Family Planning for Guatemalans Living in Poverty

It’s common knowledge that family planning is an extremely taboo topic in Guatemala.  Equally as taboo are mental health issues, another topic not openly discussed.  In Guatemala, many people think depression, anxiety, and other disorders are “made up” and don’t take them seriously. Recently, these two areas of health crossed paths in what became a learning experience for WINGS staff.

Daniel is a 36-year-old, unmarried man, without children who walked into our Antigua clinic wanting a vasectomy. For most Guatemalans, his presence would be considered odd, as he hadn’t even had any kids yet. In Guatemala, it is not common for men to get vasectomies. In addition to the culture of machismo, there is a great deal of incorrect information about vasectomies; some men think they will not be able to have sex again, some think they won’t have an orgasm again, and others believe reproductive health and family planning should only be a woman’s responsibility.

Regardless, Daniel was certain about his decision, and he underwent a vasectomy with no complications. We spoke with Daniel later on, and learned more about how WINGS helped him with the decision to have a vasectomy, a decision he made when he was 18 years old. We were surprised that at such a young age, he made such a permanent choice for his life. When we asked why, he slowly, but bravely explained that at 17, he was diagnosed with bipolar disorder. He has lived with this disorder for nineteen years now, and it has been very challenging in many ways, especially in a society that is not accepting of people who have mental health issues. Daniel shared, “I don’t want to have children because the disease is genetic, and I could never forgive myself if my child were to suffer as much as I have. I don’t know how I would handle that situation.”  

Daniel mentioned that growing up sexual health was taught in a very conservative manner in school. And while his parents never discussed contraceptives with him, they did support his decision to get a vasectomy. His female friends congratulate him for being so responsible.  His male friends constantly ask him about the pain, which is their main concern. However, Daniel explains how smoothly the process went, and some friends have become more interested in a vasectomy as an option and more open to learning about the work WINGS does. 

Because WINGS offers vasectomies for $6, Daniel was able to undergo the procedure without worrying about being in debt. Our services are affordable so that all Guatemalans, no matter their income or financial situation, can feel empowered to take control of their reproductive health. For us, it is extremely important to engage men in reproductive health, and though it can sometimes be a challenge, we are already seeing changes. Just in 2016, 101 men have gotten a vasectomy at WINGS, and we are certain that our number of patients will continue to increase from year to year, as has been the case so far.

Thanks to your valuable support, we are able to provide affordable services for patients in need. Your contributions are helping us change lives, one person at a time!

In Guatemala, there is much pushback toward family planning. Many people believe it is a sin to use contraceptive methods, and it is commonly believed that a woman’s role in life is solely to have children. Sadly, given that Guatemala is a very patriarchal country, many men support and encourage these ideals. In fact, many women in this country cannot use a contraceptive method without asking for her partner’s permission.

At WINGS, we believe that family planning is also men’s responsibility. We are certain that including and educating them about why family planning is beneficial. We have many adolescent men in our Youth Program, many of which have become Youth Leaders, and are making change in their communities. Another program we have at WINGS is our permanent procedure program; we offer vasectomies and charge roughly $6 for this surgery. We are excited to see more and more men welcoming this decision into their lives.

Lucas, 30 years old, came to our Antigua clinic in July. We held a Vasectomy Clinic, where 15 men showed up. When men arrive at our clinic during a Vasectomy Clinic day, they first get signed up, and then our Medical Director Michelle Dubón gives a talk to explain how the procedure works, along with the risks and benefits it has. After each man gets a vasectomy, they go to a room where we provide them food and a place to recover.

Lucas has two children. He had his first child when he was only 20 years old. Lucas shares his experience; “I had my first child at 20 and he was unplanned. I knew that condoms existed, but I was too afraid to buy them or ask for them. Because of how taboo this topic is in Guatemala, I felt judged. Now, I’m not embarrassed to ask for a condom but I know young people definitely feel bad when they have to do that. “

When he was young, family planning and contraceptive use were not to be spoken of in his community and in the country in general. Lucas never got information from his parents or other family members, and when he tried to ask his teacher in school, the teacher would change the subject. Lucas explained to us: “I acquired information about sexual and reproductive health from other types of people who were probably not the best role models. I think it is very necessary to get this type of advice from someone who is trained to do so and who is knowledgeable”.  Lucas mentioned that despite technology being so advanced these days, and even though more people have phones and internet now than ever before, nobody seeks reproductive health information. When asked why he thought people didn’t take the initiative to learn about their own bodies; he said that from a very young age, boys and girls are taught to feel guilty if they ask any questions related to sex. Lucas thinks the consequences of this can be seen in the high rates of teen pregnancies. He mentioned that nobody takes the time to talk to teenagers and explain what the changes in their bodies mean. Lucas has already started to talk with his little boy and with his nephews about reproductive health, so that they will never feel embarrassed to ask him anything.

When asked why he decided to get a vasectomy, Lucas shared that he made this decision because not only women should do it; “Getting a vasectomy will make it easier for me and my wife. Even though there are contraceptive methods for my wife, I am happy she doesn’t have to use them anymore. We don’t want any more children, so this is the soundest decision.”  

His wife already had two C-sections and he thinks it’s unfair for her to undergo another surgery, even if it’s a simple procedure. Lucas’s family is very supportive of him, and many of his family members have gotten a vasectomy. However, his friends have given him a hard time about his decision. They think that after getting a vasectomy, a man won’t ejaculate, hence making him less manly. “There are so many myths! My friends have the idea that a vasectomy makes you less of a man, and their attitude is very disturbing. I do what I can to reduce their misunderstandings so that they will one day make the same decision I did.”

Lucas is grateful to WINGS because in Guatemala City, this procedure can be very expensive, and he is not financially stable enough to pay a huge amount of money. He tells us that even though he had to come from the city, WINGS made everything so easy; from the low price that he preferred without hesitation, to signing up in the clinic that morning, to hearing the doctor’s explanation, to the brief procedure, to the care he was provided afterward. Lucas shared his thoughts about WINGS’ work and he mentioned that WINGS is doing a huge service for communities in Guatemala, and that he wishes we could reach the entire country. Lucas voiced his faith in the organization; “I encourage you to keep on doing what you do. Go to as many communities as you can, reach out to all the teenagers and families who are lacking information. I know that you are going to change this country.” At WINGS, we are pleased to see that more and more men are becoming involved and supporting their families by taking control of their reproductive health. We are also pleased to know that we can count on your support to make these programs possible. Thank you so much for investing in family planning services in Guatemala.