Few publicly funded family planning clinics in the United States offer vasectomy, but little is known about the reasons
this method is not more widely available at these sources of care. Between February 2012 and February 2015, three
waves of in-depth interviews were conducted with program administrators at 54 family planning organizations in
Texas. Participants described their organization’s vasectomy service model and factors that influenced how frequently
vasectomy was provided. Interview transcripts were coded and analyzed using a theme-based approach. Service
models and barriers to providing vasectomy were compared by organization type (e.g., women’s health center, public
health clinic) and receipt of Title X funding. Two thirds of organizations did not offer vasectomy on-site or pay
for referrals with family planning funding; nine organizations frequently provided vasectomy. Organizations did not
widely offer vasectomy because they could not find providers that would accept the low reimbursement for the
procedure or because they lacked funding for men’s reproductive health care. Respondents often did not perceive
men’s reproductive health care as a service priority and commented that men, especially Latinos, had limited interest
in vasectomy. Although organizations of all types reported barriers, women’s health centers and Title X-funded
organizations more frequently offered vasectomy by conducting tailored outreach to men and vasectomy providers.
A combination of factors operating at the health systems and provider level influence the availability of vasectomy at
publicly funded family planning organizations in Texas. Multilevel approaches that address key barriers to vasectomy
provision would help organizations offer comprehensive contraceptive services.Population Research Cente
