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Talking about male body-based contraceptives: The counseling visit and the feminization of contraception

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  • Kimport, Katrina

Abstract

In developed countries, women bear the primary, and sometimes exclusive, responsibility for preventing pregnancy in heterosexual sexual relations. This unequal burden is not an intrinsic fact; it is the consequence of broad social narratives and interpersonal negotiations. The contraceptive counseling visit is increasingly recognized as a site of the discursive production of normative ideas about reproduction, suggesting that clinicians themselves may contribute to the assignment of responsibility for contraceptive labor to women (i.e. the feminization of contraception). Scholars have not yet considered how providers talk to patients about methods that are male body-based (i.e. condoms, withdrawal, and vasectomy) and, as such, may disrupt the feminization of responsibility for contraception. Using transcripts of 101 contraceptive counseling visits recorded between 2009 and 2012 in the San Francisco Bay Area, I investigate how clinicians discuss male body-based methods with female patients. Drawing on a constructivist approach, I find that clinicians generally devalued male body-based methods in their counseling. They did so by, first, failing to discuss them as options for long-term contraception. Second, when they did discuss them, clinicians tended to emphasize aspects of the methods that were presumed “negative” (e.g. the lower efficacy of withdrawal and condoms) but not features that patients might view positively (e.g. the high efficacy of vasectomy or the lack of side effects with condoms and withdrawal). In aggregate, these discursive practices marginalize male body-based methods as contraceptive choices. As a practical effect, this may encourage women to choose a method that does not best meet their preferences. At a structural level, by devaluing methods that could undercut the unequal division of fertility work, these discursive patterns contribute to the feminization of responsibility for contraception and the retrenchment of the unequal gendered division of fertility work.

Suggested Citation

  • Kimport, Katrina, 2018. "Talking about male body-based contraceptives: The counseling visit and the feminization of contraception," Social Science & Medicine, Elsevier, vol. 201(C), pages 44-50.
  • Handle: RePEc:eee:socmed:v:201:y:2018:i:c:p:44-50
    DOI: 10.1016/j.socscimed.2018.01.040
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    References listed on IDEAS

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    1. Downing, R.A. & LaVeist, T.A. & Bullock, H.E., 2007. "Intersections of ethnicity and social class in provider advice regarding reproductive health," American Journal of Public Health, American Public Health Association, vol. 97(10), pages 1803-1807.
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    3. Higgins, J.A. & Kramer, R.D. & Ryder, K.M., 2016. "Provider bias in long-Acting reversible contraception (LARC) promotion and removal: Perceptions of young adult women," American Journal of Public Health, American Public Health Association, vol. 106(11), pages 1932-1937.
    4. Krystale Littlejohn, 2012. "Hormonal Contraceptive Use and Discontinuation Because of Dissatisfaction: Differences by Race and Education," Demography, Springer;Population Association of America (PAA), vol. 49(4), pages 1433-1452, November.
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    2. Stevens, Lindsay M., 2018. "“We have to be mythbusters”: Clinician attitudes about the legitimacy of patient concerns and dissatisfaction with contraception," Social Science & Medicine, Elsevier, vol. 212(C), pages 145-152.
    3. Schwarz, Joëlle & Dumbaugh, Mari & Bapolisi, Wyvine & Ndorere, Marie Souavis & Mwamini, Marie-Chantale & Bisimwa, Ghislain & Merten, Sonja, 2019. "“So that's why I'm scared of these methods”: Locating contraceptive side effects in embodied life circumstances in Burundi and eastern Democratic Republic of the Congo," Social Science & Medicine, Elsevier, vol. 220(C), pages 264-272.
    4. Bertotti, Andrea M. & Mann, Emily S. & Miner, Skye A., 2021. "Efficacy as safety: Dominant cultural assumptions and the assessment of contraceptive risk," Social Science & Medicine, Elsevier, vol. 270(C).
    5. Manzer, Jamie L. & Bell, Ann V., 2022. "The limitations of patient-centered care: The case of early long-acting reversible contraception (LARC) removal," Social Science & Medicine, Elsevier, vol. 292(C).

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