Teti Michelle, Raybon Denise, Spitz Stephanie, Webb Shelby, Witt Jacki, Metcalf-Wilson Kristin
Honors College, University of Missouri, Columbia, MO, United States.
Collaborative Center to Advance Health Services, University of Missouri Kansas City, Kanas City, MO, United States.
Front Reprod Health. 2024 Dec 18;6:1386244. doi: 10.3389/frph.2024.1386244. eCollection 2024.
Evidence suggests a new demand for vasectomies following the Supreme Court's Dobbs v. Jackson Women's Health Organization [597 U.S. 215 (2022), (Dobbs)]. Vasectomies are safer and more cost-effective than tubal sterilization. Understanding how to support men's use of this procedure is important to improving sexual and reproductive health and wellbeing (SRHW). This study is an exploration of health care providers' perspectives on the gender, cultural and political influences on vasectomies at Title X-funded clinics across all regions of the US.
Providers or health services staff ( = 21) at Title X-funded settings currently offering vasectomy services in their own clinics or via referral were recruited using list serve and email outreach. Participants took part in one-on-one or small group interviews about vasectomy procedures, patient experiences, and trends. A thematic analysis of interview transcripts through an iterative process of reviewing, note-taking, and discussing data assessed provider views on patient cultural, gender, and political vasectomy influences.
Qualitative interviews yielded four themes related to participant access to services, including income challenges, language barriers, medical distrust, and societal gender roles that stressed women's responsibility for contraception. Two additional themes focused on men's fear of losing reproductive health options and desire to "step up" to do their part to prevent unplanned pregnancies.
Interviewees stressed that vasectomy was for everyone but identified sub-groups of men who still faced logistical and social access challenges to the procedure. Providers also believed that men were concerned over reproductive justice in the US and wanted to do their part to help prevent unplanned pregnancies. They thought that the Dobbs decision may mark a turning point in reproductive care that could ultimately better public health initiatives and overall SRHW by including men in the conversation. Vasectomy education, marketing-along with policy changes that ease access, can support this goal.
有证据表明，美国最高法院对多布斯诉杰克逊妇女健康组织案[美国最高法院第597卷，第215页（2022年），（多布斯案）]作出裁决后，对输精管切除术产生了新的需求。输精管切除术比输卵管绝育术更安全且成本效益更高。了解如何支持男性采用这一手术对于改善性与生殖健康及福祉（SRHW）至关重要。本研究旨在探讨医疗服务提供者对于美国各地区由第十类计划（Title X）资助的诊所中，性别、文化和政治因素对输精管切除术影响的看法。
通过列表服务和电子邮件外联，招募了在第十类计划资助机构中目前在其诊所自行提供或通过转诊提供输精管切除术服务的医疗服务提供者或卫生服务工作人员（n = 21）。参与者参加了关于输精管切除手术、患者体验和趋势的一对一或小组访谈。通过对访谈记录进行反复审查、做笔记和讨论数据的过程进行主题分析，评估了医疗服务提供者对患者文化、性别和政治因素对输精管切除术影响的看法。
定性访谈产生了与参与者获得服务相关的四个主题，包括收入挑战、语言障碍、医疗不信任以及强调女性在避孕方面责任的社会性别角色。另外两个主题聚焦于男性对失去生殖健康选择的恐惧以及希望“挺身而出”为预防意外怀孕尽自己一份力的愿望。
受访者强调输精管切除术适用于所有人，但指出仍有部分男性群体在接受该手术时面临后勤和社会方面的获取障碍。医疗服务提供者还认为，男性关注美国的生殖正义，并希望尽自己的一份力量帮助预防意外怀孕。他们认为多布斯案的裁决可能标志着生殖保健领域的一个转折点，通过让男性参与讨论，最终可能会改善公共卫生举措以及整体的性与生殖健康及福祉。输精管切除术教育、宣传以及放宽获取渠道的政策变革都可以支持这一目标。
