The silence around men’s reproductive health

Discussions around reproductive health frequently, and rightfully, centre on women's bodies, rights, and autonomy. But in doing so, they have frequently failed to adequately inform and serve a whole half of the people. 

Despite its importance for family dynamics, individual well-being, and greater gender equity, men's reproductive health is still an overlooked topic in global health systems. Men must be included in discussions about reproductive health if we are to create inclusive, successful policies. They should not be viewed as auxiliary supports, but rather as individuals with their own reproductive health needs, rights, and responsibilities.

The reproductive health of men is rarely given priority and is very vaguely defined in many nations. Men's roles in women's reproductive outcomes—whether as dads, husbands, or decision-makers in family planning—are frequently framed by health systems. Men's personal reproductive experiences—getting over STIs, dealing with infertility, using contraception, or even overcoming social constraints related to masculinity and sexual performance—are overlooked in this paradigm. We let stigma, silence, and false information fill the hole when we ignore these problems.

In Bangladesh, where efforts to improve reproductive health have advanced significantly over the years, mostly focused on the needs of women, this disparity is especially noticeable. The 2022 Bangladesh Demographic and Health Survey (BDHS) found that of the women who are currently married, 64% use contraception, and 55% choose contemporary methods. 

However, very few of the men who are now married say they have used male-controlled modern treatments like vasectomy or condoms. Even though vasectomy is a long-term, safe alternative, the use of this method is still unlikely. These numbers indicate a deeper problem than a predilection for female-centered approaches: males are not actively participating in family planning as independent participants.

Cultural attitudes have an important part in this disengagement. In many South Asian countries, talking about sexual or reproductive health is still frowned upon, and masculinity is frequently associated with virility and invulnerability. Many males have shown uneasiness or perplexity when questioned about sexual health or contraception in my experience working in Bangladesh's humanitarian sector, notably in refugee circumstances. Many believe that the health system is unfriendly, strange, or just not made for them.

Men's mental health and relationships are negatively impacted by the emotional toll that untreated reproductive problems—from erectile dysfunction to infertility—take, which is frequently concealed beneath layers of stigma. 

The possible consequences of this lack of involvement are extensive. Men are less likely than women, worldwide, to seek medical attention, particularly for problems pertaining to fertility or sexual health, according to the World Health Organisation (WHO). Untreated STIs, untreated infertility, and mental health stress related to performance anxiety or reproductive expectations can all be consequences of this postponement or avoidance. According to studies, males in Bangladesh frequently lack knowledge about the entire array of contraceptive alternatives at their disposal, and misconceptions regarding vasectomy—such as the fear of weakness or impotence—remain pervasive.

Furthermore, excluding men from discussions about reproductive health also serves to perpetuate gender disparities. Women are solely responsible for family planning and contraception when men are denied access to education and services. Because women must shoulder the burden of decision-making, side effects, and frequently the blame for reproductive results, this leads to imbalances in both mental and physical work. Men and women should both be supported by a reproductive health system that shares that duty.

The advantages of male engagement are evident in nations that have made it a priority. In Rwanda, the use of contraceptives has significantly increased and the number of unwanted pregnancies has decreased as a result of a government-led program to engage males in family planning through peer education and community outreach. Some Indian states have allowed males to get reproductive health counseling from male health providers, which has helped to make discussions mainstream and lessen stigma. These models show that males can and do actively participate in reproductive decisions when the appropriate strategy is used, which should be data-driven, community-based, and culturally sensitive.

Bangladesh has attempted to do this to some extent. Male participation in the National Family Planning Program has been integrated by the Ministry of Health and Family Welfare. These programs, however, continue to lack national awareness and adequate funding. Male involvement is frequently viewed as optional rather than necessary, and the majority of family planning programs are still geared primarily at women. This is a chance lost. 

The achievement of important Sustainable Development Goals pertaining to gender equality, health, and universal access to reproductive care is also hampered by disregarding men's reproductive health.

We require a multifaceted strategy in order to proceed. First and foremost, comprehensive sexuality education in schools has to include males and emphasise body autonomy, consent, and contraception. Early schooling is essential for forming attitudes on gender and health that last a lifetime. Second, medical facilities ought to be prepared and educated to offer services that are inclusive of males—areas where men can seek help, ask questions, and receive treatment without worrying about being judged. Third, public awareness initiatives must specifically target men, dispelling myths and false facts through accessible stories and reliable sources. Subsequently, health policies need to be reframed to acknowledge men as not only advocates for women's health but also as stakeholders in their own reproductive health. While male education and counseling programs are vital, donor financing for sexual and reproductive health initiatives is disproportionately focused on women.

Addressing men's reproductive health is about extending the reach of reproductive rights; it's not about taking attention away from women. Men become better spouses, parents, and members of society when they are empowered to make healthy choices. More significantly, people feel more in control of their own bodies and have better overall health. Men's participation in reproductive health is essential, not optional. We must consciously and openly extend reproductive rights to men if we genuinely think that these are human rights.

Zaziratul Zannat is a public health scholar and humanitarian aid practitioner, works in a non-profit international organisation based in South Asia.

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard