Abstract
Few studies are qualitative explorations of intimate partners’ conversations among racially/ethnically diverse adults about contraception, in particular, sterilization. Sterilization is an interesting case study given its permanency and the fact that it is a possible procedure for both men and women. More research is needed because sterilization decisions can reveal complex social relationships built on gender, class, race, and power that resonate throughout many parts of societies. The present paper draws on ideas of power/agency as they intersect with gender, race, and class in an analysis of 40 semi-structured interviews of a racially/ethnically diverse group of low-income U.S. women with male partners as they recall their sterilization discussions with their intimate partners before they themselves were voluntarily sterilized. The results offer insight into how class and racial and gender norms influence reproductive behaviors. Whereas a majority of these women displayed agency in female sterilization decisions, they had little control over male partners’ vasectomy decisions, which they attributed to their place in a racial/ethnic and gender hierarchy by utilizing ambiguous, unidimensional definitions of “machismo.” These results give insights into the conceptual complexity of contraceptive power and control as well as understandings of how gendered and racialized norms at individual and structural levels influence reproductive behaviors and perpetuate harmful gender stereotypes of both men and women.
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References
Alvarez, C., & Villarruel, A. (2015). Association of gender norms, relationship and intrapersonal variables, and acculturation with sexual communication among young adult Latinos. Research in Nursing & Health, 38, 121–132. https://doi.org/10.1002/nur.21645.
Amor, C., Rogstad, K. E., Tindall, C., Moore, K. T. H., Giles, D., & Harvey, P. (2008). Men’s experiences of vasectomy: A grounded theory study. Sexual and Relationship Therapy, 23(3), 235–245. https://doi.org/10.1080/14681990802206762.
Arciniega, G. M., Anderson, C. T., Tovar-Blank, Z. G., & Tracey, T. J. G. (2008). Toward a fuller conception of machismo: Development of a traditional machismo and caballerismo scale. Journal of Counseling Psychology, 55, 19–33. https://doi.org/10.1037/0022-0167.55.1.19.
Arevalo, J. A., Wollitzer, A. O., & Arana, S. (1987). Vasectomy: Views of Latinos and White men. The Journal of Family Practice, 24(5), 493–496. https://europepmc.org/abstract/med/3572319. Accessed January 2019.
Barone, M. A., Johnson, C. H., Luick, M. A., Teutonico, D. L., & Magnani, R. J. (2004). Characteristics of men receiving vasectomies in the United States, 1998-1999. Perspectives on Sexual and Reproductive Health, 36(1), 27–33. https://www.jstor.org/stable/3181213. Accessed January 2019.
Bass, L. E., & Warehime, M. N. (2009). Do health insurance and residence pattern the likelihood of tubal sterilization among American women? Population Residence Policy Review, 28, 237–249. https://doi.org/10.1007/s11113-008-9082-9.
Bertotti, A. M. (2013). Gendered divisions of fertility work: Socioeconomic predictors of female versus male sterilization. Journal of Marriage and Family, 75(1), 13–25. https://doi.org/10.1111/j.1741-3737.2012.01031.x.
Bertotti-Metoyer, A. (2009). Racial and socioeconomic disparities in use of long-lasting contraception. Research in the Sociology of Health Care, 27, 109–134. https://www.emeraldinsight.com/doi/abs/10.1108/S0275-4959(2009)0000027008. Accessed January 2019.
Bird, C. E., & Rieker, P. P. (2008). Gender and health: The effects of constrained choices and social policies. Cambridge: Cambridge University Press.
Blanc, A. K. (2001). The effect of power in sexual relationships on sexual and reproductive health: An examination of the evidence. Studies in Family Planning, 32(3), 189–213. https://www.jstor.org/stable/2696304. Accessed January 2019.
Borrero, S., Moore, C. G., Qin, L., Schwarz, E.B., Akers, A., Creinin, M. D., … Ibrahim, S. A. (2009). Unintended pregnancy influences racial disparity in tubal sterilization rates. Journal of General Internal Medicine, 25(2), 122–128. https://doi.org/10.1007/s11606-009-1197-0.
Borrero, S., Abebe, K., Dehlendorf, C., Schwarz, E. B., Creinin, M. D., Nikolajski, C., … Ibrahim, S. (2011). Racial variation in tubal sterilization rates: Role of patient-level factors. Fertility and Sterility, 95, 17–22. https://doi.org/10.1016/j.fertnstert.2010.05.031.
Borrero, S., Farkas, A., Dehlendorf, C., & Rocca, C. H. (2013). Racial and ethnic differences in men’s knowledge and attitudes about contraception. Contraception, 88, 532–538. https://doi.org/10.1016/j.contraception.2013.04.002.
Brines, J. (1994). Economic dependency, gender, and the division of labor at home. American Journal of Sociology, 100, 652–688. https://www.jstor.org/stable/2782401. Accessed January 2019.
Burnell, G. M., & Norfleet, M. A. (2001). Psychosocial factors influencing American men and women in their decision for sterilization. Journal of Psychology, 120(2), 113–119. https://doi.org/10.1080/00223980.1986.9712620.
Butler, J. (1998). The psychic life of power: Theories in subjection. Stanford, CA: Stanford University Press.
Carey, A. C. (1998). Gender and compulsory sterilization programs in America: 1907-1950. Journal of Historical Sociology, 11, 74–105. https://doi.org/10.1111/1467-6443.00054.
Castañeda, D. (2000). The close relationship context and HIV/AIDS risk reduction among Mexican Americans. Sex Roles, 42(7/8), 551–580. https://doi.org/10.1023/A:1007095221993.
Centers for Disease Control and Prevention. (2015). Key statistics from the National Survey of Family Growth. Retrieved from http://www.cdc.gov/nchs/nsfg/key_statistics.htm#S. Accessed January 2019.
Chandler, D. (2015). Frontiers in male contraception: There are few alternatives now, but several promising avenues of research are under way. IEEE Pulse, 6(1), 22–24. https://doi.org/10.1109/MPUL.2014.2366893.
Chandra, A. (1998). Surgical sterilization in the United States: Prevalence and characteristics, 1965-95. National Center for Health Statistics. Vital Health Statistics, 23, 20. https://stacks.cdc.gov/view/cdc/6326. Accessed January 2019.
Charmaz, K. (1990). “Discovering” chronic illness: Using grounded theory. Social Science and Medicine, 30, 1161–1172. https://doi.org/10.1016/0277-9536(90)90256-R.
Choi, K., Gregorich, S. E., Anderson, K., Grinstead, O., & Gómez, C.A. (2003). Patterns and predictors of female condom use among ethnically diverse women attending family planning clinics. Sexually Transmitted Diseases, 30(1), 91–98. Retrieved from https://journals.lww.com/stdjournal/Fulltext/2003/01000/Predictors_of_Female_Condom_Use_Among_Women.18.aspx. Accessed January 2019.
Cianelli, R., Ferrer, L., & McElmurry, B. J. (2008). HIV prevention and low-income Chilean women: Machismo, marianismo and HIV misconceptions. Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 10(3), 297–306. https://doi.org/10.1080/13691050701861439.
Collins, P. H. (1991). Black feminist thought: Knowledge, consciousness, and the politics of empowerment. New York: Routledge.
Connell, R. W. (1987). Gender and power. Stanford, CA: Stanford University Press.
Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–1299. https://doi.org/10.2307/1229039.
Davidson, A., Kye Chon, A., Subhas, C., Diaz-Guerrero, R., Dubey, D. C., & Mehryar, A. (1985). The acceptability of male fertility regulating methods: A multinational field survey. World Health Organization, Geneva. Retrieved from https://www.who.int/. Accessed January 2019.
Denbow, J. M. (2015). Governed through choice: Autonomy, technology, and the politics of reproduction. New York: NYU Press.
Dudgeon, M. R., & Inhorn, M. C. (2004). Men’s influences on women’s reproductive health: Medical anthropological perspectives. Social Science & Medicine, 59, 1379–1395. https://doi.org/10.1016/j.socscimed.2003.11.035.
Fefferman, A. M., & Upadhyay, U. D. (2018). Hybrid masculinity and young men’s circumscribed engagement in contraceptive management. Gender & Society, 32(3), 371–394. https://doi.org/10.1177/0891243218763313.
Fennell, J. L. (2011). Men bring condoms, women take pills: Men’s and women’s roles in contraceptive decision making. Gender & Society, 25(4), 496–521. https://doi.org/10.1177/0891243211416113.
Flavin, J. (2009). Our bodies, our crimes: The policing of women’s reproduction in America. New York: New York University Press.
Forrest, J. D., & Frost, J. J. (1996). The family planning attitudes and experiences of low-income women. Family Planning Perspectives, 28(6), 246–255, 277. https://doi.org/10.2307/2136053.
Forste, R., Tanfer, K., & Tedrow, L. (1995). Sterilization among currently married men in the United States, 1991. Family Planning Perspectives, 27(3), 100–107, 122. https://doi.org/10.2307/2136106.
Garcia, L. (2012). Respect yourself, protect yourself: Latina girls and sexual identity. New York: NYU Press.
Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine.
Godecker, A. L., Thomson, E., & Bumpass, L. L. (2001). Union status, marital history and female contraceptive sterilization in the United States. Family Planning Perspectives, 33(35–41), 49. https://doi.org/10.2307/2673740.
Gómez, C. A., & Marín, B. V. (1996). Gender, culture, and power: Barriers to HIV-prevention strategies for women. The Journal of Sex Research, 33(4), 355–362. https://doi.org/10.1080/00224499609551853.
Gonzalez, E. U., Sable, M. R., Campbell, J. D., & Dannerbeck, A. (2010). The influence of patriarchal behavior on birth control access and use among recent Hispanic immigrants. Journal of Immigrant and Minority Health, 23(4), 551–558. https://doi.org/10.1007/s10903-009-9272-5.
Grady, W. R., Tanfer, K., Billy, J. O. G., & Lincoln-Hanson, J. (1996). Men’s perceptions of their roles and responsibilities regarding sex, contraception and childrearing. Family Planning Perspectives, 28(5), 221–226. https://doi.org/10.2307/2135841.
Grady, W. R., Klepinger, D. H., Billy, J. O. G., & Cubbinas, L. A. (2010). The role of relationship power in couple decisions about contraception in the US. Journal of Biosocial Science, 42(3), 307–323. https://doi.org/10.1017/S0021932009990575.
Guendelman, S., Denny, C., Mauldon, J., & Chetkovich, C. (2000). Perceptions of hormonal contraceptive safety and side effects among low-income Latina and non-Latina women. Journal of Maternal Child Health, 4, 233–239. https://doi.org/10.1023/A:1026643621387.
Gutmann, M. C. (2005). Scoring men: Vasectomies and the totemic illusion of male sexuality in Oaxaca. Culture, Medicine and Psychiatry, 29, 79–101. https://doi.org/10.1007/s11013-005-4624-7.
Harvey, S. M., Bird, S. T., Galavott, C., Duncan, E. A. W., & Greenberg, D. (2002). Relationship power, sexual decision-making and condom use among women at risk for HIV/STDs. Women & Health, 36, 69–84. https://doi.org/10.1300/J013v36n04_06.
Harvey, S. M., Henderson, J. T., & Casillas, A. (2006). Factors associated with effective contraceptive use among a sample of Latina women. Women & Health, 43(2), 1–16. https://doi.org/10.1300/J013v43n02_01.
Hurtado, A., & Sinha, M. (2016). Beyond machismo: Intersectional Latino masculinities. Austin, TX: University of Texas Press.
Kavanaugh, M. L., Lindberg, L. D., & Frost, J. (2012). Factors influencing partners’ involvement in women’s contraceptive services. Contraception, 85, 83–90. https://doi.org/10.1016/j.contraception.2011.04.018.
Kimport, K. (2017). More than a physical burden: Women’s mental and emotional work in preventing pregnancy. Journal of Sex Research, 55(9), 1096–1105. https://doi.org/10.1080/00224499.2017.1311834.
Landry, E., & Ward, V. (1997). Perspectives from couples on the vasectomy decision: A six-country study. In T.K. Sundari Ravindran, M. Berer, & J. Cottingham (Eds.), Beyond acceptability: Users’ perspectives on contraception (pp. 58–67). WHO: Reproducitve Health Matters. https://apps.who.int/iris/bitstream/handle/10665/42012/0953121003.pdf;jsessionid=CD0660091C5F860ED021383F3BCD97CA?sequence=1. Accessed January 2019.
Leyser-Whalen, O., & Berenson, A. B. (2013). Control and constraint for low-income women choosing outpatient sterilization. Qualitative Health Research, 23(8), 1114–1124. https://doi.org/10.1177/1049732313494483.
Lopez, I. (1998). The medicalization of Puerto Rican women. In M. Lock & P. A. Kaufert (Eds.), Pragmatic women and body politics (pp. 240–259). Cambridge: Cambridge University Press.
López, V., & Chesney-Lind, M. (2014). Latina girls speak out: Stereotypes, gender and relationship dynamics. Latino Studies, 12(4), 527–549. https://doi.org/10.1057/lst.2014.54.
MacKay, A. P., Kieke, B. A., Koonin, L. M., & Beattie, K. (2001). Tubal sterilization in the United States, 1994-1996. Family Planning Perspectives, 33(4), 161–165. https://doi.org/10.2307/2673719.
Masters, N. T., Morrison, D. M., Querna, K., Casey, E. A., & Beadnell, B. (2017). Correlates of young men’s intention to discuss birth control with female partners. Perspectives on Sexual and Reproductive Health, 49(1), 37–43. https://doi.org/10.1363/psrh.12005.
Maternowska, C., Estrada, F., Campero, L., Herrera, C., Brindis, C. D., & Vostrejs, M. M. (2010). Gender, culture and reproductive decision-making among recent Mexican migrants in California. Culture, Health & Sexuality, 12(1), 29–43. https://doi.org/10.1080/13691050903108688.
Mayo Clinic. (2018). Vasectomy. Retrieved from https://www.mayoclinic.org/tests-procedures/vasectomy/about/pac-20384580. Accessed January 2019.
Moore, L. J. (2007). Sperm counts, overcome by man’s most precious fluid. New York: University Press.
Moore, J., Harrison, J. S., Kay, K. L., Deren, S., & Doll, L. S. (1995). Factors associated with Hispanic women’s HIV-related communication and condom use with male partners. AIDS Care, 7(4), 415–427. https://doi.org/10.1080/09540129550126371.
Mosher, W. D., & Jones, J. (2010). Use of contraception in the United States: 1982-2008. Vital Health Statistics, 23, 29. Retrieved from https://europepmc.org/abstract/med/20939159. Accessed January 2019.
Noland, C. (2008). “Macho men don’t communicate”: The role of communication in HIV prevention. The Journal of Men’s Studies, 16, 18–31. https://doi.org/10.3149/jms.1601.18.
Ojeda, L., & Piña-Watson, B. (2014). Caballerismo may protect against the role of machismo on Mexican day laborers’ self-esteem. Psychology of Men & Masculinity, 15(3), 288–295. https://doi.org/10.1037/a0033450.
Padilla, A., & Baird, T. (1991). Mexican American adolescent sexuality and sexual knowledge: An exploratory study. Hispanic Journal of Behavioral Sciences, 13, 95–105. https://doi.org/10.1177/07399863910131007.
Piccinino, L. J., & Mosher, W. D. (1998). Trends in contraceptive use in the United States: 1982-1995. Family Planning Perspectives, 30(1), 4–10, 46. https://doi.org/10.2307/2991517.
Potter, J. E., White, K., Hopkins, K., McKinnon, S., Shedlin, M. G., Amastae, J., … Grossman, D. (2012). Frustrated demand for sterilization among low-income Latinas in El Paso, Texas. Perspectives on Sexual and Reproductive Health, 44(4), 228–235. https://doi.org/10.1363/4422812.
Pulerwitz, J., Amaro, H., Jong, W. D., Gortmaker, S. L., & Rudd, R. (2002). Relationship power, condom use and HIV risk among women in the USA. AIDS Care, 14(6), 789–800. https://doi.org/10.1080/0954012021000031868.
Quelopana, A. M., & Alcalde, C. (2014). Exploring knowledge, belief and experiences in sexual and reproductive health in immigrant Hispanic women. Journal of Immigrant Minority Health, 16, 1001–1006. https://doi.org/10.1007/s10903-013-9807-7.
Rico, B., Kreider, R. M., & Anderson, L. (2018). Growth in interractial and interethnic married-couple households. United States Census Bureau. https://www.census.gov/library/stories/2018/07/interracial-marriages.html. Accessed January 2019.
Riehman, K. S., Sly, D. F., Soler, H., Eberstein, I. W., Quadagno, D., & Harrison, D. F. (1998). Dual-method use among an ethnically diverse group of women at risk of HIV infection. Family Planning Perspectives, 30(5), 212–217. https://doi.org/10.2307/2991606.
Riessman, C. K. (1983). Women and medicalization: A new perspective. Social Policy, 14(1), 3–18. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10264493. Accessed January 2019.
Ringheim, K. (1993). Factors that determine prevalence of use of contraceptive methods for men. Studies in Family Planning, 24(2), 87–99. https://doi.org/10.2307/2939202.
Rivers K., Aggleton, P., Elizondo, J., Hernandez, G., Herrera, G., Mane, P., … Setiadi, B. (1998). Gender relations, sexual communications and the female condom. Critical Public Health, 8, 273–290. https://doi.org/10.1080/09581599808402916.
Sandlow, J. I., Westefeld, J. S., Maples, M. R., & Scheel, K. R. (2001). Psychological correlates of vasectomy. Fertility and Sterility, 75(3), 544–548. https://doi.org/10.1016/S0015-0282(00)01744-1.
Sangi-Haghpeykar, H., Ali, N., Posner, S., & Poindexter, A. N. (2006). Disparities in contraceptive knowledge, attitude and use between Hispanic and non-Hispanic whites. Contraception, 74, 125–132. https://doi.org/10.1016/j.contraception.2006.02.010.
Saul, J., Norris, F. H., Bartholow, K. K., Dixon, D., Peters, M., & Moore, J. (2000). Heterosexual risk for HIV among Puerto Rican women: Does power influence self-protective behavior? AIDS and Behavior, 4(4), 361–371. https://doi.org/10.1023/A:1026402522828.
Smith, D. E. (1987). The everyday world as problematic. Boston: Northeastern University Press.
Smith, D. E. (1990). Texts, facts, and femininity: Exploring the relations of ruling. London: Routledge.
Smith, D. E. (2005). Institutional ethnography: A sociology for people. Oxford: AltaMira.
Soler, H., Quadagno, D., Sly, D. F., Riehman, K. S., Eberstein, I. W., & Harrison, D. F. (2000). Relationship dynamics, ethnicity and condom use among low-income women. Family Planning Perspectives, 32(2), 82–88, 101. https://doi.org/10.2307/2648216.
Terry, G., & Braun, V. (2011a). “I’m committed to her and the family”: Positive accounts of vasectomy among New Zealand men. Journal of Reproductive and Infant Psychology, 29(3), 276–291. https://doi.org/10.1080/02646838.2011.592976.
Terry, G., & Braun, V. (2011b). “It’s kind of me taking responsibility for these things”: Men, vasectomy and “contraceptive economies”. Feminism & Psychology, 21(4), 477–495. https://doi.org/10.1177/0959353511419814.
Vernon, R., Ojeda, G., & Vega, A. (1991). Making vasectomy services more acceptable to men. International Family Planning Perspectives, 17(2), 55–60. https://doi.org/10.2307/2133555.
Wade, J. C. (2015). Measurement of masculinity ideologies: A commentary. Psychology of Men & Masculinity, 16(2), 137–140. https://doi.org/10.1037/a0038988.
Wood, M. L., & Price, P. (1997). Machismo and marianismo: Implications for HIV/AIDS risk reduction and education. American Journal of Health Studies, 13, 44–52. Retrieved from https://search.proquest.com/docview/210469064?accountid=7121. Accessed January 2019.
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We would like to thank Isabel Tovar for continued interest and work on this topic and Mahta Rouhani for help with data collection and translation.
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The interviews for this study were approved by the Institutional Review Board at the University of Texas Medical Branch and all participants signed informedconsent forms. This work has not been published and is not being considered for publication elsewhere and I do not have any conflicts of interest to report.
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Leyser-Whalen, O., Berenson, A.B. Situating Oneself in the Intersectional Hierarchy: Racially Diverse, Low-Income Women Discuss Having Little Agency in Vasectomy Decisions. Sex Roles 81, 748–764 (2019). https://doi.org/10.1007/s11199-019-01027-x
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DOI: https://doi.org/10.1007/s11199-019-01027-x