The vasectomy gap: Hispanic men's use of vasectomy and the cultural politics of sexual-reproductive wellbeing in the USA.

Abstract

Hispanic men have vasectomies at markedly lower rates than non-Hispanic White men in the USA, even though vasectomy is safer, more effective, and less expensive than female sterilisation. Conceptualising vasectomy beyond a biomedical intervention, the article positions vasectomy as a site of political contestation where masculinity, sexual expertise, fertility accountability, access to care, and memories of sterilisation abuse intersect. The results run counter to traditional explanations based solely on machismo. Instead, factors including low awareness, sexual dysfunction myths, Spanish-language counselling barriers, lack of insurance coverage for male contraception, female-focused family planning, provider bias, and medical mistrust from sterilisation abuse against Latina and Mexican-origin women help explain the Hispanic-White vasectomy disparity. Recent increases in vasectomy requests following the US Supreme Court ruling on Dobbs v. Jackson Women's Health Organisation, which ended federal constitutional protection for abortion and returned its regulation to individual states, suggest that men will access permanent contraception when reproductive circumstances change. However, inequities may continue to limit Hispanic men's access and use unless sexual and reproductive health policy is culturally grounded, gender-balanced, linguistically accessible and responsive to the history of coercive sterilisation in the USA.