Post Vasectomy Pain Forum

Psychologic effects of vasectomy in voluntarily childless men

Here is an excerpt from the study:

Psychologic effects of vasectomy in voluntarily childless men

Published to “Urology” in 1979

This study investigates the determinants and psychosocial effects of vasectomy in the childfree by comparing vasectomized childfree men with vasectomized parents.

The subjects were 51 married vasectomized fathers and 44 married vasectomized voluntarily childless men … averaged approximately two years postvasectomy.

Ninety per cent of both groups said that they still believed vasectomy was a very good means of birth control, and no subjects said the method was less than “good.” Eighty per cent of both groups said they definitely would have the operation again, and another 15 per cent said that they probably would.

Both groups reported between a 5 and 10 per cent incidence of short-term or long-term complications. These complication rates are similar to what has been reported in other studies and are low in comparison with other contraceptive methods. There were four reported physical and one psychologic complaints, in the childless group, and three physical and one psychologic complaints by parents. One in each group reported a decrease in sexual sensitivity or pleasure, and an additional subject in each group reported unusual pain. Additional complaints in the childless involved the formation of sperm granuloma, a problem with itching and urine retention, and rejection of silk tieoffs; for the parents, the complaints were prolonged bleeding and improper closure of the incision.

None of the physical complaints was considered major, and the frequency and severity of the complaints were far less than has been reported for female sterilization procedures.

Both the parents and childless reported overwhelming satisfaction with the clinic care they had received. However, the childless seemed to report that the counseling was less adequate than the parents (14 per cent to 6 per cent, respectively, responding not adequate), but the difference was not significant (X2=1.66, df=l, p>O. 10). Moreover, in response to a question asking for comments, 35 of the childless as opposed to only 25 of the parents responded critically (X2=9.46, df=l, p<O.Ol), and 7 of the parents but only 3 of the childless reported that the counseling process had been a good one. Negative comments included remarks that specific information was left out, the staff was indifferent, they were not informed of the possibility of a sperm bank, and counseling was too short or superficial. Two childless men indicated that the counselor or physician discouraged the vasectomy on the grounds that the couple was not mature enough to make the decision.

https://pubmed.ncbi.nlm.nih.gov/452223/

Reviewing that passage with my critical reading glasses on I note the following:

Out of 95 men surveyed, 90% of them (86 men) said that they still believed vasectomy is a “very good” means of birth control and it sounds like the other 9 men rated vasectomy as “good.” That’s roughly the vibe the whole text of the study conveys. Vasectomy is good. Side effects are no big deal. Child-free men with vasectomies are not depressed about it. Everything is hunky-dory.

Let’s dig a little more.

Eighty per cent of both groups said they definitely would have the operation again, and another 15 per cent said that they probably would.

So out of the 95 men, 76 of them would definitely have it again, 14 of them probably would, and that leaves 5 men who, one can only guess, would probably not have a vasectomy again even though they are on record saying it’s a “good” means of birth control.

In other words,

“Do you agree that vasectomy is a good means of birth control?”

“Yes”

“Would you do it again?”

“No.”

Moving on…

Both groups reported between a 5 and 10 per cent incidence of short-term or long-term complications. These complication rates are similar to what has been reported in other studies and are low in comparison with other contraceptive methods.

Everything in life has risk, amirite?

There were four reported physical and one psychologic complaints, in the childless group, and three physical and one psychologic complaints by parents.

Let me go ahead and break down the numbers here:

  • 2 reported decrease in sexual sensitivity or pleasure
  • 2 “unusual pain”
  • 1 sperm granuloma
  • 1 problem with itching and urine retention
  • 1 rejection of the silk tieoffs
  • 1 prolonged bleeding
  • 1 improper closure of incision

As best as I can tell, the complaint that the authors categorize as “psychologic” (as opposed to “physical”) would be the “decrease in sexual sensitivity or pleasure”. I find this to be hilarious, but I guess a decrease in pleasure is arguably a psychological phenomenon. Come to think of it, pain is a psychological phenomenon too, so perhaps they have miscounted the total number of “psychologic” complaints.

Looks like 10 men (10%) said that the counselling was not adequate:

Negative comments included remarks that specific information was left out, the staff was indifferent, they were not informed of the possibility of a sperm bank, and counseling was too short or superficial.

One wonders what relevant “specific information” was left out of the pre-op counselling.

This study investigates the determinants and psychosocial effects of vasectomy in the childfree by comparing vasectomized childfree men with vasectomized parents.

These complication rates are similar to what has been reported in other studies and are low in comparison with other contraceptive methods.

None of the physical complaints was considered major, and the frequency and severity of the complaints were far less than has been reported for female sterilization procedures.

I think it’s interesting that the study sets out to study the psychologic impact of vasectomy on childfree men, as compared to men with children, but includes these comments that attempt to contextualize the side effects by comparing them with “other contraceptive methods” and “female sterilization procedures.” It seems to me that the authors are motivated to include points like this by a preference that their study should have positive, or at least neutral impact on the desire of men to get a vasectomy.

I’m not going to go so far as to say that this preference would cause the scientists to fudge the truth, but it seems plausible that such a preference could, shall we say, blunt their ingenuity when it comes to discovering the truth.

I heard someone say that when people want to believe that something is true they evaluate it by asking:

“Does the evidence allow me to believe this?”

Conversely, when people do not want to believe something, they evaluate it by asking:

“Does the evidence force me to believe this?”

None of the physical complaints was considered major

That’s great news!

Hey wait a second.

None of the physical complaints was considered major

Uh, what about the complaint you guys are calling “psychological”?

You know, the “decrease in sexual sensitivity or pleasure” one?

<crickets>

To me, decreased pleasure and sensitivity during intercourse counts as a major complaint. In fact, this is probably the first question men want an answer to when they are considering a vasectomy. “Will it change sex for me?” This is the the complication that so many pamphlets laugh off as absurd. Of course they have to treat it as an unthinkable outcome, because many men will consider that risk to be a deal-breaker.

But once you get a vasectomy, and find out that yes, it did change sex for you… How do you cope with that psychologically? Do men use denial as a coping tool?

What makes a guy say “Vasectomy is a good option for birth control. I wouldn’t do it again.”?

I think when men say that vasectomy is good and “you should go get one” you have to be careful about what that says about their personal experience. They may be commenting on the idealized vasectomy that they think is typical, not to their own experience.

You have to get creative with the science on this. For example, maybe you could ask:

“If you could go back in time, would you still choose to get the vasectomy, if that mean that you would have exactly the same experience again?”

Then I think you will get some real data about what men experienced and how they feel about it, rather than feedback that is skewed by the positive reputation that vasectomy has.

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