After Andy and Erin Gress had their fourth child, Andy decided it was time for him to “step up” and help with the family planning. So he did something that the mere thought of makes some men cringe: He got a vasectomy.
It was early one morning last winter - a brief moment of peace, before juggling getting the kids ready for online school and work Zoom calls. He happened to see a local news story about discounts being offered during “World Vasectomy Day.” He made an appointment that day.
His wife had taken birth control pills, but she struggled with the side effects. She had worked as a night nurse through four pregnancies, and the couple had children ranging in age from 2 to 11.
“The procedure was a total relief, almost like the covid shot - like I’m safe now,” said Gress, who works in higher education. “I wanted to man up.”
But Gress’s action wasn’t just about his family. He also believed he should do more to support his wife and other women who don’t think the government should decide what they do with their bodies. “I’ve seen the miracle of life,” he said. “But I’ve also seen kids who are born into poverty and misery and don’t have a fair shot.”
With the Supreme Court set to decide the fate of Roe v. Wade next year and with more than 20 states poised to ban or impose restrictions on abortion depending on what the court decides, some reproductive rights advocates say it is time for men to take a more active role in both family planning and the fight for reproductive rights.
In their own form of protest, state lawmakers in Alabama, Illinois and Pennsylvania introduced legislation that highlights the gendered double standards with regards to reproductive rights.
Pennsylvania state Rep. Chris Rabb, a Democrat, introduced “parody” legislation this fall in response to the Texas law that amounts to a near-total ban on abortion. Rabb’s proposal would require men to get vasectomies after the birth of their third child or when they turn 40, whichever comes first. It would be enforced by allowing Pennsylvanians to report men who failed to comply, for a $10,000 reward.
“As long as state legislatures continue to restrict the reproductive rights of cis women, trans men and nonbinary people, there should be laws that address the responsibility of men who impregnate them. Thus, my bill will also codify ‘wrongful conception’ to include when a person has demonstrated negligence toward preventing conception during intercourse,” Rabb wrote in a memo about his proposal, as reported by the Keystone.
Rabb, a father of two who had a vasectomy in 2008, noted that he only had to discuss his choice with his wife and his urologist. The point of his proposal, he said, was to highlight the sexism, double standard and hypocrisy inherent in the antiabortion debate. But it blew up in a way he didn’t expect.
“I underestimated the vitriol this proposal brought,” Rabb said in an interview, adding that he received thousands of hate-filled emails, Facebook posts and even death threats. “The notion a man would have to endure or even think about losing bodily autonomy was met with outrage, when every single day women face this and it’s somehow OK for the government to invade the uteruses of women and girls, but it should be off limits if you propose vasectomies or limit the reproductive rights of men.”
Since Dec. 1, when the Supreme Court heard a case that is expected to decide the future of Roe v. Wade, social media has been filled with tweets, memes and quips using tongue-in-cheek humor to point out how men’s role in reproduction is almost never talked about. “Against abortion? Have a Vasectomy,” says one bumper sticker.
Koushik Shaw, a doctor at the Austin Urology Institute in Texas, said his practice saw about a 15% increase in scheduled vasectomies after the Sept. 1 Texas abortion ban went into effect.
Patients are saying “‘Hey, I’m actually here because some of these changes that [Gov. Greg] Abbott and our legislature have passed that are really impacting our decision-making in terms of family planning,’ so that was a new one for me as a reason - the first time, patients are citing a state law as their motivating factor,” Shaw said.
Advocates say they want to be clear: They are not pushing vasectomies as a replacement for the right to obtain an abortion, nor do they believe men should have a say in the decision to have an abortion. In 1976, the Supreme Court ruled in Planned Parenthood v. Danforth that the father’s consent to an abortion was no longer required, largely because of a risk of violence or coercion in a relationship.
Doctors who perform vasectomies say they want men to be open and comfortable talking about the procedure instead of recoiling in horror at the idea, said Doug Stein, a urologist known as the “Vasectomy King” for his billboards, bar coasters and ads at child support offices around Florida.
“An act of Love,” for their partners, “the ultimate way to be a good man,” is how he and others market the procedure.
“It’s a remarkable trend in the family planning community of recognizing and promoting vasectomy and birth control for men, where this was once considered more fringe,” said Sarah Miller, a family medicine doctor who has a private practice in Boston and joined Stein’s movement.
Advances in the needle- and scalpel-free 10-minute procedure need a cultural push and maybe some fun to make men less bashful around doctors coming near their “junk,” Stein said.
He has a full-time vasectomy and vasectomy-reversal practice in Tampa and has traveled the world performing the procedure. He was inspired by his concern about population growth, but he also wanted to empower men to be responsible.
Stein, a father of two, had his own vasectomy more than 20 years ago.
Reliable statistics on the number of men who have sought vasectomies since the Texas ban and the U.S. Supreme Court hearing aren’t available, doctors say. But, Miller said, she has seen an increase in patients at the small clinic she opened in Boston less than three years ago because she couldn’t believe “the paucity of options for men and people with men parts.”
At one point, she was told that vasectomy was not considered part of family planning, and she had to make her own arrangements to get the necessary training.
“It warms my heart to hear men say, ‘I am so nervous, but I know this is NOTHING compared to what my wife has gone through,’” she said in an email.
“It’s outrageous that we don’t have more contraceptive options for people with man parts,” Miller said. “There’s even a misguided sense that birth control is not a man’s job. That men can’t be trusted, or that they would never be interested, and that has led to lack of funding and development,” she said.
Engaging men in the abortion debate is tricky, experts say, because on the abortion rights side, men don’t want to be viewed as questioning a woman’s right to choose. And on the antiabortion side, the procedure is viewed as murder. But some abortion rights advocates contend that men have a huge stake in legal and safe abortions, and “the fact we’re not out there fighting every bit as hard as women is shameful,” said Jonathan Stack, a co-founder with Stein of World Vasectomy Day.
“The quality of life for millions of men will be adversely affected if this right is taken from women,” said Stack, a documentary filmmaker who made a film about Stein called “The Vasectomist.”
Stack said that while filming the documentary, he would ask men: “Why are you choosing to do this?”
“They expressed something rarely heard in films about men - love or kindness or care,” he said.
“I had already come to believe that there was a story about masculinity that was not being told - not of power and control or rage, but of alienation, of insecurities, of uncertainty and of fear,” he said.
“We already know that men don’t always want to wear condoms, or they don’t work, or well, they take them off,” Esgar Guarín said with a sigh and chuckle. He is a family medicine doctor who runs SimpleVas in Iowa and performed Gress’s vasectomy.
Guarín trained under Stein and joined his movement. “We have to invest in helping men understand how easy and safe vasectomies are,” he said. After having two children, Guarín performed a vasectomy on himself.
The doctors also started “Responsible Men’s Clubs,” chat groups where men can share information such as how sexual performance is just fine after the procedure, and that it “doesn’t take away their manhood, but in fact makes them a better man,” Guarín said.
One man asked for a sort of “vasectomy passport,” a letter from Guarín to show his wife that sex would now be free of worry.
Brad Younts, 45, said his wife, Lizz Gardner, wants him to become a “vasectomy evangelist,” after he had the “simple procedure” without any problems.
“Men are big babies. Considering everything women go through - menstruation, Pap smears, OB/GYN visits,” said Younts, who lives in Chicago. “I’m proud I did it. And I went on to tell two friends who are also looking into it, too.”