Vasectomies in India – Or the Do’s and Dont’s of Population Control

Photo by Arseny Togulev on Unsplash
Recent events in the Indian state of Madhya Pradesh illustrate how the term “population control” can get a bad name. On February 11th, an order was issued to male health workers in that state to convince at least one man to undergo a vasectomy by the end of the fiscal year or face losing their job. As news spread on social media, Madhya Pradesh’s governing Congress Party faced a barrage of criticism and retracted the order.

It was also the Congress Party, at the national level, that in 1975 launched the “emergency” campaign of mass sterilization during which, over a one-year period, six million men underwent vasectomies, many of them forcibly, and 2,000 died from bungled operations. That campaign was led by Sanjay Ghandi, son of then Prime Minister Indira Ghandi. As it happens, the current chief minister of Madhya Pradesh, Kamal Nath, was a close aide of Sanjay Ghandi during the 1975 emergency. Members of the rival Bharatiya Janata Party (BJP) embarrassed the Congress Party by invoking the disastrous 1975 campaign.

It is not as if population control in India is not desperately needed – and while politicians may be aware of it, few have dared to specifically address the matter in the decades since the emergency.

However, earlier in February, India’s vice-president, Venkaiah Naidu of the BJP, brought up the issue when he said, “The population is growing leaps and bounds, creating problems. See the problems in Delhi, traffic, more human beings, more vehicles, more problems, more tension.”  Mr. Naidu is right. In fact, India will soon be the world’s most populous country, projected to overtake China by 2027.

But efforts to curb growth in India rarely take the form of strengthening family planning programs with increased access to contraceptives. Rather, undue emphasis has been placed on sterilization, especially of women. The Guardian reports rates of male sterilization have fallen from one percent to 0.3 percent in the last decade.

Furthermore, the promotion of sterilization is often at the expense of other contraceptive methods such as condoms, birth control pills and hormonal injections. Consequently, female sterilization accounted for two-thirds of contraceptive use in India until 2015-2016. This skewed focus has in fact limited the options that women have in terms of planning their families.

PIC supports the objective of the Indian government (and individual Indian states) to address the population issue. But, clearly, the way to achieve that objective without violating human rights or producing a counterproductive backlash is not through coercion but through education and universal access to a wide range of family planning choices. The fact that many men in India believe that vasectomies affect sexual functioning and virility, and are tantamount to castration, illustrates the need for better sex education. People who have accurate information about reproductive anatomy and physiology, as well as of the range of options for contraception and sterilization, are more likely to make informed choices and be open toward the benefits – both for themselves and the country – of smaller families.

There has to be “population control” to bring human numbers to a sustainable level, to reduce poverty and reverse environmental degradation. Scarcity and environmental degradation are more likely to lead to conflict and violence than to human rights and gender equality. But these goals should be achieved through education and voluntary family planning services and not forced sterilization programs. That is the only way to make “population control” a good thing in everyone’s mind.