Commentary Contraception

RHTP Agrees Condoms Do Not Cause Cancer and Has Never Stated Otherwise

Jessica Arons

On Friday, Melissa White, the CEO of an online condom retailer, attacked the findings of a study that found a small number of the condoms she sells on her website contain a chemical carcinogen called nitrosamines. In doing so, she misrepresents both our report and its conclusions.

Today, Melissa White, the CEO of an online condom retailer, attacked the findings of a study that found a small number of the condoms she sells on her website contain a chemical carcinogen called nitrosamines. In her piece, “Cigarettes Cause Cancer; Condoms Don’t,” she critiques the methodology of a report that my organization, the Reproductive Health Technologies Project (RHTP), published in partnership with the Center for Environmental Health (CEH) this past September. She also claims that I declined to comment for her article “on the study’s methodology, the evidence that several brands targeted in their study had undetectable nitrosamines, or on the implications of publicizing or promoting the ‘condoms contain carcinogens’ argument.” I would like to take the opportunity to address her misleading statements directly.

Our report found that progress is being made on eliminating nitrosamines from condoms.

This issue of nitrosamines in condoms is one that requires a delicate balancing of public health concerns. Therefore, I thought it might be helpful to start by setting the context for why RHTP and CEH commissioned the testing of condoms for the presence of nitrosamines.

No governing body has set specific limits for the levels of nitrosamines in condoms, but in 2010 the World Health Organization (WHO) and the United Nations Population Fund (UNFPA) recommended that manufacturers minimize the presence of nitrosamines in male latex condoms. There has been little follow-up testing to see if the WHO and UNFPA recommendation has been implemented. Thus RHTP, in partnership with CEH, commissioned testing to determine if condoms available in the U.S. released nitrosamines.

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What we found was encouraging: Of the condoms we tested, almost one-third did not release any detectable levels of nitrosamines, including some well-known brands with large market shares. Approximately another third released levels that fall below an EU standard for certain rubber toys (the best proxy we could find), meaning that some nitrosamines were detected but at low levels. The remaining third exceeded the EU threshold, some by twice as much. But of those, the makers of half have already indicated to RHTP that they are aware of the issue and taking steps to monitor and reduce the levels of nitrosamines in their products.

Our report acknowledged all manufacturing changes that had been reported to us at the time of publication

Given these results, I find it odd that Ms. White claims that we failed to comment on “the evidence that several brands targeted in their study had undetectable nitrosamines.” We specifically highlight in Figure 2 of our report the seven condoms we tested that had undetectable levels of nitrosamines. We also acknowledge in the footnotes to Figure 1 that one of the manufacturers had provided evidence to us that it had changed its manufacturing process to reduce the nitrosamine levels in its product but its updated product was not yet available for sale in the U.S.; that another manufacturer provided evidence to us that one of its products that has a similar manufacturing process to the product we tested released low amounts of nitrosamines; and that a third claimed it had changed its manufacturing process to reduce the level of nitrosamines in its product but had not provided documentation to us to substantiate that claim. Moreover, we also state that we removed one of the products from the report because its maker had provided documentation to us that it had lowered the nitrosamine levels in the product and the new version was already on the U.S. market.

RHTP provided extensive comments to Ms. White in response to her questions

I personally responded to 3 rounds of questions from Ms. White and repeatedly directed her to the parts of our report that detail our methodology and acknowledge where evidence of manufacturing changes had been supplied to us. Of particular relevance to Ms. White’s claims, the methodology section of the report states:

The condoms we selected for testing varied by color, flavor, feature (i.e., warming or tingling sensation), texture (i.e., ribbed), and thickness (i.e., ultrathin). We also chose condoms based on high in-store availability, large number of units sold in the United States according to the market research company IRI, and with input from issue and industry experts. In addition, we tested condoms that were previously found to have higher levels of nitrosamines and condoms that are marketed as “organic” or “natural.” We acquired the selected condoms by purchasing them from retail pharmacy chains or ordering them from online condom vendors and then shipped them to the Tun Abdul Razak Research Centre laboratory for testing, with one exception. Pre-market samples of Sustain condoms were shipped directly from the company to the laboratory for testing as they were not yet available for purchase at the time.

Furthermore, in an email exchange with Ms. White, dated Nov. 20, 2014, I stated:

We made a great effort to be as transparent as possible in our report and the majority of the questions you’ve asked are available in the methodology section, the footnotes to the tables and text, and the acknowledgments. You are of course welcome to follow up with the lab we used and confirm with them that they conducted the testing for us, the dates of the testing, and the sample size, and to ask them any questions you have about the testing method they used.

We established several firewalls to ensure the independence and integrity of our report. RHTP and CEH staff and consultants were solely responsible for final decisions about the selection of the products tested and the design of the study; with the exception of the Sustain sample sent directly to the lab, all samples were purchased and handled solely by RHTP staff before being sent to the lab; test results were not shared or discussed with anyone associated with Sustain prior to the release of the report; and no one associated with Sustain had any editorial control over the report.

In response to her question, “How do you account for the complete lack of even one medical study demonstrating cause or correlation of condoms with reproductive cancers?” I replied: “To have cited data suggesting condom use can cause reproductive cancers would have been in direct contradiction with our conclusions” and cited our statement in our report that repudiates the use of our study to suggest otherwise:

RHTP and CEH recognize that some people with an anti-condom agenda or a sensationalist bent may seek to distort the results of this study and erroneously claim that condoms cause cancer. Anyone who does so – be it the media, politicians, or advocates – is acting irresponsibly and not in the best interests of public health. Our perspective on this issue is similar to that on contaminants in breast milk. The presence of chemicals in breast milk should not discourage women from breastfeeding their children. On the contrary, the health benefits of breast milk are indisputable, even when the potential for exposure to environmental toxins exists.

Our only interest is in furthering public health

There are a lot of claims being made on both sides of the debate about nitrosamines in condoms by those with a financial stake in the matter. RHTP and CEH have no interest in promoting one particular condom brand over another. We simply want people to have the information they need to protect their health and well-being. That includes knowing that 1) condoms are safe and effective and should be used to prevent HIV/AIDS, sexually transmitted infections, and unintended pregnancy; and 2) there are options on the market to reduce exposure to a substance that is found in food, water, and a variety of consumer products and is unnecessarily present in some condoms.

RHTP and CEH adhere to the values of scientific integrity, evidence-based decision making, and the right to accurate information. And we believe these standards should apply as much to journalism as to policy. Debate on challenging issues is welcome; the intentional spreading of misinformation is not.

Commentary Economic Justice

The Gender Wage Gap Is Not Women’s Fault, and Here’s the Report That Proves It

Kathleen Geier

The fact is, in every occupation and at every level, women earn less than men doing exactly the same work.

A new report confirms what millions of women already know: that women’s choices are not to blame for the gender wage gap. Instead, researchers at the Economic Policy Institute (EPI), the progressive think tank that issued the report, say that women’s unequal pay is driven by “discrimination, social norms, and other factors beyond women’s control.”

This finding—that the gender pay gap is caused by structural factors rather than women’s occupational choices—is surprisingly controversial. Indeed, in my years as a journalist covering women’s economic issues, the subject that has been most frustrating for me to write about has been the gender gap. (Full disclosure: I’ve worked as a consultant for EPI, though not on this particular report.) No other economic topic I’ve covered has been more widely misunderstood, or has been so outrageously distorted by misrepresentations, half-truths, and lies.

That’s because, for decades, conservatives have energetically promoted the myth that the gender pay gap does not exist. They’ve done such a bang-up job of it that denying the reality of the gap, like denying the reality of global warming, has become an article of faith on the right. Conservative think tanks like the Independent Women’s Forum and the American Enterprise Institute and right-wing writers at outlets like the Wall Street Journal, Breitbart, and the Daily Caller have denounced the gender pay gap as “a lie,” “not the real story,” “a fairy tale,” “a statistical delusion,” and “the myth that won’t die.” Sadly, it is not only right-wing propagandists who are gender wage gap denialists. Far more moderate types like Slate’s Hanna Rosin and the Atlantic’s Derek Thompson have also claimed that the gender wage gap statistic is misleading and exaggerates disparities in earnings.

According to the most recent figures available from the Census Bureau, for every dollar a man makes, a woman makes only 79 cents, a statistic that has barely budged in a decade. And that’s just the gap for women overall; for most women of color, it’s considerably larger. Black women earn only 61 percent of what non-Hispanic white men make, and Latinas earn only 55 percent as much. In a recent survey, U.S. women identified the pay gap as their biggest workplace concern. Yet gender wage gap denialists of a variety of political stripes contend that gender gap statistic—which measures the difference in median annual earnings between men and women who work full-time, year-round—is inaccurate because it does not compare the pay of men and women doing the same work. They argue that when researchers control for traits like experience, type of work, education, and the like, the gender gap evaporates like breath on a window. In short, the denialists frame the gender pay gap as the product not of sexist discrimination, but of women’s freely made choices.

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The EPI study’s co-author, economist Elise Gould, said in an interview with Rewire that she and her colleagues realized the need for the new report when an earlier paper generated controversy on social media. That study had uncovered an “unadjusted”—meaning that it did not control for differences in workplace and personal characteristics—$4 an hour gender wage gap among recent college graduates. Gould said she found this pay disparity “astounding”: “You’re looking at two groups of people, men and women, with virtually the same amount of experience, and yet their wages are so different.” But critics on Twitter, she said, claimed that the wage gap simply reflected the fact that women were choosing lower-paid jobs. “So we wanted to take out this one idea of occupational choice and look at that,” Gould said.

Gould and her co-author Jessica Schieder highlight two important findings in their EPI report. One is that, even within occupations, and even after controlling for observable factors such as education and work experience, the gender wage gap remains stubbornly persistent. As Gould told me, “If you take a man and a woman sitting side by side in a cubicle, doing the same exact job with the same amount of experience and the same amount of education, on average, the man is still going to be paid more than the woman.”

The EPI report cites the work of Harvard economist Claudia Goldin, who looked at the relative weight in the overall wage gap of gender-based pay differences within occupations versus those between occupations. She found that while gender pay disparities between different occupations explain 32 percent of the gap, pay differences within the same occupation account for far more—68 percent, or more than twice as much. In other words, even if we saw equal numbers of men and women in every profession, two-thirds of the gender wage gap would still remain.

And yes, female-dominated professions pay less, but the reasons why are difficult to untangle. It’s a chicken-and-egg phenomenon, the EPI report explains, raising the question: Are women disproportionately nudged into low-status, low-wage occupations, or do these occupations pay low wages simply because it is women who are doing the work?

Historically, “women’s work” has always paid poorly. As scholars such as Paula England have shown, occupations that involve care work, for example, are associated with a wage penalty, even after controlling for other factors. But it’s not only care work that is systematically devalued. So, too, is work in other fields where women workers are a majority—even professions that were not initially dominated by women. The EPI study notes that when more women became park rangers, for example, overall pay in that occupation declined. Conversely, as computer programming became increasingly male-dominated, wages in that sector began to soar.

The second major point that Gould and Schieder emphasize is that a woman’s occupational choice does not occur in a vacuum. It is powerfully shaped by forces like discrimination and social norms. “By the time a woman earns her first dollar, her occupational choice is the culmination of years of education, guidance by mentors, parental expectations, hiring practices, and widespread norms and expectations about work/family balance,” Gould told Rewire. One study cited by Gould and Schieder found that in states where traditional attitudes about gender are more prevalent, girls tend to score higher in reading and lower in math, relative to boys. It’s one of many findings demonstrating that cultural attitudes wield a potent influence on women’s achievement. (Unfortunately, the EPI study does not address racism, xenophobia, or other types of bias that, like sexism, shape individuals’ work choices.)

Parental expectations also play a key role in shaping women’s occupational choices. Research reflected in the EPI study shows that parents are more likely to expect their sons to enter male-dominated science, technology, engineering, and math (often called STEM) fields, as opposed to their daughters. This expectation holds even when their daughters score just as well in math.

Another factor is the culture in male-dominated industries, which can be a huge turn-off to women, especially women of color. In one study of women working in science and technology, Latinas and Black women reported that they were often mistaken for janitors—something that none of the white women in the study had experienced. Another found that 52 percent of highly qualified women working in science and technology ended up leaving those fields, driven out by “hostile work environments and extreme job pressures.”

Among those pressures are excessively long hours, which make it difficult to balance careers with unpaid care work, for which women are disproportionately responsible. Goldin’s research, Gould said, shows that “in jobs that have more temporal flexibility instead of inflexibility and long hours, you do see a smaller gender wage gap.” Women pharmacists, for example, enjoy relatively high pay and a narrow wage gap, which Goldin has linked to flexible work schedules and a professional culture that enables work/life balance. By contrast, the gender pay gap is widest in highest-paying fields such as finance, which disproportionately reward those able to work brutally long hours and be on call 24/7.

Fortunately, remedies for the gender wage gap are at hand. Gould said that strong enforcement of anti-discrimination laws, greater wage transparency (which can be achieved through unions and collective bargaining), and more flexible workplace policies would all help to alleviate gender-based pay inequities. Additional solutions include raising the minimum wage, which would significantly boost the pay of the millions of women disproportionately concentrated in the low-wage sector, and enacting paid family leave, a policy that would be a boon for women struggling to combine work and family. All of these issues are looming increasingly large in our national politics.

But in order to advance these policies, it’s vital to debunk the right’s shameless, decades-long disinformation campaign about the gender gap. The fact is, in every occupation and at every level, women earn less than men doing exactly the same work. The right alleges that the official gender pay gap figure exaggerates the role of discrimination. But even statistics that adjust for occupation and other factors can, in the words of the EPI study, “radically understate the potential for gender discrimination to suppress women’s earnings.”

Contrary to conservatives’ claims, women did not choose to be paid consistently less than men for work that is every bit as valuable to society. But with the right set of policies, we can reverse the tide and bring about some measure of economic justice to the hard-working women of the United States.

Roundups Sexual Health

This Week in Sex: Women Want More Sex Than Men Think, and Who Needs a $15K Vibrator?

Martha Kempner

This week, there's not enough of an important syphilis drug to go around, a new study shows that men don't know how much sex their female partners want, a beer company unveils a new same-sex marriage ad, and a sex toy recommended by Gwyneth Paltrow's website is gold (literally).

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Temporary Penicillin Shortage Could Be Dangerous for Pregnant Women with Syphilis

The development of antibiotics in the 1940s ushered in a new era in which bacterial infections—including syphilis, one of the oldest sexually transmitted infections (STIs)—could be treated or cured. With that came the ability to prevent congenital syphilis, which occurs when a pregnant woman passes the bacteria to her infant. Congenital syphilis can cause miscarriage, stillbirth, severe illness in the infant, and even early infant death. And, as Rewire recently reported, it is on the rise; between 2012 and 2014, there was a 38 percent increase in the rate of congenital syphilis.

The good news is that if a pregnant woman is treated with an antibiotic at least 30 days before giving birth, there is a 98 percent cure rate, meaning her infant would not be born infected. The bad news is that, until next month, there is a shortage of the one antibiotic approved for treating syphilis in pregnant women.

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Bicillin L-A, an injectable form of penicillin that is also used to treat other infections such as strep throat, is manufactured by Pfizer. The company said in April that it was experiencing “an unanticipated delay in manufacturing,” and that it would be shipping just 30 percent of the usual supply until July.

Typically, pregnant women are tested for syphilis during their first prenatal visit. If infected, they are treated with three injections of Bicillin L-A. In an attempt to keep these routine “test and treat” efforts going despite the shortage, the Centers for Disease Control and Prevention (CDC) has asked that health-care providers refrain from prescribing Bicillin L-A for any infection other than syphilis if other treatments are available.

Supply issues are unfortunately common in the pharmaceutical industry. NPR explains that generic, injectable drugs—like Bicillin L-A—are particularly susceptible to shortages because they are difficult to make but cheap to purchase, meaning few drug companies manufacture them. If those companies experience a difficulty in manufacturing that forces them to shut down temporarily, such as rust in the equipment or mold in the factory, there is no other supplier to pick up the slack.

Luckily, Pfizer expects to be back to full capacity on Bicillin L-A by July, which will help make sure there are no disruptions to efforts to prevent congenital syphilis. This is particularly important given the number of cases that have been seen in recent years and the seriousness of the outcomes. In 2014, there were 438 nationwide cases of congenital syphilis, which led to 25 stillbirths and eight deaths within 30 days of birth.

Women Want More Sex than Their Male Partners Think

There is an enduring myth that men always want sex and women, well, not so much. It turns out that women in long-term relationships with men want more sex than their partners realize. To determine if perception and reality differed, researchers conducted three studies with couples—44 couples in the first study, 84 in the second, and 101 in the third. All but ten were opposite-sex couples.

Though questions varied according to the study, each participant was asked to keep a diary that recorded some combination of the following factors: their own sexual desire; relationship satisfaction; commitment to their partner; and their perception of their partner’s sexual desire, relationship satisfaction, and commitment. Couples were also asked to keep a log of their sexual activity. Couples in the third study were asked to record how motivated they were to avoid sexual rejection on any given day.

While men in the study did report higher levels of sexual desire than their female partners, what was more striking was that across all three studies men consistently underestimated their partner’s desire. The researchers are not sure why men’s perceptions were so frequently off but they have at least two theories.

First, as Amy Muise, the lead author on the study, told Fusion via email it might be about avoiding complacency: “We don’t know exactly what men do when they underperceive, but it’s possible that this keeps them from becoming lazy about maintaining their partner’s interest.”

Alternatively, men may perceive less desire from their partners as a way to avoid sexual rejection. This is supported by the additional finding that men were particularly likely to underestimate their partner’s desire on days when they felt ill-equipped to handle rejection.

Of course, it could just be that men have been trained by every television show, movie, and magazine to believe that women just don’t want sex as much as they do.

No matter where the misperception comes from, the results of this study once again point out how important it is for couples to communicate openly and honestly about what they want and how often they want it.

Bud Light Ad Celebrates Same-Sex Marriage

While Budweiser ads of the past seem to have mostly celebrated bikini-clad women and Clydesdale horses, a new ad released in honor of LGBT Pride Month takes a big turn for the beer company. The ad depicts scenes of a wedding and features actor Seth Rogan and comedienne Amy Schumer leading a beer-bottle toast to the groom and the groom.

The company said in a press release: “June is the height of wedding season, and it is also LGBT Pride [M]onth in America. That’s why right now is the time to spark a national conversation by celebrating every kind of wedding—and everyone’s right to marry whoever they choose.”

The ad was released in partnership with Ellen DeGeneres and first appeared on her social media channels. The company will continue to air the ad on social media and plans a primetime television airing as well.

Gwyneth Paltrow’s Goop Suggests a Gold-Plated Vibrator

You may remember when Goop, the lifestyle site launched by Oscar-winning actress Gwyneth Paltrow, suggested steam-cleaning vaginas with the herb multwort, a practice that was roundly criticized by experts as unnecessary (the vagina cleans itself) and potentially dangerous (steam is hot). Goop made news again recently with a sexual-health suggestion that may be good for vaginas, but not so great for bank accounts.

Suggested on the website’s list of favorite sex toys was the LELO INEZ, a 24-karat gold vibrator that costs $15,000. Other pricey toys included a whip for $535 and a vibrating necklace for $395.

We here at This Week in Sex are all for sex toys. But we want to assure you that there a lot of good sex toys out there that won’t break the bank. You should be able to find some reliable toys for between $35 and $65 and even less, if you want to visit a local pharmacy and find vibrating rings (which, as an added bonus, are often packaged with a condom).