Vasectomy rates increased from 2014 to 2021. Why these men decided to undergo the procedure.

A year after the reversal of Roe v. Wade, the landmark decision continues to shape the landscape of reproductive rights. One effect of this reversal is a significant rise in interest in vasectomies, a more permanent male contraceptive.

“I have seen an increase in the number of men without any children coming in for vasectomies,” says Dr. John Lin, a urologist in Gilbert, Ariz. “This is likely because abortion is made much more difficult, and these men never wanted any children at the outset. They are now taking responsibility for their desires.”

But there's been an uptick in vasectomy requests even before Roe was struck down. New research from the University of Chicago has found that while just approximately 4% of men report having had the procedure, vasectomy rates for privately insured men in the U.S. between the ages of 18 and 64 increased from 2014 (0.427%) to 2021 (0.537%) — a 26% relative increase. In analyzing insurance claim data, researchers saw the biggest absolute increase among men with three children or more, men with two children, men with wives who were not of advanced maternal age and men aged 35 to 44. The relative changes were greatest in men with no children (61%), men who had wives of advanced maternal age (40.8%), single men (40.6%) and men aged 18 to 24 (36.7%).

Vasectomy offers lasting birth control through a minor surgical procedure that prevents sperm from exiting the body; the procedure closes the tubes that carry sperm. While reversals exist, it's an expensive procedure with varying success rates. “I make sure that the patient is 100% certain about permanent sterilization and never having kids naturally ever again,” says Lin.

Dr. Aaron Grotas, a clinical assistant professor of urology at the Icahn School of Medicine, has noticed a pattern of younger patients and new fathers seeking vasectomy consultations. “Recent restrictions on abortion have prompted people who are contemplating moving to states outside of New York [where abortion is legal up to 24 weeks, and then permitted in high-risk cases] to consider elective sterilization through vasectomy,” says Grotas, “because their partners may not be candidates to get a termination of pregnancy based on which state they live in.”

While everyone’s situation is different, vasectomy remains a safe and effective option for birth control. “Almost everyone is a good candidate,” says Grotas, “as long as they can tolerate the procedure and can consent.” Compared to tubal ligation, the surgery necessary for female sterilization, vasectomy is far less invasive.

But how does someone know if they’re ready for a vasectomy? Here’s how these men decided they were ready for the procedure.

Alex Saylor, 36, first considered a vasectomy around age 18. “I’ve always been a decisive person," he says. "I wanted sex but didn’t want a family. I wanted to make a good living to support myself and give me some freedom. But I didn’t want to contribute to overpopulation.”

The Tennessee native received a vasectomy in his early 30s while single. “I was old enough to justify a vasectomy and established enough in life to say: This is my decision alone, and any future partner will have to embrace this plan I have for my life.” Saylor sought a vasectomy knowing he could adopt or marry a woman who already has children. “I was comfortable with an ambivalent mindset. I still didn’t want to have children, but I could picture having a family in the right circumstances," he says.

For Saylor, the procedure went smoothly; he enjoyed chatting with the doctor during the operation. “It was a snap," he shares. "You need a little downtime to recover before you can run around and lift heavy objects, but it’s always good to take a break.”

A few years after his vasectomy, Saylor found a partner who already had children; he now enjoys family life with stepchildren and not burdening his partner with birth control. “My partner and I have exactly the family we want together," he says. "We have no plans to expand, and my vasectomy made this convenient.”

Denis, a Canadian based in London, Ontario who asked to not share his last name, gave serious thought to a vasectomy after the birth of his second child. At the hospital the doctor offered to perform a tubal ligation on his partner but they weren’t prepared for this decision. Later, they considered the risk of his partner, 42, having a third child along with the reality of an already busy schedule that would only become more chaotic with another kid. Another factor the couple dealt with was their non-monogamous relationship. “We wanted to make sure I didn’t accidentally impregnate anyone else and complicate things” he says.

Considering his wife had already endured two cesarean births made the decision for Denis, 43, an easy one. “Birth control is a shared responsibility and men should be more willing to step up and do their part,” he says.

The procedure had little impact on his daily life. “I didn’t have any complications, nor did it change anything physically or hormonally. I still produce semen, get erections and have sex," he says.

Dale VanVlerah, 42, had no reservations about getting a vasectomy. He didn’t want his wife to receive tubal ligation, an in-patient surgery with a lengthy recovery time. “It seemed ridiculous,” says VanVlerah, “to expect her to go through so much pain when I could go in, get a vasectomy, be home the same day and be healed in a matter of days.”

The Sycamore, Ill. resident began discussing a vasectomy with his partner around the time his wife got pregnant with their third child. Once it was likely the baby would go to term, he got serious about planning the procedure.

When asked about the reluctance of some men to get vasectomies, VanVlerah notes that “a lot of men are afraid of letting a doctor near such a sensitive part of their anatomy. A lot of men that I’ve talked to have listened to myths and falsehoods about what happens to their bodies and sex drives after a vasectomy; they are afraid of losing a part of their masculinity.”

VanVlerah felt his decision to get a vasectomy made him more masculine. “It seemed more manly to get a vasectomy done and take on my role in birth control instead of relying on her. She had gone through the birth of two children, and was getting ready to birth a third, and it only seemed fair that I go through a small amount of discomfort to make up for all the pain she endured over the years," he says.