What keeps America so quiet about vasectomy? Why aren't we seeing and hearing the compelling case for men to man up in a final act of family planning? These are no idle questions: of the many birth control methods, vasectomy could well be the simplest and easiest of all.
A vasectomy also defuses the abortion issue. It leads to no fetus, confers no rights on the unborn. There's no reason to deny funding to Planned Parenthood for performing vasectomies, or simply spreading the word. It's where I had mine 43 years ago. My wife had given birth to our second son, and we decided that two was the magic number. I was drafted (and should have volunteered) for end-phase family planning.
Let's review the basics: how vasectomies work, the powerful reasons for getting them, the powerful cultural norms that weigh against them. Let's see how, in an ironic twist, the last path to women's reproductive rights is men who give up theirs.
The standard vasectomy is a routine outpatient procedure, done in less than half an hour under a local anesthetic. The procedure cuts and seals the tubes that carry sperm to the semen, effectively ending a man's ability to impregnate a woman. According to FamilyDoctor, this minor surgery on the male "may be the safest, most effective kind of birth control. Only about one or two out of 1,000 couples get pregnant the first year after a vasectomy." There's also a no-scalpel alternative that's less invasive, simpler and equally effective. Some weeks after either option, a semen sample has to be checked to be sure there's no sperm. An all-clear allows unprotected sex from then on (maybe better sex than ever, given the shared freedom of mind).
Despite the strong rationale for male family planning (and the roughly half-million men a year who opt for it), the birth control burden in America still falls disproportionately on women. "Biology is destiny." Women become pregnant and bear children, ergo it's women who are expected and urged, relentlessly and always, to "be careful." They do so most often with oral contraceptives, intra-uterine devices (IUDS), patches, and, lastly, tubal ligations (tying the fallopian tubes). Another irony: while the birth control pill may have set women free, it also trapped them ever more tightly in their role as the precaution-taking sexual partner.
The data underscore how women, far more than men, go under the knife for the final family planning. WebMD says that 27 percent of women in the United States get tubal ligations, compared to only 9 percent of sexually active men who get vasectomies (and the disparity doesn't even count the women who stick with other methods until their child-bearing years are past).
Males in some other countries handle a more equitable share of family planning, topped by the 50% vasectomy rate in New Zealand. In general though, it's a man's world--and a woman's job to control family size. The national healthcare system in most Canadian provinces provides free vasectomies; even so, only one out of three Canadian men gets the procedure.
There are, of course, good reasons to think twice (or three or four times) before having a vasectomy. It's huge to choose never again to be a father. A man's masculinity can feel threatened. While vasectomies can be reversed, a reversal is expensive and not a sure thing.
Medical advances have made tubal ligation simpler and easier over the years. There's also a new alternative that blocks the fallopian tubes with implants. It's an outpatient procedure that takes about 10 minutes and doesn't require anesthesia. In any form, of course, female sterilization simply keeps the final family planning where it's usually been: in a woman's hands. Next to the glass ceiling, there may be no greater example of sexism in America.
More than a generation ago, in the edgy Norman Lear sitcom "All in the Family," the Rob Reiner character steps up and gets a vasectomy. The last words in the episode come from the doctor as he's about to begin the procedure: "Okay, let's boogie!"
To America, to the media, to every Rob Reiner: "Okay, let's boogie!"
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