Texas Policy Evaluation Project
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New Research Examines Barriers to Texas Clinics Providing Vasectomy

Low Reimbursement Rates and Lack of Training Reduce Access

AUSTIN, Texas—New research from the Texas Policy Evaluation Project (TxPEP) 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 based on interviews with program administrators at 54 family planning clinics in Texas, researchers found that a range of barriers exist. Many organizations lacked funding for vasectomy services and did not have a clinician on staff that was trained to perform 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.

“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.”

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.

The full citation for the paper is:

  • White K, Campbell A, Hopkins K, Grossman D, Potter J.E.  Barriers to offering vasectomy at publicly funded family planning organizations in Texas, American Journal of Men’s Health. Pp. 1-10 Online First, 2017.

About the Texas Policy Evaluation Project

The Texas Policy Evaluation Project, or TxPEP, is a comprehensive effort to document and analyze the impact of the measures affecting reproductive health passed by the Texas Legislature. The project team includes researchers at the University of Texas Population Research Center, the University of California San Francisco, Ibis Reproductive Health, and the University of Alabama-Birmingham. The project is supported by grants from the Susan Thompson Buffett Foundation and the Society of Family Planning. Infrastructure support for the Population Research Center is provided by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Funders of the Texas Policy Evaluation Project have no role in the design and conduct of the research, interpretation of the data, approval of the final manuscript or decision to publish.

Editor’s note: For more information or to request a copy of the study, contact Kat Harris (kharris@echristianpr.com) or Heath Riddles (hriddles@echristianpr.com), or call 512.472.9599.