“Vas Madness.” “Vasectomy Vacation.” Urologists have used these terms for years to signal that when real men get snipped, they get to watch sports on the couch.
Urologists have encouraged vasectomies, the only permanent contraception for cisgender men, by promising that patients can recover while binging the NCAA men’s basketball tournament that happens every March.
“You go in for a little snip snip and come out with doctors’ orders to sit back and watch nonstop basketball,” an announcer promised in a 2009 commercial for an Oregon urology clinic, one of the earliest recorded examples of medical professionals tying vasectomies to March Madness. “What could be better?”
Vasectomies have never had the ubiquity of hormonal pills, intrauterine devices and other birth control options in the United States. Part of that is because the procedure, while technically reversible (with variable success), is considered permanent. But it’s also cultural. Does a doctor shot-blocking your sperm make you less of a man?
Medical professionals have tried to change that using campaigns like the March Madness push. The idea is simple: Men who are done having kids can use a vasectomy as an excuse to sit on the couch, armed with a remote, frozen peas and no other responsibilities.
Take the Oregon clinic ad, which noted that they had added extra slots to get a vasectomy done in time for the tournament. It ended by warning men about what they risked if they skipped this chance for “The Big V.”
“If you miss out on this, you’ll end up recovering during a weekend marathon of ‘Desperate Housewives,’” the announcer promised. “That’s painful.”
The message has been effective. The number of vasectomies spike every March, with many men directly citing the annual push and their excuse to watch basketball. One study suggested urologists see a 30 percent increase in appointments during the tournament. For the most part, men getting a procedure fit a specific profile: older, married dads who have decided they are done having children.
But even with that March surge, the share of heterosexual couples relying on vasectomies for birth control remained stagnant for years, hovering around 5 percent. Now, though, the procedure may be getting more popular, for reasons totally unrelated to (basket)balls.
Younger men — including those who are unmarried, and who don’t have kids — have turned to the procedure as a way to support their partners as abortion bans have spread. They’re offering a different rationale for when and why men might choose sterilization.
The fall of Roe v. Wade in 2022 added a new level of urgency to an explanation that many men have turned to for decades when choosing vasectomies: the feeling that their partners have suffered enough.
Men who shared their experiences with The 19th said they’re more worried about the risks of an unwanted pregnancy than they once were. Some said that they were already considering a vasectomy, but Roe’s overturn pushed them over the edge.
And not one of them ever thought about doing it to watch basketball.
For Barry Nelson, a 32-year-old outside of Minneapolis, a vasectomy offered a way to be an equal partner to his girlfriend.
He’d known his whole life he didn’t want biological children, fearing he might pass on his Tourette syndrome. His girlfriend had already raised kids. Dobbs v. Jackson Women’s Health Organization, the decision that overturned Roe, spooked him.
Nelson felt safer in his home state, where abortion is protected — until Election Day in 2024, when President Donald Trump was reelected. He worried that the president, who had taken credit for Roe’s overturn, might next turn to a national abortion ban or restrictions on contraception.
“If in the future, she can’t get access to birth control, then at least I’ll have myself taken care of, and I’ll be able to take care of her in that way,” he said.
The morning after the election, unsure of what the future might bring, Nelson swallowed his fear of needles and called the local hospital to schedule his vasectomy. The employee on the phone told him he was one maybe a dozen people to call so far that day.
“The reason I got a vasectomy is to make sure my girlfriend could be cared for if she wasn’t able to have the same options,” he said. “And me doing my part to help our relationship and our future, that is masculine: helping your partner.”
Basketball, he added, never would have figured into his timing. “I’m not a sports person,” he said.
Mike Keon, a 42-year-old who lives in Nashville, said a vasectomy “was always in the back of my head. But Roe really was the deciding factor.”
It wasn’t that he didn’t want to have kids. But if he did, he would foster or adopt children.
When Roe was overturned and Tennessee banned most abortions, Keon and his then-girlfriend, a registered nurse, started hearing stories. Reproductive health professionals were leaving their home state. They worried about what would happen if their birth control failed. And they were both scared that even if they traveled out of state for an abortion, she might somehow be held legally liable. (No abortion ban criminalizes out-of-state travel.)
“When you hear horror stories about how they might prosecute people who have these things done — we didn’t want to take any risks,” he said.
So in 2024, confident in his relationship and their future together, he got his vasectomy. The procedure took no more than 15 minutes; he spent the remainder of the day resting in bed. In less than a week, he said, he was back to normal.
His partner called it “the most romantic thing someone’s ever done for her.” They have since gotten married.
So far, 13 states including Tennessee have banned abortion almost entirely. Still more states have other strict bans, including six- and 12-week cutoffs. Pregnancy is now more dangerous: Research has linked abortion bans and restrictions to higher rates of pregnancy-related death. Multiple women have died or nearly died from pregnancy-related complications in states with bans, with reporting suggesting they would have lived with access to abortion.
Sex, frankly, is a higher-risk proposition than it was before.
When Trevor O’Hare, a 37-year-old dad in Florida, got his vasectomy in September, it was because he feared what might happen if his wife became pregnant again.
“It just makes sense if you think about it for more than two seconds,” he said. “There’s an assault on women’s bodily autonomy and their rights, and this is one way that as men we can help stem the tide.”
Interest was climbing well before Dobbs. A study from 2023 showed a 26 percent increase in vasectomies between 2014 and 2021; even then, men appeared to be factoring abortion access in their increasing interest in vasectomies.
But Dobbs changed things: A health care research company found an 850 percent increase in the number of people searching for information about vasectomies after the decision. A study from last summer looked at men in Texas who got vasectomies after the state’s six-week abortion ban, which took effect in 2021, as well as after Dobbs, finding that almost 40 percent of the post-Dobbs vasectomies were for men who cited the decision specifically.
These post-Dobbs vasectomies represent a demographic shift for the snip. That same study found that the people who got a vasectomy after the Texas law took effect were more likely to be younger, childless and single. After Dobbs, men who cited the decision had fewer kids and were younger compared with men who sought vasectomies without factoring in the court ruling. A 2024 study also found that more men got vasectomies after Dobbs, and that they were more likely to be younger and childless.
Dr. Raevti Bole, a urologist at the Cleveland Clinic who has studied vasectomy trends, said most of her patients do still fit a conventional image: They’re married men and have had their “perfect number” of children; they are considering a vasectomy relatively later in life. But she’s noticed more people — including those who aren’t parents — having serious, open conversations about sterilization earlier than they otherwise might have.
“There’s a sense of timeliness that people — not that they changed their mind in what they were intending to do, but they were making that decision having those conversations with partners in a more timely fashion,” she said. “Something about their situation has prompted them to sit down and say, ‘Let me have a serious conversation about where are we now, do we want kids or not.’”
What she’s increasingly noticing, Bole said, is that “men want to be engaged in their care and be equal partners.”
A vasectomy is a serious decision, said Matthew Gutmann, an anthropologist who has studied masculinity and vasectomies, predominantly in Mexico. He notes that people can change their minds about whether they want to have children. But in his research, too, many people who opted for the procedure — largely in Oaxaca — articulated a similar reasoning. They felt their partners had suffered enough.
“The vast majority told me about, ‘Oh, my wife, she’s been pregnant three times, miscarried but gave birth twice, and goodness she’s been taking birth control for 15 years and it hasn’t been fun. It’s my turn,’” he said.
American men are less likely than those in other wealthy Western nations to get vasectomies. The cultural stigma plays a big role: Some have said they fear they might not be perceived as manly. In a qualitative study in San Francisco, some Black men and Latinos expressed particular concern about a sterilizing procedure, citing historical efforts of forced sterilization in the United States. And research has found that many men worry a vasectomy will diminish their sex drive, or make it harder to get an erection or orgasm. (There’s no evidence to suggest that.)
“Erection is a weird phenomenon. It’s such a quick transformation of the body in such a visible and blatant way, and I think that people who are used to having erections get used to it,” Gutmann said. “And therefore any kind of procedure in the genital region is going to cause preoccupation for a lot if not all.”
Whiskey Miller said he understood the concerns some men might have — even though for him, getting a vasectomy ultimately felt like an obvious choice.
“Obviously any surgery is scary to undergo. But I think a lot of it is the emotional symbolism or just machismo, all of that,” said the 33-year-old Coloradoan. “There’s a ton of misinformation about how it will affect your hormone levels or energy.”
He’s talked to many men since getting his vasectomy, which took place only months after Roe’s fall, and he’s surprised by how many seem hesitant about a procedure that felt like an obvious step to take.
Previously, he said, his partner relied on an intrauterine device, a highly effective form of birth control but one that can be particularly painful to insert. She was approaching the time when she’d have to get it replaced. And it hit him that maybe, with Roe gone, he should take a more active role in their family planning, even though abortion is protected by Colorado’s state constitution.
“She had been taking on the lion’s share of the responsibility in managing our decision to not have children and be sexually active,” Miller said. “Admittedly, there was a level of protest against the way the world’s going. Hearing that it had gotten revoked just kind of galvanized me into action.”
That men without children are considering vasectomies is particularly noteworthy, said Dr. Kara Watts, a urologist at Albert Einstein College of Medicine, who has also studied post-Dobbs trends.
“It’s one thing to search this out and say let me see what’s available. To go through with it — we consider it a permanent decision for sterilization,” she said. “There is an option to reverse it but success rates are highly variable and it’s not always covered by insurance.”
But for Miller, it was simple.
“I was like, ‘I don’t ever want to have kids.’ She was like, ‘Why don’t you get a vasectomy?’” he said. “And I was like, ‘Why don’t I?’”
When O’Hare was preparing to become a father in 2021, he and his wife still thought they might want multiple children. Then she gave birth, needing a Caesarean section and spending multiple days in the hospital. It was, he said, “traumatic,” and something neither of them wanted her to experience again.
The couple, who lives outside Orlando, talked about his getting a vasectomy. But Dobbs was the turning point: ”A big, ‘oh shit’ moment,” he said.
“What if my wife accidentally got pregnant again and something went wrong?” he said. “What if she needed an abortion that was medically necessary to save her life, and we live in Florida?”
They weighed their decision for years before deciding, making sure they were confident in their decision — that there was no chance they’d want another kid.
“It’s my turn to take some responsibility in this situation and make sure no harm comes to her just because I didn’t take action,” he said.
Six months ago, he got his procedure. In the recovery, no basketball was required.