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American Journal of Public Health. 1985 Jan; 75(1):73-5.In this study of 1600 men ages 25-50 from semirural Guatemala, 3/4 had heard of vasectomy. Among these, 54% approved of it. However, the survey reveals a widespread lack of knowledge regarding the procedure, as well as negative perceptions or doublts about its effect on sexual performance, ability to do hard work, health, and manhood. 1/4 of the respondents who knew of vasectomy and who desired no more children expressed interest in having the operation, a finding which raises questions as to the potential (unrecognized) demand for vasectomy in other developing countries. (author's modified)
Research in Community and Mental Health. 1981; 2:327-57.Contemporary professional approaches to mental illness are based on the conviction that important causal factors lie outside the individual in the social milieu. Traditional notions of mental illness, on the other hand, locate its cause in moral or constitutional inadequacies of individuals, either genetic or otherwise unchangeable, and call for the constraint or removal of affected individuals from society for its protection. It is suggested that compulsory sterilization statutes are an indicator of the extent to which traditional assumptions concerning the causes and control of mental illness persist despite professional redefinition. Although growing research evidence shows that most conditions covered by sterilization statutes are not hereditary, sterilization continues to be seen by many as a viable method of control. In 1968, 27 states still had compulsory sterilization statutes, although 8 states repealed or modified these statutes in the 1968-73 period. Where early sterilization laws emerged from the belief that conditions covered by the statutes were genetically transmitted, more recent interest in such statutes has been punitive and economically motivated. There is a further trend for the application of compulsory sterilization statutes to be masked by acceptance of voluntary sterilization as a method of population control. It is concluded that compulsory sterilization statutes will be repealed only when the public comes to accept the assumptions of complex causality and changeability as regards mental illness.
In: Hsia YE, Hirschhorn K, et. al., ed. Counseling in genetics. New York, Alan R. Liss, 1979. 189-222.American contraceptive patterns have shown consistent acceptance and progressive improvement in its usage. Efficacious methods which offer maximum contraceptive protection are highly favored by all strata of the American population. The 4 methods which the writer examines from a clinical and psychological viewpoint are sterilization, artificial insemination, abortion and selective sex predetermination processes. The increased popularity of sterilization by males and females is accounted for by its development into a simpler surgical procedure, few unpleasant side effects, shifts in smaller family size planning, and easing of medical and legal age restrictions. Vasectomy and tubal ligation are reviewed in terms of positive and negative reactions to the procedures with particular emphasis about psychological adjustment common to both procedures. Artificial insemination with a donor's semen is used primarily when the husband is infertile or when the husband or both parents are carriers of genetic defects. This method is preferred when parents are dissatisfied with adoption procedures, selection process in terms of infant conception is desired, knowledge of pregnancy 1st hand is wanted and when faith in the donor is strong. Abortion and prenatal diagnosis are seen as means of selective reproduction and biological control in family planning decisions. Legal change about abortion has accompanied a decline of public opposition as seen in tables which chart America's public opinion from 1962 to 1975. Psychological aspects of selecting abortion and prenatal diagnosis include the concern parents have over health of the child, security of the family , fairness to the unborn child, to the living children and to themselves. The writer establishes the need for counseling and emotional support when stress, depression and self doubts associated with each procedure is apparent. Technology involved in sex determination is seen by the author as having a future radical impact on sex ratios of developing nations where a greater cultural emphasis is on having sons. From a psychological point of view, sex determination will alleviate the disappointment some parents feel about the sex of the child as well as encourage fertility.
[Unpublished] 1982. Presented at the Conference on Vasectomy, Colombo, Sri Lanka, October 4-7, 1982. 13 p.There are 2 general types of barriers to vasectomy acceptance, cultural and individual. Cultural barriers include: 1) the idea that contraception should be the woman's responsibility, 2) that vasectomy represents a tampering with the natural processes of reproduction and this conflicts with many religions, 3) there is confusion over the legal status of vasectomy even though very few countries actually prohibit it, 4) the idea that men, due to their higher status in many societies, should not be exposed to unnecessary risks, 5) the idea that men who are not capable of reproducing have no worth in society, and 6) that men may need to be able to reproduce at a future date since in many societies only men are permitted to remarry. Research on psychological barriers to vasectomy is based on followup studies of vasectomized men and shows that negative male attitudes toward vasectomy stem from negative perceptions about the nature of consequences of the operation. Some men feel that vasectomy is like castration, that it is painful, has demasculinizing effects, causes a loss of vitality, and is irreversible. The population must be educated in order to overcome these barriers. Any communication program must include: 1) identifying existing sources of motivation for vasectomy, 2) increasing awareness of vasectomy through mass media and interpersonal channels, 3) increasing awareness through wider availability of the operation, and 4) improving the public attitude by publicizing client satisfaction with the operation. Men should be encouraged to seek vasectomy for the intrinsic benefits of the operation.
[Unpublished] 1982. Presented at the Conference on Vasectomy, Colombo, Sri Lanka, October 4-7, 1982. 6 p.This report attempts to synthesize Italy's experience regarding mobilizing and influencing public opinion for vasectomy acceptances in terms of basic policies and initiatives which may be extended to other countries and cultures. On the basis of Italy's experience, it is believed that no uniform approach can be applied to the different leading groups of a given country. Each religious and political group should be approached with specific arguments. With religious groups and leaders and the political parties directly influenced by them, the focus should be on the importance of family planning in general, and of vasectomy in particular, for the stability of the family and for a strengthening of affective ties between the spouses and between parents and children. The argument with nationalist groups and leaders should be that the key to military and international power is quality, not quantity, and technological advancement rather than sheer numbers. The basic arguments with Marxists, feminists and other radicals should concentrate on human rights and women's health. Finally, the argument that birth control is crucial for economic development, social advancement, reduction of unemployment and poverty can be effectively used with "mild" liberals and "mild" conservatives. The support of the media is necessary in any effort aimed at influencing public opinion. Personal contacts with influential journalists should be pursued. The popular strata should be primarily approached at the emotional level with the use of initiatives that can capture their imagination and messages which can effectively motivate them to surgical contraception. Much good work has already been done with medical and paramedical personnel, but better results might be obtained through motivational psychology. Capability and proficiency in vasectomy and sterilization procedures should be rewarded and honored in order to make them an object of professional competition among both medical and paramedical personnel. Special career advantages should be attached to proficiency in this area. Public and professional opinion may be influenced by transforming legal actions into national cases. Public and professional opinion may be influenced by transforming legal actions into national cases. The initiatives taken before and after the trial of the gynecologist Diorgio Conciani, incriminated by the Public Attorney of Lucca for having performed about 80 vasectomies on Italian citizens from many towns of Italy who had formally requested the procedure, by the Italian Association for Voluntary Sterilization may be usefully adapted to other countries. At the medical level some physicians in Milan, Rome, Venice, and Naples agreed to perform both male and female sterilizations. At the legal level the Association formed a legal council of defense.