Vasectomy: An Easy But Neglected Form of Birth Control

While it is a routine operation—nearly 500,000 are performed in the United States every year—the myths about vasectomies fester.

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.”

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

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.”

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
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.

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:

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.”