My first thought after having a vasectomy: why aren’t more British men having them? | Tim Burrows

6 hours ago 6

There I was, lying on the operating table in just my socks and a Steely Dan T-shirt. I had taken the train back to my seaside home town in Essex to have a vasectomy after being on the NHS waiting list for almost two years, since our third child, Sylvia, was born. Three was our magic number. Any more and the car would become a wagon and dinner would turn into feeding time. And now, finally, the contraceptive burden would fall on me. After Hayley’s years of toil with a coil, and the pain of childbirth, I was due a little discomfort.

A vasectomy, as the pre-op letter explained, “is designed to make you sterile”. (You’d hope so.) It would involve “removing a segment of a tube called the vas deferens from each side so that sperm cannot pass through”. There would be an “injection of local anaesthetic to the skin of the scrotum” before “a tiny incision through the painless area of the scrotum, first on one side and then the other”.

As if coming full circle, I had lost my virginity on the same street as the surgery I was booked into. That night 25 years ago – to the inexplicable backdrop of Arnold Schwarzenegger’s action-horror film End of Days on DVD – was actually far more uncomfortable than the procedure was. Aside from the initial “sharp scratch” of the local anaesthetic and the weirdness of making small talk with the surgeon and the nurse while the former operated on my scrotum, it was unnervingly simple and pain-free. It made my previous worries, prompted by things I had read online, feel a bit hysterical.

Vasectomy rates in the UK have declined significantly, according to research published in 2022. In 2004-05, approximately 30,400 vasectomies were conducted, whereas in 2015-2016 the total was 10,880, accounting for a 62% decrease. Women, as ever, are clearly bearing the burden of contraception: the same report said that in the 16 years up to its publication, the percentage of contraceptive service subjects who were male was just 5.3%.

One reason for this might be the way the procedure is discussed online, where negative but niche health outcomes are elevated. When I mentioned to the surgeon that I was feeling a little anxious, he said he had performed scores of vasectomies, and nothing had ever gone wrong. It was just that a handful of horror stories were out there in the world. For example, the Reddit page r/postvasectomypain has 2,000 visitors a week, but the academic Kevin Pimbblet of the University of Hull has said that post-surgical pain is “typically expected to resolve within days or weeks”.

Urban myths inevitably circulate. One man in the comments under a video about vasectomies vows never to have one, as his friend did and “lost his sex drive”. It’s a common claim that vasectomies affect hormones and testosterone, damaging libido. According to research, this claim is false, but that doesn’t stop posts by strangers about how having a vasectomy had caused erectile dysfunction, adding, conspiratorially, that “Big Vasectomy” was “spreading lies about side-effects and recovery times”.

Ultimately, though, it was the cuts that did for the snip. The austerity years in Britain led to funding cuts for vasectomies, with some areas restricting them to “exceptional circumstances”. This turned access, as with dentistry, into a postcode lottery. In 2015, it was reported that NHS Basildon and Brentwood Clinical Commissioning Groups near me had capped the numbers of vasectomy referrals that individual practices can make, while NHS North East Essex CCG had a £22m funding shortfall resulting in a restriction on vasectomies and other practices. I talked to a dad at my kids’ school who decided against the procedure after being on the NHS waiting list for more than nine months; by that point, the fear had got the better of him.

The vasectomy’s decline, like many other things in decline in the UK, is just one symptom of a general, long-term malaise. The phrase the surgeon used when asking for my consent for the operation was that I had decided that my family was “complete”. He was correct in my case. But how many families are even able to feel “complete” in an economy in which a dependable job and home ownership are out of reach for so many? The vasectomy, then, represents yet another slice of modern life in which our agency draws a blank.