Pierson Benjamin C, Banaag Amanda, Janvrin Miranda Lynn, Koehlmoos Tracey Pérez
Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.
Int J Impot Res. 2024 May 18. doi: 10.1038/s41443-024-00905-7.
Dobbs v. Jackson Women's Health Organization (Dobbs decision) has already had profound impact on reproductive health care in the United States. Some studies have reported increased incidence of vasectomy after the Dobbs decision. The Military Health System (MHS) provides a unique opportunity to evaluate this relationship in a universally insured, geographically representative population. We conducted a retrospective cross-sectional study of vasectomies among all male beneficiaries in the MHS, ages 18 to 64, from 2018 to 2022. Beneficiaries receiving a vasectomy were identified via billing data extraction from the MHS Data Repository (MDR). Descriptive statistics of demographic factors of all those receiving a vasectomy in the study period were evaluated. Crude and multivariate logistic regression models were used to evaluate for differences in demographic variables in those receiving a vasectomy pre-Dobb's decision as compared to after the Dobb's decision. The total number of men receiving a vasectomy each month over the study period was analyzed, as were the numbers in a state immediately implementing abortion access restrictions (Texas), and one without any restrictions on abortion access (Virginia). Our analysis found that men receiving a vasectomy post-Dobbs decision were more likely to be younger, unmarried, and of junior military rank than prior to the Dobbs decision. In the months following the Dobbs decision in 2022 (June-December), there was a 22.1% increase in vasectomy utilization as compared to the averages of those months in 2018-2021. Further, it was found that the relative increase in vasectomy after the Dobbs decision was greater in Texas (29.3%) compared to Virginia (10.6%). Our findings highlight the impact of the Dobbs decision on reproductive health care utilization outside of abortion.
多布斯诉杰克逊妇女健康组织案（多布斯裁决）已经对美国的生殖健康护理产生了深远影响。一些研究报告称，多布斯裁决后输精管切除术的发病率有所上升。军事医疗系统（MHS）提供了一个独特的机会，可在一个全民参保、具有地域代表性的人群中评估这种关系。我们对2018年至2022年期间MHS中所有年龄在18至64岁的男性受益人的输精管切除术进行了一项回顾性横断面研究。通过从MHS数据存储库（MDR）提取计费数据来确定接受输精管切除术的受益人。对研究期间所有接受输精管切除术者的人口统计学因素进行了描述性统计。使用粗逻辑回归模型和多变量逻辑回归模型来评估在多布斯裁决前接受输精管切除术者与多布斯裁决后接受者在人口统计学变量上的差异。分析了研究期间每月接受输精管切除术的男性总数，以及立即实施堕胎准入限制的一个州（得克萨斯州）和一个没有任何堕胎准入限制的州（弗吉尼亚州）的相关数据。我们的分析发现，多布斯裁决后接受输精管切除术的男性比裁决前更有可能年龄更小、未婚且军阶较低。在2022年多布斯裁决后的几个月（6月至12月），与2018年至2021年这些月份的平均水平相比，输精管切除术的使用率增加了22.1%。此外，还发现多布斯裁决后输精管切除术的相对增加在得克萨斯州（29.3%）比在弗吉尼亚州（10.6%）更大。我们的研究结果凸显了多布斯裁决对堕胎之外的生殖健康护理利用的影响。
