/ 12 November 2010

The pill that changed the world

The Pill That Changed The World

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 inquiry — 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 past 50 years the leitmotif was contraception. For the present 50 years, it’s conception,” says Djerassi (88). 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.

Women were 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, I fancy at one point that 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?

The burden of contraception
“To me, the greatest disadvantage is what it has done in the Eighties, Nineties, perhaps not so much recently: modern, intelligent men won’t take responsibility, won’t even use condoms. They shrug and say: ‘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, because 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 10-foot pole. The first question a man would ask is: Would it affect my potency? There have been clinical trials and it has no effect on potency. The second question is erection. The third 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 losing his or her 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): Austrian-born Djerassi has a flat in London. It’s beautiful and laden with art (he is the largest private collector of Paul Klee in the world — those are at his San Francisco estate).

He is entirely erudite and still concerned about whether people can have sex without negative consequence.

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 100 million, every 24 hours. And they produce about a million conceptions, about half of which are unexpected. Of the 500 000, half are unwanted. As a result, every 24 hours, 150 000 abortions occur; of these, more than 50 000 are illegal.” He leaves a moment for it to sink in, how much squalor and danger still surrounds unwanted pregnancy, so long after its means of prevention should be universal.

Naturally, though, there are countries such as Britain and the United States 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. I’m not saying that everyone should do this. But if you do, then you might as well get sterilised. Because why bother with contraception? You have your eggs in the bank.”

Ultimately, although he admits to some slight reservation about sex selection, he is clear that 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. —