 This blog series highlights pertinent publications that were featured in MCI's monthly newsletter editions in the first quarter of 2022. The purpose of this blog is to report interesting or relevant work from MCI Fellows, Grantees, staff members, and other community authors in the field of male contraception.
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 According to Merriam-Webster, transfeminine people are whose gender identity is partially or fully feminine and differs from the sex the person had or was identified as having at birth; they are are people who were assigned male at birth (AMAB) but identify more with a feminine identity.
 Shyann Stewart, our most recent intern from North Carolina Central University, sat down with us to discuss her motivation in joining the team and her interest in male contraception. This blog post shares highlights from that conversation. What's your academic background?
I am a senior at North Carolina Central University, where I am studying Public Health Education. I wish to graduate from this program with expanded understanding of public health measures and the skills to apply the most effective health promotion initiatives.  Our most recent MCI Youth Advisory Board member Meghana Reddy sat down with us to discuss her motivation in joining the board and her interest in male contraception. This blog post shares highlights from that conversation. In 2021, I decided that I wanted to start my own company focused on providing non-hormonal contraceptive options for women. Before starting my business, I created my own research protocol, and was able to interview over 50 individuals about the perspectives of contraception, sexually transmitted infections (STI)s, and the stigma surrounding sexual health. Because of the responses I received, I reached out to plenty of contraceptive pioneers, and was able to connect with Heather Vahdat, the Executive Director of Male Contraceptive Initiative (MCI). Through Heather, I was exposed to MCI's Youth Advisory Board (YAB), and decided it was the right fit for my interests and previous experiences. When I was conducting my personal research, I did not meet a lot of individuals that had an immense interest in contraception, until I met the individuals in the YAB. After joining the YAB in February 2021, I was able to learn more about new male birth control methods.
 MCI's Youth Advisory Board member Molly Ring shares frustrations with existing contraceptive methods and her motivation for joining the board in this blog post. I joined MCI's Youth Advisory Board (YAB) because, like so many others, I found myself in a stable relationship and looking to find a more reliable method of contraception than condoms. From speaking to friends who had experience with taking hormonal oral contraceptives, I felt very apprehensive about side-effects, unsatisfied with the range of non-hormonal options and above all frustrated that the burden of preventing an unwanted pregnancy rested with me simply because I was born with a uterus – as if the prospect of pregnancy and childbirth alone is not enough to contend with.
 The critical work developing the next generation of non-hormonal, reversible male (or sperm-targeting) contraception is ongoing, and it is likely to be years before the first of these methods is available. Despite this, there are plenty of reasons to be excited about and optimistic for the future. These new methods will be transformational in ensuring reproductive autonomy for all, addressing significant challenges like unintended pregnancies, and helping meet the lofty sustainability goals necessary to improve the health of the planet and all its inhabitants.
 There is no contraceptive “silver bullet” - no one method that everyone will see as the be-all-end-all of methods.
Imagine this - there’s an injectable contraceptive that lasts for a few months, but it requires seeing a provider, in their office, to administer the drug when it’s time. Or, alternatively, there’s a new daily pill, and it has almost no side effects, but it requires strict adherence to be efficacious, and missing a dose by even a few hours can be problematic. Or instead, imagine an option that works for years on end and is very effective, but requires a provider to make a small surgical incision in the scrotum during an administration procedure, and users would be sore for a few days afterwards.  A persona is a fictional character created to represent a user type that might use a site, brand, or product in a similar way. They are incredibly useful tools in user-centered design, marketing, and other disciplines focusing on customers or “users”, and they are particularly useful during ideation activities for new products and services as they allow for the extrapolation of user preferences to inform attributes, thereby removing some of the ambiguity inherent in new product design.
 In 2021, MCI's Youth Advisory Board (YAB) was able to release an undergraduate research opportunity in an effort to engage young scholars in the field of male contraception. The opportunity was made available with support from the Parsemus Foundation and contributions from Male Contraceptive Initiative.
 What potential male contraceptives are out there, and when will they be available?
These are two of the most frequent questions we hear and are asked. While it is difficult to pinpoint an exact date and time that the next generation of male contraceptives will be on the market, we wanted to at least attempt to provide some clarity on the great work being done to bring new methods of sperm-targeting contraception to market. As such, we have developed a dedicated space on our website to catalogue the various non-hormonal, reversible male contraceptives being researched.  (Source: Cancer Research UK) The bladder, or urinary bladder, is a hollow muscular organ that stores urine from the kidneys before it is disposed of through urination. Urine enters the bladder via the ureters and exits via the urethra. The typical human bladder will hold between 10 and 16 fluid ounces before the urge to urinate occurs, but can hold considerably more. It is situated at the base of the pelvis in humans.
 (Source: Cancer Research UK) The rectum is the final straight portion of the large intestine in humans and some other mammals. The adult human rectum is about 4.7 inches (12 centimetres) long, and begins at the rectosigmoid junction, which is located at the end of the sigmoid colon.
 (Source: Cancer Research UK) The anus is the opening at the end of the digestive tract where stool (or feces) leaves the body. This is not to be confused with the rectum, which is the section of the digestive tract above the anus where stool is held before it passes out of the body. In humans, the anus is the external opening of the rectum, located inside the intergluteal cleft, known colloquially as the butt crack, and separated from the genitals by the perineum. Its primary purpose is to control the exit of feces from the body during defecation.
 Support for young researchers is a key pillar of MCI’s mission. We find it so important that we have a variety of ways to get behind today’s brightest, including a fellowship program, internships, and our Trainee Success program. The Trainee Success program is one of our most versatile ways to help young researchers as it comes to meet students where they are. If they are in need of travel support, professional development, or other help, our Success Program can find a way to develop these young scientists in such a way that the future of male contraception is sustained for years to come.
 Modern hormonal and prescription contraception is primarily focused on giving cisgender women, or people who identify as women who were also assigned female at birth, the means to protect themselves against an unintended pregnancy. While pills, patches, and IUDs are useful tools to help cis women control their fertility, they may fall short at protecting some cis men, trans, nonbinary, and intersex people. In recent years, there has been an increased awareness of sexual and reproductive health disparities adversely affecting LGBTQ populations.
Reproductive Autonomy For All
Male Contraceptive Initiative takes our mission seriously. We are constantly looking for ways to reach our goals and contribute to expansive contraception access. After an internal review of how we convey our values, MCI realized it was time to update. We have updated our vision to "Reproductive Autonomy for All." We believe that our work is more than just drug or product development. It's a mission to empower everyone with the freedom to choose how they manage their fertility, contraception, and family planning.  Achieving the sustainable development agenda will require partnerships between governments, the private sector, and civil society; collaborations across sectors and countries will be the only way we can create a more sustainable future for everyone and everything on this planet.
 Findings from a review conducted by Population Reference Bureau indicated that, “reduced fertility translates into more stable population growth rates, eased pressures on the job market, fewer unemployed youth, and as a consequence, an environment more conducive to cultivating strong democracies. Shifts in age structure from a youthful population to a more mature one helps lay the foundation for social and political stability—a cornerstone of robust national institutions”.
 Humanity is impacting environmental degradation on a global scale. The Intergovernmental Panel on Climate Change’s sixth assessment report indicates that “It is indisputable that human activities are causing climate change, making extreme climate events, including heat waves, heavy rainfall, and droughts, more frequent and severe. Given that the global population is increasing at an exponential rate, demand and use of natural resources will also continue to increase.
 As the global human population continues to grow, the already untenable strain on global fisheries continues, while pollution and climate change further impact the viability of our ocean resources.
 Climate change is real, and its impacts are already being felt by every human on the planet. One way we can take action today is to provide new methods for men and women to choose if and when to have children.
 Ensuring sustainable consumption and production patterns is necessary to ensure the viability of the environment for future generations and the longevity of humanity itself.
 Estimates indicate that the world is confronting the largest wave of urbanization in human history, with an anticipated 5 billion people expected to live in city settings by 2030. This shift to urban settings will add significant additional pressure on critical infrastructures, such as health systems, water, sanitation, and education, that are already struggling to meet the needs of the current urban population.
 Inequality exists in various forms including economic, gender, disability, race, and social inequality. With respect to family planning, inequality is deeply felt with respect to availability of contraceptives in developed versus developing countries, as well as across genders with only limited options available to sperm-producing people.
 Building resilient communities, families, and systems is a crucial part of proactively supporting recovery in times of crisis. Rapid population growth leads to an increased demand for infrastructure systems including housing, schools, and health centers. In the absence of sufficient funding or capacity to respond to these increasing demands, existing resources become strained, making them exceedingly vulnerable in times of crisis and more difficult to rebuild in times of recovery.
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