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
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
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
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
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
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
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
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
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