Performed and refused vasectomy: A secade of waning popularity and increasing awareness of safety

Abstract

Family planning clinics and a random sample of private physicians throughout the United States were surveyed in 1972 and 1984 to learn the incidence of performed and refused vasectomy, and to discern attitudinal change over time toward delayed physical and psychological sequelae related to vasectomy. Data show that, after a dramatic rise in popularity in the early 1970's, incidence has fallen significantly in the intervening years. The greater decrease was reported by physicians. Clinics experience a lower refusal rate which may be partially explained by physicians’ predilection to practice defensive medicine. Other factors, such as counseling quality and applicant eligibility criteria, show little difference. Concern about physical sequelae has diminished, as has the importance of psychiatric symptomatology as a screening tool. Delayed psychological sequelae remain more ambiguous, with physicians deemphasizing the potential phenomena but clinical staff becoming somewhat more concerned. Nevertheless, both groups refused roughly the same percentage of applicants for psychological reasons.