"The best decision of my life": The men who chose a vasectomy
World Vasectomy Day, which falls on 20 November this year, is an annual celebration of the men who choose a vasectomy to help share the burden of contraception and responsible family planning. Population Matters Campaigner Katrina Dixon gathered testimonies from men across the world about their personal experiences of getting "the snip".
It's 2020, yet there are still only two methods of contraception for men: male condoms and vasectomies (male sterilisation). Although the first-known vasectomy was performed on a dog in 1823, vasectomies emerged during the Second World War as a form of birth control for men and have since become more widely available, with the procedure covered under national health insurance in some countries.
Getting the Snip
Vasectomies are standard surgical procedures. A vasectomy is 99% effective, and considered permanent. Usually carried out under local anaesthetic within just a few minutes, the tubes that carry a man's sperm (called vas deferens) are cut or sealed, preventing the sperm from entering the urethra. This removes sperm from semen during ejaculation and ensures that a woman's egg is not fertilised. For many men and their partners, the procedure is life-changing, removing the need to worry about unplanned pregnancies or having condoms at hand, and relieving the burden that women are traditionally expected to shoulder throughout their reproductive lives. Vasectomies do not affect sex drives and men that undergo the method can continue to enjoy healthy and satisfying intimate relationships.
Despite these perks, vasectomy remains one of the least common contraceptive methods globally, while tubal ligation (female sterilisation), a more complex, riskier procedure, remains the most common. On average, less than 0.1% of men have had vasectomies in the world's 69 least developed countries. This rate increases to 10% in the Global North, reaching up to 20% in a small number of countries.
Some men undergo a vasectomy after making the choice to be childfree, and they often report that they do not regret the decision to be sterilised. For these men, it allows them to take ownership of their reproductive choices and removes the worry of accidental conception.
"I asked my GP in 2019 for a vasectomy. There was no resistance, just simply the questions: "Do you have children? Do you want children? Do you want to freeze your swimmers?" I answered "No." to all. The vasectomy was done, and I have never regretted it." - Anonymous, UK
Allan also has no regrets:
"I have no children, and I got a vasectomy to take my fair share of responsibility and ensure that it stays that way. I have never, not once, regretted my decision." - Allan, Malta
Albert feels that the procedure should be encouraged:
"I chose to have no children, and I got a vasectomy twenty-five years ago. It was the single best decision of my life. Men should be encouraged and supported socially, culturally, and even financially, to get a vasectomy." - Albert, USA
Paul found his experience painless and agrees that vasectomies should be normalised and more readily available:
"I had a vasectomy and found it painless, apart from a little prick (the anaesthetic) and it was only mildly uncomfortable for a few days. Overall, it was an easy experience and I feel much more comfortable with my sex life since then. Much more needs to be made of the benefits and ease of vasectomies. They should be normalised as lifestyle choices. Men also need to be able to take control and responsibility of their bodies more easily. Vasectomies should be publicly promoted on the NHS - unfortunately, I didn't have my vasectomy in the UK." - Paul, New Zealand
An Act of Love
Other men decide along with their partners to be sterilised after they have had children. For these men, a vasectomy is a valid choice of contraception that enables them to plan the size of their family:
"I opted for a vasectomy through the NHS three months after fathering one daughter at the age of 40. I chose a smaller family primarily so that I could still pursue my life goals and other hobbies, as well as be a fully present father." - Anonymous, UK
Phil and his wife decided that they didn't want to have more than two children to help ease the burden of population growth on the planet. They decided that a vasectomy would be the best option for them:
"When I was 30, my wife and I had two children, and we knew that it would be unsustainable to have more as we had already 'replaced ourselves'. We took the decision that the safest solution healthwise was for me to have a vasectomy, rather than my wife being sterilised or being on the contraceptive pill indefinitely." - Phil, UK
Similarly, Elio and his wife decided to have a vasectomy after having two children for environmental reasons, and to ensure that they could provide the best quality of life for their smaller family. Elio was able to have the operation straight after the birth of his second child:
"My wife and I decided to limit our family to two children. We wanted to be able to give our children the best schooling and life experiences within our limited finances. We were also concerned about population growth with its complicated ramifications: water, food, and space shortages, and the impact on animals, increased pollution and so on. We decided that I would have a vasectomy, which would be much simpler than my wife having a hysterectomy. When my wife left the hospital with our daughter, I entered for my operation. It was the best decision we ever made." - Elio, Italy
Barriers to Access
While insufficient interest and resistance are the main reason vasectomy rates are very low compared to other methods, it can also be difficult to access a vasectomy. Men can be faced with doctors that will refuse the procedure until they have had children, or insist that they might change their minds later on. Such experiences are similar to those often reported by younger women who have their desire to be sterilised rejected by healthcare providers. Provision can vary widely by country, and be limited on religious or insurance grounds. The Affordable Care Act in the USA, for example, does not cover vasectomies.
"A good friend of mine has limits on her insurance as she works for a Catholic hospital system. They will not pay for her husband to get a vasectomy which is their preferred method. I think that is ridiculous." - Anonymous, USA
In some countries, the procedure is entirely outlawed:
"I tried to get help financially for a vasectomy in the Netherlands but was unable to do so. I am an Iranian staying in the Netherlands with my wife, who is studing here. In my country, Iran, vasectomies are not allowed." - Anonymous, Iranian living in the Netherlands
John, originally from the UK but now living in Bulgaria, has spent years trying to access the procedure, despite being certain of his decision.
"My experience getting a vasectomy has been very difficult. I've been certain I want one for over 7 or 8 years. I have learnt the local language for it in many countries. I have sat in many doctors’ rooms being talked to like a broken person, and told that I will change my mind. So far, they have refused my request." - John, British living in Bulgaria
These encounters can be very frustrating for those men who want to take on reproductive responsibility, as echoed by Bill:
"I tried in my early twenties to have a vasectomy, but was repeatedly met with the response: "You can’t be sure, you may change your mind". I eventually paid privately for the operation, which I have never regretted. At that time in my early years, population and the environment was not the issue to me. My concern was my responsibility toward the women I might and did encounter, in avoiding unintended pregnancies.
Through the years, my awareness of the plight of our world has intensified. I believe that the majority of the problems that the planet is suffering are linked to the numbers of people creating the problems. I am happy with my decision to have a vasectomy." - Bill, UK
Despite inequality of access around the world, it is clear that for those men who have successfully undergone sterilisation, the experience was transformative. Until further contraceptive methods are made available for men, vasectomies should be normalised as a valid and highly effective (permanent) form of family planning, and we applaud the men who help advance gender equality by doing their part to prevent unwanted pregnancy.
Do you have a story about your experience of having a vasectomy? If so, send it to our Campaigner Katrina Dixon by emailing firstname.lastname@example.org. Find out more about World Vasectomy Day here.
The views expressed in personal testimonials do not necessarily reflect the opinions and position of Population Matters.