Shawn never really wanted children. A 32-year-old software engineer and amateur weightlifter living in central Florida, he had long contemplated a vasectomy. When he met his fiancee and learned that she also held no grand designs on reproduction, the matter was all but settled. He was, by his estimate, “90% certain”.
The supreme court’s recent overturning of Roe v Wade, and the nationwide convulsions over abortion access, was the final push he and his partner needed. When he read that Justice Clarence Thomas mentioned, in his opinion concurring with the controversial ruling, that the court should reconsider access to contraception, Shawn knew he had to move fast.
Shawn (who asked that his last name be withheld) booked the surgery with a local urologist in Lutz, Florida, who has performed the procedure tens of thousands of times and is renowned in the region as “the vasectomy king”. From the consultation to the surgery itself, the ordeal was totally painless, Shawn says. “I can’t lift weights or anything yet,” he says, six days into his recovery. “But I’ve had worse dental procedures.”
Shawn is one of many American men seizing control of their own reproductive health, as millions of American women are stripped of that right. Since the draft decision on Roe was leaked in May, data collected by Innerbody Research showed a huge increase in the number of daily web searches relating to vasectomies. Searches for “where can I get a vasectomy” swelled by 850%. Related queries – “how much is a vasectomy?” and “is a vasectomy reversible?” – also exploded.
“There is a definitive uptick in men exploring vasectomies,” says Dr Alex Shteynshlyuger, a New York City urologist. “The supreme court decision has prompted a lot of conversation about contraception in general, as well as raising the awareness about vasectomy as an effective, low cost, safe, and permanent method of contraception that gives men control over their procreation.” Shteynshlyuger says that in the weeks since the landmark decision, his midtown Manhattan office has seen a marked increase in vasectomy-related inquiries. On a normal week, he’d average about 15 consultation calls. In the last week of June, following the 24 June Roe decision, he fielded 72 requests.
This increase is also visible in red states. Innerbody’s original Google search data showed that most vasectomy-related queries were coming from Texas, where a 1925-vintage, pre-Roe abortion ban was restored on 1 July.
Barbara Nielsen, a spokesperson with a urologic institute in Idaho (where a trigger law banning abortions will soon take effect), confirms that its offices have seen 60% more vasectomy consultations in the past month. “Men are upping their game a little bit,” Nielsen says. “In the first couple weeks [after the Roe decision], we did see a definite uptick in calls. And I know other area urologists did as well.”
Once perceived as drastic and irreversible, vasectomy surgeries are now simple, routine and relatively painless. Urologists advertise “no needle, no scalpel” procedures. A small hole is punctured in the scrotum, allowing access to the vas deferens – the ducts that transmit sperm from the testicles to the urethra. The procedure is completed in about half an hour, usually in a doctor’s office. Most men report the only real pain as the initial anesthetic needle to the region. And crucially, vasectomies are now a bit easier to undo – though Shteynshlyuger is quick to note that this doesn’t necessarily mean that men should take the decision to compromise (even semi-permanently) their reproductive abilities lightly. Vasectomy reversal operations are pricey (costing as much as $10,000), with success rates that decrease substantially as time since the vasectomy elapses.
Despite practicing in New York, where abortion remains legal, Shteynshlyuger says his calendar has been filling with men coming in from out of state. “I have had some patients express concern to me,” he says. “They live part-time in a state where they may have difficulty accessing abortion services, or their partners may have difficulty accessing abortion services. And that certainly has contributed to the complex decisions that men and their partners make about contraception.”
Iain Little, a 40-year-old banker living in Philadelphia, had to call a half-dozen urologists before finally booking his surgery. “It’s been a long process,” he grumbles. Little had always been fairly certain that children weren’t part of his life plan. For years, his wife agreed. Now, recently divorced and dipping his toe back into the dating pool, he felt it was an appropriate time to seriously consider a vasectomy. “Then the Roe thing happened,” Little says. “That cemented it. That was the stars aligning. This needs to be done.” His surgery is booked for this week.
Shawn’s reasoning is similarly practical. He worried that broader bans on contraception could follow in the wake of the Roe decision. “To be really honest,” he says. “I’m a straight, white dude in America. Typically, I’m the least worried about these things. But they might come for that one. So I was like, ‘I’m just gonna get this done while I still can.’”
America’s more prominent anti-abortion organizations seem to have no particular objection to vasectomies. The National Right to Life Committee, an establishment anti-abortion group who recently celebrated Roe’s downfall at an annual convention, says that the group “takes no position” on the procedure, stopping short of pushing a full-on anti-contraception agenda. “In fact,” says NRLC spokesperson Laura Echevarria in an e-mail, “National Right to Life does not take a stance on anything that prevents fertilization. However, National Right to Life does oppose any device or drug that would destroy a life already created at fertilization.”
Other groups are a bit more drastic – in orthodoxy, if not in practice. Theresa Notare, of the secretariat of laity, marriage, family life and youth for the United States Conference of Catholic Bishops, helps clarify the Church’s official position. “Direct sterilization? That would be a major problem. Mortal sin. It’s in the books.”
The Conference of Catholic Bishops has long served as a powerful anti-abortion lobby. In 1973, James T McHugh, a prominent priest and former directly of the NRLC, proclaimed: “The only reason that we have a pro-life movement in this country is because of the Catholic people and the Catholic church.” Nevertheless, Notare rebuffs ideas that the Catholic church is gunning for contraception (or sterilization) next, “mortal sin” or no. “To my knowledge, there is no plan,” she says. “There doesn’t seem to be any necessity to do that.”
In the current climate, a vasectomy almost seems like a political gesture. It’s a way for men to take a more active stake in big decisions about contraception and reproduction that typically fall to women.
As Shawn and his fiancee were mulling more permanent options for contraception, he began to notice in an obvious disjoint between the care he was offered and that which women are typically afforded. He’s heard stories of women seeking tubal ligation (colloquially, “tube-tying”) procedures who are pressed about the considerations of “the hypothetical man” – husbands, or even prospective husbands, who may take issue with the procedure. “I see women talking about how they need their husbands’ signatures,” he explains, shaking his head, a little disbelieving. “My fiancee was there for my vasectomy. No one asked her. There’s a huge double standard with reproductive rights.”
Suddenly, with the upsetting of Roe, the cultural response to a “child-free” lifestyle has itself been overturned. Once regarded as a selfish gesture, sterilization can now seem downright altruistic. Little has certainly entertained these sorts of bigger political and social considerations. But he ultimately sees them more as post-hoc justifications for something he was already considering. “It sounds grandiose to say that it’s a show of solidarity,” he says. “I don’t want to get a girl pregnant, right? Abortion was never the first choice, obviously. But it was a choice.”
Now, those choices are being reduced. Republicans in Little’s home state of Pennsylvania have advanced legislation to restrict abortion access – efforts the Democratic governor, Tom Wolf, has vowed to veto. Such promises seem only modestly encouraging nowadays. If there was a lesson to be learned in the reversal of Roe, it’s that one should never say never.
Indeed, Shawn’s thinking on the subject can trend towards openly despairing. His vasectomy was more than just a way of chipping in. The rolling back of abortion rights has served to strengthen his – and his fiancee’s – conviction that procreating at all in the modern US is vaguely immoral. He mentions the ballooning costs of raising a child, the increase in climate disasters, and even the supreme court’s reversal of Roe v Wade itself. “Even if I wanted children,” he says, “There’s lots of reasons not to bring a kid into the world right now.”