Following the US Supreme Court’s decision to overturn Roe v Wade in the summer of 2022, urologists have noted an influx in demand of vasectomies. Americans are taking matters into their own hands or, should I say, balls.
A vasectomy is a medical procedure in which the vas deferens (the small tubes in the scrotum) are cut and tied to prevent sperm from leaving the body, thereby preventing fertilization upon ejaculation
Vasectomies have been performed since the late 19th century (though there are notes of experimentation from as early as 1785), and have become far more common since the 1950’s. Like many forms of reproductive health practices, in addition to providing bodily autonomy for some, vasectomies also have a significantly dark history – most notably in India in the 1970’s when vasectomies were enforced nonconsensually during national campaigns for sterilization due to the procedure’s low cost, and highly measurable success rates. Public officials in influential positions coerced patients to get sterilized, and crammed people into buses that took them to camps for forced sterilization.
It’s a simple procedure performed by a doctor that typically takes less than an hour – patients can go home same-day.
Vasectomies are 99% effective, and are designed to prevent pregnancy permanently. It’s a simple procedure performed by a doctor that typically takes less than an hour – patients can go home same-day. Though they are intended to be permanent, vasectomies can be reserved. However, reversal can be a complicated and expensive surgery, depending on how long ago your initial procedure was.
Curious about getting snipped? In addition to contacting a medical professional, read below for representation of lived experiences of recent vasectomy-getters in the post-Roe era.
Jason (he/they), 28, Brooklyn NY
Jason requested ‘he’ pronouns for the duration of the article.
Jason was 21 when the idea of a vasectomy first crossed his mind. He recalled thinking, “I don’t want to have kids. I wonder if there’s a way I can make that happen without just using condoms. I wonder if there is a male birth control option. [Vasectomies] seemed to me like just a thing that old men did, or people who were already married and didn’t want more kids, rather than something that I could choose to do as a young adult.”
"Ultimately, I knew I didn't want kids. So I had to remind myself that that choice was okay."
Over the years, Jason explored the idea at a deeper level. “I did a lot of soul searching and ultimately realized that the thing that was keeping me hesitant was that I had this belief that having kids was something I was supposed to do. Ultimately, I knew I didn’t want kids. So I had to remind myself that that choice was okay. A lot of things in my life were pointing to getting a vasectomy being a good thing – I realized I should probably just listen to my gut.”
Jason made the decision to move forward with the procedure in July 2022, just a week or two after the overturn of Roe v. Wade made headlines. “This was a real red flag to me. I thought: ‘I have insurance right now that’ll let me do it for free. I should do this now before it’s taken away. The timer has started, so I gotta shit or get off the pot.’”
Jason’s journey followed a simple path that lasted just a mere matter of weeks from start to finish. He described the steps
- Research your insurance plan and see if the procedure is fully covered. Confirm if a primary care referral is needed.
- Find a Board-certified urologist (he used ZocDoc) who takes your insurance, and book an appointment for the mandatory consultation.
- Complete the consultation. Jason described his consultation as “super easy. For the most part, the questions were just confirming I really did want it.”
- Wait 30 days between consultation and procedure, as mandated by NY State. The wait period may vary depending on where you live.
- Attend the procedure and go home after 45-minutes, pain-free.
- Attend a follow-up appointment 6-weeks post-operation to ensure proper healing and test semen sample to ensure no sperm is present.
“For two or three days after the procedure I was a little sore. But a week after the procedure, I was back to full mobility, including having sex again! I was instructed to ejaculate at least 15-20 times to get the rest of the sperm out of my system. I had a lot of great friends and partners ‘help’ me with this, so that the very first time the doctors tested my semen it tested negative for any sperm and I was good to go.”
Afterwards, he reflected: “The shocking part was thinking about how easy it was to get a vasectomy, compared to so many stories I’ve heard from people about how hard it can be to get birth control… It’s been really great to see how much relief my partners have felt, knowing that there is no chance of getting pregnant from me. I think if you’re already considering it, going and seeing a urologist to get more information is not a bad idea. Ultimately it’s a personal choice.”
Michael (he/him), 37, Monterey County, CA
Michael is a polyamorous sex therapist based in Monterey County, California. For Michael, the decision to get a vasectomy was a highly collaborative process with his partner.
“I’ve been married for 15 years and I’m married to a diabetic. They had trouble with birth control, both from an emotional perspective and their weight made it less effective. Having another possible medication and increase in blood clot risk were all factors in them stopping birth control. And then we – on purpose – had a child. The doctor told us we couldn’t have any more children after that. So that became a decision point. We’d initially wanted two or three kids, but it was very risky for my partner to get pregnant. So it was an easy decision [to get a vasectomy] after that.”
Michael’s vasectomy was quick and relatively painless. “The incision was almost thinner than a fingernail. They just used a topical numbing agent. I’ve had more unpleasant back rubs! Then there’s one day of pain meds, most people don’t even take them. I iced myself and watched television. And then I went about my life. It was utterly fine. For so many people I talk to, it’s the most ‘non-event event’ situation.
"There’s no worry anymore. It can unlock a new sexual space in your relationship, and create a new spark."
It felt really empowering. It has led to more spontaneity in my sex life that is beautiful and reminiscent of teenage years, or at least the media portrayal of teenage sexuality. There’s no worry anymore. It can unlock a new sexual space in your relationship, and create a new spark. I’m polyamorous – it has also created a space of less worry between my partners. I don’t have to worry about getting anyone else pregnant, and that removes a conversation there and alleviates concerns, too.”
In addition to his personal experiences, Michael has years of professional experience counseling others through their vasectomies and the complex emotions that can arise before, during or after. “I’m a sex therapist. I’ve counseled people successfully with their vasectomies. In male sexuality, some men have an empowerment or fetishization of their ability to impregnate. Some people fear losing their power by getting a vasectomy. So that’s a concept to be aware of. Some men think they are more of a man for having virility. I remind them that they can play with the idea or engage in role play about it, and you’ll be doing it without the risk of any kind of pregnancy. You can still have a fantasy in your head, and play the role of it, even if you’ve had a vasectomy.
There are also a lot of individuals who have some pregnancy turn offs – they fear they’ll get someone pregnant and feel extra worry during sex. So if they can have sterilization, they feel a sense of freedom. I’ve often heard it’s ‘one less thing on my mind’ – they experience more safety and comfort in having the pregnancy equation off the table. From my personal experience, I’m able to share that I had a positive experience and can validate that it’s safe.”
Michael pulls from his expertise to caution to folks against the misconception that vasectomies are easily reversible.
Michael pulls from his expertise to caution to folks against the misconception that vasectomies are easily reversible. “In the feminist spaces, it can be short-sighted and inappropriate to push for men to ‘take care of themselves.’ A vasectomy is incredibly insurance-supported. But a reversal can be anywhere between $5,000-50,000 out of pocket, and has to be done within seven years ideally – there’s a window in which reversal can happen safely and have the highest chance for success. The reversal is a surgery that will never be insurance-supported. It’s not just a temporary decision, as some feminist spaces are shouting. Almost every urologist I’ve spoken to suggests you consider it to be non-reversible, and believe it to be non-reversible.”
A Personal Choice
Whether you’re ready to get snipped, or merely curious to learn more, it’s important to contact a medical professional to get all the information about your options. Highly effective, and often covered by insurance, a vasectomy may be the exact right fit for your family planning needs in the post-Roe era and beyond. Ultimately, though, it’s a personal choice, and it’s crucial to amass as much information – and hear from lived experiences – before making a decision for yourself. No matter what parts you have: your body, your choice.
