Medical Examiner

Men, It’s Time to Consider a Vasectomy

Stop leaving birth control up to the women!

A woman smiles as she leans over a man lying in bed
We-Vibe Toys on Unsplash

Imagine a hormone-free birth control that is nearly 100 percent effective. There’s no scrambling to get it ready before you have sex, and it’s impossible to forget it at home. Only thing is, you have to have testicles.

We’re talking, of course, about vasectomies. And with Roe v. Wade on the brink of being overturned, it’s time for anyone who is capable of impregnating someone to consider having the procedure.

“Absolutely more men could get them,” says Dr. Marah Hehemann, a urologist specializing in men’s reproductive and sexual health at the University of Washington. She sees a wide range of patients in her clinic: men with kids, young men without kids, adults getting divorced. “After they get them, guys are like, ‘Wow, that was it?’ ” she says. Snipping the vas deferens—the tube that helps launch the semen out of the body—is so easy, Hehemann adds, that one evening at a party she told her friends’ husbands she “could do the procedure in their living room. They were blown away.” For the patient, it just involves a little local anesthesia, and then wearing some snug underwear during the recovery time.

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Yet, on the list of contraceptives that people rely on, vasectomies are down toward the bottom, at least in the U.S. Condoms aren’t too high up either, actually. What most people rely on to prevent pregnancy is—wait for it—women, or, more precisely, contraception for a body that produces eggs, not sperm. According to the Centers for Disease Control and Prevention, 18 percent of sexually active women count on their tubes being tied, 14 percent on the pill, and 10.4 percent on intrauterine devices or implants; condoms, for comparison, account for 8.4 percent of contraceptive use. Vasectomies? A mere 5.6 percent.

When testicle-owners do get snipped, it’s usually after they’ve had children, and they usually make that decision with their spouses. It’s less common among younger men who haven’t had children. Maybe more should consider them. Vasectomies can be reversed (although having had the procedure in the first place can still affect your chances of getting someone pregnant). More relevantly, younger men are in a demographic increasingly less likely to want kids and therefore more likely to benefit from the procedure (as are their partners, arguably more so). According to a Pew survey, a growing share of adults in the U.S. don’t expect ever to have children: 44 percent of nonparents ages 18 to 49 say it is not too or at all likely they will have children someday, up 7 percentage points from 2018; from 1990 to 2013, only about 5 percent of adults didn’t want kids, so clearly there’s been a huge cultural shift. It’s safe to assume the pandemic has fed some of the doubt, but so too probably have the effects of climate change and economic instability, conditions that are projected only to worsen in the foreseeable future. While getting a vasectomy isn’t itself a solution to larger systemic issues, not getting anyone pregnant who doesn’t want to be can only make the world a better place, right?

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Maybe there’s hope on that front. Since the draft opinion on Roe v. Wade was published, daily searches for “vasectomy” have increased 99 percent, according to Innerbody Research. Searches for “vasectomies near me” were highest in a few states where abortion bans or restrictions are already in place, which seems logical. Whether or not keyword searches translate into meaningful action is anybody’s guess. What is certain, though, is that more cis men in the U.S. could be making birth control a lot more gender-equitable by opting to get vasectomies. They have a lot of catching up to do: Vasectomy rates have been on the decline in recent decades, and there is no state in the U.S., red or blue, where more men are sterilized than women. In most states, the percentage of women sterilized is more than double that of men.

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My vasectomy story is not so interesting (the lack of drama, I hope, will be a selling point). After having two kids together, my partner and I came to realize that making babies and raising them is really, really hard. Even though my fantasy had been three children, we accepted that, in reality, two was probably our limit. He got a vasectomy a year after our second was born. It has made life easier. The sex has also been a lot more fun—not worrying about pregnancy makes you a lot more present. Overall, the vasectomy has given us a sense of freedom we didn’t have before. Now’s the perfect time to get one for yourself.

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