From ‘women’s business’ to ‘men’s business’: Exploring connections between vasectomy acceptance and equitable gender relations in South Tarawa, Kiribati

Engaging men in sexual and reproductive health and rights (SRHR) has implications for gender equality and sustainable development. Promoting vasectomy can foster more equitable gender relations between partners, but research on this topic is extremely limited. My research shows that, in Kiribati, vasectomy uptake is both a cause and a consequence of gender equitable relationships, but connections are complex. Vasectomy uptake can also result from, and lead to, inequitable behaviours. Links between vasectomy uptake and gender relations among couples in South Tarawa, Kiribati were explored using a qualitative case study informed by feminist theory and principles from indigenous methodologies. Semi-structured informal interviews were held with five vasectomised I-Kiribati men and their wives, interviewed as a couple and individually. Comparative analysis was undertaken with two same-sex focus group discussions, one with non-vasectomised men and the other with their wives; and with six key informant interviews. Information generated was analysed thematically and further triangulated with international and Kiribati studies. Among the participant-couples, vasectomy decision-making seemed equitable, consistent with other household decision-making. Notably, the wives were actively involved in their husbands’ decision to be vasectomised. Husbands were often prompted by egalitarian concerns. However, vasectomised men are in the minority and challenge gender normative behaviour. Family planning was widely viewed as women’s responsibility. Most participants felt vasectomy created new opportunities that empowered women. Yet, some participants knew of men who used their vasectomies to control their wives’ sexual and reproductive agency, and to enable extramarital relationships. Although vasectomy freed women from contraceptive responsibility, significant shifts in the gender division of labour did not follow, but exceptions existed. This research shows that gender equity is likely to be a pre-condition of vasectomy, and that vasectomy can lead to equitable outcomes. Moreover, gender relations within and among couples were multifaceted and contradictions existed. My research makes a strong case for why heterosexual men should be central to gender and development