Essentially female in France, contraception can however be shared with the partner. If the condom is often used, male sterilization remains extremely in the minority. The reasons for this delay.
A quarter of an hour of inconvenience for a life of pleasure … Cyrille, 33, still remembers his crossing of Arizona during his vacation: “Huge billboards by the side of the road praised the merits of vasectomy! “, he says, surprised.
Thirteen times more common across the Atlantic
If this technique represents only 0.8% of contraceptive methods in France, it is thirteen times more frequent across the Atlantic!
“In North America as in England, vasectomy is considered as a male method of contraception and not as mutilation,” explains Cécile Ventola, a public health researcher at Inserm. It is part of the contraceptive panel that doctors offer while in France, 34% of practitioners do not consider sterilization, whether male or female, as an acceptable contraceptive method. “
However, it is one of the possibilities presented by the website of the Ministry of Health (choisirsacontraception.fr).
The obstacles linked to male sterilization still numerous
“I don’t talk about it at every contraception consultation, recognizes Dr. Elisabeth Paganelli, gynecologist and general secretary of Syngof *. On the other hand, I suggest it systematically when a woman has difficulties with contraception when the couple is stable and does not want any more children. But it’s complicated: either they don’t want to damage their man, or the man doesn’t want to, or it’s the urologist who discourages more than one! ”
The brakes, in fact, are numerous. Vasectomy was only authorized in France in 2001 without criteria of age or number of children, but doctors are reluctant to sterilize men who are not yet fathers.
For men in a relationship and already fathers
“In most cases, they are in a relationship and their choice is linked to the fact that their wife’s contraception becomes difficult”, observes Prof. Franck Bruyère, a urologist at the CHRU in Tours.
Although their semen can be stored before the operation, its irreversible character imposes a four-month reflection period that allows couples to address many delicate questions: what if one of the two dies? What if they split up? What if one of the children dies?
“In general, men arrive determined and informed”, notes Professor Stéphane Droupy, urologist at the Nîmes CHU.
The operation does not affect sexuality
But in the population, the confusion between fertility and sexuality endures.
“The operation consists in cutting and blocking the vas deferens, it does not modify either the erection or the ejaculation, says Prof. Nicolas Thiounn, a urologist at the Georges Pompidou European Hospital in Paris. But it does not interest many doctors because it has no surgical interest and remains poorly rated by Medicare, around € 60. ”
Involve men more in contraception
That’s not all. “The brake is also cultural, says Martin Winckler, doctor, a specialist in contraception. In France, choosing not to have children is considered abnormal whereas, in Quebec, it is a private matter and the individual’s decision is respected. Our role is to support, not to decide. There is no medical logic to decree who may or may not benefit from a vasectomy. ”
This is confirmed by Dr. Michel Labrecque, professor at Laval University in Quebec City, who has been performing vasectomy for over 30 years. “The sharing of responsibilities is more important here. The involvement of men in contraception, in particular, is greater. ”
Any regrets remain. “Five to 10% of men, according to studies, regret their choice”, admits Dr. Labrecque, who offers “reverse” surgeries to restore fertility. But the chances of having a child are slim.
* National Union of Obstetrician Gynecologists of France.
Also read: Are natural contraceptive methods reliable?