A growing number of childless guys are ensuring they don’t accidentally become fathers. Ever.
A man in his early thirties walks into the waiting room of a medical office, avoiding eye contact with three other men all nervously studying the carpet. In the consultation room, he removes his jeans and underpants, lies down on the bed and braces himself for the needle that will numb a small patch of his scrotum. But unlike the stereotypical vasectomy patient, he doesn’t have a scrum of screaming children at home. In fact, he’s at the clinic to make sure he never ever becomes a father.
32-year-old Caleb* from Tāmaki Makaurau decided to get “the snip” last year because he and his long-term partner knew for certain they didn’t want kids, despite the social pressure to procreate. The prospect of starting a family never appealed to either of them, partly for environmental reasons, but mostly because of lifestyle preferences. “It feels like we’re already quite busy,” he laughs. “I honestly don’t know how people with kids do it.” Not wanting to leave such a life-changing event to chance, he booked himself in for the permanent contraceptive procedure.
Caleb is not alone. While the bread and butter of male sterilisation is still married fathers in their mid 30s to mid 40s, in recent years there has been a rise in a new profile of vasectomy patient: young, sometimes single men without kids who are proactively taking their fertility into their own hands and opting for vasectomy as a preventative measure.
Vasectomies have been performed in Aotearoa since the 1960s and are by far the safest and most effective method of birth control. They are a relatively popular option here, and while there is no recent or reliable data available, we are thought to be among the top in the world for vasectomy rates. Even former prime minister John Key famously admitted to having one.
This quick and mostly painless keyhole procedure involves sealing closed the vas deferens (the tubes that carry the sperm from the testicl*s to the penis), physically stopping a man’s swimmers from being able to rendezvous with an eligible egg.
Dr Simon Snook, founder of SNIP, New Zealand’s largest provider of vasectomies, jokes that he has had a lifelong interest in testicl*s. Over the last twenty years, he has observed the changing demographic of vasectomy patients, and is supportive of men taking this proactive step regardless of their age, marital status or number of offspring.
Despite seeing a growing number of younger, childless patients, Snook points out that patients in their late teens and early 20s are still the exception to the rule. Of the 5,000 vasectomies performed at his SNIP clinics last year, only 11 were on men aged 22 or younger.
While technically the age of consent for a vasectomy is 16 (as per all other medical procedures), Snook’s youngest patient to date was 18. It may feel young to be making such a permanent life-changing decision, but “if you’re old enough to consent and to become a parent,” Snook points out, “you’re old enough ethically to consent to not becoming a parent.” In fact, he generally finds that younger patients are very clear on their decision and committed to that pathway. “I personally have never come across a younger childless person who wants a vasectomy that hasn’t given it a heck of a lot of thought,” he tells me, “usually a lot more thought than someone older.”
Dr Gabriel Espinoza from the No Scalpel Vasectomy Clinic, who has over 4,000 vasectomies under his belt, describes the classic cohort of childless guys coming to see him. They are usually in their mid 20s and have known they don’t want to have kids since they were teens but waited until they were more mature to go ahead with the procedure. He finds this type of patient is usually so confident in their decision that they stroll into the clinic like they’re just getting a haircut.
Younger, childfree men have a range of reasons for not wanting children. As with Caleb, there is often an environmental aspect: those who are ecologically aware don’t want to further strain the planet by producing carbon-emitting, resource-consuming offspring. Then there’s the men with potential hereditary conditions, such as Huntington’s Disease or Danlos Syndrome (both have a 50% chance of being passed down), who want to stop their genetic material propagating. But many simply have the strong conviction that they personally never want to be a parent.
Vasectomies are only performed through the private system in New Zealand, and no longer require a referral from a GP, so new patients can make an appointment directly with their clinic of choice. A phone consultation before the big day is a chance to discuss failure rates, possible complications, and to clear up any questions, but Snook is quick to point out that this is not a counselling session or psychological assessment.
He says the attitude of vasectomy providers has evolved over time. Gone are the days of paternalistic approaches to medicine where a doctor dictates what is best for their patient. “You have to come from the stance that you know very little about someone else who is coming to you for that procedure,” he says, “and making decisions on their life is wrong and very misjudged.” What he does do, though, is make sure all his patients are very clear about the long-lasting consequences of their decision, regardless of their age or life stage.
While reversal is an option, there are no guarantees of success, so those considering a vasectomy need to approach the decision assuming the sterilisation will be permanent. A small number of men choose to freeze their sperm as an insurance policy, but Caleb, who is not the slightest bit fussed about carrying on his biological bloodline, didn’t bother. He knows that in the very unlikely chance he changes his mind about having children, he can foster or adopt instead.
Since it takes two to tango, Snook thinks it is hugely important for men to share the contraceptive load with their female sexual partners. Currently there are only two methods of contraception available to men (other than abstinence): condoms and vasectomy. At less than 90% effectiveness, he compares using condoms to playing ten-bullet-chamber russian roulette. By contrast, vasectomies are over 300 times more effective. Espinoza likes to put the same info in real terms: “If 2,000 couples are having regular intercourse using condoms, then 304 will fall pregnant.” Of those same couples relying on vasectomy instead, only one would end up with an accidental bun in the oven.
Caleb agrees that contraception shouldn’t be women’s responsibility by default. In fact, it was when his partner was due for an IUD change that he suddenly became motivated to step up and book the vasectomy appointment. “I had been with her before to get her IUD swapped out,” he says, “and it was from that experience that we were like, ‘this f*cking sucks.’” Knowing that after one quick visit to the doctor, neither of them would ever have to worry about hormonal side effects or unplanned pregnancy again made a vasectomy a no-brainer.
Because it is 10 times more effective than the best forms of reversible contraception for women, vasectomies make for a compelling long-term solution for those in committed relationships. In fact, getting one can be seen as the ultimate act of love. Espinoza says that 90% of his patients without kids have a partner who is on the same page. And for those who already have a family, it is a chance for the male partner to contribute. “You do get a sense that the guy is picking up the slack,” he says. “The women have put most of the effort in for pretty much everything from when they were 15 years old, all the fertility control, the pregnancies and labours and breastfeeding.”
Other than being completely sure it’s what you want, Snook has one piece of advice for men considering getting the snip: “Don’t overthink it, don’t worry about it from a surgical point of view.” He explains that the procedure is very low risk and well tolerated by pretty much all men. Most clinics now offer a scalpel-free technique, with a laser cauterising the blood vessels under local anaesthetic and no incisions or stitches required. While a patient will be in and out within half an hour, the procedure itself only takes around 10 minutes.
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After getting over the initial awkwardness of having someone else rummaging around in his private parts, Caleb found the process to be relatively low-key and no more invasive than a prostate check. “It’s uncomfortable and weird,” he says, “and it pays not to think about the singeing of flesh, but other than that, it’s cool, it’s fine.”
Snook says that while a vasectomy is a relatively minor procedure compared to female sterilisation (and on par with having an IUD fitted), it is important to acknowledge that a man’s testicl*s are a sensitive area, both physically and emotionally. “[A man] spends his whole life protecting them from injury, subconsciously or consciously, and putting them in the hands of someone he’s never met with a laser or even a scalpel is a big step.” That is why the SNIP clinic likes to celebrate its patients by calling them “contraceptive heroes”.
After Caleb’s own transformation to superhero status, it took two hours of frozen peas to the crotch, and a few days of tenderness and rest, before life returned to normal. After his post-op sem*n analysis confirmed he was indeed shooting blanks, he felt an enormous sense of relief knowing that he will never accidentally get one past the goalie and father a child he doesn’t want.
Now all he has to do is tell his parents.
