Prescrire, proscrire, laisser choisir : Autonomie et droits des usagers des systèmes de santé en France et en Angleterre au prisme des contraceptions masculines

Abstract : Contraceptive use in France and England differs strongly with regard to male methods: half of English users resort to vasectomy and condoms, compared to just15% of the French population. From the 1960s on, the medicalization of contraception has gone hand in hand with its feminization but it appears that national contraceptive norms allow for different levels of male involvement in each country.In order to understand the process leading to variously gendered contraceptive models, this research draws a comparison between the institutional contexts of contraceptive prescription, which contribute to defining possible and desirable contraceptive choices. In addition to anin-depth historical and institutional analysis, this comparison draws upon 34 semi-structured interviews with prescribers in both countries in order to unveil the logic behind their actions and their influence on contraceptive norms.This analysis underlines the consequences of contrasting political perspectives on birth control in both countries: the legacy of the British eugenicist movement proves more liberal regarding sterilization methods than the French pro-natalist context. Moreover, the National Health Service in England and the French health system address the issues of medical regulation very differently. In France, public supervision of clinical practice is low, which allows for considerable heterogeneity between professionals, and, notably, a paternalistic approach to contraceptive choice and the influence of gendered reluctance towards male methods. In England, public regulation of medical training and practices encourages the standardization of prescribers’ approaches to contraceptive choice and more respect for users’ preferences.
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Cécile Ventola. Prescrire, proscrire, laisser choisir : Autonomie et droits des usagers des systèmes de santé en France et en Angleterre au prisme des contraceptions masculines. Sociologie. Université Paris-Saclay, 2017. Français. ⟨NNT : 2017SACLS082⟩. ⟨tel-01795009⟩

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