Posted on February 17, 2015 at 7:02 AM
In recognizing the health-related and financial benefits of preventive reproductive health services, the Affordable Care Act (ACA) has included them (namely contraception and preconception care) as part of standard care and without co-payment. While the inclusion of women’s reproductive health care in the ACA is a milestone for women’s health, children’s health, and reproductive health overall, it is troubling that the ACA does not seem to make any mention of men’s reproductive health
Men’s reproductive health is not only missing from policy, also from everyday practice. Whereas women know to see a gynecologist for their reproductive health and can easily do, men are often unsure of where to turn for the reproductive health needs. Most men have never heard of the field of andrology, which is devoted to men’s reproductive health, and this field is so small and fragmented that it may be difficult for a man to find a nearby andrologist. Some men seek out urologists for their reproductive health, but many urologists are not trained in all areas of men’s reproductive health. Men may also talk to their primary care physician about their reproductive health needs, but many of these physicians are not very familiar with men’s reproductive health since it is barely covered in medical school. Family planning centers tend to focus on treating women and some family planning providers have even been known to be hostile toward men. The lack of healthcare providers trained to treat in men’s sexual and reproductive health contributed to American Board of Obstetrics and Gynecology recent statement that condoned OBGYNs treating certain areas of men’s sexual and reproductive health.
The conspicuous absence of men’s reproductive health in both policy and practice fortifies the conflation of women and reproduction, reifying the cultural narrative that men play little to no role in reproduction. However, men’s characteristics and behavior affect all areas of reproduction not only biologically, but also socially and ethically. For instance, on a biological level, preconception care is important for men since their actions (e.g. drug use) and characteristics (e.g. age) can impact the quality of their sperm and thus their future offspring. On a social and ethical level, men are increasingly interested in taking responsibility for reproductive matters (e.g. some studies found that many men would use future male hormonal contraceptives).
Yet, there is a dearth of literature on the topic of men and reproduction, especially in the humanities and social sciences. In order to achieve the public health goals of reducing unintended pregnancies (which are half of all pregnancies in the U.S.) and improving preconception care (with the ultimate goal of healthy pregnancies and babies) we must expand the empirical research, conceptual analysis, clinical standards of care, and public policies on reproduction to include men.
The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website.