Love, Responsibility, and Male Contraception: Lessons from Adolescent Boys in South Africa

5/20/2026

Dominick Shattuck, representing American Institute for Boys and Men, has partnered with MCI for a series of webinars integrating men's health and male contraceptives. Summarizing the recent webinar, Dr. Shattuck wrote this blog post.

When most people think about contraception, they think about women.

That framing has shaped decades of policy, programming, and product development. Women have carried the overwhelming burden of preventing pregnancy, managing side effects, and navigating health systems that treat contraception as primarily their responsibility. Meanwhile, boys and men are often treated as peripheral to the conversation, expected to be supportive but rarely viewed as contraceptive users and decision-makers in their own right.

That paradigm may soon begin to change.

More than 30 novel male contraceptive products are currently in development, including daily pills, on-demand pills, injectables, and reversible methods designed to block sperm transport. The scientific pipeline is more robust than ever. Market research conducted across multiple countries suggests that men are interested in these methods and that many women say they would trust their partners to use them.

But a critical question remains: Are boys and men actually prepared to use them?

That was the central theme of a recent webinar hosted by the Male Contraceptive Initiative and the American Institute for Boys and Men featuring Dr. Tsidiso Tolla of the University of Cape Town. Drawing on her PhD research with adolescent boys in South Africa, Dr. Tolla offered a compelling reminder that the future of male contraception will depend not only on biomedical innovation, but also on relationships.

Romantic Relationships as a Public Health Classroom

Dr. Tolla's research challenges one of the most common assumptions in sexual and reproductive health: that adolescent boys are primarily motivated by sex.
Through interviews, focus groups, and diary entries with boys aged 14 to 19, she found something much more nuanced. These young men spoke about love, companionship, and building a future with their partners. They were thinking about marriage, fidelity, and the possibility of creating a stable life together.

One participant captured this distinction beautifully: "Love is love and sex is sex."

This simple statement reflects a profound insight. For these boys, romantic relationships are not merely pathways to sex. They are emotionally meaningful relationships rooted in affection, commitment, and aspirations for the future. Sex matters, but it is only one part of a much larger relational experience.

As public health often discusses adolescent sexuality outside the context of romance, this finding is transformative to the field. When public health focuses only on risk, it misses the emotional and relational dimensions that shape how young people actually make decisions.

Pregnancy Prevention as an Expression of Care

Dr. Tolla's work also found that boys saw pregnancy prevention as a shared responsibility.

As one participant explained: "It is both our responsibility."

This statement challenges the common assumption that boys are indifferent to contraception. Many of the young men in the study believed they had a moral obligation to help prevent pregnancy. Their sense of responsibility was tied to care, respect, and a desire to protect both their own futures and those of their partners.

One boy expressed this concern directly: "I don't want to ruin her future."

This quote is especially powerful. It shows that pregnancy prevention was not framed as avoiding inconvenience. It was about safeguarding a partner's educational and economic opportunities, as well as preserving the possibility of a shared future together.

In other words, these boys were already thinking relationally. They understood that unintended pregnancy could alter the lives of two people, not just one.

Responsibility Without Preparation

Despite their desire to act responsibly, many boys were navigating pregnancy prevention with incomplete and sometimes inaccurate information.

They relied on condoms, withdrawal, and their partners' use of hormonal contraception. Some expressed confidence in withdrawal as a method they could "manage" through self-control. Others worried about condom failure or feared the side effects associated with hormonal methods.

This led to one of the webinar's most important insights: the real gap is not responsibility. The gap is preparation.

We have created a system that expects boys to be responsible without equipping them with the knowledge, tools, and support they need to fulfill that responsibility.

Schools often provide limited or uncomfortable sexuality education. Clinics are frequently designed with girls and women in mind. Policies rarely treat boys as full reproductive health clients.

The result is a generation of boys who care deeply about avoiding unintended pregnancy but are largely left to figure it out on their own.

What This Means for Male Contraception

The arrival of new male contraceptive methods represents a remarkable scientific achievement. But science alone will not determine whether these products succeed.

Uptake will depend on whether boys and men:

See contraception as part of their role in a relationship
Trust the methods and understand their side effects
Feel comfortable discussing contraception with partners
Receive accurate information from providers and educators

Reflecting a growing body of research on the acceptability of new male contraceptive methods, Dr. Tolla's research suggests there is reason for optimism. Many boys already view pregnancy prevention as a shared responsibility. Novel male contraceptives could give them a concrete way to act on values they already hold.

At the same time, their concerns about side effects and sexual desire remind us that adoption will be shaped by masculine norms, peer conversations, and trust.

A Relational Lens for Reproductive Health

One of the most valuable lessons from this work is that contraceptive decision-making is inherently relational. It is shaped by boys’ relationships with their partners, their conversations with peers, and their interactions with healthcare providers. Each of these relationships influences what boys believe about responsibility, risk, and care. If we want male contraception to reach its full potential, we need to invest in all three.

That means providing earlier reproductive health education, strengthening relationship and communication skills, and designing health services that recognize boys as caring decision-makers rather than bystanders.

Boys Are Not the Problem

Dr. Tolla's research offers a hopeful and evidence-based reframing.

Boys are not disengaged from pregnancy prevention. They are not simply seeking sex without consequences. Many are thoughtful, emotionally invested, and deeply concerned about their futures and their partners' futures. They are, however, underprepared.

As male contraceptive technologies move closer to market, the challenge before us is clear. We must build the social and institutional infrastructure that allows boys and men to use these methods effectively and responsibly.

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