For the past decade or so, the reproductive health community has been talking about how to improve men's sexual and reproductive health. We as a community have expanded our view on the roles men play in important reproductive health outcomes, and we have made efforts to reach out to men—as partners and in their own right (PDF). And indeed, they have done better: National data document shifts toward increasingly responsible and healthy sexual behavior by men (especially adolescents), including increased condom use, declines in early sexual activity and fewer sexual partners, which is a major risk factor for STIs. But we've made too little real progress in advancing an effective policy agenda. Instead, the biggest relevant policy initiative to include males has been one that puts ideology over evidence—abstinence-until-marriage education that has proven to be ineffective and a colossal waste of taxpayer dollars.
The fact is that our efforts to heighten awareness and recognition of men's sexual and reproductive health have not been enough. If we want to move forward with policies and programs to reach young men, we need to start taking our agenda beyond the safe and familiar confines of the reproductive health community. Only then will we reach the health care providers, educators, youth group leaders, policymakers and other dedicated professionals who care about young men's sexual and reproductive health.
Realistically, we have to make the best of a situation in which men's sexual and reproductive health is not yet a high priority, certainly not when it comes to funding. The second-best solution, then, is to see how we can use existing funding streams directed at men and add a critically needed sexual and reproductive health component.
One area of particular promise may be the rapidly expanding federal and state initiatives to promote healthy marriage and responsible fatherhood. Congress has budgeted up to $150 million per year for five years for programs to help couples form and sustain healthy marriages, up to $50 million of which may be used to encourage responsible fatherhood. Unfortunately, sexual and reproductive health advocates and practitioners largely have been on the sidelines of these efforts, in part because these initiatives are backed by many of the same social conservative groups that promote abstinence-only education. It may be time to overcome our reluctance, however well-founded it may be. As our colleague Cynthia Dailard argued more than two years ago, we have much to contribute and need to take a seat at the table (PDF). Let's not just talk amongst ourselves, but start new conversations with folks who might not be used to chatting about reproductive health.
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So, how can we link marriage and fatherhood initiatives with male sexual and reproductive health? One step to linking agendas is highlighting areas of common concern. Both the marriage and fatherhood initiatives strive for men's greater involvement in intimate family roles and behaviors. We share this overarching goal. We also share a belief in the value of efforts to improve relationship skills for adolescents and young adults, and we have valuable experience in teaching these skills. But as researchers and practitioners in reproductive health, we also know that making good decisions about when to become a father and being prepared in advance for that responsibility are just as important as being involved in your children's lives once they arrive. And we know that the promotion of contraceptive use and the prevention of unintended pregnancy (and unwanted or too-early fatherhood) are pathways to greater male involvement and to healthier relationships. These are messages that reproductive health advocates across the country need to take to their local crop of marriage and responsible fatherhood programs. Promoting these ideas can be an area of collaboration and can invigorate a positive view of male sexual and reproductive health. And that would be something to talk about!