(255) “WHAT PUSHED IT FOR ME WAS THE OVERTURNING OF ROE V. WADE”: ASSESSING THE PATIENT-REPORTED INFLUENCE OF SOCIOPOLITICAL ISSUES ON POST-DOBBS VASECTOMY DECISIONS

Abstract Introduction Following the June 2022 US Supreme Court decision on Dobbs v Jackson Women’s Health Organization overturning the federal constitutional right to abortion recognized since Roe, high levels of vasectomy interest and confusion regarding male reproductive healthcare options have persisted despite no direct impact to male contraception. To the best of our knowledge, the patient-reported influence of sociopolitical issues on male patients’ vasectomy decisions has not been studied. Objective Our objective was to characterize the impact of sociopolitical issues, including the Dobbs reversal of the right to abortion recognized since 1973, on male patients’ vasectomy decisions and timing. Methods Patients of a men's reproductive health outpatient clinic within a large academic healthcare system in Southwestern Pennslyvania who had initiated a vasectomy consult from July 2022 – February 2024 were eligible to participate in a survey questionnaire. Patients were called retrospectively or approach prospectively in-person. Demographics, factors influencing vasectomy, and general economic and political interest data were collected via modified Likert and short free-text answers. Chi-square, logistic regression, Mann–Whitney U, and Kruskal-Wallis tests were performed as indicated. Results 311 patients completed the survey. Mean age of patients was 37 years of age (range: 21, 61); 11.7% (n = 30) were under 30 at time of appointment. Median number of biological children was two (IQR: 1, 3); 19.6% (n = 50) had no biological children. Patients spent on average 2.9 years (range: 0, 33) considering a vasectomy prior to deciding. Regarding factors influencing vasectomy, 31.3% (n = 80) of participants indicated sociopolitical issues as very influential in deciding to undergo a vasectomy, with 17 participants writing in the “reversal of Roe v Wade” or “abortion legislature” in response to a free-text question asking what prompted their vasectomy decision. Men with no children were seven times more likely than men with to cite sociopolitical issues as influencing their vasectomy (sociopolitical: OR = 7.3, p < 0.001). When asked how Roe would influence access to male reproductive healthcare options in their home state, 21.9% (n = 56) answered Roe would limit or prevent access to the listed options (ie, hormone replacement therapy, IVF, vasectomy, or sperm cryopreservation). Conclusions While recent sociopolitical and legislative issues may not directly impact male patients’ reproductive healthcare, our results demonstrate the influence broader events have on male patients’ contraceptive decisions and reproductive healthcare understanding. Furthermore, clinicians may need to proactively address uncertainty and confusion around the impact of reproductive healthcare legislature on male patients’ reproductive healthcare options. Disclosure No.