#5 Men, Masculinities, and Reproduction: Love, Suspicion, Shame: Stratified Vasectomies in Northwest India

Vasectomies in India

Amidst worldwide gender unevenness in contraceptive use, where the global distribution of contraceptive methods comprises more than 70% of female users and only 1.8% of vasectomies, India too reports a stark gender disparity in sterilisation use. With the world’s highest share of female sterilisation, which constitutes 68.5% of the modern contraceptive method-mix, vasectomy accounts for only 0.5% of the total contraceptive use in India.

At the same time, India is the only country with a history of widespread (and coercive) vasectomies in the 1960s and 1970s. Amidst international and domestic pressure to curb high fertility rates, policymakers were uniquely invested in “motivating men” as primary users of contraception, and as seemingly rational and active decision-makers in contrast to ostensibly passive women (Balasubramanian 2018). These social-behavioural interventions were disproportionately targeted at poor and working-class populations. For instance, a 1969 Government of India poster promoting condom use for men invoked the “power” that lies in men’s hands to prevent pregnancies while simultaneously advertising subsidised prices and discounted packages. A defining feature of this period were “vasectomy camps” (Ahluwalia and Parmar 2015), i.e. makeshift state-sponsored sterilisation services incentivised through cash, household amenities, and other welfare benefits. Under the national Emergency from 1975 to 1977, popularly remembered as nasbandi ka waqt — the era of (male) sterilisations — eight million people were reportedly sterilised at such camps, primarily men from oppressed-caste, Muslim, and working-class populations (Tarlo 2003). In its aftermath, with concerted efforts made by the state and international development actors to consolidate a welfare-oriented agenda of voluntary family planning, the focus shifted away from men and vasectomies towards a women-centric population control agenda in India (Basu 1985).

Over the last two decades, policymakers and civil society actors in India have begun highlighting the role of men and gender equality in reproductive health, drawing on dominant tropes of masculine responsibility and heroism alongside developmental narratives of population control and family planning. Mass media campaigns addressing the stigma associated with male contraception invoke rapid population growth and two-child norms. Grassroots research around gender-equitable contraceptive decision-making is framed as doubling the impact of family planning. The annual “vasectomy fortnights” organised by local governments offering free of cost male sterilisation services in public hospitals are publicised through slogans like “Healthy mother, healthy child, when the husband contributes to family planning.” In a social media post by an NGO in north India, a working-class man undergoing sterilisation is described as “resilient…championing family planning…saving his wife.”

Stratified Vasectomies

Everyday narratives around vasectomies, however, go beyond tropes of masculine responsibility and gender equality. At a family planning clinic providing state-sponsored sterilisation services in Rajasthan, where I conducted fieldwork between 2023 and 2024, masculine love and heroism was selectively applied to vasectomies amongst men from socioeconomically privileged backgrounds, while vasectomies amongst poor, working-class, and oppressed-caste men were subject to moral suspicion and shame. Within the state population control agenda, vasectomies thus circulate as a stratified contraception with differential experiences based on people’s material and socioeconomic conditions (Sheoran 2015). In the following ethnographic sections, I explore such stratified notions of love, suspicion, and shame at the clinic where a selective celebration of vasectomies as heroic and desirable masculinity is made possible against the scrutiny and shaming of other masculinities. 

Love

Sanjay (pseudonym) visited the clinic with his wife in November 2024 for a vasectomy. He was 32 years old, had studied engineering in the local government college, and was working at the time as a data operator in a private firm. His wife, a few years younger than him, was a homemaker. While signing the state-mandated information and consent form, Sanjay explained to the counsellor and nurses, “After having my two sons, my family is complete…I told my wife, I convinced her, that I will do it, I will get the nasbandi (sterilisation).” While his wife sat silently next to him, Sanjay described his decision to get a vasectomy with pride, emphasising his online research and discussion with family and friends about the procedure, before arriving at what he described as the “best decision for me and my family.” The counsellor listened with sincere interest, and replied earnestly, “You are a wise man…There are very few men like you.” Sanjay received a heroic reception in stark contrast to the routine provision of female sterilisation at the clinic. 

After Sanjay left, one of the nurses, a recently married 28-year-old woman, remarked with a huge grin, “He seems like such a loving husband.” Others nodded in agreement. Turning to me, she elaborated, “Men like him are rare…Other men coming to the clinic are poor and backward…getting [sterilisation] just for the money.” This money refers to the monetary compensation stipulated under the national family planning programme for sterilisation and other contraceptive services. At the clinic, men received 1200 Indian Rupees ($13.5 USD) for vasectomies, equivalent to approximately four days of wages for unskilled labourers in Rajasthan, and around four percent of the monthly salary for a clerical employee like Sanjay. While Sanjay would also receive this compensation, his vasectomy is seen to be motivated by a “masculine responsibility” (Wentzell et al. 2023), which is tied to his educated, middle-class, and dominant-caste social status, and consolidates his disposition as a loving husband. In contrast, money is viewed as the sole motivation for vasectomies amongst other poor, uneducated, and oppressed-caste men. 

Suspicion

Two young men came to the clinic in March 2024 with Manoj (pseudonym), the part-time gardener at the clinic, who declared that the men were “ready for nasbandi.” Manoj had met them earlier in the morning at a “labour point” in the city where daily wage workers congregate. The counsellor asked for the men’s government identity documents as per standard protocol, necessary for completing the state-mandated paperwork and processing the monetary compensation. Manoj tentatively responded that they did not have their IDs at the moment, but could bring them after the procedure. He suggested that the cheque for the monetary compensation be made out in his name for the time being. When the counsellor refused, Manoj insisted, saying that the two men lived in the outskirts and would not be able to travel all the way back. However, the counsellor did not seem convinced, calling out Manoj and the other men as “farji,”, a Hindi word commonly used to describe illegal practices, forged documents, or made-up stories, and asked them to return with the required documents.

A couple of hours later, one of the two men came back with his ID card. After the registration process was initiated by a male counsellor, he pointed out that the man had presented a “farji” ID card. “The picture on the ID is not clear, I got suspicious, so I decided to interrogate him. He couldn’t tell me his father’s name correctly, how is that possible? He is clearly lying.” I did not get to hear the man’s side of the story, who was threatened and sent away by the security guard. The male counsellor reprimanded Manoj and criticised the government’s initiatives towards promoting vasectomies. “It is risky with these kinds of men,” he said. “They are desperate for alcohol and some fun…[and] can go to any lengths for some cash.” Even though women coming to the clinic for sterilisation were primarily from socioeconomically underprivileged backgrounds, working-class men’s vasectomies created increased suspicion and scrutiny. Sanjay’s vasectomy was regarded as an act of love and responsibility, but the moral gaze of suspicion precludes other “kinds of men” from possibilities of masculine love and responsibility, relegating them to immoral masculinities presumptively desperate for money, alcohol, and sex. 

Shame 

Vasectomies are generally described by providers as safer and simpler than female sterilisation: no incisions, no stitches, no anaesthesia. However, postoperative anxieties went beyond these prescriptions of safety and efficacy. Firstly, working-class families were concerned about vasectomies causing weakness and debility, hampering men’s capability to perform essential tasks like riding a bike, lifting heavy items, and harvesting crops. Similar postoperative anxieties for female sterilisation were normalised within women’s repeated exposure to biomedical interventions. As one of my interlocutors explained, “I have already had two [caesarean section] operations, so I can more easily endure another [operation]… But nasbandi will make my husband very weak. Who will drive us around or harvest our crop if you sterilise him?” Relatedly, vasectomies also created gendered moral anxieties around the postoperative body and its reproductive function: 

“Vasectomies have a greater risk of bringing shame to the family…Imagine if the man’s nasbandi does not work, and the wife becomes pregnant…People will say, how is she pregnant? Is it someone else’s? This cannot happen if the woman’s nasbandi fails…a woman’s womb is only hers, but a man’s sperm can belong to anybody…”

This explanation for reluctance towards vasectomies was shared by a senior healthcare worker at the clinic. Alongside the fear of vasectomies diminishing men’s sexual virility, it resonates with the totemic conception of male sexuality as uncontrollable (Gutmann 2005; Wentzell et al. 2023). The sperm is viewed as philandering and ambiguous, which can belong to anyone, in contrast to the fixed and unambiguous womb that can only belong to the mother. In turn, preserving the family’s patrilineage calls for disciplining the womb rather than the sperm. The masculine love and responsibility that was associated with Sanjay is displaced here, overtaken by the potential shame around conjugal fidelity and patrilineage, and the moral burden of shielding one’s families from allegations of infidelity and promiscuity.

Vasectomies as acts of heroic love are selectively applied to dominant and desirable enactments of manhood, while vasectomies amongst poor, working-class, and oppressed-caste populations remain subject to moral suspicion and shame. This stratified nature of vasectomies highlights the limits of a simplistic framing of male sterilisation as pathways for shared contraceptive responsibility, and instead accounts for the multiple and unequal interactions between sterilisation, family planning, gender relations, and masculinities. Under India’s state population control agenda, vasectomies circulate as a deeply stratified technology: class and caste-bound registers of masculinities enable a selective celebration of vasectomies as heroic against the scrutiny and shaming of those very men whose reproductive bodies are targeted and incentivised for fertility control. 

Bibliography: 

• Ahluwalia, Sanjam, and Daksha Parmar. 2015. “From Gandhi to Gandhi: Contraceptive Technologies and Sexual Politics in Postcolonial India, 1947–1977.” In Reproductive States: Global Perspectives on the Invention and Implementation of Population Policy, edited by Rickie Solinger and Mie Nakachi. Oxford University Press. https://doi.org/10.1093/acprof:oso/9780199311071.001.0001.

• Balasubramanian, Savina. 2018. “Motivating Men: Social Science and the Regulation of Men’s Reproduction in Postwar India.” Gender & Society 32 (1): 34–58. https://doi.org/10.1177/0891243217743221.

• Basu, Alaka M. 1985. “Family Planning and the Emergency: An Unanticipated Consequence.” Economic and Political Weekly 20 (10): 422–25.

• Gutmann, Matthew C. 2005. “Scoring Men: Vasectomies and the Totemic Illusion of Male Sexuality in Oaxaca.” Culture, Medicine and Psychiatry 29 (1): 79–101. https://doi.org/10.1007/s11013-005-4624-7.

• Sheoran, Nayantara. 2015. “‘Stratified Contraception’: Emergency Contraceptive Pills and Women’s Differential Experiences in Contemporary India.” Medical Anthropology 34 (3): 243–58. https://doi.org/10.1080/01459740.2014.922081.

• Tarlo, Emma. 2003. Unsettling Memories: Narratives of the Emergency in Delhi. C. Hurst & Co. Publishers.

• Wentzell, Emily, Maral Erol, and Salihcan AciksöZ. 2023. “Anthropologies Of Men, Masculinities, And Reproduction.” In A Companion to the Anthropology of Reproductive Medicine and Technology, edited by Cecilia Coale Van Hollen and Nayantara Sheoran Appleton. John Wiley & Sons, Ltd. https://doi.org/10.1002/9781119845379.ch11.