Americans and Contraception - a long story that bears repeating
Over the weekend, I read Andrea Tone’s Devices & Desires: A History of Contraceptives in America. Tone tracks the history of American use and attitudes toward contraception - and records a striking and historic gap between the two. To sum up the history: the loudest voices in America seem to have always been opposed to the use of contraception and have said that we don’t need contraception if only we will be moral and not have sex outside of marriage; the majority of Americans have ignored them and sought ways to manage their fertility.
Tone recounts the long struggle between moralists who are convinced that we can shame people into not having sex outside of marriage and realists who would rather give people the tools they need to prevent both pregnancy and STI’s. In a favorite chapter of mine, Tone tells the story of how the military came to a realistic set of conclusions about prophylaxis and treatment of venereal diseases. She recounts how the military discovered, during the World War One conscription, that large numbers of draftees had STIs and that even larger numbers contracted them during their service. The American Expeditionary Force in Europe reported significantly higher rates of STIs than did their European counterparts - who had ready access to condoms and honesty. Military policy stated that soldiers returning from leave were required to report if they had engaged in sexual intercourse; if they had, they were subjected to an embarrassing treatment - doctors would first examine the patient’s genitals, then inject a solution into their urethras (which was a painful experience), then rub their genitals with an ointment. Because the treatments depended on honesty and were less than effective, many doughboys simply opted for the condoms readily available from both allies and prostitutes. Rates of new infections declined remarkably. Interestingly, later research showed that many cases of STIs among the AEF were contracted in the states. Realists concluded we didn’t so much need protection from decadent Europeans we did some honesty about our own sexual practices. Interestingly, doughboys purchased condons in European towns and used them rather than submit to the embarrassing US Military exams
By the 1930s, military leaders had quietly shifted official policy to provide condoms to soldiers - either through making them available for purchase or by using troop funds to purchase them and distribute them for free to soldiers.
Changing official military policy from promoting abstinence to promoting prophylaxis was done quietly for a reason - to avoid rousing the ire of moralists who were convinced that soldiers would abstain if they did not have access to contraception.Â
In an instance of “the more things change, the more they stay the same,” moralists were convinced that the availability of prophylactics encourage people to have sex. Like today’s moralists, they believed they could use shame and calls to abstinence to keep people from having sex. According to Tone, the efficacy of those calls was low - 70% (or more) of doughboys engaged in sexual intercourse during their tours of duty.
Tone theorizes that upon returning the states, these doughboys introduced their spouses to contraception (condoms were legalized in the states in 1918). When condoms were legalized, it was for the prevention of STIs; pretty much everyone acknowledged that people were using condoms for contraception but decided it was best to not say anything about it - again to avoid arousing the ire of moralists, always on the lookout for anyone having dirty thoughts, or worse, having the sex.
Again and again, Tone describes situations in which American moralists fought tooth and nail against medical knowledge that would empower individuals to make healthy choices about their sexuality and their behavior. Sadly, these same moralists are with us - worrying not so much about keeping people safe as lecturing them for their alleged immorality.
