Vasectomy: Pro and Con

Unlike the physical sciences, the behavioral disciplines offer no absolutes. On practically any issue, "scientific" evidence is used to support diametrically opposite points of view. Take vasectomy, for example. According to one recently reported investigation, this procedure for male sterilization (in which the tubes that transport sperm are severed) makes sex more pleasurable and marriage happier. According to another, the operation can lead to less satisfying sex, and ultimately to separation and divorce.

The favorable findings come from the Midwest Population Center of Chicago, a nonprofit medical organization that does nothing but perform vasectomies. To evaluate its work, the center sent questionnaires to 740 couples six months after vasectomy. Of the 320 who replied, 70% said that the husband's birth control operation had resulted in "a better sex life," while 30% reported no change. Of the men, 93% asserted that they felt "exactly as much a man as before"; another 6% felt even more masculine. Among the women, 75% considered their sense of femininity unchanged and 22% described it as enhanced. An improved relationship was reported by 32% of the couples; 18% believed that they had better rapport with their children since vasectomy.

On the other hand, Family Service-Travelers Aid of Des Moines, a social agency that gives help for marital problems, studied 26 couples who came for counseling; in each case the husband had had a vasectomy performed. In this group the operation resulted in "relatively disastrous" consequences, with worsening of old problems or development of new ones. Some of the wives began to feel that their husbands were "no longer a man." Extramarital affairs became more frequent, drinking and job troubles increased, and minor disagreements seemed less tolerable. Though the number of cases in the study is small, Staff Supervisor Shirley Southwick of the Family Service Organization of Worcester, Mass., asserts that they are not atypical: across the country, she says, marriage counselors have growing doubts that vasectomies are always benign.

Though it is impossible to know for sure, the discrepancy between the pro and con studies may result from the psychological health--or distress --of the couples before vasectomy. In the unsuccessful cases the marriages were immature to begin with, Family Service reports. Both husbands and wives were dependent personality types who chose sterilization because it was easy, sure to work, simple to obtain and required no continued effort or selfdiscipline. They looked to the operation as a magic cure-all for problems ranging from sexual inadequacy to financial insecurity. Inevitably, they were disappointed.

But the results of vasectomy need not be unpredictable. "Men with healthy egos and self-confidence apparently can accept sterility without psychological dysfunction," Southwick believes. The moral of the two studies, then, may be that vasectomy should be preceded by psychiatric consultation--a requirement that responsible vasectomy centers already demand.

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