A few years ago, I booked a flight to Ireland. Some friends of mine had recently announced their engagement, and the wedding was to be held in Cavan, a small country town in the Border Region where the groom had grown up. I arranged to fly into Dublin five days before the ceremony. That would give me time to catch up with some old friends, visit the Yeats exhibition at the National Library and put back a few dozen pints.
I also booked an appointment at a clinic downtown to have a vasectomy.
If my timing seems off, allow me to give you a little background. I had been looking into getting the snip since I turned 18. Truth be told, I’d been ready for it since I was 12.
It’s nothing against kids. It’s nothing against parents (not most of you, anyway). I’d be lying if I didn’t admit that childhood trauma and mental health issues played a role in my decision, but those are merely incidental factors. The crux of the matter is that the qualities of the parent lifestyle that I find appealing could be counted on one hand with all the fingers missing, whereas the things I find unappealing could fill up the Grand Canyon. It’s utterly nonnegotiable, and I’ve never been more sure of anything in my life. Luke, I will not be your father.
Before we go any further, let’s define the terms. A vasectomy is a surgical procedure for permanent male sterilization. The vas deferens, the small tubes in the scrotum which carry sperm, are cut and sealed so that sperm cannot leave the body. Afterward, for all intents and purposes, everything looks and feels exactly the same. All that changes is that, from that point on, you’re firing blanks.
In the ongoing struggle for women’s reproductive rights, there’s a talking point that repeatedly arises: Why is it that a man can have a vasectomy at 18 with no hassles, while women have to fight an uphill battle for tubal ligation? The adversity women face when seeking voluntary sterilization is ridiculous. The internet is sick with stories of women being turned down for the procedure when their doctors object on religious grounds or because they think a patient is too young, childless, single, or needs their spouse’s permission (yes, that’s actually a thing). I read the testimony of a 26-year-old woman whose doctor refused to tie her tubes because her husband was on active duty, and if he was killed, so the logic went, she might want to remarry with someone who wanted kids. The arrogance and condescension boggle the mind.
However, I can say from personal experience the notion that men have an obstacle-free path to the scalpel is inaccurate.
As I mentioned, I took my first steps towards an assuredly child-free future when I was 18. At the time, I was a first-year student at the community college in my rural Maryland hometown. I made an appointment with my general practitioner to discuss the procedure. Knowing full well that this probably wasn’t something he heard every day, I prepared a list explaining the reasons for my choice in detail.
Yet after listening to my reasons, he told me that he wouldn’t help me pursue sterilization on the grounds that I was too young to make a decision that would affect the rest of my life (unlike, for instance, joining the military or taking out student loans). He added that he might have been more accommodating if I’d been older, had fathered several children and was in a committed relationship. Also, while he didn’t explicitly state that he was objecting on religious grounds, we went to the same church, and it was well-known he was an ultra-conservative Catholic.
“After listening to my reasons, [my doctor] told me that he wouldn’t help me pursue sterilization, on the grounds that I was too young to make a decision that would affect the rest of my life (unlike, for instance, joining the military or taking out student loans).”
Two years later, I decided to try again. By that point, I’d transferred to a private college on the Eastern Shore. I made an appointment with a urologist at a hospital close to Baltimore. This time, I made sure to clarify over the phone what the appointment was about and had the receptionist confirm that yes, the doctor would be willing to give a vasectomy to a 20-year-old. Alas, after driving an hour and a half to the hospital, he told me I’d been misinformed, as he couldn’t possibly perform the operation on someone so young.
A few years after graduation, I moved to Italy. Once I’d established residence in Rome, I decided to make yet another attempt at getting an Ides of March performed on my balls. Unfortunately, I was informed by my GP that as an elective procedure, vasectomies were not covered under the national health service. And, of course, both he and the nurse on duty asked me why on earth I would want to do something like that, especially being so young. By then, I was almost 30.
I can’t remember exactly what prompted me to look into Ireland as a potential place to have my shamrocks clipped. It might have been conversations I’d had with Irish friends about their country’s growing support for a woman’s right to choose (later achieved by referendum with the Thirty-sixth Amendment in 2018).
By then, I’d begun to frame my struggle as a feminist issue. As it stands, with the exception of condoms, the onus of contraception is almost always on the individual with the uterus. This is particularly problematic given the physical and emotional toll that birth control can take on a person’s body. The pill, miracle drug that it is, can cause a slew of side effects, including nausea, migraine, fluctuating weight and breast tenderness. On top of that, the shifts in hormone levels can play hell with a person’s emotions, leading to depression and decreased libido.
As for the more permanent forms of birth control, current data shows no link between tubal ligation and an increased risk of any type of cancer. There is a risk for post-tubal ligation syndrome (PTLS), a menopause-like rollercoaster caused by a rapid decline in estrogen and progesterone. It’s also much more expensive than a vasectomy.
Compared with tubal ligations, vasectomies are easier, safer, cheaper, very low-risk and virtually painless — and yet we still expect women and others with uteruses to compromise their well-being in the name of contraception. And at the end of the day, when any of these methods fail, it’s these individuals who are stuck with the physical consequences. In reflecting on this, my decision became not just about my own peace of mind, but about stepping up to the plate and shouldering some of the responsibility.
When I first came across Vasectomy Ireland, I approached them with caution, steeling myself for another disappointment. I emailed the doctor and told him up-front that I was 32, unmarried and had no children, and if any of these things would disqualify me, I would like to know in advance. Dr. John McCormick wrote back immediately saying there was no problem, gave me a brief questionnaire and a quote for the procedure (€450) and we agreed on a date.
Shortly before the trip, word of my pre-wedding plans got out among my circle of friends, then quickly spread to the rest of the wedding guests. As a result, the stag party was catered with an open bar of questions and an all-you-can-eat buffet of free advice.
Why are you doing this?
You’re going to regret it later.
What if you meet the girl of your dreams?
What if your parents had done the same thing?
What’s the point of living if you don’t have children?
One of the groomsmen, whom I’d never met before, decided that as a new father, it was his mission in life to talk me out of my decision. For hours, he used every argument he could muster, no matter how convoluted, to convince me he knew more about my life than I did. Six or so beers into the afternoon, he resorted to, “Come on, don’t you want a little version of you?”
“That would be my worst nightmare,” I said.
That seemed to shut him up.
On the day of my appointment, I rolled up to the clinic at 11 a.m. Dr. McCormick asked me some preliminary questions about my medical history, then made a few respectful inquiries into my motives.
“Say, for the sake of argument, you meet a woman you fall head over heels for, and she says she needs to have children to be happy.”
Without missing a beat, I replied, “That would be a deal-breaker.”
He was leading into a largely misunderstood aspect of this ordeal: vasectomies should be considered permanent. Yes, they are reversible, but the likelihood of a successful reversal begins to decrease exponentially after four years. Also, a reversal operation can cost anywhere from $7,000 to $9,000. Bottom line: I shouldn’t do this unless I was 100% sure.
Dr. McCormick performs the no-scalpel version of the procedure. The big difference between a no-scalpel vasectomy and a traditional one lies in the way the vas deferens are accessed. Rather than making cuts on each side of the scrotum, he makes a tiny opening in the skin with a pointed surgical tool called a hemostat and the skin is spread rather than cut. There’s hardly any blood and no need for stitches.
“The whole thing, from the Q&A to buttoning up my jeans, lasted less than an hour. I had a harder time deciding whether to order fish and chips or a shepherd’s pie at the pub afterward.”
My one fear going into this was how the anesthesia was going to be administered (my dreams of late had been haunted by images of a beachball being pierced by a harpoon). I was relieved to learn there were no needles involved. I felt the equivalent of two flicks with a rubber band, and then I was numb.
The whole thing, from the Q&A to buttoning up my jeans, lasted less than an hour. I had a harder time deciding whether to order fish and chips or a shepherd’s pie at the pub afterward. For a few days, I experienced a dull ache, but nothing that stopped me from dancing at the wedding.
This was five years ago. Since then, I’ve enjoyed a happy and healthy sex life, and not a day has gone by that I’m not glad I made the decision to protect both myself and my future partners from unwanted pregnancy. And yes, I still use condoms (because even if you don’t hear about them as much, sexually transmitted infections are still a thing.)
However, there is an unfortunate downside to getting a vasectomy that no one ever talks about.
Anyone who knows they don’t want kids is familiar with the smug sanctimony that manifests in the form of, “Oh, you’ll change your mind someday!”
I used to think that after I’d gotten snipped, I could throw it down like a trump card and lay these conversations to rest forever.
Well, not quite. Shortly after I got home, an acquaintance, upon hearing I had no interest in raising a family, assured me that one day I would change my mind.
“Not likely,” I said. “I just had a vasectomy.”
“Oh,” he replied. “Well, that’s reversible.”
Jonathan Balog lives in Rome, where he works as a writer, teacher and tour guide. His fiction and poetry have appeared in “Dark Moon Digest,” “Chiral Mad 3,” “Chilling Ghost,” “Dark Visions vol 1,” “Ominous Realities and Dread: A Head Full of Bad Dreams ― The Best of Grey Matter Press.” He’s also done lots of guest blogging and published the occasional freelance article on Italian history, art, wine, and food. When he’s not working or in lockdown he’s (preferably) traveling somewhere in Europe or Southeast Asia. Follow him on Instagram at @jonbalrog.