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    Masculinity Crisis: The End of Male

    On a Thursday
    in August, I walk into a budget health clinic in downtown Los Angeles. At the end of a maze of pistachio-colored
    hallways, I find a room marked LabCorp–it’s essentially a storage closet full
    of folded cardboard boxes, a jumble of plastic tubs, a bin marked “Dry Ice,”
    and a few desks and chairs. It’s reminiscent of where the janitors at
    elementary school would hang out, only with microscopes. I’ve paid $129 to have
    a test done: “Semen Analysis, Basic.” 
     

    There is no waiting room. I stand in the doorway until
    Maria–a lab-tech with a sweet-looking face, long black hair, and a pink shirt
    sprinkled with fine black polka dots under a white coat–acknowledges me. She
    hands over some forms and a plastic cup.

    “You have to ejaculate everything inside, and when you’re
    finished put it in here,” Maria says, pointing at a box next to me crowded with
    plastic cups in baggies. “The bathroom’s out the door, a quick left.”

    I enter the handicap-accessible bathroom. The walls are a
    chalky shade of blue. A knot of toilet paper drifts around the toilet bowl. An
    overworked plunger sits in the corner. I can hear someone unfurling a roll of
    duct tape beyond the door. There is no porn. There is no chair. I do my thing.
    I return to the office and put the cup into the box. I avoid Maria.

    In my rush to leave, I forget to hand in my paperwork. When
    I revisit Maria, she tells me they’ll measure volume and concentration here on
    the spot. Then the sperm will travel south, to another lab in San Diego, where a technician will analyze
    their shape and size, and how well they swim. I’ll get the results–a
    password-protected PDF–a few days later.

    I signed up for a fertility test not because I’m trying to
    have a kid (please) but as a barometer of my maleness, in its most medieval,
    distilled sense. Admittedly, it was a ridiculous thing to do. But I was
    curious. As you may have heard, male anxiety is on the rise in 21st-century America.
    Employers no longer value our strength to lift or make things (we sent those
    jobs overseas). Society is sick of our risk-taking bravado (that’s what crashed
    the economy). Women don’t need our financial support (matriarchy is the new
    patriarchy). Every week there’s a new think piece or cover story ripping holes
    in the trappings of traditional manhood.

    As a gay man, I welcome the growing irrelevance of
    old-school masculinity. I’m less likely now than at any point in history to be
    impeded by my failure to conform to traditional notions of manhood. I can be
    the CEO of Apple. I can be a drag queen. Whatever I choose, I’m still a man.

    But a creeping masculinity crisis, one that’s biological,
    affects me just as much as any frat boy or military officer. Around the world,
    male fertility is sharply declining. Birth defects afflicting the penis and
    testicles are on the rise. So is testicular cancer. Scientists expect that these
    problems will plague future generations even more than ours.

    Whether you’re RuPaul or Paul Ryan, functional genitals
    matter–and contribute to an understanding of your maleness. “When you boil it
    down to it, the essence of masculinity might be a hard penis and semen,” says
    Lisa Jean Moore, professor of gender studies at Purchase College-SUNY.
    Specifically, semen dense with healthy, tail-wagging sperm.

    It’s a reductive idea, but maybe that’s why it’s valuable.
    Cultural understandings of masculinity are always shifting, after all. They’re
    temporary. Cock and balls are forever. Or at least they’re supposed to be.

    Since the 1990s endocrinologists have issued warnings on the
    future of male reproductive health–“penis and semen,” in Moore’s
    words. In 1992, Danish scientists published a meta-analysis of 61 studies on
    semen quality from around the world, concluding that the average sperm
    concentration had declined by nearly 50 percent over a 50-year period, from 113
    million to 66 million sperm per milliliter. “Every man sitting in this room
    today is half the man his grandfather was,” reproductive biologist Lou
    Guillette told Congress in 1993. “Are our children going to be half the men we
    are?”

    An increasingly solid–but by no means conclusive–body of
    evidence links low sperm density and other problems in male reproductive health
    with a class of chemicals called endocrine disruptors, which are present in everything
    from pesticides to plastics to beauty products. First identified in the 1990s,
    endocrine disruptors are named for the way they mimic hormones and tinker with
    the signals sent between cells. These include news-making plastic components
    like bisphenol-A and phthalates, recently banned from use in baby bottles and
    children’s toys, respectively, but still present at low levels in the blood and
    urine samples of more than 90 percent of the U.S. population.

    “They’re not all identical and they have different actions.
    Some interfere with estrogen; some with androgen, the male hormone,” explains
    Philip Landrigan, an epidemiologist at Mount Sinai
    Hospital in New York. “It’s a mixed lot, and very
    complex.” Wildlife biologists first identified them in connection with birth
    defects and decreasing populations of birds and fish. “For the first few years,
    the concept of endocrine disruption was treated with a lot of skepticism
    outside of environmental circles. But in the last four or five years it’s moved
    very much into mainstream medicine,” says Landrigan, particularly as study
    after study suggests connections to the contemporary decline in male reproductive
    health.

    In 2000, American researchers not only confirmed results
    from the original Danish semen quality study, they found sperm density in the
    United States and Europe to be falling at an even faster clip: by 1.5 to 3
    percent per year. And last summer, an Israeli study noted a steady decline in
    semen quality at one local bank over the past 15 years. A full 38 percent of
    all sperm-donation applicants are now rejected, up from one-third prior to 2004. That year, the
    bank lowered its minimum sperm count for acceptance to widen its net for
    donors. Under those more stringent standards, 88 percent of contemporary
    samples would have been rejected.

    Sperm-bank rejects aren’t necessarily infertile. But if the
    downward trend continues, by 2030 the researchers predict that even
    above-average men will reach “subfertility” levels. Globally, an average of 15
    percent of men are considered infertile, up from 10 percent 20 years ago.

    Psychologists have shown that men who get an infertility diagnosis
    “feel isolated, they feel lost,” says William Petok, a psychologist who
    specializes in treating infertility. “One of the things we often see is a
    feeling that in some ways they are a failure sexually, because there’s a
    conflation between being fertile and being potent.” Indeed, two-thirds of
    infertile men say they worry about their “physical potency.” This conflation is
    especially visible in non-Western cultures, or ones where structural economic
    disadvantages mean men are unable to fill traditional roles like provider or
    protector–which is where Hanna Rosin, in her book The End of Men, says
    we’re headed. “I think a man considers his sperm far more an annunciation of
    his identity than a woman considers her egg,” Petok says. “It’s visible. Every
    time a guy has an ejaculation it’s evidence of his capacity to produce a
    child.”

    The masculinity-fertility relationship is reified in the
    sperm bank industry. When I called up the Cryobank in Los Angeles, California’s
    largest sperm bank, director of client experience Scott Brown told me what an
    accepted donor looks like. He’s a “college graduate or student. Average age is
    probably 22 to 25. Altruistic in nature, successful in life. Healthy. Tall.” A
    real catch, but only for the ladies: he can’t have had sex with another man in
    the past five years. Like the FDA prohibition on blood from gay donors, it’s “a
    leftover prejudice from the days of HIV and not understanding how it’s
    transmitted,” conjectures Brown, even though all sperm is tested for disease.

    How does one man end up making more, better sperm than
    another? Endocrinologists believe a man’s capacity for sperm production is
    capped by the time he leaves the womb–so, maybe he’s born with it? But with an
    increasing body of evidence implicating chemicals found in everything from
    carpeting to cosmetics, the more crucial question becomes: Maybe it’s
    Maybelline?

    It’s a relief when
    I get my lab results back the next week: I’m fertile. This shouldn’t come as a
    surprise. I’m 25; I don’t regularly take drugs, linger in the sauna, ride a
    bike, or huff gasoline fumes. But my sperm count shows up on the low side of
    normal: with just 33 million sperm per milliliter, it’s right above the lab’s
    cutoff of 20 million per milliliter.

    I am guilty of lifestyle choices that could lower my count:
    I spend my days at a desk; I’m prone to stress; I’ve recently experimented with
    tighter underwear styles. But it’s possible the explanation goes back much
    further, to the chemicals that infiltrated my mother’s womb.

    It was the ’80s. My mom applied hairspray liberally. She
    didn’t seek out pesticide-free food or use glass instead of plastic. Yet
    there’s no way to prove that endocrine disruptors affected my or anyone else’s
    development, according to Niels Skakkebaek, a pediatric endocrinologist in Copenhagen. “You can’t do
    experimentation in humans.”

    You can document the patterns, though. Skakkebaek was one of
    the first researchers to highlight the connection between endocrine disruptors
    and a variety of problems in male reproductive health, starting with testicular
    cancer. The disease became commonplace in the 20th century–1 in 100 Danish men
    were getting it–and as a young doctor in the 1970s, Skakkebaek set out to
    determine why. “You can’t see such an increase in one or two generations just due
    to genetic factors alone,” Skakkebaek says. “It had to be an environmental
    problem.”

    Skakkebaek’s research showed that the signs of testicular
    cancer–which strikes after puberty–are present in the womb. In the testes of
    miscarried fetuses, he found cells similar to precursor testicular cancer
    cells. In his clinical practice, he observed a spate of birth defects like undescended
    testes. Meanwhile, semen-quality studies in the 1980s revealed surprisingly low
    sperm counts among working-class Danes.

    Skakkebaek started to connect the dots. “I noticed that
    infertile men–they more often had undescended testes and other childhood
    abnormalities,” and were at a greater risk for testicular cancer, he says.
    Another observation: The precursor cancer cells were more often found in men
    with birth defects. He started reviewing semen-quality studies, which led to
    his landmark meta-analysis in 1992 that found sperm density was half as high as
    it was 50 years ago.

    His work coincided with environmentalists’ growing concerns
    about endocrine disruptors. In 1991, World Wildlife Federation zoologist Theo
    Colborn held the first major symposium about the possible effects of
    environmental toxins on animals’ sexual organs and behavior. Researchers
    presented data showing how pesticides in Florida
    swamps appeared to raise the levels of estrogen in male alligators to unusually
    high levels, shrinking their penises to three-quarters the usual size. Lesbian
    seagulls had been outed in Southern California.
    Later, fish turned intersex in the Potomac.

    The evidence was starting to pile up that “we all might
    be–without knowing it, unintentionally–exposed to chemicals that had hormonal
    effects,” Skakkebaek says, “which at that time was completely new for me.” And
    it posed a possible explanation for the problems he was finding among men.

    Researchers began replicating these environmental conditions
    in the lab, exposing rodents to a variety of endocrine disruptors, including
    phthalates. Male rodents exhibited malformed prostates, undescended testes, and
    other problems. In 2010, male frogs introduced to the herbicide atrazine
    started producing eggs, copulating with other male frogs, and giving birth to
    healthy young. They were seven times as likely as the unexposed frogs to
    display homo-sexual behavior.

    Why would all of these problems affect males more than
    females? The answer is sexual differentiation: Before hormones kick in, male
    and female fetuses are mostly indistinguishable. If left alone, gonads become
    ovaries–it takes androgens to command them to morph into testes. During
    gestation, “the reproductive organs and other organs are undergoing rapid
    development,” says Landrigan. “The price of that rapid development is extreme
    vulnerability.” In lab animals, the tiniest difference in hormones or hormone-mimicking
    chemicals–a teaspoon-sized drop in an Olympic-sized pool–can permanently
    undervirilize the male reproductive system and brain. The testes may not fully
    descend. The urethra might not reach the tip of the penis. The sperm count
    could be permanently lowered.

    In 1993, Skakkebaek co-authored a paper advancing an
    environmental theory for the decline in semen quality he discovered the
    previous year. And over the course of the next decade, he built an argument
    about the relationships between testicular cancer, birth defects, and
    infertility.

    Recent research has shown a strong association between these
    conditions in men and one type of endocrine disruptor in particular:
    phthalates, the anti-androgen chemical used to soften plastics and found in the
    food we eat, water we drink, and dust we inhale. Male rats whose pregnant
    mothers were fed a diet of phthalates were shown to be at risk for reproductive
    problems, “undescended testes and so on,” explains Shanna Swan, a
    biostatistician at the University
    of Rochester. Moreover,
    the distance between the anus and the genitals–normally twice as long in male
    as in female rats, and longer in human males as well–was shorter in the exposed
    rats, a sign of prenatal feminization.

    “This measure of ano-genital distance”–AGD, as it’s
    called–“has been used in animal studies for a long time, but almost never in
    human studies,” Swan says. She decided to measure it in children, and in a
    groundbreaking paper in 2005, she made a significant reveal: Boys whose mothers
    had higher levels of phthalates had shorter AGDs than normal, not to mention
    impaired testicular descent. The paper is perhaps the strongest evidence we
    have that “phthalates may undervirilize humans as well as rodents.”

    A shortened AGD has been linked with the birth defect
    hypospadias, when the urethra opens on the penis’s underside. Data cited by the
    Centers for Disease Control showed hypospadias doubled in frequency between the
    1970s and the 1990s. Affecting about one out of every 100 men, it’s among the
    most common abnormalities males are born with. But unlike autism or cleft
    palates, it’s rarely discussed.

    In the decades
    since Skakkebaek started asking questions about declining fertility in Denmark,
    research has coalesced around the association between fetal exposure to
    endocrine disruptors and feminized male genitals. Now a few researchers are
    starting to ask: Do these toxins also affect men’s brains?

    In 2009, Swan studied 145 preschoolers whose mothers had
    relatively high levels of phthalates in their urine. Parents were asked to fill
    out surveys about how their children played. Did the boys gravitate toward
    gender-typical toys like trucks and guns? Were they “rough and tumble”?

    “Now, I have to stress that these studies are small. They
    were the first studies,” Swan says. “And you know we can’t obviously randomize
    people to be exposed to phthalates or not, so we have a lot of limitations.”
    But initial results showed that boys exposed to higher levels of phthalates
    were more likely to exhibit feminized behavior–a correlation, not conclusively
    a cause.

    Still, I can’t help but ask if the study implies something
    bigger. “I actually don’t know the answer to that question,” Swan responds.
    “Behind your question is the question I get a lot: ‘What does it have to do
    with gender identity?’ “

    It’s probably unanswerable. And it feels offensively
    reductive–a vestige of the tired nature-versus-nurture debate that seeks to
    find a cause for complicated differences in gender and sexuality. Scientists
    take seriously the hypothesis that endocrine disruption affects behavior, but
    when I asked them about gender, one by one the experts steered the conversation
    toward other studies linking the toxins with ADHD or autism–behaviors that are
    more diagnosable and less controversial.

    If endocrine disruptors are indeed feminizing males, it’s a
    health problem in humans only insofar as it affects fertility and the
    functioning of sex organs. Feminine and gay men obviously still reproduce. Will
    the feminized boys in Swan’s study end up infertile? Will they end up with
    testicular cancer? Or will they just end up gay? It’s certainly possible that
    this type of research will pathologize male differences, lumping in gender variation with
    real health concerns. But it could also push the question of gender identity to
    the foreground, forcing a broader dialogue about the need for more
    accommodating notions of maleness (at a time when male reproductive organs seem
    to be changing, nonetheless).

    Swan is gearing up for another study with a bigger sample
    size of about 800 children. “If we see this again in the second study, then I
    think it will be really convincing,” she says. “I think the fact that we took
    animal data, we formed a hypothesis, went to test it in a human population, and
    found what we had predicted also strengthens our original findings. But it’s
    not conclusive.” And perhaps that’s a good thing. Plenty of experts, whether
    they’re scientists or psychologists or queer theorists, deny linkages between
    sex, gender, and the role of hormones. Gender isn’t something someone has; it’s
    something someone does. There are all sorts of people–those who are
    transgender, say, or intersex–who don’t map onto one set of norms.

    How–and why–we “do maleness” is incredibly complicated, and
    seems to be getting more so. Phthalates are among the most common chemicals on
    earth; billions of tons continue to be produced annually. What does manhood
    look like in a future where men are less likely to be able to reproduce
    naturally and far more likely to be born with imperfect sex organs? The
    questions will linger in our minds, just as long as the chemicals permeate our
    bodies.

    Zak Stone is a Los
    Angeles-based writer and editor, a staff writer for
    Fast Company’s Co. Exist
    website, and co-founder of
    Tomorrow Magazine, a crowdfunded
    publication about politics, culture, and lifestyle, from which this article was
    reprinted.

    Published on Apr 10, 2013

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