Reality Ain't What It Used to Be

BOSTON. — Boston -- From all reports this is a medical breakthrough, although breakthrough is probably a bad word to use when you're talking about condoms.

Somebody called it "a great day for women." The buzzword of the week was "empowerment." All 11 members on the FDA panel recommended the tentative approval of the first condom for women.


Well, forgive me if I don't get my "Sisterhood is Powerful" T-shirts out of storage to celebrate the invention of this vaginal pouch. I share the more subdued attitude embodied in the name of the device. It's called "Reality." Maybe it should be called "Bleak Reality."

About five years ago when alarm about the heterosexual transmission of AIDS first broke through the walls of denial, sexual entrepreneurs began marketing male condoms to women. The most straightforward of the ads featured a woman saying, "I'll do a lot for love, but I'm not ready to die for it."


The message in the marketing was clear. Women who had taken on the full responsibility for birth control were urged to take on more responsibility for disease control. The condom which once made an impression in teen-age male wallets was re-packaged for female purses.

Now it's 1992. Almost two-thirds of the AIDS cases worldwide have been transmitted heterosexually. Magic Johnson is infected with the HIV virus. And the new improved line of defense we are offered is a device that eliminates any male responsibility at all.

This is the much-touted advantage of the female version of the condom. It may be expensive. It may be awkward to use. But it circumvents the need to even "negotiate" with a man.

Mary Guinan, who works in AIDS and other sexually transmitted diseases at the Centers for Disease Control, is quite open about the female advantage. "We need protective devices for women," she says. "Then they don't have to negotiate something with a man. They can do it themselves."

This is the new Reality. The success of the female condom is predicated on the failure of male-female negotiations. The "empowerment" that comes with a vaginal pouch is proof, if we needed it, of women's lack of power in relationships.

Dr. Guinan wearily admits to the power gap she has seen in many forms and many populations. Not long ago she asked a roomful of peers -- all women doctors -- how many thought they had equality in sexual decision-making. Only 20 percent raised their hands.

Today one of her patients is a 30-year-old woman married to a hemophiliac with AIDS. He refuses to use condoms and she continues to have sex with him. She is more reluctant to hurt his feelings than he is to endanger her life.

Drawing such parameters, Dr. Guinan asks, "Do you think a woman can negotiate condom use with a crack user? They have to have something of their own so that the guy won't beat them up." Indeed her chief reservation about the female condoms is that they can be seen or felt by male partners. "The next step is a condom that a man can't detect."


The medical facts show that women are more vulnerable to sexually transmitted diseases than men. Even AIDS is not an equal-opportunity virus. It is easier for a man to infect a woman than the other way around.

But a decent product can still be lousy sign of the times. This one points to the stark unevenness of social change. The most current sexual armament coexists with the most ancient sexual passivity.

After all this time, it is still simpler for many women to insert a condom than to assert themselves. It's simpler for women to take care of themselves than to say "no" or "not now" or "not without protection" to men who aren't caring or careful.

How many women in the past two decades have found it easier to change their own behavior than to change the men in their lives? How many have found it easier to alter the way they behave independently than to alter the way they behave in a relationship?

This time it's condoms for women. "We can't afford to wait until society becomes enlightened," Mervyn Silverman of the American Foundation for AIDS Research says quite properly. "I'd hate to see a lot of women die because we were waiting for nirvana."

So, this is Reality. One step forward in female protection. One step backward in male responsibility. Something new and something very, very old.


Ellen Goodman is a syndicated columnist.