HPV Vaccine for Boys Pushes Boundaries of Sexual Equity Dynamics
Last year — three long years after it was approved for use in girls — the FDA approved the use of the HPV vaccine for boys. Now the vaccine, which is manufactured by both Merck and GlaxoSmithKline, is recommended for young men and women ages 9 to 26 to protect against several strains of the human papillomavirus (HPV), some linked to genital warts and a number of cancers. HPV is the most common sexually transmitted infection out there with 20 million Americans infected, and an additional six million new cases each year.
When the HPV vaccine was approved for young girls, it was a foray into a sexual revolution of sorts for young women. It opened the door to an uneasy thought for many parents: at some point in your daughter’s life, and probably a lot sooner than you’d like to think, she will have a sexual experience that expose her to HPV. It was a forced reckoning of the sexual choice, power, and agency of young women. Not promiscuity, but agency. Better that a young woman is educated and equipped.
Much like with objections to sex ed in schools or access to free condoms, there were sensationalist assertions that somehow protecting against an STI gives one license to just go on out and get it. Just like how making abortions safe and legal compels people to get abortions all the time, right?? I digress…
But what about boys? Are they getting vaccinated now that they can, and are even being urged to? While men are very often carriers of HPV, they less often exhibit symptoms than women do. Also, cervical cancer is far more prevalent and better-correlated to HPV than other cancers, such as penile, rectal, or throat, that might affect men.
Not surprisingly, uptake in boys of the vaccine has been much slower. I think there is a certain perception of immunity for boys, whereas our girls need to be “protected” as much as possible because…well, you never know with the frenetic and uncontrollable sexuality of women. HPV is really not seen as a disease among men, nor, I think, is there the same culture of ‘sexual health prevention’ that there is among young women. In sum, the burden of sexual responsibility and health still disproportionately lies on the shoulders of girls and women.
The recommendation of the HPV vaccine for boys can help change that. And since boys under the age of 18 are most likely not the ones, themselves, making the decision to get vaccinated, the dynamics rest on the vision of a parent who wants to raise a sexually responsible (and healthy) man. Boys are less at risk from the implications of HPV, but risk spreading it to women (or other men) who are more vulnerable.
Vaccination for boys is calling into play a new dynamic in shared sexual responsibility – just the way birth control for men, when it finally hits the market, will.
It’s high time to understand the complexity and vulnerability of young peoples’ sexuality – and do our part (as parents, as educators, as researchers, as health providers) to ensure they have access to the most cutting edge and medically sound prevention tools possible. They can make their own decisions…and they will – regardless of how we equip them.
Also time for the nascent sexuality of both young men and young women to be considered in a more equal light – equally as vulnerable, equally as responsible for infections, pregnancy and other sexual risks which may occur. Vaccine access and, ideally, uptake should reflect the equity in sexual and gender dynamics that we seek on the social side of things.