Fear of impotence, low awareness keep men off sterilisation

A recent survey by National Family Health Survey (NFHS-4), which has revealed that the male sterilisation in Tamil Nadu is at 0 per cent as against 49.4 per cent for women in the state has shifted the spotlight on the patriarchal mind-set and lack of awareness. Rekha (name changed), a 40-year-old, recently underwent sterilisation after she was delivered of her second child, a boy, in C-section. She says she wasn’t keen on it, and when the doctors explained to her the advantages of family planning, her family were quick to convince her. Rekha recounts that neither her husband nor her in-laws thought about asking her husband to undergo vasectomy. 

Rekha and others like her probably comprise the 49. 4 per cent of women that underwent sterilisation in the state, according to the survey, while the percentage for men had gone down from 0.4 per cent in 2005-2006 (NFHS-3). Other states with numbers of sterilisation for men included Karnataka, where it had dipped from 0.2% in 2005-06 to 0.1% in 2015-2016, West Bengal (from 0.8% to 0.1%) and in Bihar (from 0.6% to 0%). 

Dr Kalpana Apte, Senior Assistant Secretary General, Family Planning Association of India (FPAI), an organisation that promotes sexual health and family planning, says that the figures are not surprising. “With a society like ours, it is the women who always bear the brunt. In case of sterilization, this perpetuates as it is a socio-cultural issue. The disparity has been existing for three decades now. It is a pan-India trend and the figures for no-scalpel vasectomy(NSV) have been low across the country. There are a lot of myths and misconceptions surrounding it as men think that they will lose their libido after undergoing the procedure. There is a need to create awareness to make more men come forward,” she says.  

A senior doctor at a government hospital says that the only logical argument for men skipping vasectomy is that women can undergo sterilisation soon after delivery. “It may be logical for the men to think, when the procedure for women can be clubbed with delivery, why they should make a trip to hospital for a separate procedure. But, that alone doesn’t justify them passing on the onus of family planning to their partners. The big problem here is that women don’t have the freedom to decide on such issues in our society,” she says. 

Dr R Govindarajan, Head, No Scalpel Vasectomy Programme, Centre of Excellence in Sterilization, Kilpauk Medical College in Tamil Nadu, says that there is misinformation about NSV. “It is an OP procedure and the person undergoing it gets discharged within two hours. We need more awareness and if actors come forward to talk about in advertisements more men will come forward,” he says. 

Dr Apte says with less people coming forward to undergo the procedure, training more doctors in becomes futile. “It is vicious cycle— you need to have adequate experts to carry it out, but with less people opting for it, there is a dearth of trained surgeons,” she says.