Vasectomy - Psychological Impact

Psychological Impact

In the mid-1970s, surveys were used to examine the effects of vasectomy in relation to post-operative sexual behaviour, satisfaction and happiness, with generally positive answers in their "ticked boxes". However a different picture emerges from psychologically-based clinical interviews and tests, employing more rigorous methodology and measurement techniques. Although men in general verbally expressed satisfaction with their vasectomy, the authors of one review reflected "many men were probably describing feelings which have been distorted as part of an attempt to cope with their private concerns about the consequences of the operation". In addition, many men experienced difficulty in adjusting to the psychological consequences of vasectomy.

These differing results between simple surveys, and more elaborate interviews and psychological reviews, are revealing of some of the difficulties in trying to measure the psychological impact of vasectomy on men.

Most surveys following vasectomy show sexual desire and satisfaction levels remaining at the same level or greater (without the risk of pregnancy), and overall most men being content with their decision to have a vasectomy. Approximately 90% are generally reported in reviews as being satisfied with having had a vasectomy. While between 7-10% of men who have a vasectomy, regret their decision. Most surveys frame questions as to "satisfied" or "not satisfied"; and do not provide for ambiguous, ambivalent or complex emotions, which may exist alongside "overall satisfaction" with vasectomy.

One of the strongest contraindications to vasectomy in psychological terms, is disagreement with one's wife or feeling "bullied into" a vasectomy, with men reporting this situation as experienced the highest level of negativity and regret subsequent to having a vasectomy.

The psychological effects of vasectomy may also continue or re-surface throughout a man's life history, beyond the period of a survey's scope. While a man may initially be satisfied with his decision to have a vasectomy, this view may change "later on his life history" such as subsequent to the breakdown of his primary relationship and re-coupling with a new partner who desires children. This type of situation of re-partnering later on in a man's life history has led to what has been characterised as a boom in vasectomy reversals and regrets, in which although the man was happy with his decision at the time of getting the vasectomy, he subsequently regretted the original decision to have a vasectomy later on in his life. Altered life situations including death of a partner, relationship breakdown, children starting school or leaving home, death of a child, re-partnering and re-marriage, increased wealth (which previously factored against having more children), mean that the psychological associations and effects of vasectomy are not only those which immediately follow the vasectomy, but may be ongoing throughout a person's life history. It is acknowledged that around 5% of men go on to have a vasectomy reversal, and a much higher percentage enquire about or seek a vasectomy reversal but are put off by the high costs of surgery and its interplay with the only moderate to moderately low success rates. (See Vasectomy reversal). Men who are of a younger age at the time of having a vasectomy are significantly more likely to regret and seek a reversal of their vasectomy, with one study showing men for example in their 20s being 12.5 times more likely to undergo a vasectomy reversal later in life (and including some who chose sterilization at a young age), promoting a greater level of pre-vasectomy counseling as being required.

An area not yet subject to adequate study is the psychological impact of conflict and disharmony with his wife or partner over his reticence towards vasectomy or decision not to undergo a vasectomy. Or vice-versa, in situations where it is the man who wants the vasectomy and his partner who is against it, has similarly not been subject to part of survey results in terms of psychological impact.

In relation to masculine identity, some early research suggested that men who have undergone vasectomy adopt more steroptypically masculine beahviours as compensatory for a diminished sense of masculinity, which is opposed by the research of Amor et al who found that vasectomy often enhanced their sense of masculinity (among their study of 19 men).