(263) Evaluating Changes in Social Media Discussions Regarding Vasectomies Before and After The Dobbs V. Jackson Supreme Court Decision
Authors: Zhu M , Loloi J , Patel R , Watts K , Small A , Winokur N 
Published: February 2024

Abstract

Introduction
In June 2022, the U.S. Supreme Court overruled Roe v. Wade, the 1973 case establishing a federally protected right to abortion, through the case Dobbs v. Jackson. Subsequent research has demonstrated an increase in the number of men seeking vasectomy consultations as men take more ownership of family planning. We hypothesized that there might be a similar, paralleled change in online discussions about vasectomy following the court’s decision.

Objective
We sought to characterize themes and tones in social media discussions regarding vasectomies before and after the Dobbs decision.

Methods
We analyzed vasectomy-related discussions on Reddit, a large social media platform, using qualitative analysis and natural language processing-based sentiment analysis. Using the Reddit API, 1000 posts from 1 year before Dobbs and 1 year after were extracted from the subreddit group r/vasectomy. The group has 13,400 active members. Qualitative analysis was performed to determine overall themes within discussion posts. Poster age and comments about male sexual dysfunction were noted. Sentiment analysis was performed using the validated software VADER, which is specifically tuned expressions on social media platforms and assigns posts scores that can be interpreted as having positive, neutral, or negative sentiments.

Results
213 total posts (107 pre-Dobbs and 106 post-Dobbs) were randomly selected for thematic and sentiment analysis. Posters in the post-Dobbs period were significantly younger than posters in the pre-Dobbs period (25.5 years vs. 31.7 years, p = 0.05). Posters in the post-Dobbs period were also more likely to mention their sexual dysfunction or raise questions regarding their sexual function post-operatively (p = 0.03). Notable discussion themes pre-Dobbs focused on post-operative concerns (n = 31), actionable advice (n = 38), or second opinions (n = 50). Patients also sought to reflect upon their experiences with their vasectomy (n = 30). While similar themes were noted post-Dobbs, more posts focused on describing pre-operative anxieties (n = 36), raising second thoughts regarding a scheduled vasectomy (n = 36), and acknowledging in some way the importance or value of having an online community such as r/vasectomy (n = 60). There was no significant difference in the length of posts (p = 0.44) or the number of positive, neutral, or negative sentiment posts (p = 0.98) between time periods.

Conclusions
Online discussion forums may provide insight into patients’ experiences with vasectomies during a contentious sociopolitical time when contraceptive options are changing. After the Dobbs decision, patients seemed to express increased pre-operative anxiety and doubt regarding their decisions to get vasectomies, but also expressed greater appreciation for the online community in r/vasectomy. This overall mix of feelings may explain any lack of difference in positive and negative sentiment in posts between the time periods.

Disclosure
No.