New research from the Texas Policy Evaluation Project (TxPEP) at The University of Texas at Austin provides insight into why vasectomy is not more widely available at family planning clinics in Texas.
Vasectomy is a highly effective contraceptive option for men and couples who do not want more children; however, few publicly funded family planning clinics in the United States offer the procedure as part of their comprehensive contraceptive services.
In a paper published recently in the American Journal of Men’s Health, researchers interviewed program administrators at 54 family planning clinics in Texas to determine a range of barriers, including financial and educational, that men might face in getting a vasectomy.
“We found that the majority of barriers to the availability of vasectomy as a contraceptive method are associated with funding, training and community education,” said Kari White, the lead author on the study, co-investigator with TxPEP and assistant professor in health care organization and policy at the University of Alabama at Birmingham. “A multi-level approach that simultaneously addresses these factors could allow publicly funded family planning organizations to offer comprehensive contraceptive services that include vasectomy.”
Interviewees shared that many organizations lacked funding for vasectomy services and did not have a clinician on staff that was trained for the procedures. Administrators from organizations that received Title X funding, a federal program that requires a range of contraceptives to be provided on-site or by referral, noted that they were unable to establish contracts with trained clinicians in the community because potential contractors considered the $250 reimbursement to be too low. Additionally, study participants frequently reported that male reproductive health services were not central to the organizations’ missions.
Two-thirds of organizations in the study did not offer vasectomy on-site or pay for referrals with family planning funding. Only nine organizations frequently provided vasectomy.
Respondents also frequently commented that male clients were not interested in vasectomy. While men in general were thought to have limited interest, Latino men in particular, were considered to be more opposed to undergoing the procedure. Latino men’s opposition to vasectomy was attributed to presumed cultural norms around masculinity and attitudes about women’s responsibility for using contraception.
Recent studies show that what has been perceived as some men’s lack of interest in the procedure could actually be a general lack of awareness or incomplete information. As evidenced by organizations’ reported success with conducting tailored outreach in Latino communities in this study, as well as campaigns conducted in low-resource settings outside the United States, men are likely to express interest in the procedure when these information gaps are addressed.
The study pointed to several strategies that could eliminate barriers to accessing vasectomy. Raising the reimbursement rate for vasectomies and providing coverage for men in state-funded family planning programs may increase access to the procedure for low-income Texans. Training on-site providers in minimally invasive vasectomy techniques could counter organizations’ beliefs that the provision of vasectomy is outside their mission and scope of services.
For more information or to request a copy of the study, contact Laura Dixon (firstname.lastname@example.org) or call 512.788.2653.