THIRD Survey

Male Contraceptive Counselling Questionnaire

an ESG SURVEY

Section 1 — A. DEMOGRAPHICS
Section 2 — B. Scale 1: Frequency of Contraceptive Counselling Practices
NeverRarelySometimesOftenVery often
I discuss female contraceptive methods during counselling.
I discuss male contraceptive methods during counselling.
I encourage partner involvement in contraceptive decision-making.
I discuss male contraceptive options when female methods are unsuitable
I discuss male methods during couple-based counselling.
Section 3 — C. Scale 2: Knowledge and Confidence Regarding Male Contraception

Response scale: 1 = Very poor/Very unconfident, 5 = Very good/Very confident

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My knowledge of currently available male contraceptive methods
My confidence counselling male contraception overall.
My confidence counselling vasectomy.
My familiarity with emerging male contraceptive research.
My awareness of hormonal or non-hormonal male methods under investigation.

Checklist: Available methods I recognize

YesNo
Condom
Vasectomy
Withdrawal
Male hormonal pill
Male injection
Male gel
RISUG
Not sure
Section 4 — D. Scale 3: Attitudes Toward Shared Contraceptive Responsibility

Response scale: 1 = Strongly disagree, 5 = Strongly agree

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Male partners should be more involved in contraceptive decision-making
Gynecologists have an important role in discussing male contraceptive options
Urologists/andrologists should be knowledgeable about female methods
Male contraceptive methods are underrepresented in routine counselling
The healthcare system places disproportionate contraceptive responsibility on women
Interdisciplinary collaboration would improve contraceptive counselling
Section 5 — E. Scale 4: Perceived Barriers to Discussing Male Contraception

Response scale: 1 = Not important, 5 = Extremely important

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Limited male contraceptive options.
Lack of updated knowledge or training.
Limited consultation time
Low patient demand.
Low male partner involvement.
Female-centered structure of contraceptive care.
Lack of referral pathways or collaboration
Section 6 — F. Scale 5: Patient Responses to Male Contraception in Your setting

Response scale: 1 = Very negative, 5 = Very positive

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Typical patient/couple response to discussing male contraception
Typical patient response to vasectomy as an option

Checklist: Reasons for declining vasectomy

YesNoUnsure
permanence concerns
pain
sexual function
masculinity
cultural factors
lack of knowledge
preference for female methods
uncertain fertility
partner refusal
cost or access
other
Section 7 — G. Referral Practice (Single Items)
Section 8 — H. Training and Educational Needs (Single Items)
Section 9 — I. Open-Ended Questions