, 90s, perhaps not so much recently: modern, intelligent men won't take responsibility, wouldn't even use condoms. They shrugged and said: 'All women are now on the pill, I don't need to bother.' This has become another woman's burden."
How burdensome is it, though? He wonders, would women believe a man, if he said he'd taken the pill? That's a moot point, since this hassle has now ossified into a fact of life. "Of the 20 largest pharmaceutical companies in the world, not one is working on male contraception. They wouldn't touch it with a 10ft pole. The first question a man would ask is: would it affect my potency? There have been clinical trials – it has no effect on potency. The second question is erection. The third one is prostate cancer. There would be questions we would not be able to answer. Medicine is mainly geared towards geriatric concerns, Alzheimer's, cancer, anti-inflammatories, and people there are not concerned about side effects. No cancer patient has ever sued for vomiting during chemotherapy or losing their hair. But if you lost your hair because of your oral contraceptive, male or female, I can assure you that there would be lawsuits."
This is where we are (literally, not culturally): Austria-born Djerassi has a flat in London. It's beautiful: the corridors and landings could hold a diplomatic reception. The flat itself is laden with art (he is the largest private collector of Paul Klee in the world – those are at his San Francisco estate). The bookshelves are full of Frankfurt School Marxists and science giants. He is a theoretically impossible person: entirely erudite, and nevertheless still concerned about whether or not people can have sex without negative consequence.
"How many acts of sexual intercourse would you guess occur every 24 hours?" he asks. "I often do this with my students, and they say a billion. I say: 'No, no, no, you're dreaming. There are six billion people. Well, you need two for sexual intercourse, so there are only three billion. And some of them are five years old, so they're out.' So then they say a million. Well, now you're underestimating, because you're sitting here and you're not having sex. It's actually 100m, every 24 hours. And they produce about a million conceptions, about half of which are unexpected. Of the 500,000, half of them are unwanted. As a result, every 24 hours, 150,000 abortions occur; of these, over 50,000 are illegal." He doesn't labour the point; rather, leaves a moment for it to sink in, how much squalor and danger still surrounds unwanted pregnancy, even so long after its means of prevention should be universal.
Naturally, though, there are countries such as the UK and the US that have moved on, where the pressing issue is conception. He is droll on the subject of egg freezing and casts himself as a 20-year-old woman: "So, I am a young woman, I collect my eggs – I haven't the foggiest idea yet whether I want children, I have not yet met the man with whom I would like to have children, I do not know yet whether I want to be a single mother, I have not made up my mind yet but I have it in the bank. Men could do this, but men don't do this unless they have testicular cancer, because we produce sperm all the time."
Ultimately, while he admits to some slight reservation about sex selection, he is clear, in his creative writing (taken up over the past 20 years), in his lectures, in everything he does: sex and reproduction have been severed. This is the future – you freeze your material, then get yourself sterilised. It looks a little bald written down. But when you think about it, you want to stand up and cheer.
Zoe Williams,The Guardian,UK
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