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Hey Guys, Don't Want Kids? A Vasectomy Is Probably the Way to Go

Historically, the burden of family planning has almost always fallen on women. Isn't it about time for that to change?
 
 
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You will lose your sex drive. Your genitals will swell. You will suffer excruciating pain. You won’t be able to get an erection or ejaculate. You won’t be a man anymore. While it is a routine operation—nearly 500,000 are performed in the United States every year—the myths about vasectomies fester. In fact, the outpatient procedure is a simple form of birth control for men, intended to be permanent, in which the health care provider closes or blocks the tubes that carry sperm. This prevents sperm from leaving the body or causing pregnancy; the body instead absorbs it. Used as birth control, vasectomies are nearly 100 percent effective.
Of course, vasectomies are not for everyone. Particularly, they must be weighed against a person or couple’s desire to have children in the future —considering such dire circumstances that may intervene in one’s life, such as death or divorce. While vasectomies can sometimes be reversed, the procedure is intended to be permanent; reversals do not always work. Doctors warn against depending upon it for any future change of heart.

Jason, a 38-year-old man from Turlock, California who had a vasectomy and asked that his last name not be used, said that vasectomies seem to be shrouded in mystery for most men.

“They don't understand that it is virtually painless,” Jason said. “It is extremely safe. Also, most men are extremely protective and shy about male organs, outside of being in a sexual situation. To think that some doctor will be cutting them open and doing stuff turns off a lot of men to the idea.”

Julius, a 49-year-old from Winston-Salem, North Carolina, noticed a similar sort of thinking.

“Men always seem to cringe when vasectomies are discussed, like it would really hurt,” Julius said. “I was in so little pain that I did have intercourse the evening of the procedure, and there was no pain involved. I had the procedure on a Friday, and was easily back to my desk job on Monday.”

Still, the mystery about vasectomies persists—and it is most prevalent outside the United States. About 43 million men around the world have undergone voluntary sterilization—compared to 180 women who have chosen sterilization, despite the fact that vasectomies are far simpler, safer, and more affordable than tubal litigation. A vasectomy costs anywhere from $350 to $1,000; female sterilization costs nearly six times as much. (Medicaid covers sterilization for both men and women.)

“Vasectomy is extremely rare in all but a few industrialized countries and China,” according to “In Their Own Right,” a 2003 report from the Guttmacher Institute on the reproductive and sexual health of men. It further reports that most men in their forties and early fifties do not want more children. Vasectomies are most prevalent in North America, parts of Western Europe, and China; it is nearly nonexistent in much of Africa, Latin America and Eastern Europe.

And yet, cued by a tight economic outlook around the world, many people are considering permanent birth control. Besides wanting to prevent against unexpected pregnancies, men in precarious jobs often want to have the procedure while they still have health insurance that covers it.

Doctors have seen a sharp increase in the number of people inquiring about the procedure, according to U.S. News and World Report. An article from last March cites Dr. Marc Goldstein of Cornell Institute for Reproductive Medicine in New York City, who estimates that he has provided about 48 percent more vasectomy consultations than he had one year ago. CNN reports that the Cleveland Clinic in Ohio has seen a 50 percent jump in the number of vasectomies that it is performing since the nadir of the recession in Fall 2008.

There is, then, an opportunity to dispel the myth and mystery around vasectomies as couples and individuals begin to ask questions they might not have asked before.

While vasectomies are becoming more common, the procedure comes in context of a complicated history. Sterilization has been abusively applied to non-voluntary individuals, particularly people of color. While women have been the primary targets of this abuse, men too have suffered coerced vasectomies.
In India in the 1970s, reports of compulsory sterilization at “vasectomy camps” began to gain notoriety around the world. Men were coerced with substantial monetary and other incentives for having a vasectomy as part of India’s attempt to lower its national birth rate. Government officials participated in many vasectomy camps, lending it a troubling authority, according to the comprehensive book The Global Family Planning Revolution. Indeed, to “persuade” men to have a vasectomy, one state withdrew public rations for families with more than three children; another state legally required sterilization after three children. In still another state, married teachers with children had to be sterilized or they would lose a month’s pay.

The traumatic legacy of this, paired with fears that the procedure inhibits virility, has caused the unpopularity of vasectomies in that nation. A Times of India report in 2004 indicates that of the 34,000 men who come to Delhi hospitals and clinics for advice about contraception, only 2,000 of them choose vasectomies.
Alongside the lingering suspicion of sterilization as a tool of abuse, vasectomies also emerge in context of the relative dearth of male birth control options.

Historically, the burden of family planning has fallen on women.

Matt Johnson wrote in AlterNet about how his decision to have a vasectomy was in part influenced by a desire to take responsibility for his contraception:

All the other common birth control methods (besides condoms and vasectomy) have one aspect in common: They place the onus on women. Not only does our society expect women to deal with the logistics of birth control, but these methods also have severe physiological drawbacks, from roller-coaster hormonal changes to intensifying menstruation cycles to weight and skin changes. Although these methods have come a long way in a few decades, they still burden women and their bodies. Is it any coincidence that in a male-dominated society, the medical establishment has thus far focused on birth control methods that leave the burden solely on women?

Having decided that I want to take an active role in birth control, a vasectomy is fair, easy, and it confronts my privilege on this issue.

This socially conscious approach to vasectomies also takes an environmental turn. Thomjon Borges of Somerset, Massachusetts, said that he has “No regrets whatsoever” about having a vasectomy. He added that, “the chance to contribute to slowing the population growth was a plus.”

 

 
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