By: Declan McMenamin, History and Politics BA candidate, St. Hilda's College, Oxford. The opinions expressed in the article are his own.
When discussing the barriers to fertility in Britain, the pressing geographical inequalities are perhaps what comes to mind. And rightfully so, the “postcode lottery” which plagues fertility in Britain means that London and the South East have disproportionately higher access to sperm testing clinics as The rest of England trails behind. An even bleaker picture appears in Scotland, Wales and Northern Ireland where there are half the number of fertility clinics between the 3 nations than in the Greater London area.
One of the missions of Jack fFertility is to chip away at this geographical inequality with remote sperm testing. But it is not just geographical barriers Jack seeks to address.
British Gender culture makes Men much more reluctant to seek fertility treatment or see fertility as a female issue, which means problems go undiagnosed, as well as placing the fertility burden on women. A lack of proper healthcare education, especially fertility, creates inaccessibility as a wall of jargon and information leaves many unable to understand the processes in fertility healthcare.
Similar to the postcode problem, Jack Fertility seeks to combat these barriers to fertility. Jack Fertility’s mission seeks make testing more accessible and start up dialogues which remove entrenched taboos and increase the accessibility of information
The Gender Barrier to Fertility Healthcare
How does gender act as a barrier to male fertility healthcare? Men are much more likely to feel too awkward or ashamed to seek out medical help. But why is this the case? In Britain, the historically prescribed attributes of manliness are strength, stoicism, and a competitive spirit. Whilst we are moving slowly but surely away from these entrenched notions of manliness, these are still present in many men in Britain.
These male values create a “superhero syndrome” in which men avoid going to the doctors as this would mean exposing themselves, admitting weakness, or even getting emotional in front of another person. A poll by MENtion found that: 65 percent of respondents said they avoid going to the doctor as long as possible, 20 percent admitted they aren’t always honest with their doctors about their health, and 37 percent said they had withheld information from their doctors in the past, specifically because they weren’t ready to deal with the potential diagnosis that might result if they told the truth.
With fertility, these issues of awkwardness, and unwillingness to be vulnerable are worsened. The issue contains far more taboos and awkward connotations, making men far even more likely to avoid testing or treatment altogether.
Our gender culture not only deters men from seeking treatment but also creates a myth that fertility isn’t a male issue at all making men who already fear the awkwardness of seeking help even more unlikely to seek it. We are brought up hearing more about female fertility than male fertility. There is far more discussion about women’s fertility window and menopause than there is about sperm issues. Only 1/3rd of infertility causes are due to female-only factors yet because fertility is discussed mainly in female terms, it is seen as a mainly female issue.
All this has the unfortunate impact of not only preventing men from getting tested but also shifting the fertility burden onto women. Only 1/3rd of infertility causes are due to female-only factors yet whenever there is a problem conceiving, the blame is placed firmly onto women. Because of the fertility burden placed on women and the societal pressure women face to have children, women disproportionately succumb to depression and anxiety when a couple fail to conceive
Educational Barriers to Fertility Healthcare
A lack of education about healthcare is a potent barrier, especially towards fertility. Educational attainment is naturally a barrier to the understanding of healthcare and medicine, but this is only part of the problem. Possessing a university qualification in a non-scientific/biological field does very little to increase graduates’ aptitude to process information surrounding healthcare.
One would expect that in the age of the internet, healthcare information would be more accessible than ever before but if anything, the internet has only worsened the problem. Just because information is more available doesn’t mean it is easier to understand. What so often happens is we consult Google over a health question and are bombarded with various contrasting claims which are behind an incomprehensible wall of medical science and Jargon.
A House of Lords report confirms these suspicions, finding that over 61% of British Adults have poor health literacy, evidence of the poor accessibility of health information. With poor health literacy, patients are far more likely to be unaware or ignore health issues which will fester and cause permanent damage and hospitalizations which could’ve been avoided with a sufficient public health educational campaign.
The sphere of fertility health is an even bleaker picture. Despite over 3.5 million Britons being affected by fertility issues, discussions of fertility are cast to the side. It is an issue deemed too awkward and too unimportant to the NHS. With funding and capacity already stretched to record limits, something which doesn't threaten to fill hospital beds or foot a large bill is low on the Agenda of the Health service.
As fertility is rarely discussed in British healthcare, the already high inaccessibility of healthcare information makes the impacts of poor health literacy even worse in this sphere. With an even poorer understanding of fertility healthcare, issues are even more likely to be ignored and untreated.
What is the Solution?
These bleak problems in fertility healthcare do have a solution however and it lies in tech-driven remote sperm testing innovations such as Jack Fertility.
With remote testing, more men will hopefully engage in fertility testing as much of the awkwardness and vulnerability which turns men away from an in-person test vanishes. If more men are getting tested, issues which would otherwise go unnoticed by avoiding a doctor’s visit can be spotted and addressed as well as alleviating the fertility burden which is unfairly placed on women. The testing process itself alleviates many of the educational barriers to fertility health as results are broken down in simple terms unlike in current fertility testing where results are a bombardment of figures and medical jargon with explanation only coming from a second paid consultation. This is hardly accessible when most of us don’t have the health literacy which comes from scientific training.
Jack’s missions beyond providing testing and engaging in fertility education and discussions are hopeful solutions to these fertility barriers. In opening up discussions and dialogues around male fertility and making testing easier, more men will become aware of their part in the fertility process which is mostly believed to be a female-only responsibility. Jack Fertility also has a strong drive to spread understandable educational content to combat the deficit in public understanding of fertility care in Britain.
Whilst gender and education are tough and often unspoken barriers to fertility healthcare, Jack Fertility’s products and missions are a valuable solution to overcome these hidden barriers.
References:
UK House of Lords Report: https://lordslibrary.parliament.uk/covid-19-health-literacy-and-public-health-information/#:~:text=However%2C%20the%20public's%20ability%20to,included%20both%20text%20and%20numbers.
Government report on the impacts of Health Literacy-
Fertility data- https://fertilitynetworkuk.org/.
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