When it comes to planning a medical procedure that involves a vulnerable part of the body, it is not difficult to find reasons to postpone it. There is the need to take time off from work, the discomfort and recovery period that comes with it. In the case of a vasectomy, a person (or a couple) must also come to terms with the decision not to have children in the future.
The stereotypical patient is a middle-aged father who no longer wants children and whose wife may welcome this opportunity to finally take on the burden of their family's reproductive planning.
Many vasectomy patients still fit this profile, but doctors are seeing increasing interest in the procedure from people who are younger and do not have children. (Note that vasectomies are usually reversible, but successful pregnancy after a reversal depends on a number of factors.)
The motivations for vasectomies vary – and are currently changing.
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For some patients, the decision is made with a sense of urgency. Robert*, who is now in his 70s, told HuffPost: “My wife has had three C-sections in three years and three months, two of which were due to failed contraception. It had to be done.”
Others feel less rushed and can wait because of convenient timing. Matthew* told HuffPost that he chose to have the procedure done on the Wednesday before the opening weekend of March Madness “because I knew I was just going to have to lie down all weekend. I might as well have something to watch.”
David (who asked to be identified by first name only, like the men quoted in the rest of this article), had the procedure performed not long after his wife had twins, bringing the total number of children to five. “It was good timing because the twins didn't have to do as much work since it was before they could even crawl, and the other three kids were with the grandparents for a few weeks so I could get a good rest and recovery without putting too much strain on my wife,” he told HuffPost.
Many men said they felt ready once their family was complete, like Tom, who said, “When my third child was almost one year old and healthy, I made an appointment for the vasectomy.”
Age can be a compelling factor, as it was for Eric, who told HuffPost, “I wanted more kids since I only have one, but the idea of raising kids until I was 60 didn't sound like a great time. I'm currently 43, so I opted to have it done.”
Financial responsibility for a child was also a top priority for the men who spoke to HuffPost. “The last of my three children was born when I was 39,” a man named Elton told HuffPost. “When I did the calculations, it seemed irresponsible to plan for any more offspring when my time helping them study and get to independence would equal my time getting my affairs in order for a reasonably independent retirement.”
Anthony explained that he had been scheduled to have a vasectomy in 2020, but it was postponed as an elective procedure due to COVID-19. He “didn't want any more children” and was concerned about the means to support another child. “The financial and emotional demands of giving a child a decent life become too much,” Anthony told HuffPost.
There is also the ease of the procedure compared to a person with a female anatomy who has their tubes tied, as well as the feeling that here is finally an opportunity for a man to “do his part” when it comes to family planning.
“The vasectomy is a much quicker and less invasive operation than anything my wife could have done with the same effect,” said Chris, who, along with his wife, decided their family was complete with two children. “Cutting me off was much less invasive and the recovery time was much shorter than having her tubes tied or something else. It just made sense to us.”
David felt the same way: “Vasectomies are non-invasive and painless, so for me it was a no-brainer.”
Not all men who want to have a vasectomy are fathers, and even more men are younger than you might expect.
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The cultural impetus for this shift appears to be Dobbs v. Jackson Women's Health Organization, the June 2022 decision by which the U.S. Supreme Court overturned Roe v. Wade and took away the constitutional right to abortion in the United States. Since the ruling, the number of people planning a vasectomy has increased and the reasons for doing so have changed.
Dr. Kathleen Hwang, a urologist at Penn Medicine, has experienced this increasing interest in vasectomy in her practice. Around the fall of 2022, she said, “the number of consultation requests increased exponentially to the point where I had to adjust my clinical practice to accommodate the increase in volume.”
Hwang was involved in a study on men's reasons for having vasectomies. She and her colleagues surveyed more than 300 men who wanted to undergo a vasectomy after June 2022, the time of the Dobbs ruling.
Thirty percent of respondents identified “sociopolitical issues,” including the Dobbs decision, as an “important” or even “the most important” factor in their decision.
Patients who felt this way, Hwang explained, were often younger and single. They were also more likely to be childfree. Patients without children were five times more likely to say that sociopolitical issues influenced their decision, Hwang said.
“The fastest growing group of men interested in this method of contraception are men who are childless and younger men (under 30 years old),” Hwang told HuffPost.
In the study, she said, “many of the patients provided feedback that their decision to proceed with a vasectomy was largely intended to reduce the burden on their female partner of using an existing contraceptive method and/or to protect them from ever having to consider an abortion.”
Interestingly, the study found that men who considered sociopolitical reasons for getting a vasectomy spent a lot of time thinking about their decision – an average of four years, or about twice as long as those who reported no sociopolitical influence.
“In the past, it was thought that younger men or childless men would make more rash decisions and regret sterilization, but our data shows that they spend a lot of time considering vasectomy and are unlikely to regret it,” Hwang said.
Thomas, a 27-year-old who recently underwent a vasectomy, exemplifies this cultural shift in motivations.
“Personally, I have never wanted to have children in my life and I have wanted a vasectomy since I was 22,” he told HuffPost. He was delayed because of a lack of health insurance, but also because he thought health care providers would question his decision.
“I wasn't very confident that doctors would willingly perform the procedure on me as I have no children and am quite young,” he said.
The 2024 election results strengthened his resolve to seek the procedure
“I have come under increasing pressure recently to get one because of the administrative shift. As prenatal health care becomes increasingly difficult to access, someone who does not want a child is naturally concerned that he or she will be forced to have one. That is in my own self-preservation, but also in the interest of protecting women and people with a uterus, as pregnancy is a two-way street,” he said.
As for women's feelings about men having a vasectomy, it seems that at least some feel relieved to find a partner who has had one. A man named Jon told HuffPost that he had the procedure done while he was married, shortly after the birth of his third child. He divorced several years later, he said, and “when I started dating again, apparently that was a 'plus' for me.”
*Not his real nameThis article originally appeared on HuffPost.
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