vasectomy

Pill Use Down, Tubal Ligation Up in the U.S. Relative to UK, Netherlands, France

Posted by figleaf | Tags:
Fri, 2010-05-28 12:23

In a news roundup Katy of Jezebel passes along news about contraception in the U.S.

Out of married U.S. women, only 16% are currently on the pill, compared to 29% in the UK and more than 40% in the Netherlands and France. Surprisingly, sterilization is a much more popular option in America.

1 in 4 married ladies here have had their tubes tied, while most other countries that reported figures have sterilization rates below 10%. These patterns also appear to apply to all women – not just the ones who have tied the knot.

She said it here.

Statistics for contraceptive use by men is surprisingly sketchy — since virtually all the focus around contraception and pregnancy is on women, including focus on statistics-gathering, virtually all information about men and contraception has to be extrapolated from assumptions that women who use contraceptives tend to have male partners. Oh, and I say “surprisingly” because men still have direct access over three kinds of contraception: condoms, withdrawal, and vasectomies, with the most recently invented (vasectomies) still being nearly 200 years old! So how long would that questionnaire be anyway? But I digress…

The best… or at least most frequently-cited estimate for male sterilization in the U.S. is one in six men over age 35 or, I think, a little more than 15%.

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Unintended Consequences of Anti-Choice Laws that Attempt to Force, Well, Unintended Consequences

Posted by figleaf | Tags:
Sat, 2010-05-15 19:51

Via Tyler Cowen of Marginal Revolution an article in The Economist points out yet another unforeseen consequence of restricted reproductive choice

Today, four out of ten married Mexican women are sterilised, a radical measure that partly reflects the continuing lack of other contraception in some areas as well as strict laws against abortion everywhere but the capital.

Read the quote in context here.

Cowen adds “Mexicans in the United States are now more fertile than Mexicans in Mexico.”

Two points I’d like to add

Second, this makes a lie of, oh, dozens of myths, stereotypes, and outright racist slurs about “irresponsible” population inevitabilities in “third” world, particularly “third world” highly-religious countries.

Second, the sterilization option makes perfect sense to me. For instance he continuing lack of other contraception for me, a man is why I got a vasectomy back when I was 21. And because, years later and after a painful, expensive, and statistically risky reversal, the same continuing lack of other contraceptive options let me to get sterilized yet again after the birth of our last planned, wanted child.

Presumably if they had other options the women of Mexico would choose less drastic, less medically risky*, and possibly less irreversible means of contraception.

As, presumably, would men if we had less drastic, less medically risky, and less difficult-to-reverse means.

I think that latter point, by the way, ties nicely into dozens of myths, stereotypes, and outright sexist slurs about “irresponsible” reproductive behavior in men.

* Note I only said more risky — tubal ligation is still relatively low-risk. Other methods just happen to be lower risk… but also happen to be easier to block distribution and use of.

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Personal PR Pitch for Vasectomies

Posted by figleaf | Tags:
Mon, 2009-06-15 16:42

Intern Katy of Jezebel says (emphasis mine)

Unfortunately, the vasectomy is hard to sell, according to doctors. Many men, like Michael Lewis, author of Home Game: An Accidental Guide to Fatherhood, view the procedure as somewhat akin to castration. Lewis says his own vasectomy made him feel like a “traitor to [his] sex.“

She said it here.

Well, he’s got the traitor to his sex part right.

Seriously? The guy’s supposed to be some great big-swinging dick reporter? (He actually introduced the term “big swinging dick” to financial reporting in Liar’s Poker!) He’s supposed to be good enough to report credibly on Iceland’s entire economic meltdown after a long weekend spent there but in 49 years he can’t even figure out how his own penis works? W the F?

—-

More from Katy’s source (USA Today, I think, but visit her post and follow the links.)

Myths about vasectomy persist. The biggest, doctors say, is that it will lower testosterone levels and affect sexual function and desire. “We still spend a lot of time explaining that there is absolutely no effect on sexual function or libido,” [University of Illinois at Chicago professor Lawrence] Ross says.

Yeah, like I had any less testosterone when I got my first vasectomy?

Like I had any more after my reversal?

Like I have any less after my follow-up vasectomy?

I don’t think so.

Actually I’m pretty sure when it comes to testosterone I’ve got plenty. If I had anymore I’d grow antlers.

Hey, you want the inside scoop on what vasectomies have done to my sex life? Wanna know what women have generally done to my penis after seeing those little scars?

Raunchy things.

Lascivious things.

Exotic things.

Loving things.

Enthusiastic things.

Repeated things.

Repeated things.

More repeated things.

Eager things.

Things that by and large have felt very, very good!

But most importantly?

Exactly the same things they wanted to do before I had them.

Except more frequently. Because for a man, before or after, there’s really no… well… fucking difference between having a vasectomy and not having one except neither he nor his partner needs to worry about anymore, um, “innocent byproducts.”

Than they already have.

Than they already wanted.

Than they already planned.

Sheesh!

Katy says

Despite the fact that the vasectomy is a safer, simpler process than female sterilization, more women undergo sterilization surgery than men (half of women using birth control ages 40-44 had had their tubes tied, while only 20% of men that age have). It seems that the vasectomy has a real PR problem.

Seriously! More sex more often? Zero concern about unplanned, unwanted pregnancies? Less stressed out partners? No impact on testosterone? Opportunity to call Michael Lewis a wuss? What more PR do you possibly need?

Sheesh!

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Fade to Numb on Fading to Zero Sperm Count

Posted by figleaf | Tags:
Thu, 2009-03-26 10:52

You know that little statistic about the first-year reliability rate for vasectomies is 99% instead 100%? Fade to Numb, who had a vasectomy about three months ago, has an important public service announcement that’s strongly related to that.

In the meeting with the doctor at the time, as well as from the papers I brought home afterwards, I learned something interesting. Evidently, no more than half of the guys that get vasectomies actually go back into the lab at a later date to make sure their specimen is all clear. (“Specimen is all clear” could be translated as “all the little spermies are completely gone from the semen system.”)

And (surprise surprise) it can take many months and upwards of 20 ejaculations before they all get cleared out. So some of those people that have “miracle children” after vasectomies? I suspect some of them are less “miracle” and more “didn’t bother to follow up after an operation.”

...

Long story short (or, rather, less long), I got a letter back from the doctor the next week. Sadly, it stated that I’ve still got some sperm swimming around in the system, and I need to take another specimen back to the lab in another three months, and until that time I need to make sure I use proper protection during sex.

Read the quote in context here.

Point being that vasectomies actually are extremely good for keeping new sperm cells out of semen. But you’re not sterile till the last of the old cells are out of your system.

For the record there’s a very, very small chance that his vasectomy really didn’t work and that sperm is somehow getting past the snips. If so then his follow-up check will detect that and he and his partner can decide what to do next. meanwhile, though, they’re not going to make assumptions about whether he is or isn’t still fertile.

Cool post.

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Sociobiologists Oddly Silent On Older Women / Younger Men Fertility Benefits

Posted by figleaf | Tags:
Mon, 2009-03-23 19:51

Via Em & Lo, Emily Nussbaum, writing in New York Magazine says

Earlier this month, the journal PLoS Medicine analyzed data from a study of over 50,000 pregnant women and came to a simple but stunning conclusion: Older fathers have dumber kids. The more geriatric the dad, the dimmer the progeny, on measures including “thinking and reasoning, concentration, memory, understanding, speaking, and reading.” (Luckily, geezer offspring had no problems with motor skills, making them ideal for wheeling around their elderly dads.)

It was another unsettling addition to the growing pile of evidence that men have their own biological clocks, with older fathers also producing higher rates of schizophrenia and autism. But what really caught my eye was the secondary finding, which was that older mothers were associated with smarter children. I quickly did the calculations and was pleased with my findings. The most intelligent children, I deduced, must be the outcome of 45-year-old career women inseminated by their 21-year-old personal trainers.

Read the quote in context here.

Oddly usual amen chorus of ev-psych/sociobiology apologists are silent on this confirmation of the exact opposite of traditional gender ideology and sexual stereotype.

Mind you the actual authors of the study (who I’ve heard interviewed) are clear that the decline in intelligence with paternal age is very real, it’s also very, very slight — on the order of one IQ point drop for every ten years or so after the father turns 35.

Not that that’s ever stopped pop-evobios before…

Hmm, must be some other reason. Can’t imagine what that might be.

—-

Seriously, a one or two point IQ drop isn’t a terribly serious liability for offspring of older parents. Certainly not compared to the many other, potentially much more serious liabilities.

—-

And speaking of other liabilities, the most recent but still substantially scientifically unverified being a sixfold correlation between older fathers and children with autism. And considering how, um, cautious people have been about extremely difficult to confirm links between autism and vaccination a strong, 6x correlation with paternal age ought to be a category-five, slam-dunk, outta-tha-ballpark red flag.

—-

It might not be the most important reason for older gentlemen to become “extinguished members” of the vasectomy party. But it’s not a bad one. (By contrast an excellent reason being that sex is just more enjoyable when the possibility of unplanned, unwanted pregnancy is remote.)

[Note: “Continue reading…” image is… almost modest but still better viewed in private. —fl]

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Snipping Away Misperceptions About Men's Interest in Contraception

Posted by figleaf | Tags:
Mon, 2009-03-23 08:13

Amanda Gardner, HealthDay Reporter forMSN.COM says

FRIDAY, March 20 (HealthDay News) — Doctors around the United States are reporting a sharp increase in the number of vasectomies performed since the economy soured last year, with one noting that many of his clients are from the beleaguered financial industry.

...

“Nobody came in and said they were having a vasectomy because the [stock] market crashed,” Goldstein added. “Most are saying, ‘We’ve been thinking about it for a long time,’ and [the crash] influenced their decision. They’re saying with the cost of private school for three kids, they can’t afford to have another one.”

Dr. Harry Fisch, a professor of clinical urology at New York-Presbyterian Hospital/Columbia University Medical Center, in New York City, said: “The issue about kids is often a financial one, and, if finances are low, it makes sense that people would be less likely to have more kids. And if they’re thinking about it, this is the time.”

Read the quote in context here.

It’s also worth considering that the lifetime cost of a vasectomy is substantially lower, not to mention enormously lower risk to the man, than any comparable form of contraception available for women.

The drawback, obviously, is that vasectomies are generally** irreversible and therefore inappropriate for men who aren’t ready to give up on future reproduction: a vasectomy is not fertility control, it’s fertility termination.

And yet…

And yet…

An awful lot of men get them, making them, incidentally, one of the more popular forms of contraception in the U.S. and elsewhere around the world. How common? Well, as the author of this article at Vasectomy-Information.com

The uptake rate of vasectomy is not entirely straightforward, owing to the way statistics are calculated in the USA. For years, vasectomy figures have been calculated from data about the birth control methods women rely on – not a straightforward count of the number of procedures. It’s currently guestimated based on this method of calculation that annually 500,000 men in the USA undergo the procedure, and about 12% of the male population between 18 and 65 years of age have had a vasectomy. In other countries the rate is higher, with New Zealand topping the table at 20% plus of men in that age group being vasectomized. Personally, I feel that if the same method of calculation (a straightforward count of procedures performed annually) was used, the figures in the USA would be higher.

The author said it here.

I’ve mentioned several times lately that intense, and I think intensely conservative cultural biases frame contraception entirely as a women’s issue. I think the tendency to track vasectomy entirely in terms of “methods women are protected by” rather than “men who’ve had them” is a symptom of that bias.

12-20% of adult men is a lot of men! Furthermore, 12-20% of adult men is a lot of men not to be exactly sure about… not even to bother tracking separately! (Note: While I was Googling around… and I had to Google a while to find this article… most sources simply lumped vasectomies and tubal ligations together under “women protected by sterilization. The Guttmacher Institute does a better-than-average breakout.)

And yet…

And yet…

We still hear, over and over, there’s no market for male contraception because men are neither interested in or responsible enough to use contraception.

Even though, estimating conservatively, sooner or later at least 10% of men are interested enough, and responsible enough, to choose a form of contraception that involves getting their testicles cut open, usually in front of their eyes to have it done permanently.***

And considering that an economic downturn is enough to nearly double the rated suggests maybe men are subject to, you know, rational decision-making when it comes to contraception.

Gee, I wonder how many more men would choose a method that was less permanent and less surgical? A moot question at this point, I know, since there are still only two methods available for men. (The more recently introduced of the two methods for men, vasectomies were first mentioned in medical literature in 1830. 179 years seems like a very long time to have to wait for a third!)

[** I had mine reversed, and I’m glad I did, but it wasn’t… exactly… effortless. —fl]

[*** Some of us are interested enough, and responsible enough, to have done it twice! (10 days after our final planned, wanted child was born I had an appointment to have my vasectomy reversal reversed.) —fl]

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Cool, Funny, Informative Vasectomy Story

Posted by figleaf | Tags:
Sat, 2009-01-17 18:22

JohnR of Mind on Fire and cross-posted at Feminist Mormon Housewives has an encouraging, detailed, very cool, and very funny account of his recent vasectomy. I’ll do my best not to quote the funny or surreal parts (you should read those yourself) but I did want to flag the following paragraph

So, you may ask, why am I choosing to render my testicles useless? (At least as gonads–thankfully, they will continue to be fully functioning members of my endocrine system.) Mainly, it’s because we’re cheap. For the cost of one month of pills for Jana or two Costco megapacks of condoms we don’t have to pay for birth control ever again. (Well, if we were really chintzy, we could just stop having vaginal intercourse altogether. We’re not that cheap.)

There are other reasons. We already have two wonderful, precocious, beautiful, and according to the Guardian, extremely expensive teenage children. ... I’m just kidding, of course. Our kids are priceless. And we’re satisfied with them.

Read the quote in context here.

It’s cool that he qualified “render my testicles useless” with “they will continue to be fully functioning members of my endocrine system.” Because that speaks to a frequent but completely unfounded concern men have about the procedure. It’s cool too that he detailed the breakdown in costs — compared to all other forms of contraception it’s not only extremely** effective dead cheap.

I also think it’s funny that he and his partner considered the costs and benefits of discontinuing sexual intercourse.

And I really appreciate his point that he and his partner were satisfied with the children they had and that they had no further need of reproduction.

All in all a cool post. So check it out.

—-

One last point. I didn’t quote the bits about his doctor or the circumstances of his procedure because they’re the funniest parts.

But.

The physician, a friend JohnR identifies as a dean of a medical school, was certainly qualified. It’s a simple procedure after all, one that an intern performed ably the first time I got one at age 21. But a better choice might have been whichever local physician has the most, and most recent, practice performing them. It not only might be less expensive, but chances are that a doctor who makes vasectomies a regular part of his practice is going to have a quieter examining room and less intrusive support staff. Sure, it might not have been as amusing a story (I never got to yell “Come in! This is where the party is!” after the umpteenth interruption) but it almost certainly would have been a more comfortable experience.

Case in point: When my partner and I were ready to have children (20 some years after my vasectomy) we sought out the best qualified, most experienced urologist in the area to do my reversal. Several years later, after our planned, wanted, second, and last child was born, I did not go back to my urologist. Even though I liked him, and even though he was obviously qualified to undo with a couple of quick snips the intricate microsurgery he’d performed earlier I went instead to a local doctor who has an entire clinic just for doing vasectomies. Because, again, even though he wasn’t a med-school dean or ace surgeon he wasn’t just cheaper his clinic was set up for it, he knew what he was doing, and so did his staff.

Something to think about if you’ve got a mind to follow JohnR’s and my example.

[** But like anything else not one-hundred point zero, zero, zero, zero percent. Sometimes they really don’t work. But once sterility is confirmed it’s as close to a closed deal as you get. —fl]

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HNT - Vasectomy Week?

Posted by figleaf | Tags:
Wed, 2008-12-10 18:13

FTN of Fade to Numb just had one. Kidder at Sex is Fun has (duh, medical not erotic but still not work safe) photos of his. Em and Lo interviewed a younger (27-year-old) about why he got his (it’s a long list.)

And late last week I gave a friend a ride home from the clinic after he had his.

It’s been a while but I’ve had two (one at age 21, another at 44, with a reversal in between) but this just seemed like a good week to break out my two vasectomy-related mementos. The ring I cast from silver and gold in my college metal-arts shop. The license plate I picked up at a yard sale recently (the seller’s partner had given him a vasectomy shower years before when he got his.)

Happy HNT (or Half-nekkid Thursday!)




More like this here.

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Men and Mitigating Unwanted, Unplanned Pregnancies

Posted by figleaf | Tags:
Fri, 2008-11-21 12:47

Following up on a remark towards the end of Echidne of the Snakes post last week about how men should actually work on taking responsibility for our own fertility instead of just fretting about whether women should or should not be able to get an abortion. Since I think that’s a good idea I’m passing along Em and Low Daily Bedpost excerpts from their column about vasectomies in Glamour magazine,

Forty percent of pregnancies are unintended. Yes, some of that is teenagers and you’re not going to sterilize them, obviously. But a lot of that 40 percent are people who wouldn’t mind if the wand of infertility touched them, but something fails (like their planning or their contraception) and they accidentally get pregnant and have the kid.

They said it here.

For the record for all but about three and a half years when my partner and I wanted children I’ve enjoyed the benefit of a vasectomies (and, for those three and something years, the benefits of a reversal) since I was 21. And don’t give me that stuff about young men and their futures — a stereotype-bustingly large chunk of that 40% of unplanned, unwanted pregnancies befall older, long-term marriages who weren’t planning more children. Just saying.

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Systematically Bad Advice For Men

Posted by figleaf | Tags:
Sat, 2008-07-12 18:24

Commons
Photo by Flickr user Thomas Hawk. Used under a Creative Commons license.

I just wanted to follow up a bit on what I mean when I say that magazines like Details (for men) and Cosmopolitan (for women) are meticulously careful to *dis*serve their reader’s best interests in order to keep them a) increasingly dissatisfied with their situation, b) irretrievably stuck in their situation with advise that sabotages their efforts to get ahead so that c) they’ll continue to purchase the magazine and at least aspire to own the advertiser’s products.

Take the egregiously self-centered, misogynistic article about men who get vasectomies so that unscrupulous women can’t dun them for child support.

First clue? While ostensibly a pean to the virtues of vasectomies the rhetoric employed is almost entirely discouraging. Consider the second paragraph:

About a hundred years ago, slash and yanks—so called because the original method involved cutting the scrotum and pulling out as much of the vas deferens tubing as possible before stitching it back up…

First of all, I’ve had two vasectomies with a reversal in between. I know tons of urologists as friends and, for almost 30 years now, as a patient. I’ve been interested in the history of contraception for years. And yet… and yet…?

I’ve never heard that anyone, anywhere has ever referred to vasectomies as “slash and yanks.” That’s not saying no one ever has, just that you’d have to look long and hard. (Oh, unless it, like the Details article, was trying to scare people out of actually having the procedure.)

Another sign of “encouragement?”

Before the procedure, patients go through a rigorous consultation, most of which consists of warnings. Warning: You’ll have an ice pack on your balls for 24 hours. Warning: You also must wear a “scrotal supporter” for 48 hours. Warning: Your first postoperative ejaculations might be bloody. Warning: There may be heavy bruising and/or swelling. Warning: You will not be sterile right afterward; it takes 6 to 12 weeks or 15 to 20 ejaculations to clear out old sperm.

All true. Although after my first vasectomy, when I was 21, I wound up having to ride the bus standing up (the procedure was in Brighton, Mass., and I was staying way out on Mass. Ave in Lexington.) I also wound up moments from intercourse that evening with a friend I was staying with before thinking better of it (I was a little sore and hadn’t been using much ice.) And that was the old-style bigger-incision with lots of stitches method. After my second, “stitchless method” vasectomy I was able to comfortably drive home and then I sat around, with an ice-pack and some Tylenol sure, but watching videos with my two-year-old son and two-week-old daughter.

No bloody ejaculations. Some bruising. “Whitey-tighty” underwear counts as a “scrotal supporter.” It does not take six to twelve weeks to ejaculate “15 to 20” times. Also the actual number is probably closer to 8-12 ejaculations.

The point being that vasectomies aren’t a walk in the park… in fact unlike me you’ll probably recover more quickly if you don’t walk in the park for 24 hours after yours. But that’s true of any procedure that breaks tissue integrity including body piercings and tattoos.

And therefore WTF does the author and/or his editors have in mind for dwelling on “yank and slash” type rhetoric? They’re no more serious about their readers either protecting or “protecting” themselves contraceptively than their readers are. The whole article is designed to both offer and withhold a solution to… what at the end of the day is a substantially made-up problem anyway.

A couple of other issues: The article says an Illinois student had to pay $850 for a vasectomy. They cite another doctor who charges $2500! All well and good but almost anywhere in America you can find one for less. (And almost anywhere else they’re covered by either private or National health insurance.) But not for Details readers, who’s advertisers don’t want them getting the idea of bargain hunting… or even paying plain-old everyday low prices.

Further discouragement comes towards the end where, after warning you about regrets, “scrotal support,” and ice packs, they say mysterious doctors in China are working on something involving reversible blocks.

The whole upshot of the article is that, sort of like a 1970s situation comedy, meticulous care is taken to insure that no matter how many conniptions and convolutions take place in the mean time, by the end of the episode everything is returned to it’s exact, unchanged original condition, ready for the next exciting… or not so exciting… episode.

Another point? Not to push too hard on the learned taught helplessness of the magazine but…

“A guy can tell an angry grandfather-to-be ‘Look, here’s money to take care of this at the clinic right now instead of dealing with this mistake for 18 years,’” says Doug Stein, a doctor in Florida who has performed more than 17,000 vasectomies over the past 30 years.

Riiiggghhttt. You’re supposed to go to her father and get him to pay for your vasectomy? So you won’t get his daughter pregnant?

We’re talking grown-ups here, dudes. Adult men. One guy they interview is 23. Another is 34! But, talk about learned taught helplessness, the 23-year-old thought he had to lie about his age! (He “says he walked into a doctor’s office, told the receptionist he was 30.”)

I dunno. Maybe it takes them six to twelve weeks to have 15 ejaculations because their moms still wash their sheets and underwear? Again, I dunno.

Oh yeah, see also grown-up language like

“Now I can never have a girl say I made her pregnant,” Whitlock says. “I don’t have to worry about being tricked.”

Or “oopsed,” as some advocates of vasectomy put it—as in “Oops, I guess that was a breath mint, not a birth-control pill.”

...

Tim Vass, a 34-year-old technical writer in Florida, got snipped in May 2007 after a half-dozen pregnancy scares, including what he says were two attempted oopsings.

Yeah, “oopsed.” The gerund for which would be “oopsing.” (The word is used in the context of pregnancy outside of the article. 92 whole times according to Google!)

What. Ever.

I’m just saying that, unlike the situation comedies I mentioned above, anyone who takes articles like these to heart is likely to put the article down knowing less useful information than whatever they started with. Not to mention a) gaining a falsely lower impression of women and b) giving women a legitimately lower impression of themselves. Nobody wins from this. Everyone loses. Except perhaps Details advertisers. It’s a real shame.

—-

P.S. To seal the deal check out the links at the end of the article

Is Being Well Hung the Key to Happiness?
Some guys never seem to worry. The reason for that is probably in their pants.

How Far Would You Go to Get Taller?
Why an increasing number of vertically challenged men are subjecting themselves to excruciatingly painful leg-lengthening surgery.

Look Who’s Sleeping With Your Wife
It isn’t just the tennis pro—there’s a whole new crop of predators after her.

I gotta say I love that last line. “It isn’t just the tennis pro…” So many invalid assumptions to unpack, so little time.

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