Wednesday, September 15, 2010

Vasectomy Saga: The Quest Begins

The decision to get a vasectomy should never be made lightly. Although the procedure is among the safest surgical procedures one can have performed, its results are permanent and can have an important effect on one's life. The decision to have children is also permanent but the implications for one's life are much more severe. Once sterilized, you can still adopt, foster, or buy a puppy to sate that damnable urge to procreate. On the other hand, it is quite difficult to rid yourself of a child once it has been birthed because post-natal abortions are sadly still illegal.

Before I get into the personal stuff, let me tell you a little bit about vasectomies. The procedure involves making a small incision in the scrotum and then severing the vas deferentia. The vas deferentia are the tubes that carry sperm from the testicles to the urethra where they mingle with the seminal fluid before being ejaculated. Five hundred thousand vasectomies are performed every year in the United States. In Canada, the rate of couples who choose vasectomies over tubal ligations is twice as high as in the States. Vasectomies are the single most effective method of birth control available today (0.02-0.2% failure rate).

Why do I want to get a vasectomy? There are many answers to that question, but let me give you just a few. For starters, I simply don't want to have any children. I don't aspire to be a father and I never have. Even if I did eventually want to have children (which I won't), I'll adopt. I know it's not a simple process and I know that it takes years, but it would be worth it to go through that effort to save a child from the disastrous foster care system we have in this country. I would want to take care of a child who already exists, rather than needlessly creating more. Another reason that I want to have a vasectomy is so that I would no longer have to rely on my partner taking a pill every day to avoid an unwanted pregnancy. Jac is extremely responsible and reliable, but she isn't as reliable as a permanent solution like a vasectomy. Also, by not purchasing the pill, we would stop the constant flow of money to the for-profit pharmaceutical industry. I want to take control of my ability to reproduce, and for me, getting a vasectomy is by far the best option.

I recently began my quest for sterilization in earnest by going to my family doctor – a nervous, nebbish fellow – to ask for a referral to a testicular technician. I had done some research about getting a vasectomy at a young age, and I was ready for a struggle. Most doctors won't perform the procedure unless you've succeeded in living for at least 25 years or have already sired a sizable litter of man-pups. I don't fit either of those categories, but I fancy myself a persuasive sort of fellow, so I decided to give it the old college try.

To my surprise, Dr. Coodin didn't put up much of a fight at all. I think it might have had something to do with his discomfort with the subject of scrotal surgery, but he only asked a few short questions - “You're 23? Any kids?” - and agreed to send off my profile to a doctor who was more talented in the area of ball sack butchery than himself.

I selected Dr. Jason for my first attempt at achieving permanent baby-freedom because: 1) the name Dr. Jason connotes the sort of laid-back attitude that I'm looking for in a vasectomist. A guy with a first name for last name should be the same sort of guy who doesn't ask a lot of questions before performing semi-invasive surgery. And, 2) he had come highly recommended from my spouse's former spouse. Yes, you read that right. Jac's former common-law had a vasectomy done while they were together. She's a real black widow, that one.

It turns out that Dr. Jason isn't nearly as cool as his first-name-for-a-last-name name would suggest. When I gave him a call to discuss my eligibility, he went on an on about all the tragic sob stories he has been privy to, where men who got vasectomies too young soon lived to regret them or had to resort to multiple surgeries and huge medical bills (vasectomy reversals aren't covered under public health insurance) to get them reversed. What about all the sad stories of people getting pregnant when they weren't ready for the responsibility of having a child, I wanted to ask. But I held my tongue. This man was the gatekeeper to the land of prophylactic and pill-free bliss that I've always dreamed of. I had to prove to him that I am the most mature and thoughtful 23 year old in history and/or that I hate babies more than a crazed French woman.

The good doctor asked me very pointedly, “Do you travel a lot?” It's a question that doesn't really seem to have anything at all to do with vasectomies, but my mind raced to come up with the perfect answer to this potentially all important question. I guessed that Dr. Jason, like many other people, is annoyed by listening to babies cry on airplanes, so he doesn't want frequent fliers to spawn. “We want to switch back and forth between living in communes and living in the city,” I proclaimed proudly. It was a mostly honest answer, as Jac and I had tossed around that idea with some seriousness and I hoped it would meet the threshold for being too well-travelled to conceive. He then relayed to me a tale about a young military man who he gave a vasectomy to because he travelled so much that caring for a child would be impractical. Yes! Travelling lots is the right answer!

Alas, all the effort was all for nought. Dr. J said that if I was 19 months older he would love to stick sharp instruments into my nether-regions, but at this present time he would be unable to fulfil my wishes. I made him promise to refer me to another sterilization specialist and we bid each other adieu.

Stay tuned for the continuing vasectomy saga. This is only a temporary set back. My resolve has redoubled. I will have my infertility or I will die trying! Or maybe I'll just write a strongly worded blog entry about it.


Frequently asked vasectomy questions:

Description of most of the birth control methods available today:

Someone with a very similar perspective on vasectomies:


  1. I eagerly await the day when any man has the freedom to have his ball-sack horribly mutilated.

  2. My experience:

  3. Your only given reasons are: a) you don't want kids, b) you don't think it's fair to make your partner take pills, and c) you don't want to support the pharmaceutical industry.

    These are all great reasons for wearing a condom; they're free at any Klinic and very easy to use.

    Maybe if you explained why permanent surgery is so much better than wearing a condom (or using any other contraceptive method besides the pill) that you would make such an irrevocable damage to your body . . . you might persuade someone to consider it himself. Otherwise, good luck convincing anybody to join you.

  4. Greg – I am absolutely stunned to hear condoms touted as a permanent form of birth control for someone who does not plan to have children. Condoms? Seriously? Number one: have you ever worn one? I don’t want to go into a sensation-based argument here and make everyone uncomfortable, but really? A condom? Every time, for the next thirty years? Number two: they are less effective than most other birth control methods (with a typical-use failure rate of 15%), and it is generally advised they be used as a supplement to another forms of birth control (for STI protection) as opposed to as a primary means. Number three: if environmental sustainability/ethical consumption is at all important to a person, it might be worth doing a few condom-related calculations before opting for three decades of condom use.

    We'll take Rob's case for example. I have it on pretty good authority that he has sex about 4-5 times per week, so let’s take the average of about 4.5 and multiply that by the number of weeks in a year for a total of 234. Let’s say, for the sake of argument, that he and I remain married our entire lives. I’m 27 right now and so will be at risk of bearing children inadvertently for about the next 25 years. Even if we allow for the inevitable decrease in sexual activity that comes from spouses no longer liking each other (let’s estimate 4.5 times a week for another three years, then 3.5 times a week for the next seven, twice a week for the following decade, and then once or twice a week for the half-decade after that), it is within the realm of possibility that Rob, if he follows your advice, will use 3,406 condoms before he is 50 years old.

    At least they’re free at Klinic, but do you know what they’re made out of? And which companies profit from their sale? Maybe one person using over 3,000 latex cylinders seems small compared to the environmental devastation wrought elsewhere, but I assume you mean this advice to be applicable to every man who doesn’t want children and is reluctant to foist a lifetime of hormone ingestion on his lover. (Not to mention all those men who do want children but don't want 15 of them and so still do require birth control at various points during their lives.) I’m sure it’ll add up.

  5. “Irrevocable damage” is a very strange phrase to use to describe a vasectomy. If by “damage”, you mean that the surgeon severs a tube and that it is very difficult to un-sever it later, you are correct -- that’s sort of the point of the surgery, after all. But “damage” usually implies harm, and damaging side effects are very rare with vasectomies. It is truly one of the safest surgeries you can have. As mentioned in the blog, my spouse prior to Rob had a vasectomy at the age of 28. We rode out to good ol’ Dr. Jason’s clinic on the city bus at 10:15 am and left the same way at 11:45, and that includes the time it took to watch the mandatory “So-you-want-to-have-a-vasectomy” video and make small talk with the receptionist. The patient is conscious for the entire procedure, and is then sent home with orders not to lift anything heavy for two weeks, and to start having sex or masturbating again after five days (the sooner and the more frequently you “clean the pipes”, as Dr. Jason says, the quicker you’ll be free of residual sperm).

    You criticize Rob for not having provided sufficient reasoning for his vasectomy. After all, he only has three reasons, and one of them is “a) I don’t want to have kids”. But how could he possibly need any other reason than that first one? Not wanting to have kids seems adequate to me. In fact, I can’t think of any better reason to take steps to restrict your fertility than that you don’t want to have kids. Can you? Your assertion that a vasectomy causes “damage” is baseless. What’s your issue with the procedure, then? That it’s permanent? You know what else is permanent? Having children. And people make that decision at age 23 all the time with relatively little skepticism from their friends, family, colleagues and acquaintances. Why is one permanent decision subject to such scrutiny and judgment, while the other is not?

    Vasectomies are THE form of permanent birth control. They’re safe, they’re effective, they’re pro-feminist, and they’re fun! (Okay, I don’t think getting one is actually fun, but the awkwardness they generate in dinner party conversation is always fun, especially if you get one under the age of thirty.)

    For more information on why vasectomies rule, contact me, Winnipeg’s unofficial vasectomy ambassador.

  6. Hey long time reader, first time commenter.

    As one of Rob's old buds, I'm finishing up my medical degree and am reading with great interest this debate about vasectomy.

    First the facts. Well nothing can really be taken as fact but these concise guidelines certainly describe what the evidence suggests. And what the doctor is thinking when you ask for the procedure. (

    I also have to agree with Jac on her points above, especially re condoms.

    An option that I'm sure you've thought of but one that is very popular among couples in their 30s, is an IUD or intrauterine device. They come in copper or progesterone impregnated forms and have their own headaches which I can go into if you'd like. However surprisingly they have similar efficacy to vasectomy (about 0.2% use failure rate) and are reversible.

    Tell me what you think.

  7. I didn't state my position on vasectomies, I stated it on the argument. I never said that I have an issue with the procedure; what I said was that Rob didn't give any reasons that were specific to a vasectomy itself. He didn't. You gave some. Thanks (I am not being facetious, I mean it.)

    As for condoms, yes I've used them and yes I understand their shortcomings. I'm not sure if you were trying to provoke me or what . . . But condoms weren't the point of my post.

    My point was that the most important reasons Rob mentioned weren't specific enough to vasectomies to defeat the stigma around the operation. To be honest, I don't think your reasons were either.

    I'm not saying that I don't care about wasteful use of latex or that I don't care about the failure rate of condoms, but I think that it's a bad idea to assume that most people do. Most people don't, or at least they don't care enough to inflict permanent "change" (to avoid any more semantics) on themselves.

    I didn't mean to provoke, all I wanted to say that I thought there needs to be a stronger and more relevant argument addressing the initial misgivings that the reader has.

  8. First: What other form of birth control resolves Rob's concerns, though? (To recap, the concerns were: wanting to avoid having children, hopefully forever; wanting to avoid making his partner take pills; and wanting to avoid financial support of the pharmaceutical industry). You first suggested condoms and I think I've outlined the insurmountable issues with those. Do you have another option that meets the aforementioned criteria?

    Second: You have set the standard for a good vasectomy argument at, “In order for this to be a good argument, your reasons for wanting a vasectomy need to be completely unique to vasectomies. If any other form of contraceptive also meets those criteria, then obviously that contraceptive would be the better option, since there is presently a stigma around vasectomies.” How about instead we challenge the stigma around vasectomies, as we good progressives and radicals do with most stigmas?

    As I see it, the vasectomy stigma is founded on two tenets:

    1) That vasectomies are major surgery, that they are dangerous, that they render you impotent or otherwise affect your sexual performance, that they will obliterate your masculinity, that they're “like getting castrated”, etc, etc. Obviously, this one is insane. Vasectomies are very safe, very effective, very rarely have damaging side effects, and they let you keep your balls.

    2) Vasectomies are an inherently rash decision, because deep down we all aspire to have children, even if we don't know it. And even if we don't want to have children, what if we one day meet someone who does and we marry them? Won't we then compromise our values and renounce our lifestyles for the sake of love? Therefore, it is important to always keep your procreation options open, since procreation is what humans were meant to do. And even if you think you don't want to do it, and even if it goes against everything you stand for personally and politically, you'll probably grow out of that (or a future wife will make you grow out of it). Obviously, this one is insane. Not just insane, but offensive.

    Would anyone like to put forward an argument that either 1) or 2) are not insane? Or maybe there are other reasons for the vasectomy stigma that I'm not thinking of. But if it's just 1) and 2), and if indeed they are insane, then why would Rob (or anybody) need to spend time coming up with reasons why simply nothing but a vasectomy would do?

    P.S. I wasn't trying to antagonize you with my “Do you wear a condom?” remark; it was more meant as a rhetorical question, as in: “Nobody who has ever actually worn a condom could possibly recommend them as a long-term form of birth control within a monogamous relationship.”

    Jonah – I'm so glad you're following the blog, especially this debate! One or the other of us will write more soon about paternalism in medicine and the moral responsibilities of doctors to their patients, and how that plays out in this whole thing. I'll be interested to hear your thoughts.

    On IUDs, I have read such wonderful things in the research, but I have a handful of friends who have had just disastrous experiences with them – serious cramping, bleeding, and in one case actually having to have it removed. I know anecdotes are not the ideal means of gathering information for medical decision-making, but I can't help but get squeamish hearing girlfriends describe their lady-part-related pain in graphic and horrifying detail. I haven't ruled it out as a Plan B, but damned if I'm not spoiled after having lived with a vasectomized man for so long previously. I don't want to give up hope just yet!

  9. "and if indeed they are insane, then why would Rob (or anybody) need to spend time coming up with reasons why simply nothing but a vasectomy would do?"

    Most people are insane! Or at least they subscribe to insane ideas. So, if you want to beat the stigma, you've got to spend time coming up with counterarguments to insanity!

    I concede that I can see why it is the best option for Rob(and others)!

  10. As someone who has also aspired to get a vasectomy and think procreating unethical, I enjoyed this post very much. However, the part about "post-natal abortion still [being] illegal" really threw me off. Is it part of your ideology that it should be legal? If so, can you elaborate on it vis-a-vis the murdering of a human being?

  11. I was making a joke. I'll admit, it's an incredibly dark and offensive joke that 99% of people wouldn't laugh at, but a joke nonetheless. I don't think murder should be legalized or allowed; whether it is your own child or someone else's.

  12. OK, I thought it a joke, but then I remember mention of "voluntary extinction" so I wasn't sure. Go vasectomy! As to your poll: I'd love to have and be in care of a child someday, so my desire to have a vasectomy doesn't follow the "common pattern".